Use of traditional Chinese medicine in Chinese patients with coronary heart disease.

OBJECTIVE: To study the use of traditional Chinese medicine (TCM) or both TCM and guideline-recommended Western medicine (WM) in Chinese patients with coronary heart disease (CHD). METHODS: A cross-sectional nationwide survey of 2803 CHD outpatients was completed by collecting information, including general demographic data, disease history, and use of drugs (including TCM and WM). RESULTS: Of the 2712 CHD outpatients with complete drug treatment data, only 3.1% received TCM without any WM for CHD, 30.0% received both TCM and WM recommended by current CHD guidelines, and 66.9% received only WM. Patients with a longer history of CHD or with a history of stroke, were more likely to use TCM. However, 90.6% of CHD patients who used TCM also used certain WM. Furthermore, patients who used more types of TCM tended to use much less WM recommended by current guidelines. CONCLUSION: A substantial proportion of Chinese CHD outpatients use both TCM and WM for secondary prevention of CHD. It is important to assess the effect of combined TCM and WM on major clinical outcomes in Chinese CHD patients.

[Impact of gender on lipoprotein-associated phospholipase A2 activity and association with known cardiovascularrisk factors].

OBJECTIVE: To explore the impact of gender on lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity and association with known cardiovascular risk factors. METHODS: Participants in this study were recruited from Beijing sub-cohort from the Chinese Multi-provincial Cohort Study (CMCS) database. A total of 1471 participants with complete laboratory data were included in the study (688 male). Lp-PLA(2) activity was determined by colorimetric assay kit.Lp-PLA(2) activity level and correlation between Lp-PLA(2) activity and known risk factors were compared between men and women. RESULTS: (1) Lp-PLA(2) activity was higher in males than in females [(22.73 ± 8.52) nmol·min(-1)·ml(-1) vs.(20.01 ± 8.06) nmol·min(-1)·ml(-1), P < 0.01].(2) Age, waist circumference, systolic blood pressure, diastolic blood pressure and the prevalence of hypertension were higher in males than in females, while total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were higher in females than in males (P < 0.05 or P < 0.01).(3)Pearson correlation showed that Lp-PLA(2) activity was correlated with lipids ( total cholesterol, LDL-C, HDL-C, and triglyceride), blood pressure (systolic blood pressure and diastolic blood pressure), and adiposity associated parameters (waist circumference and body mass index) in males (all P < 0.01) and was correlated with lipid level (total cholesterol, LDL-C, HDL-C, and triglyceride) and age in females( P < 0.05 or P < 0.01). Correlations with variables associated with obesity or blood pressure in females were much weaker than those in males (in females, r = 0.02-0.08; in males, r = 0.10-0.16).(4)After adjustment for age, waist circumference, systolic blood pressure, glucose, LDL-C, HDL-C, triglyceride and high sensitivity C-reactive protein by multiple logistic regression model, Lp-PLA(2) activity was still significantly higher in males than in females (OR = 1.72, 95% confidence interval = 1.34-2.21, P < 0.01). CONCLUSIONS: Lp-PLA(2) activity and association with known cardiovascular risk factors differed in males and females. The gender difference in Lp-PLA(2) activity still presents after adjustment for known cardiovascular risk factors in this cohort.

[The epidemiology of out-of-hospital deaths due to acute coronary events in young Beijing adults].

OBJECTIVES: To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing. METHODS: Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing. The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease (CHD) death were compared upon gender, area, occupation and marital status among people aged between 25 - 45 years old. RESULTS: A total of 3489 cases were identified during 2007 to 2009 with acute coronary events (male: 3183, female: 306), with a mean age of (40.5 ± 4.3) years old. The 3-years' overall mortality was 26.0%, with female's higher than male's (51.0% vs 23.6%, P < 0.05); and it was higher in rural area than in urban areas (28.9% vs 22.9%, P < 0.05). Ninety-five percent of death due to acute coronary events occurred prehospital, with the proportion of 95.2% in male and 94.2% in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death. Majority of prehospital deaths (64.8%) occurred at home. CONCLUSION: More than 90% of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital, and the site of prehospital deaths was mainly at home.

