Association of sex, adiposity, and diet with HDL subclasses in middle-aged Chinese

Association of lipid levels with motor and cognitive function and decline in Parkinson's disease

BACKGROUND

Most studies have focused on comparing blood lipid biomarkers between Parkinson's disease (PD) and normal controls (NC). However, further research is necessary to explore the impact of blood lipid levels on motor and cognitive function, as well as the progression of motor dysfunction and cognitive decline over time. Thus, the aim of this study is to investigate the relationship between blood lipid biomarkers and these indicators in individuals with PD.

METHODS

The cohort study enrolled 157 PD patients and 146 NC from the Tianjin Huanhu Hospital from September 2017 to September 2019. Serum lipid fractions were detected in fasting serum samples. PD patients were followed up at 2 ± 0.6 years for clinical assessment.

RESULTS

PD patients exhibited lower serum triglyceride (TG) levels as compared to NC (P = 0.008). PD male patients exhibited lower serum lipoprotein cholesterol(LDL-C) and total cholesterol (TC) levels than female patients (LDL-C: P = 0.034; TC: P = 0.019). Serum TG levels correlated significantly with Unified PD Rating Scale III, Hoehn and Yahr stage and Montreal Cognitive Assessment scores in PD patients. Additionally, serum TG levels were associated with follow-up motor function decline and cognitive decline in adjusted regression models in PD patients.

CONCLUSIONS

To summarise, the study findings suggest that decreased serum TG levels are significantly associated with greater motor dysfunction, cognitive dysfunction and the greater deterioration of the two indicators.

Sex-specific responses in glucose-insulin homeostasis and lipoprotein-lipid components after high-dose supplementation with marine n-3 PUFAs in abdominal obesity: a randomized double-blind crossover study

Background

Clinical studies on effects of marine-derived omega-3 (n-3) polyunsaturated fatty acids (PUFAs), mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and the plant-derived omega-6 (n-6) PUFA linoleic acid (LA) on lipoprotein-lipid components and glucose-insulin homeostasis have shown conflicting results, which may partly be explained by differential responses in females and males. However, we have lacked data on sexual dimorphism in the response of cardiometabolic risk markers following increased consumption of n-3 or n-6 PUFAs.

Objective

To explore sex-specific responses after n-3 (EPA + DHA) or n-6 (LA) PUFA supplementation on circulating lipoprotein subfractions, standard lipids, apolipoproteins, fatty acids in red blood cell membranes, and markers of glycemic control/insulin sensitivity among people with abdominal obesity.

Methods

This was a randomized double-blind crossover study with two 7-week intervention periods separated by a 9-week washout phase. Females (n = 16) were supplemented with 3 g/d of EPA + DHA (fish oil) or 15 g/d of LA (safflower oil), while males (n = 23) received a dose of 4 g/d of EPA + DHA or 20 g/d of LA. In fasting blood samples, we measured lipoprotein particle subclasses, standard lipids, apolipoproteins, fatty acid profiles, and markers of glycemic control/insulin sensitivity.

Results

The between-sex difference in relative change scores was significant after n-3 for total high-density lipoproteins (females/males: -11%*/-3.3%, p = 0.036; *: significant within-sex change), high-density lipoprotein particle size (+2.1%*/-0.1%, p = 0.045), and arachidonic acid (-8.3%*/-12%*, p = 0.012), and after n-6 for total (+37%*/+2.1%, p = 0.041) and small very-low-density lipoproteins (+97%*/+14%, p = 0.021), and lipoprotein (a) (-16%*/+0.1%, p = 0.028). Circulating markers of glucose-insulin homeostasis differed significantly after n-3 for glucose (females/males: -2.1%/+3.9%*, p = 0.029), insulin (-31%*/+16%, p < 0.001), insulin C-peptide (-12%*/+13%*, p = 0.001), homeostasis model assessment of insulin resistance index 2 (-12%*/+14%*, p = 0.001) and insulin sensitivity index 2 (+14%*/-12%*, p = 0.001), and quantitative insulin sensitivity check index (+4.9%*/-3.4%*, p < 0.001).

Conclusion

We found sex-specific responses after high-dose n-3 (but not n-6) supplementation in circulating markers of glycemic control/insulin sensitivity, which improved in females but worsened in males. This may partly be related to the sex differences we observed in several components of the lipoprotein-lipid profile following the n-3 intervention.

Clinical trial registration

https://clinicaltrials.gov/, identifier [NCT02647333].

Lower serum triglyceride levels linked to more severe motor performance in Parkinson’s disease

Introduction

Emerging evidence has suggested that lipid metabolism is correlated with Parkinson’s disease (PD) onset and progression. However, the effect of lipid metabolism on motor performance in PD patients is still unknown. This study estimated the association between lipid profiles and the severity of motor performance in PD.

Methods

This cross-sectional study enrolled 279 idiopathic PD patients from the Department of Neurology of Beijing Tiantan Hospital from May 2016 to August 2018. Serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (Apo-A1), and apolipoprotein B (Apo-B) levels were detected in fast serum samples. Motor performance was assessed by Movement Disorder Society-Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS III) total scores and subscores in these patients. The associations of lipid profiles with motor performance were analyzed using multivariable linear regression models.

