C-reactive protein (CRP) gene polymorphisms, CRP levels and risk of incident essential hypertension: findings from an observational cohort of Han Chinese.

C-reactive protein (CRP), an acute phase reactant and marker of inflammation, has been shown to be associated with CRP genetic variants and incident hypertension, but it is unclear whether this link is causal. We therefore conducted a prospective, nested case-control study to examine the relationship between single-nucleotide polymorphisms (SNPs) within the CRP gene, circulating CRP levels and the development of hypertension. Plasma CRP levels and the genotypes of eight SNPs were determined in 2000 unrelated Shanghai residents, including 908 hypertensive individuals and 1092 normotensive individuals. Among the 1092 normotensives, 968 subjects were followed up for 2 years, during which 71 developed hypertension. Plasma CRP levels were independently associated with the development of hypertension in the follow-up study (odds ratio per quartile=1.64; 95% confidence interval: 1.18-2.26; P<0.001). The minor alleles of rs1130864 (P<0.001) and rs3093059 (P<0.001) were significantly associated with elevated CRP levels, and the minor alleles of rs1205, rs1800947 and rs2246469 (all P<0.001) were associated with decreased CRP levels. A haplotype-based analysis strengthened the results of single-locus analysis. However, none of the SNPs or haplotypes was significantly associated with blood pressure, incident hypertension or changes between baseline and follow-up blood pressure levels. Taken together, our findings demonstrated that plasma CRP levels were substantially associated with common genetic variants in the CRP gene and could predict the development of hypertension. However, the relationship between genotype and CRP levels was not associated with a change in hypertension risk.

[Mutation of drug resistant gene in HIV/AIDS patients with antiretroviral therapy in Shandong province in 2011].

OBJECTIVE: To investigate drug resistance status in patients with highly active antiretroviral therapy (HAART) in Shandong province. METHODS: A total of 758 patients were separated from the anticoagulatory whole blood during May and October in 2011. The entire protease gene and part of the reverse transcriptase gene were amplified by RT-PCR and nest-PCR in the samples with viral load larger than 1000 copies/ml, then sequenced the gene fragments. Mutation of drug resistant gene and drug susceptibility was analyzed by the online tool HIV db program developed by Stanford University. RESULTS: The rate of virologic failure in patients was 9.1% (69/758). A total of 53 gene sequences that acquired were used for genotypic resistance analysis. A total of 23 patients were indicated drug resistance with the total of 3.1% (23/742). Drug resistance rates of nucleotide reverse transcriptase inhibitor (NRTI) and non-NRTI(NNRTI) were 2.4% (18/742) and 3.0% (22/742), respectively, and the primary mutation types of drug resistance were M184V and Y181C for NRTI and NNRTI, with no resistance to protease inhibitor (PI). In the 23 patients indicated drug resistance, 78.3% (18/23) were NRTI resistance, 95.7% (22/23) were NNRTI resistance and 73.9% (17/23) dual NRTI and NNRTI resistance. CONCLUSION: The presence of drug resistant gene in HIV strains among AIDS patients with HAART in Shandong province was at low level, but mutation diversity was found in drug resistant gene.

[The prevalence and evolution of HIV drug-resistant strains in people who live with HIV/AIDS during HIV antiretroviral therapy in Shandong province].

OBJECTIVE: To understand the prevalence and evolution of HIV drug-resistant strains in people who live with HIV/AIDS (PLWHA) during HIV antiretroviral therapy in Shandong province. METHODS: Viral load testing was performed by using fluorescence real-time quantitative PCR (NucliSens EasyQ system) on 324 patients who were under HIV antiretroviral therapy (ART) over 1 year in Shandong province. HIV resistance testing was conducted on the samples with more than 1000 copies/ml by using genotypic resistance testing method established in our lab. We tested the samples from drug-resistant patients before and after treatment to analyze the evolution of HIV resistant strains. RESULTS: The resistance rate for the patients under HIV ART over 1 year was 6.2% (20/324). The rate of drug-resistant mutation, but not resistant to ART was 0.6% (5/324). Nucleoside reverse transcriptase inhibitor (NRTIs) and non-NRTIs (NNRTIs) accounted for 93.1% (94/101) and protein inhibitors (PIs) accounted only 6.9% (7/101) of all mutations. M184V (48.0%, 12/25) and Y181C (32.0%, 8/25) were the most frequent mutations among 25 samples. Our research showed 20.0% (2/10) patients were resistant to primary ART and 1 patient was detected drug resistance in 6 months after ART treatment. HIV evolved from wild type to drug resistant virus, from low level to high level drug resistance, and from resistance to few to multiple drugs. In addition, interactions between mutations may influence the sensitivity of patients to other drug treatment. CONCLUSION: The prevalence of HIV drug-resistant strains in Shandong province is still at a low level, but its evolution is complex.