[Real world use of statins for secondary prevention in patients with high risk coronary heart disease in China].

OBJECTIVE: To observe the real world statins use for secondary prevention in patients with high risk coronary heart disease (CHD) in China. METHODS: Sixty-four hospitals across 31 provinces of China including 32 secondary hospitals and 32 tertiary hospitals were selected for baseline survey. Fifty consecutive outpatients with established history of acute coronary syndrome were recruited in each hospital. Information of these patients including statins use was collected. RESULTS: A total of 2516 high risk CHD outpatients were involved in present report. Mean age of the patients was (65 ± 10) years and 69.4% patients were male. Fifty-seven point nine percent patients were treated with a statin at the time of interview and recommended low-density lipoprotein-cholesterol (LDL-C) target was achieved in 29.8% patients. Percent of statin use and achieving LDL-C goal was significantly higher in male outpatients than in female outpatients. Outpatients admitted in tertiary hospitals were more likely to have achieved their LDL-C targets than those admitted in secondary hospitals. Statin use was more often for patients in South China than patients in North China. The percentage reaching the optimal LDL-C treatment target was the highest in Central China (38.5%) and the lowest in Northeast China (18.5%). At this interview, 68.2% outpatients were prescribed statins and 24.1% prescribed doses of statins were sub-minimal. CONCLUSION: There was a gap between real world statin use and guideline recommendations for secondary prevention in high risk CHD patients in China.

[Relationship between serum non-high-density lipoprotein cholesterol and incidence of cardiovascular disease].

OBJECTIVE: To evaluate the relationship between serum non-HDL-C and incidence of various cardiovascular disease (CVD) in Chinese population aged 35-64 years. METHODS: This prospective study was performed from 1992 to 2004 in 11 provinces of China and the association between baseline non-HDL-C level with the risk of various CVD events was analyzed in 29 937 subjects aged 35-64 years using Cox multivariate proportional hazards regression. CVD events in this study including acute coronary events (ACE), ischemic stroke, hemorrhagic stroke and ischemic cardiovascular disease (ICVD). RESULTS: (1) Adjusted for age, gender, smoking status, diabetes, body mass index and blood pressure, the relative risk of ACE, ischemic stroke and ICVD in groups of non-HDL-C 3.37 - 4.13 mmol/L (130 - 159 mg/dl), 4.14 - 4.91 mmol/L (160 - 189 mg/dl) and ≥ 4.92 mmol/L (190 mg/dl) was 1.24 (0.91 - 1.70), 1.78 (1.25 - 2.53), 2.23 (1.48 - 3.35); 1.34 (1.07 - 1.68), 1.38 (1.04 - 1.83), 1.38 (0.97 - 1.94) and 1.37 (1.12 - 1.63), 1.52 (1.22 - 1.90), 1.70 (1.30 - 2.22), respectively. The risk of hemorrhagic stroke was declined obviously in group > 4.92 mmol/L (190 mg/dl). (2) The correlation between VLDL-C and ACE was the strongest in four CVD events when VLDL-C and LDL-C were joint analyzed, ICVD events ranked the second. The risk for ischemic stroke also borderline increased with increasing VLDL-C and LDL-C (P > 0.05). CONCLUSION: Increased non-HDL-C is associated with increased risk of suffering ACE, ischemic stroke and ICVD and VLDL-C plays a critical role in the development of ICVD events, especially ACS, in middle aged Chinese population.

[Association between plasma fibrinogen concentration and ten-year change in blood pressure].