Results

Compared to males, females with PD exhibited significantly higher serum TC, LDL-C, HDL-C, Apo-A1, and Apo-B levels. When accounting for covariates, lower serum TG levels were significantly associated with higher MDS-UPDRS III total scores and gait/postural instability subscores. Additionally, the univariate linear regression model showed that in males with PD, serum HDL-C or Apo-A1 levels were significantly associated with tremor subscores.

Conclusion

Lower serum TG levels were associated with more severe motor performance in patients with PD and TG may be a potential predictive biomarker for motor performance in PD patients.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10072-022-06113-9.

Anthracycline-induced cardiotoxicity: targeting high-density lipoproteins to limit the damage?

Doxorubicin (DOX) is an anthracycline antibiotic frequently used against a wide range of cancers, including breast cancer. Although the drug is effective as a treatment against cancer, many patients develop heart failure (HF) months to years following their last treatment with DOX. The challenge in preventing DOX-induced cardiotoxicity is that symptoms present after damage has already occurred in the myocardium. Therefore, early biomarkers to assess DOX-induced cardiotoxicity are urgently needed. A better understanding of the mechanisms involved in the toxicity is important as this may facilitate the development of novel early biomarkers or therapeutic approaches. In this review, we discuss the role of high-density lipoprotein (HDL) particles and its components as possible key players in the early development of DOX-induced cardiotoxicity. HDL particles exist in different subclasses which vary in composition and biological functionality. Multiple cardiovascular risk factors are associated with a change in HDL subclasses, resulting in modifications of their composition and physiological functions. There is growing evidence in the literature suggesting that cancer affects HDL subclasses and that healthy HDL particles enriched with sphingosine-1-phosphate (S1P) and apolipoprotein A1 (ApoA1) protect against DOX-induced cardiotoxicity. Here, we therefore discuss associations and relationships between HDL, DOX and cancer and discuss whether assessing HDL subclass/composition/function may be considered as a possible early biomarker to detect DOX-induced cardiotoxicity.

Moderate alcohol consumption and lipoprotein subfractions: a systematic review of intervention and observational studies

CONTEXT

Moderate alcohol consumption is associated with decreased risk of cardiovascular disease (CVD) and improvement in cardiovascular risk markers, including lipoproteins and lipoprotein subfractions.

OBJECTIVE

To systematically review the relationship between moderate alcohol intake, lipoprotein subfractions, and related mechanisms.

DATA SOURCES

Following PRISMA, all human and ex vivo studies with an alcohol intake up to 60 g/d were included from 8 databases.

DATA EXTRACTION

A total of 17 478 studies were screened, and data were extracted from 37 intervention and 77 observational studies.

RESULTS

Alcohol intake was positively associated with all HDL subfractions. A few studies found lower levels of small LDLs, increased average LDL particle size, and nonlinear relationships to apolipoprotein B-containing lipoproteins. Cholesterol efflux capacity and paraoxonase activity were consistently increased. Several studies had unclear or high risk of bias, and heterogeneous laboratory methods restricted comparability between studies.

CONCLUSIONS

Up to 60 g/d alcohol can cause changes in lipoprotein subfractions and related mechanisms that could influence cardiovascular health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. 98955.

A review of menopause nomenclature

Menopause nomenclature varies in the scholarly literature making synthesis and interpretation of research findings difficult. Therefore, the present study aimed to review and discuss critical developments in menopause nomenclature; determine the level of heterogeneity amongst menopause definitions and compare them with the Stages of Reproductive Aging Workshop criteria. Definitions/criteria used to characterise premenopausal and postmenopausal status were extracted from 210 studies and 128 of these studies were included in the final analyses. The main findings were that 39.84% of included studies were consistent with STRAW classification of premenopause, whereas 70.31% were consistent with STRAW classification of postmenopause. Surprisingly, major inconsistencies relating to premenopause definition were due to a total lack of reporting of any definitions/criteria for premenopause (39.84% of studies). In contrast, only 20.31% did not report definitions/criteria for postmenopause. The present findings indicate that there is a significant amount of heterogeneity associated with the definition of premenopause, compared with postmenopause. We propose three key suggestions/recommendations, which can be distilled from these findings. Firstly, premenopause should be transparently operationalised and reported. Secondly, as a minimum requirement, regular menstruation should be defined as the number of menstrual cycles in a period of at least 3 months. Finally, the utility of introducing normative age-ranges as supplementary criterion for defining stages of reproductive ageing should be considered. The use of consistent terminology in research will enhance our capacity to compare results from different studies and more effectively investigate issues related to women's health and ageing.

Fat mass changes during menopause: a metaanalysis

OBJECTIVE

Data: Fat mass has been shown to increase in aging women; however, the extent to which menopausal status mediates these changes remains unclear. The purpose of this review was to determine (1) how fat mass differs in quantity and distribution between premenopausal and postmenopausal women, (2) whether and how age and/or menopausal status moderates any observed differences, and (3) which type of fat mass measure is best suited to the detection of differences in fat mass between groups.

