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Feng W, Ma M, Gao H, Yuan W, Li R, Guo H, Gu C, Sun Z, Zhang Y, Zheng L. Association between handgrip strength asymmetry and cognitive function across ethnicity in rural China: a cross-sectional study. Front Aging Neurosci 2023; 15:1191197. [PMID: 37273648 PMCID: PMC10235480 DOI: 10.3389/fnagi.2023.1191197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/05/2023] [Indexed: 06/06/2023] Open
Abstract
Background Recently, the association between handgrip strength (HGS) asymmetry and cognition has been revealed, but evidences are still scarce. Particularly, the association between asymmetric HGS and cognitive performance in various cognitive domains is unclear and whether this association is stable across ethnic groups is unknown. Method The population was from a longitudinal study in rural areas of Fuxin, Liaoning, China. The Chinese version of Montreal Cognitive Assessment-Basic (MOCA-BC) was used to evaluate the cognitive function. The HGS ratio was calculated as maximal non-dominant HGS divided by maximal dominant HGS. HGS ratio <0.9 or >1.1 was classified as asymmetric dominant/non-dominant HGS, respectively. Generalized linear models were used to analyze the relationship between asymmetric HGS and cognitive function adjusted for HGS, handedness, wave, age, sex, education, ethnicity, smoking, drinking, physical labor level, BMI, hypertension, diabetes and dyslipidemia. Result A total of 2,969 participants ≥50 years were included in this study. Adjusted for HGS and other confunding variables, there was an inverted U-shaped association between HGS ratio and MoCA-BC scores (P non-linear = 0.004). The association between HGS ratio and MoCA-BC scores was inconsistent among ethnic groups (P interaction = 0.048). In Han, only asymmetric non-dominant HGS was associated with lower cognitive scores [β = -0.67, 95% confidence interval (CI): -1.26 ∼-0.08, P = 0.027]; in Mongolians, asymmetric dominant HGS(β = -0.60, 95% CI: -1.35 ∼ 0.15, P = 0.115) and asymmetric non-dominant HGS (β = -0.56, 95% CI: -1.42 ∼ 0.31, P = 0.206) were all associated with lower cognitive scores, although no statistical significance was found. Asymmetric non-dominant HGS and lower HGS, but not asymmetric dominant HGS were all independently associated with impairment of Delayed Recall (OR = 1.35, 95% CI: 1.05 ∼ 1.74; OR per 5 kg decrease = 1.10, 95% CI: 1.01 ∼ 1.21) and Fluency (OR = 1.43, 95% CI: 1.15 ∼ 1.78; OR per 5 kg decrease = 1.10, 95% CI: 1.02 ∼ 1.19). Both asymmetric dominant HGS (OR = 1.34, 95% CI: 1.07 ∼ 1.67) and lower HGS (OR per 5 kg decrease = 1.21, 95% CI: 1.10 ∼ 1.32) were associated with impairment of visuoperception. Conclusion HGS and HGS asymmetry were all independently related to lower global cognitive performance. The association between HGS asymmetry and cognitive function varies among ethnic groups.
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Affiliation(s)
- Wenjing Feng
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Mingfeng Ma
- Department of Cardiology, Fenyang Hospital of Shanxi Province, Fenyang, Shanxi, China
| | - Hanshu Gao
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Wei Yuan
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Ruixue Li
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Hui Guo
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Cuiying Gu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yao Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Muheiyati G, Mei Y, Tao N. Association of lipid accumulation product and visceral adiposity index with the risk of hypertension among oil workers in Xinjiang, China. PeerJ 2023; 11:e15273. [PMID: 37214102 PMCID: PMC10199676 DOI: 10.7717/peerj.15273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/30/2023] [Indexed: 05/24/2023] Open
Abstract
Background To explore the relationship between lipid accumulation product (LAP) and visceral adiposity index (VAI) and hypertension in oil workers and to evaluate the predictive value of hypertension by gender. Methods A sample of 2,312 workers aged 18-60 years old with more than one year of service were selected by a whole-group random sampling method in six oil field bases in Karamay City, Xinjiang. Logistic regression combined with restricted cubic spline model was used to analyze the risk of hypertension in different LAP and VAI. The receiver operator characteristic curve (ROC) with different sex LAP and VAI predicting the risk of hypertension were drawn. Results (1) There were significant differences in age, smoking, alcohol consumption, hypertension, BMI, WC, WHtR, SBP, DBP, TC, TG, HDL, LDL, FPG and Scr among different gender groups (P < 0.001).The prevalence of hypertension was 10.1%, with 13.9% in men and 3.6% in women. The prevalence of hypertension with different individual characteristics was statistically significant (P < 0.05). (2) Lipid accumulation product and visceral adiposity index were positively associated with hypertension (P < 0.001). The risk of hypertension may increase with the increase of lipid accumulation product and visceral adiposity index. After adjusting for age, sex, BMI, Scr, FPG and other factors, the risk of hypertension in the fourth quartile was (OR = 5.69, 95% CI [2.72-11.8]) and (OR = 3.56, 95% CI [2.03-6.23]) compared with the first quartile of lipid accumulation product and visceral adiposity index. (3) ROC results showed: AUC values of 0.658 (95% CI [0.619-0.696]), 0.614 (95% CI [0.574-0.654]), 0.661 (95% CI [0.620-0.703]) and critical values of 43.25, 1.58, 0.13 for LAP, VAI and combined indicators in men; the AUC values of LAP, VAI and combined indicators for women were 0.787 (95% CI [0.710-0.865]), 0.732 (95% CI [0.640-0.825]), 0.792 (95% CI [0.719-0.864]) and the critical values were 35.73, 1.76 and 0.03. Restricted cubic splines showed a nonlinear dose-response relationship between LAP, VAI, and risk of hypertension prevalence (P < 0.01 for overall trend and P < 0.01 for nonlinearity). Conclusions Lipid accumulation product and visceral adiposity index may be risk factors for hypertension in oil workers. LAP and VAI have certain predictive value for hypertension.
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Affiliation(s)
- Guliman Muheiyati
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yujie Mei
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ning Tao
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Clinical Research Center for Genitourinary System, Xinjiang Medical University, Urumqi, Xinjiang, China
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Chen L, He L, Zheng W, Liu Q, Ren Y, Kong W, Zeng T. High triglyceride glucose-body mass index correlates with prehypertension and hypertension in east Asian populations: A population-based retrospective study. Front Cardiovasc Med 2023; 10:1139842. [PMID: 37180805 PMCID: PMC10166815 DOI: 10.3389/fcvm.2023.1139842] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Background There is compelling evidence for an association between triglyceride glucose-body mass index (TyG-BMI) and cardiovascular disease (CVD). However, data on the relationship between TyG-BMI and prehypertension (pre-HTN) or hypertension (HTN) remains scant. The aim of this study was to characterize the association between TyG-BMI and pre-HTN or HTN risk, and to assess the ability of TyG-BMI in predicting pre-HTN and HTN in Chinese and Japanese populations. Methods A total of 214,493 participants were included in this study. The participants were divided into 5 groups based on quintiles of TyG-BMI index at baseline (Q1, Q2, Q3 Q4 and Q5). Logistic regression analysis was then employed to assess the relationship between TyG-BMI quintiles and pre-HTN or HTN. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results Our restricted cubic spline analysis showed that TyG-BMI was linearly correlated with both pre-HTN and HTN. Multivariate logistic regression analysis indicated that TyG-BMI was independently correlated with pre-HTN [ORs and 95% CIs were 1.011 (1.011-1.012), 1.021 (1.02-1.023), 1.012 (1.012-1.012), respectively] and HTN [ORs and 95% CIs were 1.021 (1.02-1.021), 1.031 (1.028-1.033), 1.021 (1.02-1.021), respectively] in Chinese or Japanese individuals or both groups after adjusting for all variates. In addition, subgroup analyses showed that the relationship between TyG-BMI and pre-HTN or HTN was independent of age, sex, BMI, country, smoking and drinking status. Across all study populations, the areas under the TyG-BMI curve predicting pre-HTN and HTN were 0.667 and 0.762, respectively, resulting in cut-off values of 189.7 and 193.7, respectively. Conclusion Our analyses showed that TyG-BMI was independently correlated with both pre-HTN and HTN. Besides, TyG-BMI showed superior predictive power in predicting pre-HTN and HTN compared to TyG or BMI alone.
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Affiliation(s)
- Lu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Linfeng He
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Wenbin Zheng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Qiuying Liu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Yifan Ren
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Kong
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Tianshu Zeng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
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Dong L, Wang Y, Xu J, Zhou Y, Sun G, Ji D, Guo H, Zhu B. Association of multiple anthropometric indices with in 944,760 elderly Chinese people. Epidemiol Health 2023; 45:e2023046. [PMID: 37080727 PMCID: PMC10593587 DOI: 10.4178/epih.e2023046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/29/2023] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVES The aims of this study were to update the latest data on the prevalence of hypertension (HTN) in the elderly Chinese population and to assess relationships between new anthropometric indices and HTN. METHODS Data were obtained from the Basic Public Health Service (BPHS) survey for Jiangsu Province, China. A total of 944,760 people aged 65 years and older were included in this study. Blood pressure was measured by trained investigators. Body weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), conicity index (COI), body roundness index (BRI), and a body shape index (ABSI) were included in the analysis as anthropometric indices. Logistic regression analysis and restricted cubic splines were used to evaluate the association of anthropometric indices with HTN. RESULTS The prevalence of HTN among elderly residents of Jiangsu Province was 64.7% (95% confidence interval, 64.6 to 64.8). After adjusting for multiple covariates, all anthropometric indices except ABSI showed significant non-linear positive dose-response associations with HTN across sex (pnonlinear<0.001). Among participants with BMI <28 kg/m2, abnormal weight, WC, WtHR, BRI, COI, and ABSI were positively associated with HTN. CONCLUSIONS The prevalence of HTN in the elderly in Jiangsu Province is gradually increasing. It is necessary to consider the combination of ABSI and COI with BMI for screening elderly individuals for HTN in follow-up prospective studies.
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Affiliation(s)
- Lirong Dong
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuanyuan Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jinshui Xu
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yang Zhou
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Dakang Ji
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Haijian Guo
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Baoli Zhu
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Sheng Z, Lou S, Cao J, Sun W, Shen Y, Xu Y, Ren Z, Liu W, Yi Q, Song P. The associations of obesity phenotypes with the risk of hypertension and its transitions among middle-aged and older Chinese adults. Epidemiol Health 2023; 45:e2023043. [PMID: 37054724 PMCID: PMC10593582 DOI: 10.4178/epih.e2023043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/14/2023] [Indexed: 04/15/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the associations of obesity phenotypes with hypertension stages, phenotypes, and transitions among middle-aged and older Chinese. METHODS Using the 2011-2015 waves of the China Health and Retirement Longitudinal Study, we conducted a cross-sectional analysis included 9,015 subjects and a longitudinal analysis included 4,961 subjects, with 4,872 having full data on the hypertension stage and 4,784 having full data on the hypertension phenotype. Based on body mass index and waist circumstance, subjects were categorized into 4 mutually exclusive obesity phenotypes: normal weight with no central obesity (NWNCO), abnormal weight with no central obesity (AWNCO), normal weight with central obesity (NWCO), and abnormal weight with central obesity (AWCO). Hypertension stages were classified into normotension, pre-hypertension, stage 1 hypertension, and stage 2 hypertension. Hypertension phenotypes were categorized as normotension, pre-hypertension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). The association between obesity phenotypes and hypertension was estimated by logistic regression. A comparison between different sexes was conducted by testing the interaction effect of sex. RESULTS NWCO was associated with normal→stage 2 (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.11 to 3.42), maintained stage 1 (OR, 1.62; 95% CI, 1.14 to 2.29), and normal→ISH (OR, 1.39; 95% CI, 1.05 to 1.85). AWCO was associated with normal→stage 1 (OR, 1.75; 95% CI, 1.40 to 2.19), maintained stage 1 (OR, 2.77; 95% CI, 2.06 to 3.72), maintained stage 2 (OR, 2.80; 95% CI, 1.50 to 5.25), normal→ISH (OR, 1.56; 95% CI, 1.20 to 2.02), and normal→SDH (OR, 2.54; 95% CI, 1.72 to 3.75). An interaction effect of sex existed in the association between obesity phenotypes and hypertension stages. CONCLUSIONS This study highlights the importance of various obesity phenotypes and sex differences in hypertension progression. Tailored interventions for different obesity phenotypes may be warranted in hypertension management, taking into account sex-specific differences to improve outcomes.
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Affiliation(s)
- Ziyue Sheng
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shang Lou
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Cao
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weidi Sun
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaojia Shen
- School of Public Health, Department of Maternal and Child Health, Health Science Centre, Peking University, Beijing, China
| | - Yunhan Xu
- School of Public Health, Department of Maternal and Child Health, Health Science Centre, Peking University, Beijing, China
| | - Ziyang Ren
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen Liu
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Lei F, Wang XM, Wang C, Huang X, Liu YM, Qin JJ, Zhang P, Ji YX, She ZG, Cai J, Li HP, Zhang XJ, Li H. Metabolic dysfunction-associated fatty liver disease increased the risk of subclinical carotid atherosclerosis in China. Front Endocrinol (Lausanne) 2023; 14:1109673. [PMID: 37082131 PMCID: PMC10110917 DOI: 10.3389/fendo.2023.1109673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/21/2023] [Indexed: 04/07/2023] Open
Abstract
Background and aimsMetabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to substitute NAFLD in 2020. This new term highlights the systematic metabolic disturbances that accompany fatty liver. We evaluated the correlations between MAFLD and subclinical carotid atherosclerosis (SCA) based on a nationwide health examination population in China.MethodsWe performed a nationwide cross-sectional population and a Beijing retrospective cohort from 2009 to 2017. SCA was defined as elevated carotid intima-media thickness. The multivariable logistic and Cox models were used to analyze the association between MAFLD and SCA.Results153,482 participants were included in the cross-sectional study. MAFLD was significantly associated with SCA in fully adjusted models, with an odds ratio of 1.66; 95% confidence interval (CI): 1.62-1.70. This association was consistent in the cohort, with a hazard ratio (HR) of 1.31. The association between baseline MAFLD and incident SCA increased with hepatic steatosis severity. Subgroup analysis showed an interaction between age and MAFLD, with a higher risk in younger groups (HR:1.67, 95% CI: 1.17-2.40).ConclusionIn this large cross-section and cohort study, MAFLD was significantly associated with the presence and development of SCA. Further, the risk was higher among MAFLD individuals with high hepatic steatosis index and young adults.
