Susceptibility loci for metabolic syndrome and metabolic components identified in Han Chinese: a multi-stage genome-wide association study.

Metabolic syndrome (MetS), a cluster of metabolic disturbances that increase the risk for cardiovascular disease and diabetes, was because of genetic susceptibility and environmental risk factors. To identify the genetic variants associated with MetS and metabolic components, we conducted a genome-wide association study followed by replications in totally 12,720 participants from the north, north-eastern and eastern China. In combined analyses, independent of the top known signal at rs651821 on APOA5, we newly identified a secondary triglyceride-associated signal at rs180326 on BUD13 (Pcombined = 2.4 × 10-8 ). Notably, by an integrated analysis of the genotypes and the serum levels of APOA5, BUD13 and triglyceride, we observed that BUD13 was another potential mediator, besides APOA5, of the association between rs651821 and serum triglyceride. rs671 (ALDH2), an east Asian-specific common variant, was found to be associated with MetS (Pcombined = 9.7 × 10-22 ) in Han Chinese. The effects of rs671 on metabolic components were more prominent in drinkers than in non-drinkers. The replicated loci provided information on the genetic basis and mechanisms of MetS and metabolic components in Han Chinese.

Higher Levels of Magnesium and Lower Levels of Calcium in Whole Blood Are Positively Correlated with the Metabolic Syndrome in a Chinese Population: A Case-Control Study.

Magnesium (Mg) and calcium (Ca) are essential for numerous kinds of metabolisms in human body. To investigate the associations between Mg and Ca and the ratio of Ca to Mg (Ca/Mg) in whole blood with metabolic syndrome (MetS) in a Chinese population, a matched case-control study including 204 MetS patients and 204 healthy controls (aged 48-89) was carried out in 2011. MetS were diagnosed according to the criteria of Chinese Diabetes Society. Controls had no abnormal metabolic components and were matched with cases by age, gender and region. Blood samples were collected in the morning after an overnight fast. Whole blood Mg and Ca were determined by flame atomic absorption spectrometry. Subjects who were male constituted 44.1% of the part of this study. The average age was 64.0 ± 7.18, and the average body mass index was 24.3 ± 3.75. The MetS group showed significantly higher Mg and lower Ca and Ca/Mg as compared with the control group. Comparing with the bottom tertile (T1) of Mg, increased ORs for MetS were found in median tertile (T2) and top tertile (T3) of Mg. For Ca, T2 and T3 were negatively associated with MetS. Inverse relationship was also found between Ca/Mg ratio and MetS. Our findings suggested that increased Mg and decreased Ca and Ca/Mg in whole blood were correlated with MetS in Chinese adults.

A framework for computing angle of progression from transperineal ultrasound images for evaluating fetal head descent using a novel double branch network.

Background: Accurate assessment of fetal descent by monitoring the fetal head (FH) station remains a clinical challenge in guiding obstetric management. Angle of progression (AoP) has been suggested to be a reliable and reproducible parameter for the assessment of FH descent. Methods: A novel framework, including image segmentation, target fitting and AoP calculation, is proposed for evaluating fetal descent. For image segmentation, this study presents a novel double branch segmentation network (DBSN), which consists of two parts: an encoding part receives image input, and a decoding part composed of deformable convolutional blocks and ordinary convolutional blocks. The decoding part includes the lower and upper branches, and the feature map of the lower branch is used as the input of the upper branch to assist the upper branch in decoding after being constrained by the attention gate (AG). Given an original transperineal ultrasound (TPU) image, areas of the pubic symphysis (PS) and FH are firstly segmented using the proposed DBSN, the ellipse contours of segmented regions are secondly fitted with the least square method, and three endpoints are finally determined for calculating AoP. Results: Our private dataset with 313 transperineal ultrasound (TPU) images was used for model evaluation with 5-fold cross-validation. The proposed method achieves the highest Dice coefficient (93.4%), the smallest Average Surface Distance (6.268 pixels) and the lowest AoP difference (5.993°) by comparing four state-of-the-art methods. Similar results (Dice coefficient: 91.7%, Average Surface Distance: 7.729 pixels: AoP difference: 5.110°) were obtained on a public dataset with >3,700 TPU images for evaluating its generalization performance. Conclusion: The proposed framework may be used for the automatic measurement of AoP with high accuracy and generalization performance. However, its clinical availability needs to be further evaluated.

Central rather than brachial pressures are stronger predictors of cardiovascular outcomes: A longitudinal prospective study in a Chinese population.

The purpose of this study was to assess the association of blood pressure (BP) measurements with the risk of cardiovascular disease (CVD) and examine whether central systolic BP (CSBP) predicts CVD better than brachial BP measurements (SBP and pulse pressure [PP]). Based on a cross-sectional study conducted in 2009-2010 with follow-up in 2016-2017 among 35- to 64-year-old subjects in China, we evaluated the performance of non-invasively predicted CSBP over brachial BP measurements on the first CVD events. Each BP measurement, individually and jointly with another BP measurement, was entered into the multivariate Cox proportional-hazards models, to examine the predictability of central and brachial BP measurements. Mean age of participants (n = 8710) was 50.1 years at baseline. After a median follow-up of 6.36 years, 187 CVD events occurred. CSBP was a stronger predictor for CVD than brachial BP measurements (CSBP, 1-standard deviation increment HR = 1.49, 95%CI: 1.31-1.70). With CSBP and SBP entering into models jointly, the HR for CSBP and SBP was 1.28 (1.04-1.58) and 1.22 (0.98-1.50), respectively. With CSBP and PP entering into models jointly, the HR for CSBP and PP was 1.51 (1.28-1.78) and 0.98 (0.83-1.15), respectively. For subgroup analysis, the association of CSBP with CVD was stronger than brachial BP measurements in women, those with hypertension and obesity. In the middle-aged Chinese population, noninvasively estimated CSBP may offer advantages over brachial BP measurements to predict CVD events, especially for participants with higher risk. These findings suggest prospective assessment of CSBP as a prevention and treatment target in further trials.

Association between hyperhomocysteinemia and metabolic syndrome with early carotid artery atherosclerosis: A cross-sectional study in middle-aged Chinese population.

OBJECTIVES: Homocysteine is a modifiable, independent risk factor for cardiovascular disease. The association between hyperhomocysteinemia and metabolic syndrome with the presence of early carotid artery atherosclerosis remains unknown in middle-aged Chinese adults. METHODS: Chinese adults (n = 1607) of Han ethnicity, age 35 to 65 y, and living in their communities >2 y were surveyed. Hyperhomocysteinemia was defined as homocysteine concentrations >15 µmol/L. Carotid intima-media thickness and carotid plaque were examined by ultrasonography. All participants were classified into four groups by hyperhomocysteinemia and metabolic syndrome status. RESULTS: Participants with both hyperhomocysteinemia and metabolic syndrome had the highest levels of waist circumference and systolic blood pressure compared with the three other groups. The highest proportion of increased carotid intima-media thickness (61.3%) was in the subgroup of both hyperhomocysteinemia and metabolic syndrome. After adjustments for the covariates, the risk of increased carotid intima-media thickness was only significantly higher in the group with metabolic syndrome but without hyperhomocysteinemia (odds ratio: 1.47; 95% confidence interval, 1.13-1.93) compared with people without hyperhomocysteinemia and metabolic syndrome. Furthermore, statistically significant variances of prevalence of plaque among the four subgroups were not discovered. CONCLUSIONS: Our study demonstrated that metabolic syndrome had a strong effect on carotid intima-media thickness However, the increased homocysteine levels were not significantly associated with early carotid artery atherosclerosis in middle-aged Chinese people.