STUDY

This review with metaanalyses is reported according to Metaanalysis of Observational Studies in Epidemiology guidelines.

STUDY APPRAISAL AND SYNTHESIS METHODS

Studies (published up to May 2018) were identified via PubMed to provide fat mass measures in premenopausal and postmenopausal women. We included 201 cross-sectional studies in the metaanalysis, which provided a combined sample size of 1,049,919 individuals and consisted of 478,734 premenopausal women and 571,185 postmenopausal women. Eleven longitudinal studies were included in the metaanalyses, which provided a combined sample size of 2472 women who were premenopausal at baseline and postmenopausal at follow up.

RESULTS

The main findings of this review were that fat mass significantly increased between premenopausal and postmenopausal women across most measures, which included body mass index (1.14 kg/m²; 95% confidence interval, 0.95-1.32 kg/m²), bodyweight (1 kg; 95% confidence interval, 0.44-1.57 kg), body fat percentage (2.88%; 95% confidence interval, 2.13-3.63%), waist circumference (4.63 cm; 95% confidence interval, 3.90-5.35 cm), hip circumference (2.01 cm; 95% confidence interval, 1.36-2.65 cm), waist-hip ratio (0.04; 95% confidence interval, 0.03-0.05), visceral fat (26.90 cm²; 95% confidence interval, 13.12-40.68), and trunk fat percentage (5.49%; 95% confidence interval, 3.91-7.06 cm²). The exception was total leg fat percentage, which significantly decreased (-3.19%; 95% confidence interval, -5.98 to -0.41%). No interactive effects were observed between menopausal status and age across all fat mass measures.

CONCLUSION

The change in fat mass quantity between premenopausal and postmenopausal women was attributable predominantly to increasing age; menopause had no significant additional influence. However, the decrease in total leg fat percentage and increase in measures of central fat are indicative of a possible change in fat mass distribution after menopause. These changes are likely to, at least in part, be due to hormonal shifts that occur during midlife when women have a higher androgen (ie, testosterone) to estradiol ratio after menopause, which has been linked to enhanced central adiposity deposition. Evidently, these findings suggest attention should be paid to the accumulation of central fat after menopause, whereas increases in total fat mass should be monitored consistently across the lifespan.

Effects of gender, age and menopausal status on serum apolipoprotein concentrations

OBJECTIVE

To undertake a comprehensive evaluation of apolipoprotein risk markers for cardiovascular disease (CVD) according to gender, age and menopausal status.

DESIGN

Cross-sectional analysis of independent associations of gender, age and menopause with serum apolipoproteins.

PARTICIPANTS

Apparently healthy Caucasian premenopausal (n = 109) and postmenopausal (n = 252) women not taking oral contraceptives or hormone replacement, and Caucasian men (n = 307).

MEASUREMENTS

Serum apolipoprotein (apo) B, A-I and A-II concentrations were measured, plus serum total cholesterol, low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), triglycerides, cholesterol in HDL subfractions and the apoB/apoA-I, LDL-C/apoB, HDL-C/apoA-I and HDL-C/apoA-II ratios. Analyses were undertaken with and without standardization for confounding characteristics and in 5-year age ranges.

RESULTS

Overall, apoB concentrations were highest in men but in women rose with age and menopause to converge, in the age range of 50-55 years, with concentrations in men. The LDL-C/apoB ratio was generally higher in women than in men. ApoA-I concentrations were highest in postmenopausal women and lowest in men (standardized median (IQR) 144 (130, 158) vs 119 (108, 132) g/l, respectively, P < 0·001). ApoA-II concentrations were also highest in postmenopausal women but were lowest in premenopausal women (40·3 (37·5, 44·5) vs 32·9 (30·5, 35·7) g/l, respectively, P < 0·001). Nevertheless, postmenopausal women had HDL-C/apoA-I and HDL-C/apoA-II ratios approaching the lowest ratios, which were seen in men.

CONCLUSIONS

Consistent with adverse effects on CVD risk, male gender, ageing in women and menopause were associated with increased apoB concentrations, and menopause and male gender were associated with a decreased cholesterol content of HDL particles.

Effects of demographic, dietary and other lifestyle factors on the prevalence of hyperlipidemia in Guangxi Hei Yi Zhuang and Han populations

BACKGROUND

Han is the largest nationality and Zhuang is the largest minority among 56 nationalities in China. Hei Yi (means black-worship and black dressing) Zhuang is a special subgroup of 43 ethnic subgroups of Zhuang. There are limited data about the effect of environmental factors on the prevalence of hyperlipidemia in this population. The aim of this study was to determine the effects of demographic, dietary, and other lifestyle factors on the prevalence of hyperlipidemia in Hei Yi Zhuang and Han populations.

DESIGN

We performed a cross-sectional study of 1166 randomly selected people of Hei Yi Zhuang aged 7-84 years from seven villages in Napo County, Guangxi, China; and 1018 people of Han aged 6-89 years from nine villages in the same region.