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Affiliation(s)
- Fang Lei
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xiao-Ming Wang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Changquan Wang
- Department of Neurology, Huanggang Central Hospital of Yangtze University, Huanggang, China
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Xuewei Huang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ye-Mao Liu
- Institute of Model Animal, Wuhan University, Wuhan, China
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, China
- Department of Cardiology, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Juan-Juan Qin
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Peng Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yan-Xiao Ji
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Huo-ping Li
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, China
- Department of Cardiology, Huanggang Central Hospital of Yangtze University, Huanggang, China
- *Correspondence: Hongliang Li, ; Xiao-Jing Zhang, ; Huo-ping Li,
| | - Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- *Correspondence: Hongliang Li, ; Xiao-Jing Zhang, ; Huo-ping Li,
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Hongliang Li, ; Xiao-Jing Zhang, ; Huo-ping Li,
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Zhang L, Wang T, Shen Y, Luo L, Xu G, Xie L. Increased Plasma Homocysteine Levels Are Associated with Left Ventricular Hypertrophy in Hypertensive Patients with Normal Renal Function. Kidney Blood Press Res 2023; 48:277-286. [PMID: 36996765 DOI: 10.1159/000529903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 02/22/2023] [Indexed: 04/01/2023] Open
Abstract
INTRODUCTION Renal function has an important bearing on plasma homocysteine levels. Plasma homocysteine is related to left ventricular hypertrophy (LVH). However, it remains unclear whether the association between plasma homocysteine levels and LVH is influenced by renal function. This study aimed to investigate relationships among left ventricular mass index (LVMI), plasma homocysteine levels, and renal function in a population from southern China. METHODS A cross-sectional study was performed in 2,464 patients from June 2016 to July 2021. Patients were divided into three groups based on gender-specific tertiles of homocysteine levels. LVMI ≥115 g/m2 for man or ≥95 g/m2 for woman was defined as LVH. RESULTS LVMI and the percentage of LVH were increased, while estimated glomerular filtration rate (eGFR) was decreased with the increase in homocysteine levels, both significantly. Multivariate stepwise regression analysis showed that eGFR and homocysteine were independently associated with LVMI in patients with hypertension. No correlation was observed between homocysteine and LVMI in patients without hypertension. Stratified by eGFR, further analysis confirmed homocysteine was independently associated with LVMI (β = 0.126, t = 4.333, p < 0.001) only in hypertensive patients with eGFR ≥90 mL/(min·1.73 m2), not with 60≤ eGFR <90 mL/(min·1.73 m2). Multivariate logistic regression indicated that in hypertensive patients with eGFR ≥90 mL/(min·1.73 m2), the patients in high tertile of homocysteine levels had a nearly twofold increased risk of occurring LVH compared with those in low tertile (high tertile: OR = 2.780, 95% CI: 1.945-3.975, p < 0.001). CONCLUSION Plasma homocysteine levels were independently associated with LVMI in hypertensive patients with normal eGFR.
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Affiliation(s)
- Lingyu Zhang
- Department of General Practice, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,
- Fujian Hypertension Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,
- Department of International Medical Services, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,
| | - Tingjun Wang
- Department of General Practice, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of International Medical Services, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yihua Shen
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of International Medical Services, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Geriatrics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Li Luo
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of International Medical Services, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Geriatrics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Guoyan Xu
- Department of General Practice, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of International Medical Services, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Liangdi Xie
- Department of General Practice, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of International Medical Services, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Geriatrics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Gui J, Li Y, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Obesity-and lipid-related indices as a predictor of hypertension in Mid-aged and Elderly Chinese: A Cross-sectional Study. RESEARCH SQUARE 2023:rs.3.rs-2708175. [PMID: 37034776 PMCID: PMC10081363 DOI: 10.21203/rs.3.rs-2708175/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Objective Middle-aged and elderly people in China probably suffer from hypertension. There is a close relationship between obesity-and lipid-related index and hypertension, which is recognized by recent studies. However, these studies have not systematically compared the relationship between the two. We aim to find the most effective obesity-and lipid-related index for predicting hypertension. Method A total of 9488 middle-aged and elderly people in China participated in this study. In this study, the subjects were divided into male and female groups by the definition of the 2018 Chinese Guidelines for Prevention and Treatment of Hypertension. Searching for the best predictors among 13 obesity-and lipid-related indicators through binary logistic regression analyses and receiver operator curve (ROC). These 13 indicators are body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), conicity index (CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR). Results After adjusting bias, all 13 indexes are risk factors for hypertension. In ROC curve analysis, thirteen obesity-and lipid-related factors can predict the occurrence of hypertension. Among them, CVAI has the best prediction effect (male: AUC = 0.660, female: AUC = 0.699). AUC for WHtR was equal to that for BRI and TyG - WHtR in identifying hypertension in male. Similarly, AUC of TyG-BMI and BMI were the same. In females, AUC for WHtR and BRI were the same when predicting hypertension. AUC of ABSI was much lower than other test indexes. Conclusion In predicting hypertension, thirteen obesity-and lipid-related factors are effective. In addition, in males and females, CVAI is the best indicator to indicate hypertension. TyG-WHtR, WHtR, and BRI performed well in predicting metabolic syndrome in both males and females. ABSI has a poor ability to predict hypertension.
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Affiliation(s)
| | | | | | | | - Jinlong Li
- North China University of Science and Technology
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Chen B, Dou Y, Yu X, Ma D. Influence of Internet-Based Health Management on Control of Clinical Parameters in Patients With Hypertension: Four-Year Longitudinal Study. J Med Internet Res 2023; 25:e42896. [PMID: 36939826 PMCID: PMC10131880 DOI: 10.2196/42896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/22/2022] [Accepted: 02/24/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND In recent years, more and more studies have shown that internet-based health management can help patients with hypertension control their blood pressure. However, there is a lack of similar research in China. OBJECTIVE We designed this study to clarify the impact of long-term internet-based health management on the control of clinical parameters in patients with hypertension. These results are also expected to identify the relevant factors affecting the control of clinical parameters in hypertension more accurately toward developing more targeted health management strategies. METHODS This was a longitudinal study of internet-based health management in the five provinces of northwest China. The inclusion criteria were aged ≥18 years and no serious cognitive disease or mental disorder. After collecting the physical examination data of 8567 people in the five northwest provinces in 2013, we conducted online health management (including diet, exercise, and behavior) and follow-up. In the physical examination in 2013, 1008 new patients with hypertension were identified, who were divided into a good blood pressure control group and poor blood pressure control group. Physical examination and a questionnaire survey were conducted every 2 years to understand the changes of health management on the subjects' health-related behaviors. We then analyzed the changes of clinical indicators related to hypertension and the influencing factors related to blood pressure control in patients with hypertension. All statistical analyses were performed using R software (version 4.1.2) and a P value <.05 was considered statistically significant. RESULTS A total of 8567 people met the inclusion criteria and underwent health management. Self-comparison showed that after 4 years of health management, the smoking cessation rate and amount of exercise significantly increased (both P<.001). The low-density lipoprotein-cholesterol levels also increased (P=.005), whereas the high-density lipoprotein-cholesterol levels decreased (P=.007). The newly discovered patients with hypertension in 2013 were further screened. After 4 years of health management, their smoking cessation rate increased significantly (P=.03) and the amount of exercise increased but not significantly (P=.08). In terms of clinical indicators, the diastolic blood pressure considerably decreased (P<.001) and the systolic blood pressure slightly decreased (P=.13). The correlation analysis of blood pressure control in patients with new-onset hypertension showed that gender (female) and changing relevant factors according to health management behaviors (BMI; cereals and potatoes intake; fish, livestock meat, and eggs intake; fruit intake; and physical activity) were the protective factors of blood pressure control. CONCLUSIONS Internet-based health management has a significant and long-term effect on blood pressure control in patients with hypertension.
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Affiliation(s)
- Botian Chen
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yuqi Dou
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xue Yu
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Defu Ma
- School of Public Health, Peking University Health Science Center, Beijing, China
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60
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Intensive Blood Pressure Control and Diabetes Mellitus Incidence for Patients with Impaired Fasting Glucose: A Secondary Analysis of SPRINT. Int J Hypertens 2023; 2023:7533353. [PMID: 36968629 PMCID: PMC10036175 DOI: 10.1155/2023/7533353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 03/19/2023] Open
Abstract
Background. Previous studies indicated that intensive blood pressure (BP) control (systolic BP < 120 mm·Hg) compared with standard BP control (<140 mm·Hg) was associated with an increased risk of type 2 diabetes (T2D) and impaired fasting glucose (IFG) among hypertensive patients with normoglycemia. However, the impact of intensive BP control on the incidence of T2D for those with IFG is still unknown. Methods. This was a secondary analysis of the SPRINT (Systolic Blood Pressure Intervention Trial) of the study. We included participants with IFG at randomization, which was defined as fasting blood glucose (FBG) between 100 and 125 mg/dL. The primary outcome was incident T2D, defined as events of reaching FBG ≥ 126 mg/dL, participant self-report T2D at annual examination, or a record of hypoglycemic medications at follow-up. The secondary outcome was incident IFG reversion (IFGR), defined as the time to first FBG back to normoglycemia (<100 mg/dl) among participants without incident T2D. Cox proportional hazards models were used to compare the cumulative incidence of outcomes between the two BP control groups. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Results. A total of 3310 participants were included in our primary outcome analysis (median age 67 years, 29% female). There were 293 participants who developed T2D among the intensive BP control group and 256 participants who developed T2D among the standard BP control group, resulting in 56.87 (50.36–63.39) versus 49.33 (43.29–55.37) events per 1000 person-years of treatment (HR 1.18 [95% CI, 1.00–1.40],
). After excluding 549 participants who developed T2D, 2761 participants were included in our secondary outcome analysis with 559 participants who developed IFGR among the intensive BP control group and 632 participants who developed IFGR among the standard BP control group, resulting in 141.20 (129.50–152.91) versus 158.20 (145.86,170.53) events per 1000 person-years of treatment (HR 0.9 [95% CI, 0.8–1.01],
). Conclusions. Our study found that in comparison to the standard BP control for hypertensive patients with IFG, intensive BP control was associated with a small increased risk of new-onset T2D, though it did not reach statistical significance. This kind of impact should be considered when implementing the strategy, especially for those with high risks of developing T2D. This trial is registered with NCT01206062.
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Wang Z, Hou J, Zheng H, Wang D, Tian W, Zhang D, Yan J. Genetic and phenotypic frequency distribution of ACE, ADRB1, AGTR1, CYP2C9*3, CYP2D6*10, CYP3A5*3, NPPA and factors associated with hypertension in Chinese Han hypertensive patients. Medicine (Baltimore) 2023; 102:e33206. [PMID: 36897672 PMCID: PMC9997823 DOI: 10.1097/md.0000000000033206] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
We analyzed the polymorphisms of 7 antihypertensive drugs-related genes and the factors associated with hypertension in hypertensive patients of Han ethnicity in Qingyang, China. A total of 354 hypertensive patients of Han ethnicity were enrolled from Qingyang, China. The ACE (I/D), ADRB1 (1165G > C), AGTR1 (1166A > C), CYP2C9*3, CYP2D6*10, CYP3A5*3 and NPPA (T2238C) polymorphisms were assessed. Clinical data of patients was also obtained. The influencing factors of hypertension were evaluated. The genotype frequencies of ACE, ADRB1, AGTR1, CYP2C9, CYP3A5 and NPPA loci were in Hardy-Weinberg equilibrium, with mutation frequencies of 39.27%, 74.29%, 6.21%, 4.80%, 72.46% and 0.71%, respectively. CYP2D6 locus was not in Hardy-Weinberg equilibrium. There was no statistical difference in allele frequencies between different genders (P > .05). There was significant difference in the frequencies of ACE (I/D) and NPPA (T2238C) loci among different regions of China (P < .05). Gender, ACE (I/D) and ADRB1 (1165G > C) gene polymorphism, smoking, homocysteine and HDL levels were associated hypertension. The mutation frequencies of ADRB1 (1165G > C) and CYP3A5*3 were high in hypertensive patients of Han ethnicity in Qingyang, suggesting these patients may be more sensitive to beta-blockers and calcium ion antagonists. Meanwhile, hypertension was associated with gender, ACE (I/D) and ADRB1 (1165G > C) gene polymorphisms, smoking, homocysteine and HDL levels.
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Affiliation(s)
- Zhenyun Wang
- Department of Urinary Surgery, The People’s Hospital of Qingyang City, Qingyang, China
| | - Juanjuan Hou
- Department of Clinical Laboratory Medicine, The People’s Hospital of Qingyang City, Qingyang, China
| | - Hongjun Zheng
- Department of Clinical Laboratory Medicine, The People’s Hospital of Qingyang City, Qingyang, China
| | - Dan Wang
- Department of Neurosurgery, The People’s Hospital of Qingyang City, Qingyang, China
| | - Weihua Tian
- Department of Clinical Laboratory Medicine, The Hospital of TCM of Gansu Province, Lanzhou, China
| | - Dan Zhang
- Department of Cardiology, The People’s Hospital of Qingyang City, Qingyang, China
| | - Jiamin Yan
- Department of Clinical Laboratory Medicine, The People’s Hospital of Qingyang City, Qingyang, China
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62
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Wang H, Ni X, Dong W, Qin W, Xu L, Jiang Y. Accurately quantified plasma free glycine concentration as a biomarker in patients with acute ischemic stroke. Amino Acids 2023; 55:385-402. [PMID: 36697969 DOI: 10.1007/s00726-023-03236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023]
Abstract
We developed a hollow fiber centrifugal ultrafiltration (HFCF-UF) method to study the change of plasma levels of free glycine (Gly) in patients with acute ischemic stroke (AIS). Twenty-four patients with AIS confirmed by diffusion-weighted imaging (DWI) were enrolled. During the study period, the patients did not receive any supplemental amino acids therapy that could affect the obtained results. Our results showed that although AIS patients adopted different methods of treatment (thrombolytic and non-thrombolytic), the clinical NIHSS score of AIS showed a downward trend whereas Gly concentration showed increased trend. Moreover, plasma free Gly concentration was positively correlated with ASPECTS score. The correlation between Gly levels and infarct volume showed a statistical significance. That is to say, higher Gly level predicted smaller infarct size. Thus, the change of free Gly level in plasma could be considered as a potential biomarker of AIS.
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Affiliation(s)
- Huan Wang
- Department of Pharmaceutical Analysis, School of Pharmacy, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
| | - Xiaoyu Ni
- Department of Pharmaceutical Analysis, School of Pharmacy, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
| | - Weichong Dong
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China
| | - Weiman Qin
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China
| | - Lei Xu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China.
| | - Ye Jiang
- Department of Pharmaceutical Analysis, School of Pharmacy, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China.
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Clarke R, Wright N, Walters R, Gan W, Guo Y, Millwood IY, Yang L, Chen Y, Lewington S, Lv J, Yu C, Avery D, Lin K, Wang K, Peto R, Collins R, Li L, Bennett DA, Parish S, Chen Z. Genetically Predicted Differences in Systolic Blood Pressure and Risk of Cardiovascular and Noncardiovascular Diseases: A Mendelian Randomization Study in Chinese Adults. Hypertension 2023; 80:566-576. [PMID: 36601918 PMCID: PMC7614188 DOI: 10.1161/hypertensionaha.122.20120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Mendelian randomization studies of systolic blood pressure (SBP) can assess the shape and strength of the associations of genetically predicted differences in SBP with major disease outcomes and are less constrained by biases in observational analyses. This study aimed to compare the associations of usual and genetically predicted SBP with major cardiovascular disease (CVD) outcomes, overall and by levels of SBP, age, and sex. METHODS The China Kadoorie Biobank involved a 12-year follow-up of a prospective study of 489 495 adults aged 40 to 79 years with no prior CVD and 86 060 with genetic data. Outcomes included major vascular events (59 490/23 151 in observational/genetic analyses), and its components (ischemic stroke [n=39 513/12 043], intracerebral hemorrhage [7336/5243], and major coronary events [7871/4187]). Genetically predicted SBP used 460 variants obtained from European ancestry genome-wide studies. Cox regression estimated adjusted hazard ratios for incident CVD outcomes down to usual SBP levels of 120 mm Hg. RESULTS Both observational and genetic analyses demonstrated log-linear positive associations of SBP with major vascular event and other major CVD types in the range of 120 to 170 mm Hg. Consistent with the observational analyses, the hazard ratios per 10 mm Hg higher genetically predicted SBP were 2-fold greater for intracerebral hemorrhage (1.71 [95% CI, 1.58-1.87]) than for ischemic stroke (1.37 [1.30-1.45]) or major coronary event (1.29 [1.18-1.42]). Genetic analyses also demonstrated 2-fold greater hazard ratios for major vascular event in younger (1.69 [95% CI, 1.54-1.86]) than in older people (1.28 [1.18-1.38]). CONCLUSIONS The findings provide support for initiation of blood pressure-lowering treatment at younger ages and below the conventional cut-offs for hypertension to maximize CVD prevention, albeit the absolute risks of CVD are far greater in older people.
