Correlation between triglyceride glucose-body mass index and hypertension risk: evidence from a cross-sectional study with 60,283 adults in eastern China.

BACKGROUND: Insulin resistance (IR) and obesity are established risk factors for hypertension, with triglyceride-glucose (TyG) serving as a recognized surrogate marker for IR. The aim of this study was to investigate the association between TyG-BMI and hypertension in the general population. METHODS: A total of 60,283 adults aged ≥18 years who underwent face-to-face questionnaires, anthropometric measurements, and laboratory examination were included in this study. Multivariable logistic regression models and receiver operating characteristic curve (ROC) were used to determine the association between TyG-BMI and hypertension. The restricted cubic spline model was used for the dose-response analysis. RESULTS: After fully adjusting for confounding variables, multivariate logistic regression model showed a stable positive association between TyG-BMI and hypertension (OR: 1.61 per SD increase; 95% CI: 1.55-1.67; P-trend < 0.001). The multivariate adjusted OR and 95% CI for the highest TyG-BMI quartile compared with the lowest quartile were 2.52 (95% CI 2.28-2.78). Dose-response analysis using restricted cubic spline confirmed that the association between TyG-BMI index and hypertension was linear. Subgroup analyses showed that stronger associations between TyG-BMI index and hypertension were detected in young and middle-aged individuals (P for interaction < 0.05). ROC analysis showed that TyG-BMI index could better predict the risk of hypertension than other parameters (TyG-BMI cut-off value: 207.105, AUC: 0.719, sensitivity 65.5%, specificity 66.8%), particularly among young and middle-aged people. CONCLUSION: The TyG-BMI index was independently associated with hypertension in the study population. Further studies are required to confirm this relationship.

Untangling pathways of risk factors associated with hypertension among dysglycemia adults in eastern China: a structural equation model approach.

BACKGROUND AND AIMS: Using structural equation model (SEM) to test a conceptual model of pathways of developing hypertension among dysglycemia (IFG and T2DM) adults in Eastern China, emphasizing the unique mediation effect of insulin resistance and obesity on the relationship between modified/unmodified factors and hypertension. METHODS AND RESULTS: Participants with dysglycemia (n = 10,401) were extracted from the survey of Chronic Disease and Risk Factor Surveillance in Nanjing, the capital of Jiangsu Province in China. Dietary patterns were identified by using principal component analysis (PCA). SEM was employed to evaluate multiple pathways of hypertension among participants with IFG and T2DM. Three dietary patterns were derived using PCA. The tuber animal food pattern (OR = 0.825, 95% CI 0.723-0.940) and the balanced food pattern (OR = 0.812, 95% CI 0.715-0.922) were negatively associated with hypertension, while the Chinese rural food pattern (OR = 1.163, 95% CI 1.019-1.328) was positively associated with hypertension. The best SEM model showed that BMI (0.140), smoking (0.048) and Chinese rural food pattern (0.022) positively associated with hypertension; while tuber animal food pattern (- 0.025) had a negative direct effect on hypertension. Notably, insulin resistance could mediate the link between lifestyles (smoking and dietary patterns) and hypertension. CONCLUSION: Accordingly, we emphasized the importance of lifestyle intervention, mainly including obesity management, choosing healthy diets and decreasing smoking control, which may profoundly benefit this high-risk group among Chinese population.

Prevalence, awareness, treatment and control of dyslipidaemia and their determinants: results from a population-based survey of 60 283 residents in eastern China.

OBJECTIVES: To investigate the prevalence, awareness, treatment and control of dyslipidaemia and its associated factors in eastern China. DESIGN: Cross-sectional study. SETTING: Data were collected from the 2017 Nanjing Chronic Disease and Risk Factor Surveillance. PARTICIPANTS: This study included 60 283 participants aged ≥18 years. OUTCOME MEASURES: Prevalence of dyslipidaemia was defined as self-reported history of dyslipidaemia and/or the use of lipid-lowering medication, and/or meeting at least one of the following during on-site investigation: total cholesterol ≥6.2 mmol/L, triglyceride ≥2.3 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L and high-density lipoprotein cholesterol <1.0 mmol/L. Dyslipidaemia awareness was defined as the proportion of patients with dyslipidaemia who explicitly indicate their awareness of having a diagnosis of dyslipidaemia. Treatment was based on medication use among individuals with dyslipidaemia. Control was defined as having dyslipidaemia, receiving treatment and achieving serum lipid control to the standard level. ANALYSIS: Complex weighting was used to calculate weighted prevalence. A two-level logistic regression model determined the influencing factors for dyslipidaemia prevalence, awareness, treatment and control. RESULTS: The crude prevalence rate of dyslipidaemia was 28.4% (17 093 of 60 283). Among 17 093 patients with dyslipidaemia, the crude rates of awareness, treatment and control were 40.0% (n=6830), 27.5% (n=4695) and 21.9% (n=3736), respectively. The corresponding weighted prevalence rates were 29.8%, 41.6%, 28.9% and 22.9%. Older age (OR 2.03, 95% CI 1.82 to 2.23), urban residence (1.24, 1.19 to 1.31), higher education level (1.31, 1.21 to 1.42), current smoking (1.22, 1.15 to 1.29), alcohol consumption (1.20, 1.14 to 1.26), obesity (2.13, 1.99 to 2.29), history of hypertension (1.64, 1.56 to 1.71) and diabetes (1.92, 1.80 to 2.04) were identified as independent risk factors for dyslipidaemia (all p<0.001). Participants who were older, female, living in urban areas, had higher education levels, did not smoke or drink alcohol, had central obesity, had hypertension or had diabetes were more likely to be aware of their dyslipidaemia conditions, receive treatment and achieve serum lipid control to a standard level than their comparators (all p<0.05). CONCLUSIONS: The prevalence of dyslipidaemia is relatively high in eastern China; however, awareness, treatment and control levels are relatively low.