METHODS

Information on demographic characteristics, dietary patterns, and other lifestyle factors was collected by standard questionnaires. Blood pressure, height, weight, waist circumference, serum lipids and apolipoproteins were measured, and body mass index (BMI) was calculated as a measure of weight relative to height.

RESULTS

The prevalence rates of hypercholesterolemia, hypertriglyceridemia and hyperlipidemia in Hei Yi Zhuang and Han were 23.6 versus 27.0% (P>0.05), 12.3 versus 14.4% (P>0.05) and 29.9 versus 34.2% (P<0.05), respectively. The prevalence of hyperlipidemia was positively correlated with age, BMI and blood pressure (P<0.05- 0.001) in Hei Yi Zhuang, whereas it was positively associated with age, BMI, blood pressure and alcohol consumption in Han (P<0.01-0.001). There was no significant correlation between the prevalence of hyperlipidemia and sex or cigarette smoking in Hei Yi Zhuang, Han or a combined population of Hei Yi Zhuang and Han (P>0.05), and alcohol consumption in Hei Yi Zhuang (P>0.05).

CONCLUSION

The current study reveals that there is a significant difference in the prevalence of hyperlipidemia and its risk factors between Hei Yi Zhuang and Han, which might result from different demographic characteristics, dietary habits and other lifestyle factors.

Associations between macronutrient intake and serum lipid profile depend on body fat in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

The present study aimed to investigate the relationships between macronutrient intake and serum lipid profile in adolescents from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) cross-sectional study (2006-7), and to assess the role of body fat-related variables in these associations. Weight, height, waist circumference, skinfold thicknesses, total cholesterol, HDL-cholesterol (HDL-C), LDL-cholesterol, TAG, apoB and apoA1 were measured in 454 adolescents (44% boys) aged 12.5-17.5 years. Macronutrient intake (g/4180 kJ per d (1000 kcal per d)) was assessed using two non-consecutive 24 h dietary recalls. Associations were evaluated by multi-level analysis and adjusted for sex, age, maternal education, centre, sum of four skinfolds, moderate-to-vigorous physical activity, sedentary behaviours and diet quality index for adolescents. Carbohydrate intake was inversely associated with HDL-C (β = - 0.189, P< 0.001). An inverse association was found between fat intake and TAG (β = - 0.319, P< 0.001). Associations between macronutrient intake and serum lipids varied according to adiposity levels, i.e. an inverse association between carbohydrate intake and HDL-C was only observed in those adolescents with a higher waist:height ratio. As serum lipids and excess body fat are the major markers of CVD, these findings should be considered when developing strategies to prevent the risk of CVD among adolescents.

Dietary fats and coronary heart disease

The relation of dietary fat to risk of coronary heart disease (CHD) has been studied extensively using many approaches, including controlled feeding studies with surrogate end-points such as plasma lipids, limited randomized trials and large cohort studies. All lines of evidence indicate that specific dietary fatty acids play important roles in the cause and the prevention of CHD, but total fat as a percent of energy is unimportant. Trans fatty acids from partially hydrogenated vegetable oils have clear adverse effects and should be eliminated. Modest reductions in CHD rates by further decreases in saturated fat are possible if saturated fat is replaced by a combination of poly- and mono-unsaturated fat, and the benefits of polyunsaturated fat appear strongest. However, little or no benefit is likely if saturated fat is replaced by carbohydrate, but this will in part depend on the form of carbohydrate. Because both N-6 and N-3 polyunsaturated fatty acids are essential and reduce risk of heart disease, the ratio of N-6 to N-3 is not useful and can be misleading. In practice, reducing red meat and dairy products in a food supply and increasing intakes of nuts, fish, soy products and nonhydrogenated vegetable oils will improve the mix of fatty acids and have a markedly beneficial effect on rates of CHD.

Comparison of hypertension and its risk factors between the Guangxi Bai Ku Yao and Han populations

OBJECTIVE

Little is known about the prevalence of hypertension in Bai Ku Yao, an isolated subgroup of the Yao minority in China. The aim of this study was to compare the difference in the prevalence of hypertension and its risk factors between the Guangxi Bai Ku Yao and Han populations.

METHODS

A cross-sectional study of hypertension in 1170 subjects of Bai Ku Yao and 1173 participants of Han Chinese aged 15-89 was conducted by a stratified randomized cluster sampling. Information on diet and lifestyle was collected with standardized questionnaires. Blood pressure, serum lipids and several anthropometric parameters were obtained in all subjects.

RESULTS

Systolic, diastolic and pulse pressure levels and hypertension prevalence (10.85% vs 16.45%, p<0.001) were lower in Bai Ku Yao than in Han. Hypertension was positively correlated with male, age, physical activity, body mass index, waist circumference, total energy, total fat and sodium intakes, and negatively associated with education level and total dietary fibre intake in both ethnic groups (p<0.05-0.001). Hypertension was also positively associated with alcohol consumption in Han. The rates of awareness, treatment and control were lower in Bai Ku Yao than in Han (p<0.05 for all).

CONCLUSIONS

The difference in the hypertension prevalence between the two ethnic groups might result from different diet, lifestyle, physical activity level, sodium intake and genetic factors.