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Affiliation(s)
- Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Neil Wright
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Robin Walters
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Wei Gan
- Novo Nordisk Research Centre Oxford, Novo Nordisk Ltd, Oxford, United Kingdom (W.G.)
| | - Yu Guo
- Fuwai Hospital Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China (Y.G.)
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing, China (J.L., C.Y., L.L.).,Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China (J.L., C.Y., L.L.)
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing, China (J.L., C.Y., L.L.).,Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China (J.L., C.Y., L.L.)
| | - Daniel Avery
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.)
| | - Kuang Lin
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.)
| | - Kang Wang
- NCDs Prevention and Control Department, Shibei CDC, China (K.W.)
| | - Richard Peto
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.)
| | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.)
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing, China (J.L., C.Y., L.L.).,Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China (J.L., C.Y., L.L.)
| | - Derrick A Bennett
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Sarah Parish
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).,Medical Research Council, Population Health Research Unit, University of Oxford, United Kingdom (R. Clarke, R.W., I.Y.M., L.Y., Y.C., S.L., D.A.B., S.P., Z.C.)
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Li M, Cui X, Meng Y, Cheng M, He J, Yuan W, Ni J, Liu J. Prevalence of Hypertension and Its Association with Cardiovascular Risk Factors in College Students in Hunan, China. Int J Gen Med 2023; 16:411-423. [PMID: 36760681 PMCID: PMC9904140 DOI: 10.2147/ijgm.s379957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
Background Although the prevalence of hypertension has been well studied in middle age and elderly populations, few studies have systematically investigated the prevalence of hypertension and its association with cardiovascular and cerebrovascular risk factors in young populations. Objective This study examined the prevalence of hypertension in college students and its correlation with cardiovascular and cerebrovascular risk factors, such as neck circumference and body mass index (BMI). Methods This population-based study recruited a total of 1719 students (723 were junior, 502 were sophomore, and 494 were freshman), including 996 males (average age: 20.8 years) and 723 females (average age: 20.4 years). Hypertension was defined by the 2018 revised edition of the Chinese Guidelines for Prevention and Treatment of Hypertension. Blood and pulse pressure were measured using standard protocols. Circulating levels of lipids, glucose, glycosylated hemoglobin (GHb), leptin, and adiponectin were determined using standard methods. The Chi-squared (χ2) test was used for comparison of significant differences between groups. Linear and logistic regression analyses were used to explore risk factors that significantly influence hypertension. Findings The prevalence of hypertension was 10.59% in the total cohort, and sophomores had a higher prevalence of hypertension than freshmen and juniors (χ2 = 19.372; P < 0.001). In addition, male students had a significantly higher prevalence of hypertension (10.24%) and abnormal pulse pressure (8.13%) than female students (1.4% and 0.83%) (χ2 = 327.424, P < 0.001 for high SBP and χ2 = 60.49, P < 0.001 for high DBP, respectively). Correlation analysis revealed that hypertension was significantly correlated with neck circumference and BMI (r = 0.509, P < 0.001; r = 0.474, P < 0.001), but not significantly correlated with the other parameters examined. Conclusion The prevalence of hypertension in college students is closely correlated with two obesity indicators, neck circumference and BMI.
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Affiliation(s)
- Mingpeng Li
- Department of Cardiovascular, Chenzhou No. 1 People’s Hospital, Chenzhou, People’s Republic of China,The First Affiliated Hospital of Xiangnan University, Chenzhou, People’s Republic of China
| | - Xiaorui Cui
- Department of Neurology, Affiliated Hospital of Xiangnan University, Chenzhou, People’s Republic of China
| | - Yanbin Meng
- Xiangnan University, Chenzhou, People’s Republic of China
| | - Mengli Cheng
- Xiangnan University, Chenzhou, People’s Republic of China
| | - Jinsong He
- Department of Neurology, Affiliated Hospital of Xiangnan University, Chenzhou, People’s Republic of China
| | - Wei Yuan
- Department of Neurology, Affiliated Hospital of Xiangnan University, Chenzhou, People’s Republic of China
| | - Jing Ni
- Hunan University of Science and Technology, Xiangtan, People’s Republic of China
| | - Jianping Liu
- Institute of Cardiovascular and Cerebrovascular Diseases, Xiangnan University, Chenzhou, People’s Republic of China,Correspondence: Jianping Liu, No. 25 Renmin West Road, Chenzhou, 423000, People’s Republic of China, Email
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Wang T, Xu J, Zhang H, Tao L, Huang X. Triglyceride-glucose index for the detection of subclinical heart failure with preserved ejection fraction in patients with type 2 diabetes. Front Cardiovasc Med 2023; 10:1086978. [PMID: 36793475 PMCID: PMC9923050 DOI: 10.3389/fcvm.2023.1086978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
Objectives The triglyceride-glucose (TyG) index has been identified as a reliable and simple surrogate of insulin resistance. In this study, we sought to determine the association between TyG index and cardiac function among asymptomatic individuals with type 2 diabetes (T2DM) without history of any cardiovascular disease. Materials and methods The cross-sectional study enrolled 180 T2DM patients without cardiac symptoms. Heart failure with preserved ejection fraction (HFpEF) was defined as Heart Failure Association (HFA)-PEFF score ≥ 5 points. Results A total of 38 (21.1%) diabetic patients were identified with HFpEF. Compared with the low-TyG group (TyG index <9.47), patients in high-TyG group (TyG index ≥9.47) showed increased risk of metabolic syndrome and diastolic dysfunction (p < 0.05 for each). Furthermore, after adjustment of confounding variables, the TyG index showed positive correlation with risk factors of metabolic syndrome (including BMI, waist circumference, blood pressure, HbA1c, TG, TC, non-HDL-C, and fasting blood glucose, p < 0.05 for each) and parameters of diastolic dysfunction (E/e' ratio, p < 0.0001) in patients with T2DM. Moreover, Receiver Operating Characteristic curve analysis showed that the TyG index could be better to predict the risk of suspected HFpEF than other indicators (AUC: 0.706, 95% CI: 0.612-0.801). According, on multiple regression analysis, TyG index was independently correlated with the incidence of HFpEF (odds ratio: 0.786, p = 0.0019), indicating that TyG index could be a reliable biomarker to predict the risk of HFpEF. Conclusion The TyG index showed a positive correlation with the risk of subclinical HFpEF in patients with T2DM, providing a new marker to predict and treat HFpEF in diabetes.
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Affiliation(s)
- Tingting Wang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jiani Xu
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Hong Zhang
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Lichan Tao
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China,*Correspondence: Lichan Tao, ✉
| | - Xiaolin Huang
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China,Xiaolin Huang, ✉
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Xu X, Tian W, Duan W, Pan C, Huang M, Wang Q, Yang Q, Wen Z, Tang Y, Xiong Y, Zhu Z, Liu Y, Wei D, Qi W, Ouyang X, Ying S, Wang X, Zhou Z, Li X, Cui Y, Yang S, Xu H. Quanduzhong capsules for the treatment of grade 1 hypertension patients with low-to-moderate risk: A multicenter, randomized, double-blind, placebo-controlled clinical trial. Front Pharmacol 2023; 13:1014410. [PMID: 36703729 PMCID: PMC9871381 DOI: 10.3389/fphar.2022.1014410] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/29/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Duzhong [DZ (Eucommia ulmoides Oliv.)] is regarded as a traditional Chinese medicine with a history dating back more than 2000 years. This herb is considered a nourishing herb in China and is commonly used as a tonic to strengthen muscles and bones, nourish the kidneys and liver, and soothe miscarriages. Moreover, there is evidence that DZ is capable of regulating blood pressure (BP), and several compounds isolated from DZ have been shown to have a BP-lowering effect. Quanduzhong capsules contain an extract of DZ [Eucommia ulmoides Oliv. (Eucommiaceae; Eucommiae cortex)] that is effective in treating hypertension. This multicenter, randomized, double-blind, placebo-controlled clinical trial sought to evaluate the clinical efficacy of Quanduzhong capsules in the treatment of low-to-moderate risk grade 1 hypertension patients. Materials and methods: A total of 60 patients from 3 centers with documented low-to-moderate risk grade 1 hypertension were randomly assigned in a 1:1 ratio to the test group or the control group. After a 1 week lead-in period using sham Quanduzhong capsules, all patients who met the entry criteria (29 cases in the test group and 29 cases in the control group) entered the 4 week test period. The test group took Quanduzhong capsules, and the control group continued to take sham Quanduzhong capsules. The primary endpoints [24-h mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) determined via 24-h ambulatory blood pressure monitoring (ABPM); office SBP and DBP] and secondary endpoints [mean arterial pressure; mean pulse; daytime mean SBP and DBP; nocturnal mean SBP and DBP; SBP and DBP load; area under the blood pressure (BP) curve; morning peak BP; early morning SBP and DBP; smoothness index of SBP and DBP; 24 h BP mean coefficient of variation (CV); percentage of patients with circadian restoration in ABPM; home BP; quality of life evaluated by WHO Quality of Life-BREF questionnaire; grading and quantitative evaluation of hypertension symptoms; values of plasmatic renin activity, angiotensin II, aldosterone, β-2 microglobulin and homocysteine] were assessed following the treatment. Drug-related adverse events and adverse drug reactions were also compared. Results: After a 4 week test period, a significant difference in the DBP CV between the two groups was observed (-2.49 ± 4.32 vs. 0.76 ± 4.3; p < .05). Moreover, the mean office SBP change was -7.62 ± 9.32 mmHg, and the mean DBP change was -4.66 ± 6.03 (p < .05). Among the three subjects with abnormal homocysteine levels in the test group, homocysteine levels decreased by 6.23 ± 9.15 μmol/L after treatment. No differences were observed between the two groups in any other indicators. After 4 weeks of treatment, there were no significant differences between the groups in terms of safety indicators (p > .05). No abnormal vital signs (except BP) or severe liver or renal function impairment were observed during the treatment periods; in addition, adverse events and drug reactions were mild. Conclusion: Treatment with Quanduzhong capsules reduced office SBP and DBP as well as DBP CV determined by 24-h ambulatory BP monitoring in patients with grade 1 hypertension at low-to-moderate risk. Clinical Trial Registration: https://www.chictr.org.cn/showproj.aspx?proj=32531, identifier ChiCTR1900021699.
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Affiliation(s)
- Xuan Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,The Eighth Hospital of Baotou, Baotou, China
| | - Wende Tian
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wenhui Duan
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chaoxin Pan
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, China
| | - Mingjian Huang
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, China
| | - Qinggao Wang
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, China
| | - Qinghua Yang
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, China
| | - Zhihao Wen
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, China
| | - Yu Tang
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Yao Xiong
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Zhiyun Zhu
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Yuanyuan Liu
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Dan Wei
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Wenqiang Qi
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Xiaochao Ouyang
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Shaozhen Ying
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Xiaohua Wang
- Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
| | - Zhigang Zhou
- Jiangxi Puzheng Pharmaceutical Co, Ltd., Jiangxi, China
| | - Xiaofeng Li
- Jiangxi Puzheng Pharmaceutical Co, Ltd., Jiangxi, China
| | - Yu Cui
- Jiangxi Puzheng Pharmaceutical Co, Ltd., Jiangxi, China
| | - Shuyin Yang
- Jiangxi Puzheng Pharmaceutical Co, Ltd., Jiangxi, China
| | - Hao Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,*Correspondence: Hao Xu,
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Yang Y, He K, Zhang Y, Wu X, Chen W, Gu D, Zeng Z. Ethnicity Disparities in the Prevalence, Awareness, Treatment, and Control Rates of Hypertension in China. Int J Hypertens 2023; 2023:1432727. [PMID: 36959846 PMCID: PMC10030218 DOI: 10.1155/2023/1432727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/23/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
Objectives Previous studies reported that there were disparities in hypertension management among different ethnic groups, and this study aimed to systematically determine the prevalence, awareness, treatment, and control rates of hypertension in multiple Chinese ethnic groups. Methods We searched Embase, PubMed, and Web of Science for articles up to 25 October, 2022. The pooled prevalence, awareness, treatment, and control rates of hypertension were estimated with 95% confidence intervals (CI). The heterogeneity of estimates among studies was assessed by the Cochran Q test and I 2 statistic. Meta-regression analyses were conducted to identify the factors influencing the heterogeneity of the pooled prevalence, awareness, treatment, and control rate of hypertension. Results In total, 45 publications including 193,788 cases and 587,826 subjects were eligible for the analyses. The lowest prevalence was found in the Han group (27.0%), and the highest prevalence was in the Mongolian population (39.8%). The awareness rates ranged from 24.4% to 58.0% in the four ethnic groups. Both the highest treatment and control rates were found in the Mongolian population (50.6% and 16.0%, respectively), whereas the Yi group had the lowest control rate (8.0%). In addition, the study year, the mean age of subjects, mean body mass index of subjects, tobacco use (%), alcohol use (%), residence (urban%), and education (primary school%) had varied effects on heterogeneity. Conclusions These findings highlight the disparities in prevalence, awareness, treatment, and control rates of hypertension in a different ethnic population of China, which could provide suggestions for making targeted prevention measures.
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Affiliation(s)
- Yanan Yang
- 1Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu 610500, China
| | - Kunlin He
- 2Yibin Center for Disease Control and Prevention, Yibin 644000, China
| | - Yuewen Zhang
- 1Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu 610500, China
| | - Xiuming Wu
- 1Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu 610500, China
| | - Weizhong Chen
- 1Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu 610500, China
| | - Dongqing Gu
- 3First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Ziqian Zeng
- 1Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu 610500, China
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Xu Y, Liu B, Lin L, Lei F, Sun T, Zhang X, Song X, Huang X, Zeng Q, Cai J, Wang Z, Li H. The association of apolipoprotein B with chronic kidney disease in the Chinese population. Front Endocrinol (Lausanne) 2023; 14:1083614. [PMID: 37124758 PMCID: PMC10132458 DOI: 10.3389/fendo.2023.1083614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Background Whether serum apolipoprotein B (ApoB) is a risk factor for the development of Chronic kidney disease (CKD) has not been fully established in the general population. Therefore, our study evaluated the correlation between serum ApoB level and CKD to look for an alternative approach for CKD prevention and treatment in the general population. Methods There were 146,533 participants in this cross-sectional study. 3,325 participants with more than 2 measurements were enrolled in the retrospective longitudinal study with at least a 3-year follow-up. ApoB was measured by the immunoturbidimetric method in 6 centers. Our study defined CKD as an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2. The Spearman rank correlation analysis and the Random Forest algorithm were applied to rank the importance of variables determining the levels of eGFR. We used the logistic regression model to explain the correlation between serum ApoB and CKD. We used the Cox model to detect the correlation between baseline serum ApoB and the subsequent occurrence of CKD. Results Based on a cross-sectional study, 66.5% of the participants were males, with a median age of 49 (interquartile range [IQR] 43-55). Compared to the non-CKD group, the CKD group has higher levels of lipid profile and fasting glucose as well as the proportion of hypertension and hyperuricemia. The Spearman rank correlation analysis and the Random Forest algorithm revealed that ApoB has the highest correlation with eGFR decline among lipid profiles. The logistic regression analysis revealed that ApoB had a positive correlation with the prevalence of CKD after fully controlling confounders (odds ratio [OR], 1.07; 95% confidence interval [CI]: 1.02-1.11). Moreover, baseline ApoB level was correlated with a new-onset CKD in the longitudinal cohort after full adjustment for confounding factors (hazard ratio [HR], 1.61; 95% CI: 1.02-2.54). The correlation between ApoB level and the new-onset CKD was consistently observed in all sensitivity analyses. Conclusion Serum ApoB had the strongest correlation with CKD among all lipid variables. Moreover, high serum ApoB levels might precede the occurrence of CKD, suggesting that monitoring and reducing serum ApoB levels may provide an alternative method to prevent and treat CKD.
