Association between obstructive sleep apnea and arrhythmia and heart rate variability among hypertensive patients.

BACKGROUND: The relationship between obstructive sleep apnea (OSA) and the occurrence of arrhythmias and heart rate variability (HRV) in hypertensive patients is not elucidated. Our study investigates the association between OSA, arrhythmias, and HRV in hypertensive patients. METHODS: We conducted a cross-sectional analysis involving hypertensive patients divided based on their apnea-hypopnea index (AHI) into two groups: the AHI ≤ 15 and the AHI > 15. All participants underwent polysomnography (PSG), 24-hour dynamic electrocardiography (DCG), cardiac Doppler ultrasound, and other relevant evaluations. RESULTS: The AHI > 15 group showed a significantly higher prevalence of frequent atrial premature beats and atrial tachycardia (P = 0.030 and P = 0.035, respectively) than the AHI ≤ 15 group. Time-domain analysis indicated that the standard deviation of normal-to-normal R-R intervals (SDNN) and the standard deviation of every 5-minute normal-to-normal R-R intervals (SDANN) were significantly higher in the AHI > 15 group (P = 0.020 and P = 0.033, respectively). Frequency domain analysis revealed that the low-frequency (LF), high-frequency (HF) components, and the LF/HF ratio were also significantly elevated in the AHI > 15 group (P < 0.001, P = 0.031, and P = 0.028, respectively). Furthermore, left atrial diameter (LAD) was significantly larger in the AHI > 15 group (P < 0.001). Both univariate and multivariable linear regression analyses confirmed a significant association between PSG-derived independent variables and the dependent HRV parameters SDNN, LF, and LF/HF ratio (F = 8.929, P < 0.001; F = 14.832, P < 0.001; F = 5.917, P = 0.016, respectively). CONCLUSIONS: Hypertensive patients with AHI > 15 are at an increased risk for atrial arrhythmias and left atrial dilation, with HRV significantly correlating with OSA severity.

The effects of obstructive sleep apnea on blood pressure variability and load in patients with hypertension.

BACKGROUND: Hypertension frequently coexists with obstructive sleep apnea (OSA), and their interplay substantially impacts the prognosis of affected individuals. Investigating the influence of OSA on blood pressure variability (BPV) and blood pressure load (BPL) in hypertensive patients has become a focal point of clinical research. METHODS: This cross-sectional study recruited hypertensive patients (n = 265) without discrimination and classified them into four groups based on their apnea-hypopnea index (AHI): control group (n = 40), AHI < 5; mild group (n = 74), 5 ≤ AHI ≤ 15; moderate group (n = 68), 15 < AHI ≤ 30; severe group (n = 83), AHI > 30. All participants underwent comprehensive assessments, including polysomnography (PSG) monitoring, 24-h ambulatory blood pressure (ABP) monitoring, cardiac Doppler ultrasound, and additional examinations when indicated. RESULTS: BPV and BPL exhibited significant elevations in the moderate and severe OSA groups compared to the control and mild OSA groups (P < 0.05). Moreover, interventricular septum thickness and left ventricular end-diastolic volume (LVEDV) demonstrated higher values in the moderate and severe OSA groups (P < 0.05). Multiple stepwise regression analysis identified noteworthy risk factors for elevated BPV in hypertensive patients with OSA, including AHI, maximum apnea time, total times of oxygen reduction, and mean time of apnea. CONCLUSION: Hypertensive patients with moderate to severe OSA exhibited substantially increased BPV and BPL. Moreover, BPV was correlated with AHI, maximum apnea time, total times of oxygen reduction, and mean time of apnea in hypertensive patients with OSA.

Developmental Patterns of Fecal Bile Acids in Healthy Neonates and Children.

BACKGROUND Normal profiles of FBAs in healthy neonates and children in Kunming city and surrounding areas in China have not been previously determined. The objective of this study was to determine a developmental pattern of fecal bile acids (FBAs) in healthy neonates and children. MATERIAL AND METHODS A cross-sectional study was performed on 238 healthy neonates and children recruited in the First Affiliated Hospital of Kunming Medical University, China from October 2015 to September 2016. Secreted primary and secondary FBAs in fresh feces were quantitated by liquid chromatography mass spectrometry (LC-MS). Amounts of FBAs in feces were compared among various age groups. RESULTS Trace amounts of cholic acid and chenodiol acid of primary FBAs were detectable at day 3 after birth, with a significant increase from day 3 to day 7. The primary FBAs gradually decreased from day 25 to the age of 6 years old. In contrast, a significant amount of glycochenodeoxycholic acid was detected on day 3 but decreased to a trace amount by day 7 and onwards. Primary FBAs appeared to maintain a high level, accounting for 98% of total FBAs, with no significant changes from day 7 to day 25 after birth. They gradually decreased from 90% to 10% from age 6 months to 6 years old. While the secondary FBAs were barely detected in neonates, only accounting for 2% of total FBAs, they were gradually elevated to 90% of total FBAs from age 6 months to 6 years old. CONCLUSIONS The liver can effectively synthesize primary bile acids 7 days after birth, and fecal primary bile acids tend to be stable after the neonate stage. Secondary bile acids continuously increase along with the maturation of intestinal flora, which reaches a relatively stable level at around 3 years old.