Sex differences in environmental and genetic factors for hypertension

BACKGROUND

Sex differences are observed in many aspects of mammalian cardiovascular function and pathology. Hypertension is more common in men than in women of the same age. Although the effects of gonadal hormones on blood pressure are considered contributing factors, the reasons for sex differences in hypertension are still not fully understood. The present study was undertaken to compare the differences in several environmental and genetic factors between men and women in the Hei Yi Zhuang, an isolated subgroup of the Zhuang minority in China.

METHODS

Information on demography, diet, and lifestyle was collected in 835 women and 834 men aged 15 to 84 years. Genotyping of angiotensin-converting enzyme, adrenergic receptor beta(3), aldehyde dehydrogenase 2, calpastatin, connexin 37, hepatic lipase, lipoprotein lipase, peroxisome proliferator-activated receptor gamma, thyrotropin-releasing hormone receptor, and von Willebrand factor also was performed in these subjects.

RESULTS

The levels of systolic and diastolic blood pressure, and the prevalence, awareness, and treatment of hypertension were lower in women than in men (P < .05). Hypertension was positively associated with age, physical activity, alcohol consumption, body mass index, waist circumference, hyperlipidemia, total energy, total fat, sodium intake, and sodium/potassium ratio, and negatively associated with education level, total dietary fiber, potassium intake, angiotensin-converting enzyme, aldehyde dehydrogenase 2, and hepatic lipase genotypes in men (P < .05). Hypertension was positively associated with age, hyperlipidemia, total energy, total fat, sodium intake, sodium/potassium ratio, calpastatin, and von Willebrand factor genotypes, and negatively associated with education level, total dietary fiber, potassium, calcium intake, lipoprotein lipase, and thyrotropin-releasing hormone receptor genotypes in women (P < .05).

CONCLUSION

Sex differences in the prevalence of hypertension in the Hei Yi Zhuang population may be mainly attributed to the differences in dietary habits, lifestyle choices, sodium and potassium intakes, physical activity level, and some genetic polymorphisms.

Hyperlipidaemia and its risk factors in the Guangxi Bai Ku Yao and Han populations

OBJECTIVE

To compare the differences in hyperlipidaemia prevalence and its risk factors between the Guangxi Bai Ku Yao and Han populations.

DESIGN

Cross-sectional study of hyperlipidaemia.

SETTING

Both populations were from Lihu and Baxu villages in Nandan County, Guangxi Zhuang Autonomous Region, People's Republic of China.

SUBJECTS

A total of 1170 healthy subjects of Bai Ku Yao and 1173 participants of Han Chinese aged 15-89 years were surveyed by a stratified randomized cluster sampling. Information on demographic, dietary and lifestyle characteristics was collected by standard questionnaires. Blood pressure, height, weight, waist circumference, serum lipids and apolipoproteins were measured, and BMI (kg/m2) was calculated as weight divided by the square of height.

RESULTS

The prevalence rates of hypercholesterolaemia, hypertriacylglycerolaemia and hyperlipidaemia in Bai Ku Yao and Han were 12.4 % v. 26.2 % (P < 0.001), 15.0 % v. 14.8 % (P > 0.05) and 24.4 % v. 33.9 % (P < 0.001), respectively. Hyperlipidaemia was positively correlated with BMI, waist circumference, total energy and total fat intakes, and negatively associated with physical activity and total dietary fibre intake in Bai Ku Yao (P < 0.05 to 0.001). Hyperlipidaemia was positively associated with age, alcohol consumption, BMI, waist circumference, total energy and total fat intakes, and inversely correlated with physical activity and total dietary fibre intake in Han (P < 0.05 to 0.001).

CONCLUSIONS

The prevalence of hypercholesterolaemia and hyperlipidaemia was significantly lower in the Bai Ku Yao than in the Han population, which might result from different dietary habits, lifestyle choices and physical activity level, as well as genetic factors between the two ethnic groups.

Associations of diet and lifestyle with hyperlipidemia for middle-aged and elderly persons among the Guangxi Bai Ku Yao and Han populations

BACKGROUND

There are fifty-six ethnic groups in China. Han is the largest group and Bai Ku Yao is the isolated subgroup of the Yao minority. Little is known about the difference in the prevalence of hyperlipidemia between the Han and other minority groups in the rural areas.

OBJECTIVE

The aim of this study was to compare the associations of diet and lifestyle factors with hyperlipidemia for middle-aged and elderly persons between the Guangxi Bai Ku Yao and Han populations.

DESIGN

This is a cross-sectional study. A total of 485 subjects of Bai Ku Yao and 501 subjects of Han Chinese ethnicity aged 40 years and older were surveyed by a stratified cluster random sampling technique.

METHODS

Information on demography, dietary intake, and lifestyle factors was collected by standard questionnaires. Blood pressure, height, weight, waist circumference, and serum lipid levels were measured, and body mass index (BMI) was calculated as weight (kg) divided by height (m) squared.