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Affiliation(s)
- Yu Xu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Anesthesiology, Changsha Central Hospital, Changsha, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Bo Liu
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Lijin Lin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Fang Lei
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Tao Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xingyuan Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xiaohui Song
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xuewei Huang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qiang Zeng
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhifang Wang
- Department of Nephrology Huanggang Central Hospital of Yangtze University, Huanggang, China
- *Correspondence: Hongliang Li, ; Zhifang Wang,
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, China
- *Correspondence: Hongliang Li, ; Zhifang Wang,
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Park JB, Avolio A. Arteriosclerosis and Atherosclerosis Assessment in Clinical Practice: Methods and Significance. Pulse (Basel) 2023; 11:1-8. [PMID: 37404379 PMCID: PMC10315159 DOI: 10.1159/000530616] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/24/2023] [Indexed: 07/06/2023] Open
Abstract
Alongside cancer, cardiovascular disease (CVD) exhibits the highest rates of morbidity and mortality globally, in western society as well as in Asian countries. Aging is a serious problem for the Asian population as progression toward a super-aged society is moving at a remarkably high rate. This increased rate of aging leads to increased CVD risk and, consequently, high CVD incidence. However, aging is not the only deleterious factor of vascular problems; hypertension, hypercholesterolemia, diabetes mellitus, and kidney disease may induce atherosclerosis and arteriosclerosis (i.e., arterial stiffening), and the progression of these diseases ultimately leads to cardiovascular, cerebrovascular, chronic kidney, or peripheral artery disease. Despite the existence of several guidelines on the treatment of risk factors such as hypertension and CVD, there is still an ongoing debate regarding the clinical need for assessment of arteriosclerosis and atherosclerosis, which act as a bridge between cardiovascular risk factors and CVD. In other words, although arteriosclerosis and atherosclerosis are essential to our understanding of vascular diseases, the need for additional tests beyond the conventional diagnosis method remains disputed. This is presumably due to insufficient discussion on how to apply such tests in clinical practice. This study aimed to fill this gap.
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Affiliation(s)
- Jeong Bae Park
- JB Lab and Clinic and Department of Precision Medicine and Biostatistics, Yonsei University, Wonju College of Medicine, Seoul, Republic of Korea
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Song XH, Liu B, Lei F, Liu YM, Zhang X, Chen Z, Zhang P, Zhang XJ, She ZG, Cai J, Wang JH, Li H. The Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and Peripheral Arterial Disease in the Chinese Population. Diabetes Metab Syndr Obes 2023; 16:373-384. [PMID: 36798909 PMCID: PMC9926992 DOI: 10.2147/dmso.s394414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/05/2023] [Indexed: 02/11/2023] Open
Abstract
PURPOSE Emerging evidence suggested that metabolic dysfunction-associated fatty liver disease (MAFLD) was significantly associated with atherosclerotic diseases. Atherosclerosis in the peripheral arteries is the most common cause of peripheral arterial disease (PAD), which has not been substantially controlled in the past. We aimed to investigate the association between MAFLD and PAD in the Chinese population. PATIENTS AND METHODS This observational study covered 102,115 participants who underwent health checkups with detailed examinations for PAD and MAFLD. PAD was measured by ankle-brachial index, and MAFLD was diagnosed by abdominal ultrasound. The generalized linear mixed models and random-effects Cox proportional hazards models were used to analyze the relationship between MAFLD and PAD. RESULTS The baseline characteristics showed that patients with MAFLD had higher prevalence of PAD compared with those without MAFLD (2.7% vs 2.2%). Compared to non-MAFLD, the individuals with MAFLD were associated with a higher risk of the presence of PAD (adjusted odds ratio: 1.30, 95% confidence interval (CI): 1.19-1.42, P < 0.001). In the prospective cohort study, 6833 participants underwent a follow-up of 2.76 (standard deviation: 1.36) years, and MAFLD at baseline was a higher risk of associated with incident PAD (adjusted hazards ratio: 1.67, 95% CI: 1.17-2.38, P = 0.005). Moreover, with the accumulation of metabolic abnormalities, the risk of the PAD was increased in the individuals with MAFLD. Furthermore, MAFLD attributed risk of PAD was more evident in participants without metabolic comorbidities. CONCLUSION MAFLD was associated with a significantly higher risk for the prevalence and incidence of PAD in the Chinese population. The finding suggested that individuals with MAFLD are not only have a higher risk of coronary heart diseases but also have an increased risk of atherosclerosis in peripheral arteries.
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Affiliation(s)
- Xiao-Hui Song
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Bo Liu
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Fang Lei
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- School of Basic Medical Science, Wuhan University, Wuhan, People’s Republic of China
| | - Ye-Mao Liu
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- Department of Cardiology, Huanggang Central Hospital of Yangtze University, Huanggang, People’s Republic of China
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, People’s Republic of China
| | - Xingyuan Zhang
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- School of Basic Medical Science, Wuhan University, Wuhan, People’s Republic of China
| | - Ze Chen
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Peng Zhang
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- School of Basic Medical Science, Wuhan University, Wuhan, People’s Republic of China
| | - Xiao-Jing Zhang
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- School of Basic Medical Science, Wuhan University, Wuhan, People’s Republic of China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Jin-Hua Wang
- Department of Neurology, Huanggang Central Hospital of Yangtze University, Hubei, People’s Republic of China
- Jin-Hua Wang, Department of Neurology, Huanggang Central Hospital of Yangtze University, Hubei, 438000, People’s Republic of China, Email
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
- Institute of Model Animal, Wuhan University, Wuhan, People’s Republic of China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, People’s Republic of China
- Correspondence: Hongliang Li, Department of Cardiology, Renmin Hospital of Wuhan University, Luojia Mount Wuchang, Wuhan, 430072, People’s Republic of China, Tel/Fax +86-27-68759302, Email
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Shan S, Li S, Lu K, Cao J, Sun W, Zhou J, Ren Z, Zhu S, Hou L, Chen D, Song P. Associations of the Triglyceride and Glucose Index With Hypertension Stages, Phenotypes, and Their Progressions Among Middle-Aged and Older Chinese. Int J Public Health 2023; 68:1605648. [PMID: 37020526 PMCID: PMC10067654 DOI: 10.3389/ijph.2023.1605648] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/06/2023] [Indexed: 04/07/2023] Open
Abstract
Objectives: To assess the associations of the triglyceride and glucose (TyG) index with hypertension stages, phenotypes, and their progressions. Methods: The data originated from the China Health and Retirement Longitudinal Study. Multinomial logistic regression investigated the associations of the TyG index with hypertension stages (stage 1, stage 2), phenotypes (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], systolic diastolic hypertension [SDH]), their progressions. Results: Compared with the lowest quartile of TyG index, the highest quartile was associated with increased risks of stage 1 hypertension (OR 1.71, 95% CI 1.38-2.13), stage 2 (1.74, 1.27-2.38), ISH (1.66, 1.31-2.11), IDH (2.52, 1.26-5.05), and SDH (1.65, 1.23-2.23). Similar results were found when TyG index was a continuous variable. From 2011 to 2015, a higher baseline TyG index was associated with normotension to stage 1 (per-unit: 1.39, 1.16-1.65), normotension to ISH (per-unit: 1.28, 1.04-1.56), and normotension to IDH (per-unit: 1.94, 1.27-2.97). Conclusion: The TyG index was associated with different hypertension stages, phenotypes, their progressions, and could be served as a surrogate indicator for early hypertension management.
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Affiliation(s)
- Shiyi Shan
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuting Li
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Keyao Lu
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Cao
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weidi Sun
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiali Zhou
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ziyang Ren
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Siyu Zhu
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leying Hou
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingwan Chen
- School of Public Health, Hangzhou Medical College, Hangzhou, China
- *Correspondence: Dingwan Chen, ; Peige Song,
| | - Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Dingwan Chen, ; Peige Song,
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Sun X, Liu Y, Liu Y, Wang H, Liu B, Shi L. Association between red blood cell distribution width and left ventricular hypertrophy in pediatric essential hypertension. Front Pediatr 2023; 11:1088535. [PMID: 36816384 PMCID: PMC9932496 DOI: 10.3389/fped.2023.1088535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
AIM Left ventricular hypertrophy (LVH) is one of the most common types of target organ damage in hypertension. The red blood cell distribution width (RDW) is closely related to many cardiovascular diseases, including hypertension. The aim of this study was to analyze the relationship between the RDW level and LVH in pediatric essential hypertension. MATERIALS AND METHODS A total of 429 untreated children and adolescents with essential hypertension were recruited and divided into an LVH group (n = 114) and non-LVH group (n = 315) according to left ventricular mass index (LVMI) and relative wall thickness (RWT) by color Doppler ultrasound. Spearman correlation analysis was used to determine the relationship between RDW and LVMI, RWT. The effect of RDW on LVH was determined using a multivariate logistic regression analysis. To assess the predictive value of RDW on LVH, the receiver operating characteristic (ROC) curve was used. RESULTS The level of RDW in children with hypertension in the LVH group was significantly higher than that in the non-LVH group (13.0 [12.0, 13.0] vs. 12.4 [12.0, 13.0] %, P = 0.001). The incidence of low and high quantiles of LVH was 21.0% and 32.0%, respectively. Spearman correlation analysis showed that RDW was positively correlated with C-reactive protein (CRP), LVMI, RWT, and red blood cell (RBC) count (P all < 0.05), and negatively correlated with hemoglobin (HGB) level, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) (P all < 0.05). After adjusting for various confounding factors, a multivariate logistic regression model revealed that RDW was an independent risk factor for LVH (OR = 1.946, 95% CI: 1.324-2.861, P = 0.001). The area under the ROC curve of RDW predicting centripetal hypertrophy was 0.700 (95% CI: 0.541-0.859, P < 0.05) in pediatric essential hypertension. CONCLUSIONS Increased RDW levels are an independent risk factor for LVH in pediatric essential hypertension, and RDW may be a predictor of LVH in untreated pediatric essential hypertension.
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Affiliation(s)
- Xiaodong Sun
- Capital Institute of Pediatrics, Beijing, China.,Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Yang Liu
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Yanyan Liu
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Hui Wang
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Bo Liu
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Lin Shi
- Capital Institute of Pediatrics, Beijing, China.,Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
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73
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Hao Q, Yuanyuan Z, Lijuan C. The Prognostic Value of the Triglyceride Glucose Index in Patients With Acute Myocardial Infarction. J Cardiovasc Pharmacol Ther 2023; 28:10742484231181846. [PMID: 37335126 DOI: 10.1177/10742484231181846] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Objective: The triglyceride-glucose (TyG) index is a simple and reliable surrogate for insulin resistance. Recent studies have suggested that the TyG index is an independent predictor of cardiovascular disease. However, the prognostic value of the TyG index in patients with acute myocardial infarction (AMI) remains uncertain. Thus, this study aimed to evaluate the prognostic value of the TyG index in patients with AMI. Methods: AMI patients admitted to Zhongda Hospital from 2018 to 2020 were successively enrolled. After screening the inclusion criteria, 1144 patients were divided into three groups according to the tertiles of the TyG index distribution. Patients were followed up for 1 year as outpatients or contacted via telephone, and the occurrence and timing of all-cause deaths were recorded. Results: The TyG index was significantly correlated with heart failure (HF) in AMI patients. Patients with a high TyG index (group 3) (odds ratio: 9.070, 95% confidence interval [CI] 4.359-18.875, P<.001) had a significantly higher incidence of HF compared with patients with median TyG index (group 2). Similarly, the incidence of all-cause death in group 3 was significantly higher than that in group 2 during the 1-year follow-up (hazard ratio: 2.996, 95% CI 1.058-8.487, P = .039). Conclusion: The TyG index is closely related to HF and may be a valuable indicator to predict the long-term prognosis of patients with AMI.
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Affiliation(s)
- Qian Hao
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zhao Yuanyuan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Chen Lijuan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
- Department of Cardiology, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
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74
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Yan N, Chen D, Pan R, Zhang L, Ma J, Zhang Z, Dang Y, Wang L, Ma X, Jia S. The Relationship Between Social Capital and Hypertension Among Type 2 Diabetes Mellitus Patients: The Moderating Effect of Depressive Symptoms. Patient Prefer Adherence 2023; 17:209-216. [PMID: 36713973 PMCID: PMC9875576 DOI: 10.2147/ppa.s396383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
PURPOSE This study aimed to evaluate the relationship between social capital (SC) and hypertension among type 2 diabetes mellitus (T2DM) patients, considering the moderation effects of depressive symptoms. PATIENTS AND METHODS A total of 1761 Chinese T2DM patients completed measure scales of social capital and epidemiological survey depression scale (CES-D). The Bootstrap methods PROCESS program is employed to test the moderation model. RESULTS The prevalence of hypertension among T2DM patients was 39.3%. The SC was negatively correlated with the CES-D score (r=-0.18, P<0.01); the SC was also negatively correlated with diastolic blood pressure (r=-0.05, P<0.05); and the CES-D score was positively correlated with systolic blood pressure (r=0.05, P<0.05). Both logistic regression analysis and the Bootstrap method showed that depressive symptoms weakened the protective effect of SC on hypertension, there existed a moderating effect of depressive symptoms on the relationship between SC and hypertension among T2DM patients. CONCLUSION Depressive symptoms may be one crucial moderator of the relationship between SC and hypertension in a representative sample of Chinese diabetes patients. The findings indicate that improving SC and mental health may help manage hypertension among T2DM patients.
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Affiliation(s)
- Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Dapeng Chen
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, 753000, People’s Republic of China
| | - Li Zhang
- Department of Endocrinology, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Juan Ma
- Clinical Medical College, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Zhengjun Zhang
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, 750001, People’s Republic of China
| | - Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Xueping Ma
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Ningxia Key Laboratory of Vascular Injury and Repair Research, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Correspondence: Xueping Ma; Shaobin Jia, Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China, Tel +8613519290991; +8613995078969, Email ;
| | - Shaobin Jia
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Ningxia Key Laboratory of Vascular Injury and Repair Research, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
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Xu H, Cao L, Li J, Zhang F, Wang W, Liang T, Liu X, Fu C. Is Chinese Spring Festival a key point for glycemic control of patients with type 2 diabetes mellitus in China? Front Public Health 2022; 10:975544. [PMID: 36620247 PMCID: PMC9813744 DOI: 10.3389/fpubh.2022.975544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives This study aims to explore the long-term trend of fasting blood glucose (FBG) among urban patients with type 2 diabetes mellitus (T2DM) and the impacts of the Chinese Spring Festival on their glycemic control in urban China. Methods The general information and longitudinal monitoring data of patients with T2DM in Minhang District, Shanghai China from 15 December 2006 to 31 December 2015 were collected. The FBG records were grouped into three periods, namely, the preholiday period (2 months right before the Chinese Spring Festival), the holiday period (from 28 December to 7 January of the lunar calendar year), and the postholiday period (2 months after the Chinese Spring Festival). The Mann-Kendall trend test and Cochran-Armitage trend test were occupied to explore the long-term trend, and paired t-test and chi-square (χ2) test were used to determine the differences in glycemic level and control rate between the preholiday and postholiday periods, respectively. Results From 2007 to 2015, the glycemic control rate in patients with T2DM showed an upward trend (P < 0.001), and the FBG level showed a decreasing trend (P = 0.048). After the Chinese Spring Festival, the glycemic control rate decreased significantly (P < 0.001), and the FBG level increased significantly (P < 0.001) compared to those during the preholiday period. The incidence of hypoglycemia increased during holidays. Patients who were aged 60-69 years, overweight or obese, with hypertension, with a disease duration of <3 years, or with poor glycemic control in one previous year were more likely to be affected by the holiday. Conclusion Chinese Spring Festival is a key point for glycemic control of patients with T2DM in China. Intensive holiday-specific diabetic healthcare needs to be further improved, and community-based interventions should be developed and implemented to control the possible holiday effects.