Associations between self-reported sleep duration and abnormal serum lipids in eastern China: a population-based cross-sectional survey.

OBJECTIVE: To evaluate the associations between sleep duration and total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). METHODS: The present study included 60,283 adults aged ≥18 years from the Chronic Disease and Risk Factor Surveillance in Nanjing. Generalized additive model (GAM) with forward stepwise selection method was used to analyze the nonlinear relationships between sleep duration and abnormal serum lipids. The reported effective degree of freedom (EDF) values in GAM indicates the degree of smooth curvature. EDF = 1 is a sign of linear correlation between predictors and outcome. EDF >1 is the sign of a more complex relationship between sleep duration and abnormal serum lipids. RESULTS: The evaluation of interaction of sex and sleep duration by using multivariable GAM revealed a U-shaped correlation between sleep duration and dyslipidemia (EDF = 4.60, P < 0.001), high TC (EDF = 3.38, P < 0.001), and high LDL-C (EDF = 3.67, P < 0.001) in male, and a U-shaped correlation between sleep duration and dyslipidemia (EDF = 4.69, P < 0.001), high TC (EDF = 3.33, P < 0.001), and high LDL-C (EDF = 3.21, P < 0.001) in female. There was a U-shaped correlation between sleep duration and high TG in male (EDF = 3.84, P < 0.001) and semi-linear correlation in female (EDF = 1.82, P = 0.028). Moreover, there was a linear correlation between sleep duration and low HDL-C in men (EDF = 1.04, P = 0.002), but no significant correlation in women (EDF = 3.18, P = 0.080). CONCLUSIONS: Both shorter and longer sleep durations were associated with abnormal serum lipid profiles in men and women.

Relationship between mental health and awareness of the knowledge on mental health in left-behind middle school students.

To explore the relationship between mental health of left-behind middle school students and awareness of mental health.Using cluster sampling method to select 428 left-behind middle school students in Jinan, using the mental health scale of middle school students and self-compiled mental health cognitive attitude questionnaire.We found left-behind middle school students' mental health level of force, paranoia, hostility and interpersonal sensitivity, depression, anxiety, learning pressure, maladjustment, mood swings, the psychological imbalance and total score were significant difference compared with the norm of middle school students (t = 10.67, 3.86, 3.78, 7.54, 2.51, 10.18, 8.79, 3.54, 6.56, -2.13, 6.83, P < .05). The top 5 detection rates of psychological moderate health problems are learning stress, anxiety, force, emotional instability and interpersonal sensitivity. There were significant differences in the scores of left-behind middle school students with different awareness of mental health knowledge (F = 4.880, P < .01) and emotional instability (F = 4.51 4, P < .05). The awareness of mental health knowledge was significantly negatively correlated with the total score of mental health, hostility, interpersonal sensitivity, maladjustment, emotional instability, and psychological imbalance scores. (r = 0.135, 0.182, 0.194, 0.189, -0.2, 0.124, P < .05).Left-behind middle school students' psychological health status is poorer, and closely related with the awareness of the knowledge on mental health; to improve the level of cognitive evaluation of left-behind middle school students on mental health is expected to improve their psychological health.

The Personality and Psychological Stress Predict Major Adverse Cardiovascular Events in Patients With Coronary Heart Disease After Percutaneous Coronary Intervention for Five Years.

To investigate the effects of personality type and psychological stress on the occurrence of major adverse cardiovascular events (MACEs) at 5 years in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). Two hundred twenty patients with stable angina (SA) or non-ST segment elevation acute coronary syndrome (NSTE-ACS) treated with PCI completed type A behavioral questionnaire, type D personality questionnaire, Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Trait Coping Style Questionnaire (TCSQ), and Symptom Checklist 90 (SCL-90) at 3 days after PCI operation. Meanwhile, biomedical markers (cTnI, CK-MB, LDH, LDH1) were assayed. MACEs were monitored over a 5-year follow-up. NSTE-ACS group had higher ratio of type A behavior, type A/D behavior, and higher single factor scores of type A personality and type D personality than control group and SAP group. NSTE-ACS patients had more anxiety, depression, lower level of mental health (P < 0.05; P < 0.01), more negative coping styles and less positive coping styles. The plasma levels of biomedical predictors had positive relation with anxiety, depression, and lower level of mental health. Type D patients were at a cumulative increased risk of adverse outcome compared with non-type D patients (P < 0.05). Patients treated with PCI were more likely to have type A and type D personality and this tendency was associated with myocardial injury. They also had obvious anxiety, depression emotion, and lower level of mental health, which were related to personality and coping style. Type D personality was an independent predictor of adverse events.