Personality traits and self-harm behaviors among Chinese children and adolescents: The mediating effect of psychological resilience.

BACKGROUND: Previous studies have shown that personality traits are associated with self-harm (SH) in adolescents. However, the role of resilience in this association remains unclear. Our research aims to explore the hypothesized mediation effect of resilience in the relationship between personality traits and SH in Chinese children and adolescents. AIM: To evaluate resilience as a mediator of the association between personality traits and SH. METHODS: A population-based cross-sectional survey involving 4471 children and adolescents in Yunnan province in southwestern China was carried out. Relevant data were collected by self-reporting questionnaires. Univariate and multivariate logistic regression models were employed to identify associated factors of SH. A path model was used to assess the mediation effect of resilience with respect to personality traits and SH association. RESULTS: Among the 4471 subjects, 1795 reported SH, with a prevalence of 40.1% (95%CI: 34.4%-46.0%). All dimensions of personality traits were significantly associated with SH prevalence. Resilience significantly mediated the associations between three dimensions of personality (extroversion, neuroticism, psychoticism) and SH, accounting for 21.5%, 4.53%, and 9.65%, respectively, of the total associations. Among all dimensions of resilience, only emotional regulation played a significant mediation role. CONCLUSION: The results of the study suggest that improving emotion regulation ability might be effective in preventing personality-associated SH among Chinese children and adolescents.

[Study on the determinants of prevalence in persons with overweight and obesity in rural areas of Kunming].

OBJECTIVE: This study was to explore the prevalence of overweight and obesity,and the effects of contextual and individual level determinants on them in the rural areas of Kunming city, China. METHODS: Shilin County was selected as the study site. Probability Proportional to Size (PPS) sampling method was used to select representative sample of 6006 residents aged 45 years and over from Shilin. Information was obtained from a cross-sectional survey on health. Data was analyzed using a multilevel logistic modeling. RESULTS: The prevalence rates of overweight and obesity were 12.10% and 2.15% in the study area. Males had a higher prevalence of overweight than females (13.60% vs. 10.71%). Similar situation was seen in the prevalence of obesity (2.82% vs. 1.52%). Both village level and individual level variables were associated with obesity, whereas only individual level variables were related to overweight. Elderly had lower probability of being overweight and obese than younger people with odds ratio (OR) as 0.95 (95% CI:0.83-0.97) and 0.93 (95% CI: 0.82-0.96), respectively. Males had higher probability of being overweight and obese than females: OR of 0.89 (95% CI:0.78-0.98) and OR of 0.87 (95% CI: 0.78-0.97),respectively. Individuals with lower family income had increased probability of having obesity (OR = 0.81, 95% CI: 0.73-0.95). Factor as living in a higher income village was associated with lower prevalence of obesity (OR = 0.92, 95% CI: 0.85-0.98). CONCLUSION: Interventions at village level on obesity in parallel with those at individual level were needed. Prevention and intervention on obesity should be emphasized in villages with higher income.

[Development of the system of quality of life instruments for cancer patients: colorectal cancer (QLICP-CR)].

BACKGROUND & OBJECTIVE: Based on the development of the general module of the system of quality of life instruments for cancer patients (QLICP-GM), this study was to develop and evaluate a quality of life scale for patients with colorectal cancer (QLICP-CR). METHODS: A quality of life scale for colorectal cancer patients that associated with Chinese cultural background was developed. The data from 110 patients with colorectal cancer were analyzed using statistical description, Pearson Correlation, Cluster analysis, and paired t-student test to assess the instrument. RESULTS: The test-retest reliability for the scale and 5 domains were all above 0.78. Internal consistency alpha for each domain was higher than 0.85 except for the social domain (0.66) and the symptom and side effect domain (0.63). Most of the correlation coefficients between each item and its domains were above 0.6. The differences in the scores of overall scale, general module, special domain, psychological domain, and symptom and side effect domain between pre-treatment and post-treatment were significant. CONCLUSION: The QLICP-CR is reasonably valid, reliable, and responsible, and can be used to assess quality of life for the patients with colorectal cancer.

[Temporal trend and spatial distribution of premature mortality burden due to chronic obstructive pulmonary disease in urban Kunming for the years 1998-2003].

OBJECTIVE: To study the temporal trend and spatial distribution of premature mortality burden due to chronic obstructive pulmonary disease (COPD) in terms of years of life lost (YLL) in an urban region of Kunming for the years 1998-2003. METHODS: Pan Long district was selected as the study region. YLL was used to measure premature mortality burden due to COPD. The tate of YLL per 1000 residents was calculated without age-weighting but with 3% discounting rate and broken down by year. Geographic information system (GIS) technique was used to display the spatial distribution of premature mortality burden due to COPD during the six years of study. RESULTS: During the years from 1998 to 2003, the premature mortality burden due to COPD decreased by years while males seemed to have a higher YLL rate of COPD than females. Central areas remained to have higher YLL/1000 population values of COPD for the six years, whereas remote areas tended to have a decreasing trend of YLL/1000 population values of COPD in the same period. CONCLUSION: Central areas of the city should be emphasized in further control of COPD in the urban region of Kunming.