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Affiliation(s)
- Huilin Xu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Li Cao
- School of Public Health, Fudan University, Shanghai, China,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China,Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Jun Li
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Fen Zhang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Weijie Wang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Tongtong Liang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Xiaohua Liu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China,*Correspondence: Xiaohua Liu ✉
| | - Chaowei Fu
- School of Public Health, Fudan University, Shanghai, China,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China,Key Laboratory of Public Health Safety, Fudan University, Shanghai, China,Chaowei Fu ✉
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76
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He J, Lin H, Ding Y, Liu X, Xu K, Chen X, Shen W, Zhou S, Wang M, Xia J, He N. Genome-wide associated variants of subclinical atherosclerosis among young people with HIV and gene-environment interactions. J Transl Med 2022; 20:609. [PMID: 36539828 PMCID: PMC9764595 DOI: 10.1186/s12967-022-03817-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Genome-wide association studies (GWAS) have identified some variants associated with subclinical atherosclerosis (SCA) in general population but lacking sufficient validation. Besides traditional risk factors, whether and how would genetic variants associate with SCA among people with HIV (PWH) remains to be elucidated. METHOD A large original GWAS and gene-environment interaction analysis of SCA were conducted among Chinese PWH (n = 2850) and age/sex-matched HIV-negative controls (n = 5410). Subgroup analyses by age and functional annotations of variants were also performed. RESULTS Different from HIV-negative counterparts, host genome had a greater impact on young PWH rather than the elders: one genome-wide significant variant (rs77741796, P = 2.20 × 10-9) and eight suggestively significant variants (P < 1 × 10-6) were identified to be specifically associated with SCA among PWH younger than 45 years. Seven genomic loci and 15 genes were mapped to play a potential role on SCA among young PWH, which were enriched in the biological processes of atrial cardiac muscle cell membrane repolarization and molecular function of protein kinase A subunit binding. Furthermore, genome-wide interaction analyses revealed significant HIV-gene interactions overall as well as gene-environment interactions with alcohol consumption, tobacco use and obesity among PWH. The identified gene-environment interaction on SCA among PWH might be useful for discovering high-risk individuals for the prevention of SCA, particularly among those with tobacco use and alcohol consumption. CONCLUSION The present study provides new clues for the genetic contribution of SCA among young PWH and is the starting point of precision intervention targeting HIV-related atherosclerosis.
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Affiliation(s)
- Jiayu He
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Yi-Wu Research Institute, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Shanghai Institute of Infectious Diseases and Biosecurity, Fudan University, Shanghai, China
| | - Haijiang Lin
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,Taizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang China
| | - Yingying Ding
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Yi-Wu Research Institute, Fudan University, Shanghai, China
| | - Xing Liu
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Yi-Wu Research Institute, Fudan University, Shanghai, China
| | - Kelin Xu
- grid.8547.e0000 0001 0125 2443Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoxiao Chen
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,Taizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang China
| | - Weiwei Shen
- Taizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang China
| | - Sujuan Zhou
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Yi-Wu Research Institute, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Shanghai Institute of Infectious Diseases and Biosecurity, Fudan University, Shanghai, China
| | - Miaochen Wang
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Yi-Wu Research Institute, Fudan University, Shanghai, China
| | - Jingjing Xia
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Yi-Wu Research Institute, Fudan University, Shanghai, China
| | - Na He
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Yi-Wu Research Institute, Fudan University, Shanghai, China ,grid.8547.e0000 0001 0125 2443Shanghai Institute of Infectious Diseases and Biosecurity, Fudan University, Shanghai, China
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Lyu TJ, Liu Y, Zhang H, Li LY, He RQ, Gao JQ, Liu ZJ. Clinical observation of sacubitril valsartan sodium in the treatment of resistant hypertension: A randomized clinical trial. Front Cardiovasc Med 2022; 9:1099043. [PMID: 36588555 PMCID: PMC9800823 DOI: 10.3389/fcvm.2022.1099043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To investigate the effectiveness and safety of sacubitril valsartan sodium in the treatment of resistant hypertension (RH). Methods This study is a single-center, prospective, randomized controlled study. According to the inclusion and exclusion criteria, patients with RH who met the criteria were screened, and all patients adjusted their drug treatment (valsartan 80 mg, amlodipine 5 mg, and hydrochlorothiazide 12.5 mg). After 4 weeks of drug elution, the random envelope method was used for random grouping. The treatment group took sacubitril valsartan sodium 200 mg, amlodipine 5 mg, hydrochlorothiazide 12.5 mg, and the control group took valsartan 80 mg, amlodipine 5 mg, and hydrochlorothiazide 12.5 mg for 8 weeks. The 24 h ambulatory blood pressure (BP) and the echocardiography index using the office sphygmomanometer were observed in the patients. Results A total of 100 patients with RH were included in the two groups, with 50 cases in each group. There were no significant differences in sex, age, or comorbid diseases between the two groups. During the 8-week follow-up, the office BP of the research group were significantly decreased (24.78/17.86 mmHg) compared with those of the control group. In the research group the 24 h average BP, daytime average BP, and nighttime average BP were 144.84/79.82, 147.10/82.06, and 138.67/76.31 mmHg at baseline, and reduced to 128.96/73.32, 131.50/74.94, and 122.11/69.27 mmHg at week 8, which were significantly decreased (P < 0.05 or P < 0.01), and the left ventricular ejection fraction was significantly increased (P < 0.05), compared with the control group. Conclusion Sacubitril valsartan sodium can effectively reduce BP and improve cardiac function in RH.
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Zheng S, Nie Z, Lv Z, Wang T, Wei W, Fang D, Zou X, Fu Y, Cao T, Liang Z, Lu Q, Huang H, Wen Y, Huang S. Associations between plasma metal mixture exposure and risk of hypertension: A cross-sectional study among adults in Shenzhen, China. Front Public Health 2022; 10:1039514. [PMID: 36582368 PMCID: PMC9794142 DOI: 10.3389/fpubh.2022.1039514] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Background Metal exposure affects human health. Current studies mainly focus on the individual health effect of metal exposure on hypertension (HTN), and the results remain controversial. Moreover, the studies assessing overall effect of metal mixtures on hypertension risk are limited. Methods A cross-sectional study was conducted by recruiting 1,546 Chinese adults who attended routine medical check-ups at the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen. The plasma levels of 13 metals were measured using inductively coupled plasma mass spectrometry. Multivariate logistic regression model, restricted cubic spline (RCS) model and the Bayesian Kernel Machine Regression (BKMR) model were applied to explore the single and combined effect of metals on the risk of HTN. Results A total of 642 (41.5%) participants were diagnosed with HTN. In the logistic regression model, the adjusted odds ratios (ORs) were 0.71 (0.52, 0.97) for cobalt, 1.40 (1.04, 1.89) for calcium, 0.66 (0.48, 0.90), and 0.60 (0.43, 0.83) for aluminum in the second and third quartile, respectively. The RCS analysis showed a V-shaped or an inverse V-shaped dose-response relationship between metals (aluminum or calcium, respectively) and the risk of HTN (P for non-linearity was 0.017 or 0.009, respectively). However, no combined effect was found between metal mixture and the risk of hypertension. Conclusions Plasma levels of cobalt, aluminum and calcium were found to be associated with the risk of HTN. Further studies are needed to confirm our findings and their potential mechanisms with prospective studies and experimental study designs.
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Affiliation(s)
- Sijia Zheng
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhiqiang Nie
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Wang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Weizhou Wei
- Shenzhen Yutian Community Health Service Centre, Shenzhen, China
| | - Daokui Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yulin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tingting Cao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhaoyi Liang
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qi Lu
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Hui Huang
- Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Ying Wen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China,Ying Wen
| | - Suli Huang
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China,*Correspondence: Suli Huang
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Meng H, Guo L, Kong B, Shuai W, Huang H. Nomogram based on clinical features at a single outpatient visit to predict masked hypertension and masked uncontrolled hypertension: A study of diagnostic accuracy. Medicine (Baltimore) 2022; 101:e32144. [PMID: 36626526 PMCID: PMC9750695 DOI: 10.1097/md.0000000000032144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Patients with masked hypertension (MH) and masked uncontrolled hypertension (MUCH) are easily overlooked, and both cause target organ damage. We propose a prediction model for MH and MUCH patients based on clinical features at a single outpatient visit. Data collection was planned before the index test and reference standard were after. Thus, we retrospectively collect analyzed 804 subjects who underwent ambulatory blood pressure monitoring (ABPM) at Renmin Hospital of Wuhan University. These patients were divided into normotension/controlled hypertension group (n = 121), MH/MUCH (n = 347), and sustained hypertension (SH)/sustained uncontrolled hypertension group (SUCH) (n = 302) for baseline characteristic analysis. Models were constructed by logistic regression, a nomogram was visualized, and internal validation by bootstrapping. All groups were performed according to the definition proposed by the Chinese Hypertension Association. Compared with normotension/controlled hypertension, patients with MH/MUCH had higher office blood pressure (BP) and were more likely to have poor liver and kidney function, metabolic disorder and myocardial damage. By analysis, [office systolic blood pressure (OSBP)] (P = .004) and [office diastolic blood pressure (ODBP)] (P = .007) were independent predictors of MH and MUCH. By logistic regression backward stepping method, office BP, body mass index (BMI), total cholesterol (Tch), high-density lipoprotein cholesterol (HDL-C), and left ventricular mass index are contained in this model [area under curve (AUC) = 0.755] and its mean absolute error is 0.015. Therefore, the prediction model established by the clinical characteristics or relevant data obtained from a single outpatient clinic can accurately predict MH and MUCH.
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Affiliation(s)
- Hong Meng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
- Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei, PR China
- Hubei Key Laboratory of Cardiology, Wuhan, Hubei, PR China
| | - Liang Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
- Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei, PR China
- Hubei Key Laboratory of Cardiology, Wuhan, Hubei, PR China
| | - Bin Kong
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
- Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei, PR China
- Hubei Key Laboratory of Cardiology, Wuhan, Hubei, PR China
| | - Wei Shuai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
- Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei, PR China
- Hubei Key Laboratory of Cardiology, Wuhan, Hubei, PR China
| | - He Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
- Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei, PR China
- Hubei Key Laboratory of Cardiology, Wuhan, Hubei, PR China
- * Correspondence: He Huang, Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, Hubei, PR China (e-mail: )
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Zhao X, Feng Q, Wahid A, Wang X, Wen J, Jiang W, Tang X. Sex differences in the association between blood pressure and atrial fibrillation: A case-control study. Front Cardiovasc Med 2022; 9:1061240. [PMID: 36568551 PMCID: PMC9772049 DOI: 10.3389/fcvm.2022.1061240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
Background To examine the association of hypertension (HBP) and its control with atrial fibrillation (AF) and how patient sex affects this association. Materials and methods A case control study of patients admitted to our hospital from 2015 to 2019 was conducted. Patients were divided into subgroups according to their blood pressure (BP) levels and control status, in which odd ratios (OR) by sex for AF was estimated using a logistic regression model and restrictive cubic splines before and after propensity score matching. Results A total of 3,212 patients with AF and 8,307 without AF were investigated. Compared to patients with normal BP, patients with HBP had more AF [OR = 1.75 (1.52-2.02), OR = 2.66 (2.24-3.15), and OR = 4.30 (3.40-5.44) in patients with grade 1, 2, and 3 HBP, respectively]. In HBP patients with grade 3, the OR of AF was much higher in women than in men (OR = 7.15, 95% CI: 4.43-11.50 vs. OR = 2.48, 95% CI: 1.66-3.72). BP over 133.1/79.9 mmHg in men or 127.1/75.1 mmHg in women was positively associated with AF. In patients with HBP, uncontrolled BP was more associated with AF (OR = 3.00, 95% CI: 2.53-3.56), especially in women (OR = 3.09, 95% CI: 2.27-4.19). BP and prevalence of AF correlated with each other positively in patients admitted to a cardiology ward. Lowering BP to 145.1/85.8 mmHg in men or 140.5/82.5 mmHg in women led to less AF. Conclusion There is more significant relationship between HBP and AF in female patients. A lower and individualized BP target may be formulated to prevent AF in women.
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Affiliation(s)
- Xiexiong Zhao
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qilun Feng
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China,Department of Cardiology, The Affiliated Nanhua Hospital, University of South China, Hengyang, China
| | - Abdul Wahid
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoyan Wang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Juan Wen
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Weihong Jiang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaohong Tang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Xiaohong Tang,
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Luo T, Chen S, Cai J, Liu Q, Gou R, Mo X, Tang X, He K, Xiao S, Wei Y, Lin Y, Huang S, Li T, Chen Z, Li R, Li Y, Zhang Z. Association between combined exposure to plasma heavy metals and dyslipidemia in a chinese population. Lipids Health Dis 2022; 21:131. [PMID: 36474262 PMCID: PMC9724421 DOI: 10.1186/s12944-022-01743-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Exposure to heavy metals in the environment is widespread, while the relationship between combined exposure to heavy metals and dyslipidemia is unclear. METHODS A cross-sectional study was performed, and 3544 participants aged 30 years or older were included in the analyses. Heavy metal concentrations in plasma were based on inductively coupled plasma‒mass spectrometry. The relationship between heavy metals and dyslipidemia was estimated by logistic regression. BKMR was used to evaluate metal mixtures and their potential interactions. RESULTS In logistic regression analysis, participants in the fourth quartile of Fe and Zn (Fe > 1352.38 µg/L; Zn > 4401.42 µg/L) had a relatively higher risk of dyslipidemia (Fe, OR = 1.13, 95% CI: 0.92,1.38; Zn, OR = 1.30, 95% CI: 1.03,1.64). After sex stratification, females in the third quartile of plasma Zn (1062.05-4401.42 µg/L) had a higher relative risk of dyslipidemia (OR = 1.75, 95% CI: 1.28, 2.38). In BKMR analysis, metal mixtures were negatively associated with dyslipidemia in females when all metal concentrations were above the 50th percentile. In the total population (estimated from 0.030 to 0.031), As was positively associated with dyslipidemia when other metals were controlled at the 25th, 50th, or 75th percentile, respectively, and As was below the 75th percentile. In females (estimated from - 0.037 to -0.031), Zn was negatively associated with dyslipidemia when it was above the 50th percentile. CONCLUSION This study indicated that As was positively associated with dyslipidemia and that Zn may be negatively associated with dyslipidemia in females. Combined metal exposure was negatively associated with dyslipidemia in females. Females with low plasma Zn levels are more likely to develop dyslipidemia and should receive more clinical attention in this population.
