Association between Serum Uric Acid and Hypertension in Han and Yugur of Gansu Province: The China National Health Survey.

INTRODUCTION: Serum uric acid (SUA) has been found correlated with an increased risk of hypertension, but evidence is sparse regarding the association in Gansu Province, especially in Yugur people. This study aimed to explore the nonlinear relationship between SUA levels and hypertension in Han and Yugur people in China. METHODS: The cross-sectional study samples (n = 5,327) were from the China National Health Survey (CNHS) in Gansu Province. Participants were selected using a multistage stratified cluster sampling method. SUA was measured by enzymatic methods. The restricted cubic spline regression was performed to evaluate the shape of the association. RESULTS: The overall prevalence of hypertension and hyperuricemia was 28.4% and 17.0%, respectively, in this study. Comparing the highest (>416.4 µmol/L) to the lowest (<254.1 µmol/L) SUA level groups, the multivariable adjusted differences and 95% confidence intervals (CIs) in blood pressure (BP) were 6.15 (4.22, 8.08) mm Hg and 4.87 (3.51, 6.23) mm Hg for SBP and DBP in Han, and 2.22 (-0.73, 5.18) mm Hg and 2.56 (0.38, 4.75) mm Hg for SBP and DBP in Yugur people, respectively. The corresponding odds ratios (95% CIs) for hypertension were 3.16 (2.26, 4.43) and 2.37 (1.46, 3.89) in Han and Yugur people, respectively. The restricted cubic spline regression models illustrated that both BP level and the risk of hypertension increased with elevated SUA levels in Han and Yugur people. CONCLUSIONS: SUA was significantly and independently associated with an increased risk of hypertension in Han and Yugur people. Prospective studies are needed to confirm these findings.

[Effects of different feeding practices at 0-6 months and living economic conditions on anemia prevalence of infants and young children].

OBJECTIVE: In order to understand the anemic prevalence in the infants and young children and its relation to the feeding pattern at 0-6 months and on economic income. METHODS: A questionnaire survey were used to collect the information on nutritional and health status of infants and young children (6 to 23 months) living in poverty-rural areas of Gansu Province, and hemoglobin concentration was measured. RESULTS: The prevalence of anemia was 58.2% in the children aged from 6 months to 23 months. The rate of anemia in boys was higher than that of the girls (61.0% and 55.1%), but there was no significant difference. There were significant differences in hemoglobin levels among different age groups (F = 5.206, P < 0.01). The child's hemoglobin concentration was trend to significantly decrease from 6-month-old and more, and reach to the lowest level at 12 months of age and more. After that, the hemoglobin began to gradually increase with age. The change of hemoglobin concentration was consistent with anemic prevalence, the higher prevalence of anemia was the group aged 6-month-old and more, and the group aged 12-month-old and more had highest prevalence. There were significant difference among the different feeding pattern on the anemic prevalence (chi2 = 9.245, P < 0.05), and the prevalence of anemia in children fed with infant formula had the lowest anemic rate and was significantly lower than those of the mixed feeding and breastfeeding children (chi2 = 8.529 and 7.173, P < 0.05). The living economic conditions were a linear trend with the hemoglobin level of children, but there was no significant difference among the different feeding groups (F = 0.637, P > 0.05). The better household economic conditions, tends to have the lower in anemic prevalence, but there was no significant difference (chi2 = 1.666, P > 0.05). CONCLUSION: The children had lowest hemoglobin level and highest anemic prevalence in the group aged 12-month-old and more, the anemic prevalence of children fed with infant formula had significantly lower than those of the mixed feeding and breastfeeding children, and family economic status on the prevalence of anemia was not obvious. The present results showed that we should focus on the prevention and improvement of iron status and anemia in infants more than 6-months and young children.

A diagnostic prediction model for hypertension in Han and Yugur population from the China National Health Survey (CNHS).

BACKGROUND: The prevalence of hypertension is high among Chinese adults, thus, identifying non-hypertensive individuals at high risk for intervention will help to improve the efficiency of primary prevention strategies. METHODS: The cross-sectional data on 9699 participants aged 20 to 80 years were collected from the China National Health Survey in Gansu and Hebei provinces in 2016 to 2017, and they were nonrandomly split into the training set and validation set based on location. Multivariable logistic regression analysis was performed to develop the diagnostic prediction model, which was presented as a nomogram and a website with risk classification. Predictive performances of the model were evaluated using discrimination and calibration, and were further compared with a previously published model. Decision curve analysis was used to calculate the standardized net benefit for assessing the clinical usefulness of the model. RESULTS: The Lasso regression analysis identified the significant predictors of hypertension in the training set, and a diagnostic model was developed using logistic regression. A nomogram with risk classification was constructed to visualize the model, and a website ( https://chris-yu.shinyapps.io/hypertension_risk_prediction/ ) was developed to calculate the exact probabilities of hypertension. The model showed good discrimination and calibration, with the C-index of 0.789 (95% confidence interval [CI]: 0.768, 0.810) through internal validation and 0.829 (95% CI: 0.816, 0.842) through external validation. Decision curve analysis demonstrated that the model was clinically useful. The model had a higher area under receiver operating characteristic curves in training and validation sets compared with a previously published diagnostic model based on Northern China population. CONCLUSION: This study developed and validated a diagnostic model for hypertension prediction in Gansu Province. A nomogram and a website were developed to make the model conveniently used to facilitate the individualized prediction of hypertension in the general population of Han and Yugur.

The Additive Interaction between Body Mass Index and Hypertension Family History in Han and Yugur: The China National Health Survey (CNHS).

OBJECTIVE: To estimate the additive interaction of body mass index (BMI) and family history of hypertension (FHH) on hypertension and explore whether the interaction could be influenced by behavioural risk factors. METHODS: The cross-sectional data on 5791 participants were from the China National Health Survey in Gansu province in 2016. We assessed the additive interaction by calculating the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (SI). RESULTS: ORs for hypertension were highest in Han (13.52, 95% CI: 9.45 to 19.34) and Yugur (13.85, 95% CI: 8.48 to 22.63) with the combination of obesity and FHH. The interaction of BMI and FHH was significant in Han people, with the RERI, AP, and SI and their 95% CIs being 2.48 (1.13 to 3.82), 0.33 (0.19 to 0.47), and 1.61 (1.26 to 2.07) for overweight and FHH and 6.32 (1.91 to 10.73), 0.47 (0.27 to 0.67), and 2.02 (1.33 to 3.07) for obesity and FHH, respectively. The interaction of BMI and FHH was not significant in Yugur people. Adjustment for behavioural risk factors had little influence on the interactions, and risks of hypertension remained increased. CONCLUSIONS: BMI and FHH were associated with hypertension, and the interaction of BMI and FHH on hypertension was significant in Han but not in Yugur people. Behavioural risk factors had little influence on the associations and interactions. The exacerbation of hypertension risks by overweight or obesity in hypertension families deserves attention in weight control and community care.