[Correlation study on serum adiponectin abnormity with adiponectin gene polymorphisms in hypertensive patients of phlegm-dampness constitution].

OBJECTIVE: To explore the difference of serum adiponectin (APN) level in hypertensive patients of phlegm-dampness constitution (PDC) and in those of non-PDC, as well as its association with APN gene polymorphisms. METHODS: Serum APN levels in 250 hypertensive patients (137 of PDC and 113 of non-PDC) were determined, and a correlation study was performed on 8 selected single nucleotide polymorphism (SNP) of APN gene. RESULTS: Significant differences of serum APN levels were observed between PDC and non-PDC patients (5.07 +/- 0.35 microg/mL vs 6.41 +/- 0.39 microg/mL, P = 0.045). No significant difference in polymorphism distribution of the 8 SNP sites of APN genes was found between patients of different constitutions (P > 0.05). Serum APN level was significantly lower in PDC patients than in non-PDC patients in sites of APN gene rs1063537 (3224C/T) polymorphism TT genotype (2.580 +/- 1.029 microg/mL vs 6.011 +/- 0.945 microg/mL, P = 0.017) and CT genotype (5.113 +/- 0.968 microg/mL vs 7.812 +/- 0.161 microg/mL, P = 0.021), while that of CC genotype was insignificant between the two constitutions (5.426 +/- 0.591 microg/mL vs 6.130 +/- 0.668 microg/mL). CONCLUSION: Serum APN level was significantly lower in hypertensive patients of PDC than in those of non-PDC. Moreover, the APN gene SNP3224 T allele carrier might be a hereditary feature of APN abnormity.

Study on insulin resistance and genetic polymorphisms in essential hypertension patients of two different kinds of TCM constitution.

OBJECTIVE: To investigate the relationship of insulin resistance and the polymorphisms of insulin receptor-related genes in essential hypertension patients of two different kinds of TCM constitution. METHODS: Oral glucose tolerance test (OGTT) and insulin release test (InRT) were conducted in 217 essential hypertensive patients of either sluggish meticulous (SM) constitution (139 cases) or prosperous impetuous (PI) constitution (78 cases), and the polymorphism of three genes, including insulin-like growth factor-1 receptor (IGF-1R), insulin receptor substrate-1 (IRS-1) and 2 (IRS-2) genes were detected. RESULTS: (1) OGTT, InRT and insulin resistance index (Homa-IR) were higher and insulin sensitive index (ISI) was lower in the patients of SM constitution than those in patients of PI constitution. (2) Significant difference of ISI and Homa-IR was shown in patients of both constitutions with genotype G of the 3 genes. CONCLUSION: Decrease of insulin sensitivity and increase of insulin resistance are more obvious in hypertensive patients with genotype G of the 3 genes of SM constitution than in those of PI constitution. Therefore, the difference in constitution might be one of the genetic characteristics for insulin resistance in hypertensive patients.

[Relationship between the polymorphism of alpha-adducin gene and the two phenotypes of constitutions in patients with essential hypertension classified by TCM].