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Affiliation(s)
- Tingyu Luo
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - Shiyi Chen
- grid.411858.10000 0004 1759 3543School of Public Health and Management, Guangxi University of Chinese Medicine, Guangxi 530200 Nanning, China
| | - Jiansheng Cai
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.256607.00000 0004 1798 2653Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, 530021 Nanning, Guangxi China
| | - Qiumei Liu
- grid.256607.00000 0004 1798 2653Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, 530021 Nanning, Guangxi China
| | - Ruoyu Gou
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - Xiaoting Mo
- grid.256607.00000 0004 1798 2653Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, 530021 Nanning, Guangxi China
| | - Xu Tang
- grid.256607.00000 0004 1798 2653Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, 530021 Nanning, Guangxi China
| | - Kailian He
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - Song Xiao
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - Yanfei Wei
- grid.256607.00000 0004 1798 2653Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, 530021 Nanning, Guangxi China
| | - Yinxia Lin
- grid.256607.00000 0004 1798 2653Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, 530021 Nanning, Guangxi China
| | - Shenxiang Huang
- grid.256607.00000 0004 1798 2653Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, 530021 Nanning, Guangxi China
| | - Tingjun Li
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - Ziqi Chen
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - Ruiying Li
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - You Li
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
| | - Zhiyong Zhang
- grid.443385.d0000 0004 1798 9548Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, No.1 Zhiyuan Road, Guangxi 541199 Guilin, China ,grid.443385.d0000 0004 1798 9548Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guangxi 541199 Guilin, China
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Yu M, Zhang S, Wang L, Wu J, Li X, Yuan J. Metabolically Healthy Obesity and Carotid Plaque among Steelworkers in North China: The Role of Inflammation. Nutrients 2022; 14:nu14235123. [PMID: 36501152 PMCID: PMC9740549 DOI: 10.3390/nu14235123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
This study aimed to investigate the association between metabolically healthy obesity (MHO) and carotid plaque. In this cross-sectional survey, 3467 steelworkers in North China were surveyed. There are two criteria for defining a carotid plaque: (1) the lesion structure exceeds 50% of the peripheral intima-media thickness value or invades the arterial lumen by at least 0.5 mm; (2) a thickness > 1.5 mm from the intima−lumen interface to the media−adventitia interface. Metabolic health was defined as the nonexistence of one of the metabolic syndrome (MetS) diagnostic criteria for metabolic abnormalities. Obesity was defined as having a BMI ≥ 25 kg/m2. To calculate the odds ratio (OR) for the prevalence carotid plaque, a logistic regression was used for the analysis. The prevalence of carotid plaque in the subjects was 14.3% for metabolically healthy non-obesity (MHNO), 32.4% for MHO, 18.9% for metabolically unhealthy non-obesity (MUNO), and 46.8% for metabolically unhealthy obesity (MUO). The odds ratios for suffering from carotid plaque were 1.27 (95% CI: 0.69 to 2.32) for MHO, 1.83 (95% CI: 1.29 to 2.58) for MUNO, and 1.81 (1.28 to 2.56) for MUO in comparison with MHNO after adjusting for confounders. There was no association between the MHO phenotype and carotid plaque prevalence among steelworkers in North China.
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Affiliation(s)
- Miao Yu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Shengkui Zhang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical, Beijing 100050, China
| | - Lihua Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Jianhui Wu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Xiaoming Li
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Juxiang Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
- Correspondence:
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Validating the accuracy of a multifunctional smartwatch sphygmomanometer to monitor blood pressure. J Geriatr Cardiol 2022; 19:843-852. [PMID: 36561062 PMCID: PMC9748271 DOI: 10.11909/j.issn.1671-5411.2022.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Hypertension is the most modifiable factor associated with cardiovascular events and complications. The conventional blood pressure (BP) meter method is simple but is limited in terms of real-time monitoring abnormal BP. Therefore, the development of a multifunction smartwatch (HUAWEI WATCH D) sphygmomanometer could significantly improve integrated BP monitoring. METHODS We enrolled 361 subjects from Chinese PLA General Hospital, Beijing, China to validate the accuracy of the smartwatch versatile sphygmomanometer using ISO 81060-2:2018. Resting and ambulatory BP accuracy of the smartwatch were compared with gold standard clinical sphygmomanometers using ISO 81060-2:2018 guidelines, the accuracy of 24 h systolic blood pressure (SBP) circadian rhythm monitoring, and diurnal high SBP alert for this smartwatch were assessed using a confusion matrix approach. Additionally, we analyzed online users of different ages for compliance. RESULTS Eighty-five subjects underwent resting BP measurements; the mean resting BP differences between two devices were -0.683 ± 6.203 mmHg (SBP) (P = 0.723) and 1.628 ± 5.028 mmHg (diastolic blood pressure, DBP) (P = 0.183). In 35 subjects' ambulatory BP measurements, the mean differences of ambulatory BP were -1.943 ± 5.475 mmHg (SBP) (P = 0.923) and 3.195 ± 5.862 mmHg (DBP) (P = 0.065). All data complied with ISO 81060-2:2018 guidelines (mean ≤ ±5 mmHg and standard deviation ≤ ±8 mmHg) with no significant differences. Positive predictive values (PPV) of resting SBP and DBP were 0.635 and 0.671, respectively. The PPV of ambulatory SBP and DBP were 0.686. Also, 24 h SBP circadian rhythm monitoring was performed in 107 subjects: accuracy = 0.850, specificity = 0.864, precision/PPV = 0.833, sensitivity = 0.833, and F1-measure (F1) = 0.833. The accuracy, specificity, precision, sensitivity, and F1 values in 85 subjects undergoing diurnal high SBP alerting were 0.858, 0.876, 0.706, 0.809, and 0.754, respectively. CONCLUSIONS When compared with the gold standard clinical sphygmomanometer, smartwatch results were consistent and accurate. Online user feedback showed that elderly individuals cared more about BP monitoring accuracy, with better compliance.
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Li M, Zhou M, Yang Y, Liu Y, Yin C, Geng W, Wang C, Tang F, Zhao Y, Xue F, Sun X, Yuan Z. Multi-trajectories of systolic and diastolic hypertension and coronary heart disease in middle-aged and older adults. Front Public Health 2022; 10:1017727. [PMID: 36505007 PMCID: PMC9729777 DOI: 10.3389/fpubh.2022.1017727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to investigate multi-trajectories of systolic and diastolic hypertension and assess their association with the risk of coronary heart disease (CHD) in middle-aged and older Chinese adults. Methods The study cohort comprised 4,102 individuals aged 40-75 years with records of at least four systolic blood pressure (SBP) and diastolic blood pressure (DBP). A group-based multi-trajectory model was adopted to identify multi-trajectories of systolic and diastolic hypertension, followed by a logistic model to assess the independent associations between these trajectories and CHD risk. The multinomial logistic model was used to evaluate the impact of baseline covariates on trajectory groups. Results Six distinct trajectories for systolic and diastolic hypertension were identified which represent distinct stages of hypertension and were characterized as low-stable, low-increasing, medium-decreasing, medium-increasing-decreasing, isolated systolic hypertension phase, and high-decreasing. Compared with the low-stable group, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 2.23 (1.34-3.70) for the medium-increasing-decreasing group and 1.87 (1.12-3.11) for the high-decreasing group after adjustment for baseline covariates. Compared with the low-increasing group, the ORs and 95% CIs were 1.88 (1.06-3.31) for the medium-increasing-decreasing group. Age, gender, drinking, body mass index (BMI), triglyceride (TG), and fasting plasma glucose (FPG) were independent predictors for trajectory groups 4 and 6. Conclusion Novel, clinically defined multi-trajectories of systolic and diastolic hypertension were identified. Middle-aged and older adults with medium-increasing-decreasing or high-decreasing blood pressure trajectories are potentially critical periods for the development of CHD. Preventing adverse changes in hypertension status and reducing the high risk of CHD is necessary for people in distinct trajectory groups.
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Affiliation(s)
- Mingzhuo Li
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Miao Zhou
- Office of Hospital Level Review, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Yang Yang
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Yafei Liu
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Chaonan Yin
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Wenting Geng
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Chunxia Wang
- Health Management Center, Affiliated Hospital of Jining Medical University, Jining, China
| | - Fang Tang
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiubin Sun
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China,*Correspondence: Xiubin Sun
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China,Zhongshang Yuan
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85
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Li W, Bai W, Miao C, Chen S, Zhang X, Fan Y, Li X, Wu S, Liu X, Hong J. Joint effects of carotid plaques and renal impairment on the risk of cardiovascular disease and all-cause death in a community-based population: The Kailuan cohort study. Front Cardiovasc Med 2022; 9:943718. [PMID: 36465450 PMCID: PMC9712795 DOI: 10.3389/fcvm.2022.943718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/13/2022] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE It is unknown whether renal impairment and atherosclerosis increase the risk of cardiovascular disease (CVD) and death. Atherosclerosis already raises the risk of CVD and all-cause death. This study investigated the joint effects of carotid plaques and renal impairment on CVD and all-cause death in community-based populations. METHODS The study cohort consisted of 20,416 participants from the Kailuan Study who completed a carotid plaque ultrasound in 2012. A glomerular filtration rate (GFR) of < 60 ml/min or trace semiquantitative proteinuria or higher were both considered signs of renal insufficiency. We divided them into four groups according to the presence of carotid plaque and renal impairment. These groups were categorized as no carotid plaque, estimated glomerular filtration rate (eGFR) ≥ 60 ml/min, and proteinuria < trace; no carotid plaque, eGFR < 60 ml/min, and proteinuria ≥ trace; carotid plaque, eGFR ≥ 60 ml/min and proteinuria < trace; and carotid plaque, eGFR < 60 ml/min, and proteinuria ≥ trace, respectively. We investigated the combined effect of renal impairment and carotid plaque on cardiovascular events and all-cause death in the Kailuan community-based population. RESULT Participants with carotid plaque, eGFR < 60 ml/min and proteinuria had a 2.88-fold higher risk of all-cause death (95% CI, 2.18-3.80), which was significantly higher than those with lone factors (HR, 1.57; 95% CI, 1.04-2.36; and HR, 1.91; 95% CI, 1.56-2.32), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria CONCLUSION The joint of carotid plaques and renal impairment may further increase the risk of CVD and all-cause death compared with participants with alone factors in the age of ≥ 50 years, but not in the age of < 50 years, from a community-based study.
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Affiliation(s)
- Wen Li
- Department of Ultrasound in Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenkun Bai
- Department of Ultrasound in Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Congliang Miao
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
| | - Xinyu Zhang
- Department of Ultrasound in Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanfeng Fan
- Department of Ultrasound in Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Li
- Department of Ultrasound in Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
| | - Xuemei Liu
- Department of Ultrasound in Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jiang Hong
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zhou YY, Zhou TC, Chen N, Zhou GZ, Zhou HJ, Li XD, Wang JR, Bai CF, Long R, Xiong YX, Yang Y. Risk factor analysis and clinical decision tree model construction for diabetic retinopathy in Western China. World J Diabetes 2022; 13:986-1000. [PMID: 36437866 PMCID: PMC9693737 DOI: 10.4239/wjd.v13.i11.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/20/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is the driving force of blindness in patients with type 2 diabetes mellitus (T2DM). DR has a high prevalence and lacks effective therapeutic strategies, underscoring the need for early prevention and treatment. Yunnan province, located in the southwest plateau of China, has a high pre-valence of DR and an underdeveloped economy.
AIM To build a clinical prediction model that will enable early prevention and treatment of DR.
METHODS In this cross-sectional study, 1654 Han population with T2DM were divided into groups without (n = 826) and with DR (n = 828) based on fundus photography. The DR group was further subdivided into non-proliferative DR (n = 403) and proliferative DR (n = 425) groups. A univariate analysis and logistic regression analysis were conducted and a clinical decision tree model was constructed.
RESULTS Diabetes duration ≥ 10 years, female sex, standing- or supine systolic blood pressure (SBP) ≥ 140 mmHg, and cholesterol ≥ 6.22 mmol/L were risk factors for DR in logistic regression analysis (odds ratio = 2.118, 1.520, 1.417, 1.881, and 1.591, respectively). A greater severity of chronic kidney disease (CKD) or hemoglobin A 1c increased the risk of DR in patients with T2DM. In the decision tree model, diabetes duration was the primary risk factor affecting the occurrence of DR in patients with T2DM, followed by CKD stage, supine SBP, standing SBP, and body mass index (BMI). DR classification outcomes were obtained by evaluating standing SBP or BMI according to the CKD stage for diabetes duration < 10 years and by evaluating CKD stage according to the supine SBP for diabetes duration ≥ 10 years.
CONCLUSION Based on the simple and intuitive decision tree model constructed in this study, DR classification outcomes were easily obtained by evaluating diabetes duration, CKD stage, supine or standing SBP, and BMI.
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Affiliation(s)
- Yuan-Yuan Zhou
- Department of Endocrinology and Metabolism, The Sixth Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi 653100, Yunnan Province, China
| | - Tai-Cheng Zhou
- Department of Endocrinology and Metabolism, Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Nan Chen
- Department of Endocrinology and Metabolism, The Frist People’s Hospital of Anning City, Anning City 650300, Yunnan Province, China
| | - Guo-Zhong Zhou
- Department of Endocrinology and Metabolism, The Frist People’s Hospital of Anning City, Anning City 650300, Yunnan Province, China
| | - Hong-Jian Zhou
- Department of Endocrinology and Metabolism, The Sixth Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi 653100, Yunnan Province, China
| | - Xing-Dong Li
- Department of Endocrinology and Metabolism, The Sixth Affiliated Hospital of Kunming Medical University, The People’s Hospital of Yuxi City, Yuxi 653100, Yunnan Province, China
| | - Jin-Rui Wang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Chao-Fang Bai
- Department of Endocrinology and Metabolism, Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Rong Long
- Department of Endocrinology and Metabolism, Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Yu-Xin Xiong
- Department of Endocrinology and Metabolism, Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
| | - Ying Yang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China
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Pang L, Kottu L, Guo Z, Shi Y, Ferdous M, Zhao Y, Tang M, Liu W, Fang J, Fu H, Wu X, Ma M, Wang H, Merkus D, Duo L. Dawning public health services dogma: An indigenous Southwest Chinese perspective in managing hypertension-with or without the "BPHS"? Front Public Health 2022; 10:1017795. [PMID: 36438225 PMCID: PMC9686286 DOI: 10.3389/fpubh.2022.1017795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Background To alleviate the rising mortality burden due to hypertension and other non-communicable diseases, a new public health policy initiative in 2009 called the Basic Public Health Services (BPHS). Program was introduced by the Chinese government. The goal of the study is to assess the feasibility and impact of a nationwide health care service-the "BPHS". Methods From January to December 2021, a stratified multistage random sampling method in the survey was conducted to select 6,456 people from 8 cities/districts in Yunnan Province, China, who were above the age of 35 years. 1,521 hypertensive patients were previously aware of their high blood pressure status were matched to the BPHS program database based on ID number and then further divided into BPHS group and non-BPHS (control) group. The results of the current study are based on their responses to a short structured questionnaire, a physical examination, and laboratory tests. The association between BPHS management and its effect on the control of hypertension was estimated using multivariable logistic regression models. We evaluated the accessibility and efficacy of BPHS health care services by analyzing various variables such as blood pressure, BMI, lifestyle modification, anti-hypertensive drugs taken, and cardiovascular risk factors. Results Among the 1,521 hypertensive patients included in this study, 1,011 (66.5%) were managed by BPHS programme. The multivariable logistic regression model demonstrated that the BPHS facilitated hypertension control (OR = 1.640, 95% CI: 1.237-2.175). A higher proportion of participants receiving lifestyle guidance from the BPHS management showed lowering of total cholesterol. In comparison to the non-BPHS group, those under BPHS management adhered better to antihypertensive medications either single drug (54.3%) or in combination (17.3%) of drugs. Additionally, we also noticed that urban areas with centralized and well-established digital information management system had better hypertension treatment and control. Conclusions Nearly two-thirds of the hypertensive patients in Yunnan Province were included in BPHS management. The impact of the national BPHS program was evident in lowering risk factors for cardiovascular diseases, promoting healthy lifestyles, lowering blood pressure, increasing medication adherence, and the better control rate of hypertension.