RESULTS

The prevalence rates of hypercholesterolemia, hypertriglyceridemia, and hyperlipidemia in Bai Ku Yao and Han were 19.59% vs 36.13% (P<0.001), 13.81% vs 16.97% (P>0.05), and 28.45% vs 43.11% (P<0.001), respectively. Hyperlipidemia was positively correlated with BMI; waist circumference; total energy, total fat, and saturated fatty acids intakes; and negatively associated with sex (women were higher), physical activity, and total dietary fiber intake in Bai Ku Yao (P<0.05 to 0.001), whereas hyperlipidemia was positively associated with BMI; waist circumference; total energy, total fat, and saturated fatty acids intakes; and negatively associated with physical activity and total dietary fiber intake in Han (P<0.05 to 0.001).

CONCLUSIONS

The prevalence of hyperlipidemia was significantly lower among ethnic Bai Ku Yao than among ethic Han individuals, which might mainly be attributed to the more favorable dietary patterns, lifestyle choices, and physical activity levels in the former ethnic group.

Diet, alcohol consumption, and serum lipid levels of the middle-aged and elderly in the Guangxi Bai Ku Yao and Han populations

Bai Ku Yao is an isolated subgroup of the Yao minority in China. The special customs and cultures including their clothing, intraethnic marriages, corn wine and rum intakes are still completely conserved to the present day. Little is known about the association of diet and alcohol consumption with serum lipid levels in this population. The aim of this study was to compare the differences in diet, alcohol consumption, and serum lipid levels of the middle-aged and elderly between the Guangxi Bai Ku Yao and Han populations. A total of 485 subjects of Bai Ku Yao and 501 participants of Han Chinese aged 40 and over were surveyed by a stratified randomized cluster sampling. Information on dietary intake and alcohol consumption was collected by standard questionnaires. Serum lipid levels were measured. Education level, height, weight, body mass index, waist circumference, blood pressure, hypertension, and total energy, fat, protein, dietary cholesterol, and salt intakes were lower in Bai Ku Yao than in Han (P < .05-.001), whereas physical activity level, carbohydrate, vegetal protein, and total dietary fiber intakes were higher in Bai Ku Yao than in Han (P < .001 for all). Serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (Apo) A1, and Apo B levels were lower in Bai Ku Yao than in Han (P < .001 for all). The levels of triglyceride, HDL-C, Apo A1, and the ratio of Apo A1 to Apo B in Bai Ku Yao were higher, but the levels of LDL-C and Apo B were lower in drinkers than in nondrinkers. The levels of triglyceride, HDL-C, LDL-C, Apo A1, Apo B, and the ratio of Apo A1 to Apo B in Bai Ku Yao were also influenced by the amount of alcohol consumed (P < .05-.001). High-density lipoprotein cholesterol levels in Han were higher and LDL-C levels were lower in drinkers than in nondrinkers (P < .01 for each). Serum total cholesterol, HDL-C, and LDL-C levels in Han were also associated with the amount of alcohol consumed (P < .05-.001). The differences in the lipid levels between the two ethnic groups may partially attribute to the differences in dietary habits and alcohol consumption.

Diet, lifestyle, and blood pressure of the middle-aged and elderly in the Guangxi Bai Ku Yao and Han populations

BACKGROUND

Bai Ku Yao is an isolated subgroup of the Yao minority in China. Little is known about the association of diet and lifestyle with the prevalence of hypertension in this population.

METHODS

A total of 485 subjects of Bai Ku Yao and 501 participants of Han Chinese aged 40-89 were surveyed using stratified randomized cluster sampling. Information on diet and lifestyle was collected by using standard questionnaires. Blood pressure (BP) and serum lipid levels were measured.

RESULTS

Physical activity levels, carbohydrate, vegetal protein, and dietary fiber intake were higher in Bai Ku Yao than in Han, whereas educational level, height, weight, body mass index (BMI), waist circumference, and total energy, fat, protein, dietary cholesterol, and salt intake were higher in Han than in Bai Ku Yao. Systolic, diastolic, and pulse pressure (PP) levels and the prevalence of hypertension (21.9% vs. 28.9%, P < 0.05)were lower in Bai Ku Yao than in Han. Hypertension was positively correlated with age, physical activity,BMI, and waist circumference, as well as with total energy, fat, and salt intake, and negatively associated with educational levels and dietary fiber intake in both ethnic groups (P < 0.05 for all). Hypertension was also positively correlated with triglycerides (TGs) in Bai Ku Yao and alcohol consumption in Han (P < 0.05 for each).

CONCLUSIONS

The differences in BP levels and the prevalence of hypertension among the middle-aged and elderly between Bai Ku Yao and Han might result from different dietary patterns, lifestyle choices, physical activity levels, sodium intake, and even genetic factors.