OBJECTIVE: To investigate the relationship between the polymorphism of alpha-adducin (ADD1) gene and the two phenotypes of constitution in patients with essential hypertension, the Yang-hyperactive (YH) type and phlegm-dampness (PD) type, classified by traditional Chinese medicine (TCM) approach. METHODS: Two hundred and seven patients differentiated by TCM approach as YH type (113 cases) or PD type (94 cases) were observed, with the systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting blood glucose (FBG), serum creatinine (Cr), uric acid (UA), total cholesterol (TC) and triglycerides (TG) as the criteria of observation. Gly460Trp polymorphism of the ADD1 gene was detected by MALDI-TOF mass spectrometry. Results The levels of BMI, DBP, FBG and UA, etc. in the PD group were significantly higher than those in the YH group respectively. The rate of GG, GT and TT type of ADD1 gene was 29.2%, 41.6% and 29.2% in the YH group, 28.7%, 48.9% and 22.3% in the PD group, showing no significant difference in ADD1 genotype distribution between the two groups, while there was also no difference in the hypertension phenotype distribution among different genotypes (both P > 0.05). For the patients with TT genotype, there were significant differences between the YH group and the PD group in BMI (24.11 +/- 3.04 kg/m2 vs 26.20 +/- 2.30 kg/m2), DBP (96.79 +/- 4.05 mmHg vs 99.56 +/- 3.90 mmHg), FBG (5.01 +/- 0.53 mmol/L vs 5.51 +/- 1.07 mmol/L) and UA level (302.22 +/- 71.95 micromol/L vs 358.25 +/- 88.75 micromol/L, all P < 0.05). CONCLUSION: There was no relation between ADD1 gene polymorphism and the TCM genotype of constitution in patients with essential hypertension. However, it is likely that for hypertension patients with TT genotype, those of PD type are more susceptible to cardiovascular disease and have worse prognosis than those of YH type.

Interaction between body mass index and alcohol intake in relation to blood pressure in HAN and SHE Chinese.

BACKGROUND: Blood pressure (BP) increases with body mass index (BMI) and excessive alcohol intake. Few epidemiologic studies explored the interaction between BMI and alcohol intake in relation to BP. METHODS: We randomly selected 10 villages with a mixed population of HAN and SHE Chinese in the JingNing County in Southeast China. We measured BP, anthropometric characteristics, and alcohol intake in 1688 participants. Our statistical methods included single and multiple linear and logistic regressions. RESULTS: HAN (n = 520) and SHE (n = 1168) had a similar sex and age distribution. SHE Chinese, compared with HAN, had a higher BP (128.0/79.7 v 121.5/76.9 mm Hg, P < .001), and more frequently reported alcohol intake (45.0% v 27.7%; P < .001), but showed lower BMI (22.2 v 22.5 kg/m2; P = .05) and waist-to-hip ratio (0.83 v 0.87; P < .001). In SHE, but not HAN, there was a significant interaction (P < .01) between BMI and alcohol intake in relation to BP. In SHE with BMI < 25 kg/m2, BP was significantly higher in drinkers than nondrinkers (129.4/80.2 v 124.2/77.4 mm Hg, P < .001), whereas among SHE with BMI > or = 25 kg/m2, BP was not associated with alcohol intake (134.3/84.9 v 136.8/85.7 mm Hg, P > .41). Accordingly, in SHE Chinese, the slope of BP associated with BMI was less steep (P < .01) in drinkers than nondrinkers. CONCLUSIONS: Among SHE Chinese, alcohol intake and BMI interactively influenced BP. Further research is required to elucidate the underlying mechanism.

[The epidemiological study on human immunodeficiency virus infection among paid blood donors living in Shandong provincial China Comprehensive Response Project Areas].

OBJECTIVE: To understand the current epidemic situation and high risk factors of human immunodeficiency virus (HIV) infection among paid blood donors living in Shandong provincial China Comprehensive Response (CARES) Project Areas. METHODS: All residents between 20 to 60 years old were selected from one or several counties in August 2003. RESULTS: There were 19 HIV(+) infections among 661 subjects interviewed. HIV prevalence rate among paid blood donors was higher (3.98%) than that of others (0.48%) while HIV prevalence rate was higher in plasma donors (7.24%) than that in both plasma and full blood donors (2.90%). There was no infections identified in full blood donors. Donors who donated blood during 1994 - 1995 had a higher prevalence rate (7.07%) than those who started donation after 1995 and those began donation before 1993 (0.99%). The rate of condom use was lower among paid blood donors (13.72%) than that of others. There was a lower rate of voluntary HIV testing among paid blood donors than that of others. CONCLUSION: The main high risk population of HIV infection were paid donors in CARES Project Areas, whose risk factor was plasma donation and were infected mainly before 1995. Both the rate of condom use and HIV testing were all very low, indicating that they knew little on HIV/AIDS and paid less attention to self-proctection. It is necessary to enhance HIV/AIDS health education and behavior intervention on paid blood donors.