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Affiliation(s)
- Linhong Pang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China,School of Public Health, Kunming Medical University, Kunming, China
| | - Lakshme Kottu
- Division of Experimental Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Zihong Guo
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Yi Shi
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Misbahul Ferdous
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yajing Zhao
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Mingjing Tang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Wei Liu
- School of Public Health, Kunming Medical University, Kunming, China
| | - Jiayu Fang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Hongchen Fu
- School of Public Health, Kunming Medical University, Kunming, China
| | - Xia Wu
- School of Public Health, Kunming Medical University, Kunming, China
| | - Min Ma
- School of Public Health, Kunming Medical University, Kunming, China
| | - Huadan Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Daphne Merkus
- Division of Experimental Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands,Walter Brendel Center of Experimental Medicine (WBex), LMU Munich, Munich, Germany
| | - Lin Duo
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China,*Correspondence: Lin Duo
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88
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Gu C, Ma M, Xu J, Yuan W, Li R, Guo H, Gao H, Feng W, Guo H, Zheng L, Zhang Y. Association between pulmonary ventilatory function and mild cognitive impairment: A population-based study in rural China. Front Public Health 2022; 10:1038576. [PMID: 36408049 PMCID: PMC9666756 DOI: 10.3389/fpubh.2022.1038576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background Mild cognitive impairment (MCI), a reversible intermediate state, plays an important role in the development and prevention of dementia. The relationship between pulmonary function and MCI risk has not yet been well-elucidated. Methods We included 2,947 rural Chinese residents aged ≥35 years who were free from a history of stroke, dementia, or other brain diseases and measured pulmonary ventilatory function using calibrated spirometry according to the recommended method. MCI was assessed with the Montreal Cognitive Assessment-Basic for Chinese scale. Logistic regression models and restricted cubic splines with covariate adjustment were performed to explore the association between pulmonary function and MCI risk. Results The prevalence of MCI increased with decreasing pulmonary function, from the lowest quartile to the highest quartile of pulmonary function: 63.9, 50.5, 43.8, and 43.6%, respectively. After adjustment for confounding factors, participants in the first quartile had a significantly increased risk of MCI (ORs, 1.691, 95% CI, 1.267-2.258), with the highest quartile as the reference. In the subgroup analysis, a significant association of pulmonary function and MCI was found in females and those with low physical activity. Meanwhile, we observed an L-shaped relationship between pulmonary function and MCI (P non-linear = 0.032). Conclusions Poor pulmonary function was associated with an increased risk of MCI among rural Chinese adults, and presented a non-linear relationship. These findings remind us of the need for early cognitive assessment in local populations with lower pulmonary function.
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Affiliation(s)
- Cuiying Gu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingfeng Ma
- Department of Cardiology, Fenyang Hospital of Shanxi Province, Fenyang, China
| | - Jiahui Xu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Wei Yuan
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Ruixue Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Hui Guo
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Hanshu Gao
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Wenjing Feng
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Haiqiang Guo
- Department of Health Statistics, China Medical University, Shenyang, China
| | - Liqiang Zheng
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Liqiang Zheng
| | - Yao Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China,Yao Zhang
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89
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Chen XF, Wang CJ, Han LY, Zhang X, Shu C, Dong HY, Ma YN, Zhang BY, Guo X, Sun HP, Cao GZ. Associations between Physical Activity Trajectories and Incident Hypertension. Rev Cardiovasc Med 2022; 23:385. [PMID: 39076190 PMCID: PMC11269057 DOI: 10.31083/j.rcm2311385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 07/31/2024] Open
Abstract
Purpose We aimed to characterize physical activity (PA) trajectories across adulthood and to estimate their association with incident hypertension risk. Methods Data were obtained from the China Health and Nutrition Survey (CHNS) conducted during 2004-2011. Group-based trajectory modeling (GBTM) was used to identify distinct groups of PA trajectories. The Cox proportional hazards model was used to investigate the association. Results A total of 11,162 participants whose PA was repeatedly estimated by self-report from questionnaires two to four times in the CHNS were included in our study. During the 5.4 years of follow-up, 3824 incident hypertension cases were identified. Five distinct PA trajectories were identified in men: light and slight decline, light and gradual decline then sharp rise, light to medium-heavy then decline, medium-heavy and gradual decline, and heavy and sharp decline. Two distinct PA trajectories were identified in women: light and stable, and medium and gradual decline. The PA trajectory of medium-heavy and gradual decline was significantly associated with decreased risk of hypertension in men, with the hazard ratios and 95% confidence intervals (CI) being 0.80 (0.63, 0.99), 0.74 (0.59, 0.93), 0.76 (0.60, 0.96), and 0.70 (0.55, 0.88) in models 1-4, respectively. Conclusions Our study identified five distinct long-term PA trajectories in men and two distinct trajectories in women. The PA trajectory of medium-heavy PA in early adulthood followed by gradual decline was found to be significantly associated with a decreased risk of hypertension in later life in men.
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Affiliation(s)
- Xu-feng Chen
- Department of Rehabilitation Medicine, Ningbo No.2 Hospital, University of the Chinese Academy of Sciences, 315010 Ningbo, Zhejiang, China
| | - Cong-ju Wang
- Centers for Disease Control and Prevention of Suzhou High-tech Zone, 215000 Suzhou, Jiangsu, China
| | - Li-yuan Han
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, 315010 Ningbo, Zhejiang, China
| | - Xin Zhang
- Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, 541001 Guilin, Guangxi, China
| | - Chang Shu
- Tianjin Cerebral Vascular and Neural Degenerative Disease Key Laboratory, Tianjin Neurosurgery Institute, Tianjin Huanhu Hospital, 300060 Tianjin, China
| | - Hao-yu Dong
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, 215123 Suzhou, Jiangsu, China
| | - Ya-na Ma
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, 215123 Suzhou, Jiangsu, China
| | - Bo-ya Zhang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, 215123 Suzhou, Jiangsu, China
| | - Xu Guo
- Department of Rehabilitation Medicine, Ningbo No.2 Hospital, University of the Chinese Academy of Sciences, 315010 Ningbo, Zhejiang, China
| | - Hong-peng Sun
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, 215123 Suzhou, Jiangsu, China
| | - Gui-zhen Cao
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, 215123 Suzhou, Jiangsu, China
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90
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WANG L, CAO TY, LI JQ, DING CC, LI JP, YING HB, LIU LS, HUANG X. Positive association between triglyceride glucose index and central systolic blood pressure among hypertensive adults. J Geriatr Cardiol 2022; 19:753-760. [PMID: 36338286 PMCID: PMC9618843 DOI: 10.11909/j.issn.1671-5411.2022.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND While studies have suggested the association between triglyceride-glucose (TyG) index, a reliable surrogate for insulin resistance and hypertension data are limited to the correlation of TyG and central blood pressure. This study aims to test the hypothesis that a higher TyG index is associated with elevated central systolic blood pressure (cSBP). METHODS A total of 9249 Chinese hypertensive adults from the H-type Hypertension and Stroke Prevention and Control Project were analyzed in this study. cSBP was measured noninvasively using an A-Pulse CASPro device. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Smoothing curve and multivariate linear regression models [beta coefficient (β) with 95% CI] were applied to analyze the association between TyG index and cSBP. Subgroup analyses were conducted to explore potential modifications to such a correlation. RESULTS The overall mean TyG index is 8.8 ± 0.7, and the total mean cSBP is 131.3 ± 12.8 mmHg. TyG index was observed to be independently and positively associated with cSBP among the total population (β = 0.92, 95% CI: 0.53-1.31, P < 0.001), and participants who do not use antihypertensive drugs (β = 1.03, 95% CI: 0.46-1.60, P < 0.001), which is in accordance with the result of the smoothing curve. The association between TyG index and cSBP appears robust in all tested subgroups. CONCLUSIONS TyG index is positively and independently associated with cSBP among hypertensive adults. Our study result suggests that TyG index might serve as an effective marker for vascular function.
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Affiliation(s)
- Li WANG
- Department of Nephrology, the Fourth Hospital of Harbin Medical University, Harbin, China
| | - Tian-Yu CAO
- Biological Anthropology, University of California Santa Barbara, California, USA
| | - Jin-Qiao LI
- Department of Urology Surgery, Graduate School of the Fourth Hospital of Harbin Medical University, Harbin, China
| | - Cong-Cong DING
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun-Pei LI
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hua-Bo YING
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li-Shun LIU
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- Institute of Biomedical and Health Engineering, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Xiao HUANG
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
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91
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Liu P, Tang L, Fang J, Chen C, Liu X. Association between recovery/occurrence of metabolic syndrome and rapid estimated glomerular filtration rate decline in middle-aged and older populations: evidence from the China Health and Retirement Longitudinal Study. BMJ Open 2022; 12:e059504. [PMID: 36261237 PMCID: PMC9582318 DOI: 10.1136/bmjopen-2021-059504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Few studies have explored correlations between metabolic syndrome (MetS) alterations and renal deterioration in longitudinal cohorts. We aim to investigate associations between MetS recovery/development and rapid estimated glomerular filtration rate (eGFR) decline in the China Health and Retirement Longitudinal Study (CHARLS). DESIGN Longitudinal cohort study. SETTING This study is a secondary analysis of CHARLS. PARTICIPANTS After excluding individuals with age <45 years old, eGFR <60 mL/min/1.73 m2 and clinician-reported malignant tumour, heart disease, stroke or kidney disease at baseline, 4142 participants with complete data were selected from the CHARLS during the 4-year follow-up period (2011-2015). OUTCOME MEASURES MetS were measured at 2011 and 2015 in CHARLS. A rapid eGFR decline was defined as an average annual eGFR decline of >3 mL/min/1.73 m2. The associations between rapid eGFR decline and MetS recovery/development were analysed using multivariable adjusted logistic models. RESULTS According to MetS baseline status and follow-up, participants were divided into four groups: (1) 2460 (59.4%) in the MetS-free group, (2) 361 (8.7%) in the MetS-developed group, (3) 499 (12.0%) in the MetS recovery group and (4) 822 (19.8%) in the MetS chronic group. When compared with the MetS chronic group, the multivariable adjusted OR of rapid eGFR decline in the MetS recovery group was 0.64 (OR: 0.64; 95% CI 0.45 to 0.90, p=0.01). In contrast, when compared with the MetS-free group, the multivariable adjusted OR of rapid eGFR decline in the MetS-developed group was 1.00 (OR: 1.00; 95% CI 0.73 to 1.38, p=0.98). CONCLUSIONS Over the 4-year follow-up period, we found that MetS recovery was associated with a reduced risk of rapid eGFR decline in middle-aged and older adults, while MetS occurrence was not related to rapid eGFR decline. Recovery from MetS appeared to protect against a rapid decline in eGFR.
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Affiliation(s)
- Peijia Liu
- Department of Nephrology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- Department of Nephrology, Guangzhou Eighth People's Hospital,Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Leile Tang
- Department of Cardiology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jia Fang
- Department of Nephrology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Chaojin Chen
- Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xun Liu
- Department of Nephrology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
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92
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Chen X, Liu S, Chu J, Hu W, Sun N, Shen Y. Joint effect of elevated-c-reactive protein level and hypertension on new-onset stroke: A nationwide prospective cohort study of CHARLS. Front Public Health 2022; 10:919506. [PMID: 36262245 PMCID: PMC9573958 DOI: 10.3389/fpubh.2022.919506] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/05/2022] [Indexed: 01/22/2023] Open
Abstract
Background and aims This study aimed to examine whether the combination of elevated-C-reactive protein (CRP) levels and hypertension increased the risk of stroke among middle-aged and elderly Chinese. Methods This analysis included 9,821 Chinese participants aged ≥45 years in the China Health and Retirement Longitudinal Study (CHARLS). Data based on three waves of CHARLS were used (2011, 2013, and 2015). Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with a 95% confidence interval (95%CI) of new-onset stroke risk according to elevated-CRP level and hypertension. Moreover, the area under the curve (AUC), net reclassification index (NRI), and integrated discrimination improvement (IDI) were used to evaluate the incremental predictive value. Results A total of 184 stroke events occurred during follow-up. The median follow-up time was 4 years. Compared with those with normal CRP levels (CRP ≤ 3 mg /L) and blood pressure, the adjusted HRs and 95%CI were 1.86 (0.90-3.85) for individuals with elevated-CRP levels alone, 2.70 (1.71-4.28) for those with hypertension alone, and 4.80 (2.83-8.12) for those with comorbid elevated-CRP levels and hypertension. People with the coexistence of elevated-CRP levels and hypertension had the highest risk of new-onset stroke among all subgroup analyses. Finally, adding the combination of elevated-CRP levels and hypertension to conventional factors significantly improved the risk prediction for new-onset stroke. Conclusion Our findings indicate that the combined effect of elevated-CRP levels and hypertension increase the risk of new-onset stroke among the middle-aged and geriatric Chinese population.
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93
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Zhang A, Quan J, Eggleston K. Association between the quality of primary care, insurance coverage, and diabetes-related health outcomes in a cohort of older adults in China: results from the China Health and Retirement Longitudinal Study. BMJ Open 2022; 12:e059756. [PMID: 36167393 PMCID: PMC9516163 DOI: 10.1136/bmjopen-2021-059756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study aims to identify the association between diabetes diagnosis, health outcomes, insurance scheme, and the quality of county-level primary care in a cohort of older Chinese adults. DESIGN AND SETTING Data from the China Health and Retirement Longitudinal Study, a nationally-representative panel survey of people aged 45 and over in China. PARTICIPANTS Among participants with valid diabetes-related and hypertension-related medical history and biomarkers (n=8207), participants with diabetes (n=1318) were identified using biomarkers and self-reported medical history. Individual models were run using complete case analysis. RESULTS Among 1318 individuals with diabetes in 2011, 59.8% were unaware of their disease status. Diagnosis rates were significantly higher among participants with more generous public health insurance coverage (OR 3.58; 95% CI 2.15 to 5.98) and among those with other comorbidities such as dyslipidemia (OR 2.88; 95% CI 2.03 to 4.09). After adjusting for demographics, individuals with more generous public health insurance coverage did not have better glucose control at 4 years follow-up (OR 0.55; 95% CI 0.26 to 1.18) or fewer inpatient hospital admissions at 4 years (OR 1.29; 95% CI 0.72 to 2.33) and 7 years follow-up (OR 1.12; 95% CI 0.62 to 2.05). Individuals living in counties with better county-level primary care did not have better glucose control at 4 years follow-up (OR 0.69; 95% CI 0.01 to 33.36), although they did have fewer inpatient hospital admissions at 4 years follow-up (OR 0.03; 95% CI 0.00 to 0.95). Diabetes diagnosis was a significant independent predictor of both better glucose control at 4 years follow-up (OR 13.33; 95% CI 8.56 to 20.77) and increased inpatient hospital stays at 4 years (OR 1.72; 95% CI 1.20 to 2.47) and 7 years (OR 1.82; 95% CI 1.28 to 2.58) follow-up. CONCLUSIONS These findings suggest that participants with diabetes are often diagnosed concurrently with other comorbid disease conditions or after diabetes-related complications have already developed, thus leading to worse health outcomes in subsequent years despite improvements in health associated with better primary care. These findings suggest the importance of strengthening primary care and insurance coverage among older adults to focus on diagnosing and treating diabetes early, in order to prevent avoidable health complications and promote healthy aging.
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Affiliation(s)
- Adary Zhang
- School of Medicine, Stanford University, Stanford, California, USA
| | - Jianchao Quan
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Karen Eggleston
- Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, California, USA
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Li B, Guo Y, Deng Y, Zhao S, Li C, Yang J, Li Q, Yan Y, Li F, Li X, Rong S. Association of social support with cognition among older adults in China: A cross-sectional study. Front Public Health 2022; 10:947225. [PMID: 36225770 PMCID: PMC9548585 DOI: 10.3389/fpubh.2022.947225] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/29/2022] [Indexed: 01/21/2023] Open
Abstract
Objective This study aimed to examine the relationship between social support and its sub-domains and cognitive performance, and the association with cognitive impairment among older adults in China. Design A cross-sectional study. Setting and participants We included 865 community-based individuals aged 65 and above from Hubei province, China. Methods The level of social support was evaluated using the social support rating scale (SSRC). The Mini-Mental State Examination was adopted to assess cognitive function, and its cut-offs were used to determine cognitive impairment among the participants. Multiple linear regression models and logistic regression models were used to estimate the β and odds ratios (ORs) and their 95% CIs, respectively. Results The participants were divided into quartiles 1-4 (Q1-Q4), according to the total scores of SSRC. After adjusting for sociodemographic characteristics, lifestyle factors, and history of diseases, for MMSE scores, compared to these in Q1, the β of Q2-Q4 were -0.22 (-0.88, 0.43), 0.29 (-0.35, 0.94), and 0.86 (0.19, 1.53), respectively; For cognitive impairment, the ORs of Q2-Q4 were 1.21 (0.80, 1.82), 0.62 (0.40, 0.94), and 0.50 (0.32, 0.80), respectively. Considering SSRC scores as the continuous variable, per 1-unit increase, the β was 0.05 (0.02, 0.09) for the cognitive score, and the OR was 0.95 (0.92, 0.98) for cognitive impairment. In addition, higher levels of both subjective support and support utilization were related to better MMSE performance and lower risks of cognitive impairment. Conclusion and implications Among the older adults in China, as expected, there is a positive relationship between social support and cognitive performance, and high levels of social support, particularly in support utilization, were related to low risks of cognitive impairment. More social support should be provided in this population to improve cognitive function and reduce the risks of cognitive impairment.