Effects of alcohol consumption and other lifestyle behaviors on blood pressure for the middle-aged and elderly in the Guangxi Hei Yi Zhuang and Han populations

Han is the largest group and Zhuang is the largest minority among the 56 ethnic groups in China. Geographically and linguistically, Zhuang can be classified into 43 ethnic subgroups, in which Hei Yi Zhuang is proved to be the most conservative subgroup. Little is known about the relationship between alcohol consumption and blood pressure levels in this population. Therefore, the present study was undertaken to compare the effects of alcohol consumption and other lifestyle behaviors on blood pressure levels for the middle-aged and elderly in the Guangxi Hei Yi Zhuang and Han populations. A total of 657 subjects of Hei Yi Zhuang aged 40 and older were surveyed by a stratified randomized cluster sampling. Information on demography, diet, and other lifestyle factors was collected by standard questionnaires. Anthropometric parameters and serum lipid levels were also obtained in all subjects. The results were compared with those in 520 participants of Han Chinese from the same region. The levels of systolic blood pressure and pulse pressure in Hei Yi Zhuang were higher than those in Han (P < .01-.001). Hypertension was positively correlated with sex (male), age, physical activity, alcohol consumption, serum triglyceride levels, and total energy, total fat, and salt intakes, and negatively associated with educational level in Hei Yi Zhuang (P < .05-.001), whereas positively correlated with sex (male), age, physical activity, alcohol consumption, body mass index, waist circumference, serum total cholesterol levels, and total energy, total fat, and salt intakes, and negatively associated with educational level in Han (P < .05-.001). The difference in blood pressure levels between the two ethnic groups might result from different dietary habit, lifestyle, sodium intake, educational level, physical activity, and even genetic factors.

Comparison of demography, diet, lifestyle, and serum lipid levels between the Guangxi Bai Ku Yao and Han populations

Bai Ku Yao is an isolated subgroup of the Yao minority in China. Little is known about dyslipidemia in this population. The aim of this study was to compare the effects of demography, diet, and lifestyle on serum lipid levels between the Bai Ku Yao and Han populations. A total of 1,170 subjects of Bai Ku Yao and 1,173 subjects of Han Chinese aged 15-89 years were surveyed by a stratified randomized cluster sampling. The levels of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A-I (apoA-I), and apoB were significantly lower in Bai Ku Yao than in Han. Physical activity level and total dietary fiber intake were higher, whereas body mass index (BMI), waist circumference, total energy intake, and total fat intake were lower in Bai Ku Yao than in Han. Hyperlipidemia was positively correlated with BMI, waist circumference, and total energy and total fat intakes and negatively associated with physical activity level and total dietary fiber intake in both populations, but it was positively associated with age and alcohol consumption only in Han. The differences in the lipid profiles between the two ethnic groups were associated with different dietary habits, lifestyle choices, and levels of physical activities.

Effects of Demographic Characteristics, Health-Related Behaviors and Lifestyle Factors on the Prevalence of Hypertension for the Middle-Aged and Elderly in the Guangxi Hei Yi Zhuang and Han Populations

BACKGROUND/AIMS

Hei Yi (meaning black worship and black dress) Zhuang is the most conservative group among the 43 ethnic subgroups of Zhuang in China due to its unique culture and customs. The prevalence of hypertension in this population has not been well defined. Therefore, the present study was undertaken to compare the effects of the demographic characteristics, health-related behaviors and lifestyle factors on the prevalence of hypertension in the middle-aged and elderly of the Guangxi Hei Yi Zhuang and Han populations.

METHODS

A total of 657 people of Hei Yi Zhuang aged 40 and over were randomly selected from 7 villages in Napo County of China. Information on the demographic characteristics, health-related behaviors and lifestyle factors was collected by questionnaire. Blood pressure, height, weight, waist circumference, serum lipid and apolipoprotein levels were measured, and body mass index (BMI) was calculated as a measure of weight relative to height. The results were compared with those of 520 Han who live in the same district.

RESULTS

The prevalence of hypertension and isolated systolic hypertension in Hei Yi Zhuang was significantly higher than in Han (32.9 vs. 24.6%, p < 0.01, and 16.7 vs. 5.2%, p < 0.001, respectively). The systolic blood pressure levels and pulse pressure in Hei Yi Zhuang were also significantly higher than in Han (129 +/- 20.1 vs. 125.8 +/- 17.4 mm Hg, p < 0.01, and 51.5 +/- 16.1 vs. 47.1 +/- 12.0 mm Hg, p < 0.01, respectively). The prevalence of hypertension was positively correlated with triglycerides, male, age, and alcohol consumption in Hei Yi Zhuang, whereas it was positively correlated with total cholesterol, male, age, alcohol consumption and BMI in Han. The rates of awareness, treatment and control in Hei Yi Zhuang and Han are 7.9 vs. 19.5%, 4.2 vs. 13.3% and 1.4 vs. 9.4% (p < 0.01 for all), respectively.

CONCLUSION

The current study reveals a significant difference in the prevalence of hypertension, blood pressure levels, and the relative factors between the Hei Yi Zhuang and Han ethnic groups, which may have been due to differences in geographical characteristics, lifestyle, sodium intake, education levels, and even genetic factors.