Vaccination with different M2e epitope densities confers partial protection against H5N1 influenza A virus challenge in chickens.

OBJECTIVE: Currently, research is focused on universal influenza vaccines based on various ectodomains of the influenza matrix protein 2 (M2e). Such vaccines are tested mostly using mouse-adapted influenza viruses and in mouse or ferret models. The aim of this study was to investigate in a chicken model the protective efficacy of vaccines based on avian-type M2e at different epitope densities. METHODS: On the basis of the optimized avian-type M2e gene, recombinant plasmids that contained tandem copies of different M2e were constructed and expressed in Escherichia coli. The expression and immunogenicity of the proteins were confirmed by SDS-PAGE and Western blot, as well as immunofluorescence assay and enzyme-linked immunosorbent assay. Animals were immunized with fusion proteins emulsified with an appropriate adjuvant and then infected with highly pathogenic influenza virus of A/chicken/Guangdong/04 (H5N1). Antibody levels, survival rate and weight loss were investigated. RESULTS: Multiple copies of M2e were highly expressed; higher epitope density engendered better protection but there was not a linear increase. Among the fusion proteins, the MBP-3·M2e fusion protein showed the best protective efficacy. CONCLUSIONS: This study has provided evidence that the immune response to avian-type M2e-based subunit vaccines was greater in chickens than that in mice. In addition, higher M2e epitope density can yield better protection, but not in a linear fashion.

[Rescue of H3N2 subtype swine influenza virus and substitution of hemagglutinin, neuraminidase].

OBJECTIVE: To study the mechanisms of trans-species transmission of influenza virus for developing novel vaccine of influenza in future. METHODS: We rescued H3N2 subtype swine influenza virus strain A/Swine/Henan/S4/01 successfully by a plasmid-base reverse genetics. Eight gene segments were synthesized by reverse transcriptase-PCR and cloned into bidirection expression vector pHW2000. We cotransfected 8 recombinant plasmids into 293T and MDCK cells and got the rescued virus rgH3N2. Then we replaced Hemagglutinin, Neuraminidase of rgH3N2 by Hemagglutinin, Neuraminidase gene from Human influenza virus, Avian influenza virus, Equine influenza virus. RESULTS: The rescued virus rgH3N2 and the wild type virus shared similar biological properties such as in titers of 50% embryo infective, 50% tissue culture infective dose and stability tests. The rescued virus titer in MDCK cell culture was measured by hemagglutination assay and the maximum virus titre of 1:64 hemagglutination unit was obtained after infection of MDCK cell for 60 h, The hemagglutination titre was 1:256 after several passages in embryonated eggs. With various combinations of HA, NA genes, we successfully generated high-yield reassortant viruses rgH1N1, rgH4N6 and rgH3N8 in embryonated eggs and MDCK cells. CONCLUSION: The successful rescue of reassortment viruses establish the foundation for the molecular mechanism research on how the swine influenza virus breakthrough the intermediate barriers and the function of HA, NA during transmitting among species, Also it is feasible to be used for developing novel vaccine of H3N2 subtype Swine influenza in future.

[Preparation of monoclonal antibodies against HA protein of subtype H1 of swine influenza virus].

AIM: To prepare the monoclonal antibodies(mAb) against the HA protein of subtype H1 of swine influenza virus (SIV). METHODS: To construct recombinant expression plasmid subtype H1 of SIV HA gene of A/Swine/Guangdong/LM/2004(H1N1).BALB/c mice of 6-8 weeks old were immunized endemically with the recombinant plasmid.The splenocytes from the immunized mice were fused with Sp2/0 myeloma cells after the last immunization. Hybridoma cells were screened by ELISA and hemagglutination inhibition (HI) tests.The activity and specificity of mAbs were evaluated by HI test and Western blot assay. RESULTS: Three hybridoma cell lines secreting specific mAbs named 8C4, 8C6, and 9D6 were developed. The ELISA titer of these mAbs was 1:16 000-1:256 000, the HI titer was 1:512-1:256 000; The neutralized titer of 8C4, 8C6, and 9D6 to A/Swine/Guangdong/LM/2004(H1N1) was 10(-2.83), 10(-6.4) and 10(-5.8). Western blot analysis confirmed that mAbs only reacted with HA protein of subtype H1 of SIV. CONCLUSION: These mAbs can be used as a useful tool to analyze the antigenic variation.They also provide the effective reagents for the rapid detection of subtype H1 of SIV.