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Affiliation(s)
- Benchao Li
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Guo
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Yan Deng
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Siqi Zhao
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Changfeng Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jiajia Yang
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qiuying Li
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Fang Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Xiaonuan Li
- Wuhan Municipal Health Commission, Wuhan, China
| | - Shuang Rong
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
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Ji W, Zhang Y, Cheng Y, Wang Y, Zhou Y. Development and validation of prediction models for hypertension risks: A cross-sectional study based on 4,287,407 participants. Front Cardiovasc Med 2022; 9:928948. [PMID: 36225955 PMCID: PMC9548597 DOI: 10.3389/fcvm.2022.928948] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo develop an optimal screening model to identify the individuals with a high risk of hypertension in China by comparing tree-based machine learning models, such as classification and regression tree, random forest, adaboost with a decision tree, extreme gradient boosting decision tree, and other machine learning models like an artificial neural network, naive Bayes, and traditional logistic regression models.MethodsA total of 4,287,407 adults participating in the national physical examination were included in the study. Features were selected using the least absolute shrinkage and selection operator regression. The Borderline synthetic minority over-sampling technique was used for data balance. Non-laboratory and semi-laboratory analyses were carried out in combination with the selected features. The tree-based machine learning models, other machine learning models, and traditional logistic regression models were constructed to identify individuals with hypertension, respectively. Top features selected using the best algorithm and the corresponding variable importance score were visualized.ResultsA total of 24 variables were finally included for analyses after the least absolute shrinkage and selection operator regression model. The sample size of hypertensive patients in the training set was expanded from 689,025 to 2,312,160 using the borderline synthetic minority over-sampling technique algorithm. The extreme gradient boosting decision tree algorithm showed the best results (area under the receiver operating characteristic curve of non-laboratory: 0.893 and area under the receiver operating characteristic curve of semi-laboratory: 0.894). This study found that age, systolic blood pressure, waist circumference, diastolic blood pressure, albumin, drinking frequency, electrocardiogram, ethnicity (uyghur, hui, and other), body mass index, sex (female), exercise frequency, diabetes mellitus, and total bilirubin are important factors reflecting hypertension. Besides, some algorithms included in the semi-laboratory analyses showed less improvement in the predictive performance compared to the non-laboratory analyses.ConclusionUsing multiple methods, a more significant prediction model can be built, which discovers risk factors and provides new insights into the prediction and prevention of hypertension.
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Affiliation(s)
- Weidong Ji
- Department of Medical Information, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yushan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yinlin Cheng
- Department of Medical Information, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yushan Wang
- Center of Health Management, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- *Correspondence: Yushan Wang
| | - Yi Zhou
- Department of Medical Information, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Yi Zhou
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96
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Cheng W, Kong F, Chen S. Comparison of the predictive value of four insulin resistance surrogates for the prevalence of hypertension: a population-based study. Diabetol Metab Syndr 2022; 14:137. [PMID: 36163185 PMCID: PMC9511744 DOI: 10.1186/s13098-022-00907-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Several studies have investigated the association of insulin resistance (IR) surrogates and the risk of hypertension. However, it is unclear whether there exist differences between different IR surrogates and hypertension risk. Therefore, this study aimed to explore the association of four IR surrogates (triglyceride-glucose index (TyG index), triglyceride-glucose index with body mass index (TyG-BMI), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-c), and metabolic score for IR (METS-IR)) with the prevalence of hypertension. METHODS This is a cross-sectional study with a total of 117,056 participants. Data were extracted from a computerized database established by Rich Healthcare Group in China, which included all medical records of participants who received a health check-up from 2010 to 2016. IR surrogates were grouped into quartiles as continuous variables, and multivariate logistic regression was performed to estimate the association between different IR surrogate levels and the prevalence of hypertension. Results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Missing data were accounted by multiple imputation. These analyses were considered as the sensitivity analysis. Meanwhile, the Bayesian network (BN) model was constructed to further evaluate the relationship between baseline characteristics and the four IR surrogates and the prevalence of hypertension, as well as the importance of every single variable for the prevalence of hypertension. RESULTS Multivariate logistic regression analysis revealed that TyG-BMI and METS-IR were independent risk factors for the prevalence of hypertension that increased significantly with increasing TyG-BMI and METS-IR (p for trend < 0.001). The area under the TyG-BMI curve (AUC) was 0.681 [95% CI: 0.677-0.685], and the cut-off value was 199.5, with a sensitivity and specificity of 65.57% and 61.18%, respectively. While the area under the METS-IR curve (AUC) was 0.679 [95% CI: 0.674-0.683], and the cut-off value was 33.61, with a sensitivity and specificity of 69.67% and 56.67%, respectively. The BN model presented that among these four IR surrogates and related variables, TyG-BMI was the most important predictor of hypertension prevalence, with a significance of 34%. The results before and after multiple imputation were similar. CONCLUSION TyG-BMI and METS-IR were independent risk factors for the prevalence of hypertension. TyG-BMI and METS-IR had good predictive value for the prevalence of hypertension, and TyG-BMI was superior to METS-IR.
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Affiliation(s)
- Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Fanliang Kong
- Department of Cardiology and Pneumology, University Medical Center of Göttingen, Georg-August University, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site, Göttingen, Germany
| | - Siwei Chen
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, No.1268, Jiuzhou Street, Chaoyang New District, Nanchang, Jiangxi, China.
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97
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Yue L, Chen H, Sun Q, Shi L, Sun J, Li G, Xing L, Liu S. Prevalence of isolated diastolic hypertension and the risk of cardiovascular mortality among adults aged 40 years and older in northeast China: a prospective cohort study. BMJ Open 2022; 12:e061762. [PMID: 36115666 PMCID: PMC9486366 DOI: 10.1136/bmjopen-2022-061762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Little is known about the prevalence and impact of isolated diastolic hypertension (IDH) in northeast China. We aimed to investigate the current epidemiology of IDH and to illustrate whether IDH accounted for cardiovascular disease (CVD) mortality. DESIGN A prospective cohort study. SETTING A population-based study carried out in northeast China. PARTICIPANTS We built a community-based study of 18 796 residents aged ≥40 years who were living in northeast China with blood pressure measurements between September 2017 and March 2019. OUTCOME MEASURES Information on CVD death was obtained from baseline until 31 July 2021. IDH was defined as a diastolic blood pressure ≥90 mm Hg together with systolic blood pressure <140 mm Hg among hypertensive population. RESULTS The overall prevalence of IDH was 3.9%, which decreased significantly with advancing age (p<0.001) and ranged from 7.2% (95% CI: 6.3% to 8.2%) among participants 40-49 years to 1.5% (95% CI: 1.1% to 2.0%) among participants ≥70 years. Moreover, the IDH prevalence was higher in men than in women (5.2% vs 3.1%, p<0.001). The awareness and treatment rates of IDH were 25.7% and 17.7%, respectively, which were significantly lower than those of patients with non-IDH (50.1% and 21.7%, p=0.009, respectively). During a median follow-up of 3.2 years, 314 subjects died due to CVD (rate 4.84/1000 person-years). IDH and non-IDH were both significantly associated with an increased risk of CVD death (HR: 2.55, 95% CI: 1.35 to 4.82; HR: 2.48, 95% CI: 1.81 to 3.38) when compared with participants with non-hypertension. CONCLUSIONS IDH was mainly prevalent among young and middle-aged populations, and the awareness and treatment rates in IDH were lower than those in non-IDH hypertension. Additionally, IDH and non-IDH were significantly related to an increased risk of CVD mortality. Early management of IDH is urgently required in northeast China.
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Affiliation(s)
- Ling Yue
- Department of Ultrasound, The Fourth Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Hongyun Chen
- Department of Cardiology, Dalian Municipal Central Hospital, Dalian, Liaoning, People's Republic of China
| | - Qun Sun
- Department of Chronic Disease, Disease Control and Prevention of Chao Yang City, Chaoyang, Liaoning, People's Republic of China
| | - Lei Shi
- Department of Chronic Disease, Disease Control and Prevention of Liao Yang City, Liaoyang, Liaoning, People's Republic of China
| | - Jixu Sun
- Department of Chronic Disease, Disease Control and Prevention of Dan Dong City, Dandong, Liaoning, People's Republic of China
| | - Guangxiao Li
- Department of Medical Record Management Center, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Liying Xing
- Department of Chronic Disease Preventive and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China
| | - Shuang Liu
- Department of Ultrasound, The Fourth Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
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98
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Zhang A, Luo X, Pan H, Shen X, Liu B, Li D, Sun J. Establishment and evaluation of a risk-prediction model for hypertension in elderly patients with NAFLD from a health management perspective. Sci Rep 2022; 12:15138. [PMID: 36071077 PMCID: PMC9452675 DOI: 10.1038/s41598-022-18718-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
Elderly patients with nonalcoholic fatty liver disease are at a higher risk of developing. This study established an effective, individualised, early Hypertension risk-prediction model and proposed health management advice for patients over 60 years of age with NAFLD. Questionnaire surveys, physical examinations, and biochemical tests were conducted in 11,136 participants. The prevalence of NAFLD among 11,136 participants was 52.1%. Risk factors were screened using the least absolute shrinkage and selection operator model and random forest model. A risk-prediction model was established using logistic regression analysis and a dynamic nomogram was drawn. The model was evaluated for discrimination, calibration, and clinical applicability using receiver operating characteristic curves, calibration curves, decision curve analysis, net reclassification index (NRI), and external validation. The results suggested that the model showed moderate predictive ability. The area under curve (AUC) of internal validation was 0.707 (95% CI: 0.688-0.727) and the AUC of external validation was 0.688 (95% CI: 0.672-0.705). The calibration plots showed good calibration, the risk threshold of the decision curve was 30-56%, and the NRI value was 0.109. This Hypertension risk factor model may be used in clinical practice to predict the Hypertension risk in NAFLD patients.
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Affiliation(s)
- An Zhang
- Department of Health Management, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xin Luo
- Department of Health Management, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Hong Pan
- Department of Health Management, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xinxin Shen
- Department of Health Management, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Baocheng Liu
- Shanghai Collaborative Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Dong Li
- Zhangjiang Community Health Service Centers, Pudong New Area, Shanghai, 201203, China.
| | - Jijia Sun
- Shanghai Collaborative Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
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99
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Kotruchin P, Tangpaisarn T, Mitsungnern T, Sukonthasarn A, Hoshide S, Turana Y, Siddique S, Buranakitjaroen P, Van Huynh M, Chia Y, Park S, Chen C, Nailes J, Tay JC, Wang J, Kario K. Hypertensive emergencies in Asia: A brief review. J Clin Hypertens (Greenwich) 2022; 24:1226-1235. [PMID: 36196470 PMCID: PMC9532896 DOI: 10.1111/jch.14547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022]
Abstract
Hypertensive emergency is one of the most challenging conditions to treat in the emergency department (ED). From previous studies, about 1%-3% of hypertensive individuals experienced hypertensive emergencies. Its prevalence varied by country and region throughout Asia. Asian populations have more different biological and cultural backgrounds than Caucasians and even within Asian countries. However, there is a scarcity of research on clinical features, treatment, and outcomes in multinational Asian populations. The authors aimed to review the current evidence about epidemiology, clinical characteristics and outcomes, and practice guidelines in Asia. Five observational studies and nine clinical practice guidelines across Asia were reviewed. The prevalence of hypertensive emergencies ranged from .1% to 1.5%. Stroke was the most common target organ involvement in Asians who presented with hypertensive emergencies. Although most hypertensive emergency patients required hospitalization, the mortality rate was low. Given the current lack of data among Asian countries, a multinational data repository and Asian guidelines on hypertensive emergency management are mandatory.
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Affiliation(s)
- Praew Kotruchin
- Faculty of MedicineDepartment of Emergency MedicineKhon Kaen UniversityKhon KaenThailand
| | - Thanat Tangpaisarn
- Faculty of MedicineDepartment of Emergency MedicineKhon Kaen UniversityKhon KaenThailand
| | | | - Apichard Sukonthasarn
- Faculty of Medicine, Cardiology DivisionDepartment of Internal MedicineChiang Mai UniversityChiang MaiThailand
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yuda Turana
- Department of Neurology, School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | | | - Peera Buranakitjaroen
- Division of HypertensionDepartment of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Minh Van Huynh
- Department of Internal MedicineHue University of Medicine and PharmacyHue UniversityHue CityVietnam
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Medical and Life SciencesSunway UniversityBandar SunwayMalaysia
- Faculty of Medicine, Department of Primary Care MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Sungha Park
- Division of CardiologySeverance Cardiovascular HospitalYonsei University Health SystemSeoulKorea
| | - Chen‐Huan Chen
- Department of Internal MedicineNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan
| | - Jennifer Nailes
- Department of Preventive and Community Medicine and Research Institute for Health SciencesUniversity of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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100
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Li H, Xu T, Li Y, Chia Y, Buranakitjaroen P, Cheng H, Van Huynh M, Sogunuru GP, Tay JC, Wang T, Kario K, Wang J. Role of α1-blockers in the current management of hypertension. J Clin Hypertens (Greenwich) 2022; 24:1180-1186. [PMID: 36196467 PMCID: PMC9532918 DOI: 10.1111/jch.14556] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 12/29/2022]
Abstract
There is emerging evidence that α1-blockers can be safely used in the treatment of hypertension. These drugs can be used in almost all hypertensive patients for blood pressure control. However, there are several special indications. Benign prostatic hyperplasia is a compelling indication of α1-blockers, because of the dual treatment effect on both high blood pressure and lower urinary tract symptoms. Many patients with resistant hypertension would require α1-blockers as add-on therapy. Primary aldosteronism screen is a rapidly increasing clinical demand in the management of hypertension, where α1-blockers are useful for blood pressure control in the preparation for the measurement of plasma aldosterone and renin. Nonetheless, α1-blockers have to be used under several considerations. Among the currently available agents, only long-acting α1-blockers, such as doxazosin gastrointestinal therapeutic system 4-8 mg daily and terazosin 2-4 mg daily, should be chosen. Orthostatic hypotension is a concern with the use of α1-blockers especially in the elderly, and requires careful initial bedtime dosing and avoiding overdosing. Fluid retention is potentially also a concern, which may be overcome by combining an α1-blocker with a diuretic.
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Affiliation(s)
- Hua Li
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Ting‐Yan Xu
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yan Li
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yook‐Chin Chia
- Department of Medical Sciences, School of Medical and Life SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Peera Buranakitjaroen
- Division of Hypertension, Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Hao‐Min Cheng
- Center for Evidence‐based MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM)National Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan
- Institute of Public HealthNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan
- Institute of Health and Welfare PolicyNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan
| | - Minh Van Huynh
- Department of Internal MedicineHue University of Medicine and Pharmacy, Hue UniversityHueVietnam
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiTamil NaduIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Tzung‐Dau Wang
- Cardiovascular Center and Division of Cardiology, Department of Internal MedicineNational Taiwan University HospitalTaipei CityTaiwan
- Division of Hospital Medicine, Department of Internal MedicineNational Taiwan University HospitalTaipei CityTaiwan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Ji‐Guang Wang
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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