Prevalence of Hyperlipidemia and Its Risk Factors for the Middle-Aged and Elderly in the Guangxi Hei Yi Zhuang and Han Populations

BACKGROUND

Han is the largest and Zhuang is the second largest among the 56 nationalities in China. Geographically and linguistically, Zhuang can be classified into 43 ethnic subgroups, among which Hei Yi (which means "black worship" and "black dressing") Zhuang is the most conservative group, according to its unique culture and customs. Little is known about the lipid profiles and corresponding risk factors of hyperlipidemia in this population. Therefore, the aim of this study was to compare the effects of demographic characteristics, health-related behaviors, and lifestyle factors on the prevalence of hyperlipidemia for the middle-aged and elderly in the Guangxi Hei Yi Zhuang and Han populations.

METHODS

A sample of 657 people of Hei Yi Zhuang aged 40 years and over was randomly selected from 7 villages in Napo County, Guangxi, China. Information on demographic characteristics, health-related behaviors, and lifestyle factors was collected by questionnaire. Blood pressure, height, weight, waist circumference, and serum lipid and apolipoprotein (apo) levels were measured, and body mass index (BMI) was calculated as a measure of weight relative to height. The results were compared with those in 520 people of Han living in the same region.

RESULTS

The prevalence of hyperlipidemia in the Hei Yi Zhuang was significantly lower than that in the Han (36.2% vs 42.3%; p < .05). The levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol, and apo B in Hei Yi Zhuang were also significantly lower than those in the Han (p < .05 to .001), but the levels of high-density lipoprotein cholesterol and the ratio of apo A-I to apo B in the Hei Yi Zhuang were significantly higher than those in the Han (p < .01 and < .001, respectively). There were no significant differences in apo A-I levels between the two ethnic groups (p > .05). The prevalence of hyperlipidemia was positively correlated with BMI and blood pressure in the Hei Yi Zhuang. Hyperlipidemia was positively associated with age, BMI, and blood pressure and negatively associated with gender (female higher) in the Han.

CONCLUSIONS

In the present study of the middle-aged and elderly population, the Hei Yi Zhuang have a more favorable lipid profile and a lower prevalence of hyperlipidemia than do the Han, and there is also a significant difference in the risk factors for hyperlipidemia between the two ethnic groups, which might result from the effects of different demographic characteristics, health-related behaviors, and lifestyle factors.

Prevalence, Awareness, Treatment, Control and Risk Factors of Hypertension in the Guangxi Hei Yi Zhuang and Han Populations

Han is the largest nationality and Zhuang is the largest minority among the 56 nationalities in China. Geographically and linguistically, Zhuang can be classified into 43 ethnic subgroups, with the Hei Yi Zhuang Chinese, who live in Napo County bordering northeast Vietnam and comprise a population of 51,655, having the most conservative culture and customs (Hei Yi means "black-clothing" and the Hei Yi Zhuang revere and wear the color black). The determinants of hypertension and its risk factors in this population have not been well-defined. To obtain some of this information, a cross-sectional study of hypertension was carried out in 1,166 Hei Yi Zhuang Chinese (aged 7-84; mean, 44.00+/-17.54 years) and 1,018 Han Chinese controls (42.95+/-17.11; range, 6-89 years) in the same area. Information on demographic characteristics, health-related behaviors and lifestyle factors was collected by questionnaire. The overall prevalence rates of hypertension and isolated systolic hypertension in Hei Yi Zhuang were higher than those in Han (23.2% vs. 16.0% and 11.5% vs. 3.7%; p<0.001 for each). The levels of systolic blood pressure and pulse pressure in Hei Yi Zhuang were also higher than those in Han (p<0.001 for each). The prevalence of hypertension was positively correlated with triglycerides, male gender, and age in Hei Yi Zhuang, whereas it was positively correlated with total cholesterol, male gender, age, and alcohol consumption in Han. The rates of awareness, treatment and control in Hei Yi Zhuang were lower than those in Han (8.5% vs. 20.9%, 4.4% vs. 15.3%, and 1.9% vs. 10.4%; p<0.001 for each), which may have been due to unique geographical characteristics, unwholesome lifestyles, greater sodium intake, lower education levels, and genetic risk factors in the former group.

Hormone replacement therapy and menopause: a review of randomized, double-blind, placebo-controlled trials

Hormone replacement therapy (HRT) is frequently prescribed to healthy women to ameliorate menopausal symptoms. HRT is used long term (> or = 1 year) to prevent chronic disease in older women. The objective of this study was to review the benefits and risks of HRT and studies of menopause or HRT in Taiwan via a MEDLINE search. Recommendations are provided for future HRT research in Taiwan. Randomized, double-blind, placebo-controlled clinical trials are considered the gold standard of scientific evidence. A MEDLINE literature search (January 1966-July 2002) identified 23 papers on trials (> or = 1 year) that met the inclusion criteria. The results showed that various HRT regimens used for more than 1 year caused more harm than good in healthy menopausal women and that there was no benefit for women with coronary artery disease, Alzheimer's disease, hysterectomy, hysterosalpingo-oophorectomy, and ischemic stroke. None of this research was conducted in Taiwan. A MEDLINE search using the key words "estrogen replacement therapy and menopause in Taiwan" identified 16 studies. There was only one, short-term, HRT trial. No evidence suggested benefits from long-term HRT in menopausal women in Taiwan.