OBJECTIVE: To explore the association between plasma fibrinogen (FIB) concentration and ten-year change in blood pressure in Chinese population aged 35 - 64. METHODS: A prospective cohort comprising 2683 subjects was established in Beijing in 1992. Blood pressure (BP) and other traditional cardiovascular risk factors were assessed in 1992 and 2002 respectively, and plasma FIB concentration was measured in 1992. The association of plasma FIB with ten-year change in blood pressure was analyzed. RESULTS: (1) The median concentration of FIB among this population was 3.8 g/L (3.2 - 4.3 g/L), and the percentage of the people with abnormal FIB concentration (FIB > 4.0 g/L) was 33.4% in 1992. The FIB concentration of the females was higher than that of the males (P < 0.01) and the FIB concentration of the hypertensive subjects was significantly higher than that of the non-hypertensive subjects (P < 0.05), however, there was no significant difference in the abnormal FIB rate among different age groups. (2) Compared with the BP levels in 1992, the systolic BP and diastolic BP of this population increased by 10.0 mm Hg and 5.0 mm Hg respectively in 2002. The partial correlation coefficients of baseline FIB concentration with ten-year difference for systolic and diastolic BP were 0.125 (P < 0.01) and 0.047 (P < 0.05) respectively, and the absolute value of 10-year increase of systolic pressure in the subjects with abnormal FIB was significantly higher than that in those with normal FIB (P < 0.01). (3) The BP grade 2002 was higher than the baseline grade in 1992 in 49.6% of the study population. The BP grade increase rate of the subjects with abnormal FIB was 55.3%, significantly higher than that of the subjects with normal FIB (46.8%, P < 0.05). (4) In the population without baseline hypertension the risk of BP grade increase within 10 years in those with abnormal FIB was 1.46 times the risk in those with normal FIB, the multivariable OR (95% CI) was 1.457 (1.201 - 1.768) for those with normal BP and 2.082 (1.422 - 3.048) for those with hypertension. CONCLUSION: Plasma FIB concentration is associated with the BP change. Improvement of high coagulation and high adhesion help control BP, especially in people with hypertension.

[The association between white blood cell count and 10-year cardiovascular risk in a large Chinese cohort aged 35-64 years].

OBJECTIVE: To evaluate the association between white blood cell count and the risk of cardiovascular diseases (CVD) in subjects aged 35 - 64 years. METHODS: This prospective study was carried out in 11 provinces from 1992 to 2003. The association of baseline white blood cell count and cardiovascular disease occurrence was analyzed in 30 384 subjects aged 35 - 64 years using Cox multivariate proportional hazards regression. RESULTS: (1) Compared with the group of 4.0 - 4.9 x 10(9)/L, multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD, including coronary heart disease and ischemic stroke) increased continuously in proportion to increased white blood cell count. (2) White blood cell count had different impact on different types of CVD. Positive association was observed between white blood cell count and the risk of ischemic stroke, but the relationship between white blood cell count and the risk of hemorrhagic stroke was not significant. Compared with the referent group (4.0 - 4.9 x 10(9)/L), the risk of coronary heart disease of the group of white blood count > 9.0 x 10(9)/L increased by 70% (RR = 1.71, P < 0.05) and that of ischemic stroke increased by 80% (RR = 1.85, P < 0.01). CONCLUSION: The risk of ICVD and CVD increases continuously in proportion to increased white blood cell count, the white blood cell count might be used to predict future risk of CVD, especially risk for ICVD.

[Predictive value of combined measurements of body mass index and waist circumference for the risk of cardiovascular disease].

OBJECTIVE: To evaluate the predictive value of the combined measurements of body mass index (BMI) and waist circumference (WC) for the risk of cardiometabolic diseases (including diabetes, hypertension, and dyslipidemia) and ischemic cardiovascular disease. METHOD: A total of 30,378 Chinese people from 11 provinces were studied in this prospective study conducted from 1992 to 2003. Multivariable logistic and Cox regression were used respectively to determine the predictive value of WC for cardiometabolic diseases and ischemic cardiovascular disease within each BMI categories. RESULTS: (1) The prevalence of obesity were 10% defined by BMI. Among them, 76.4% had abdominal obesity defined by WC. The prevalence of abdominal obesity was 17.5% by WC categories, and 43.4% of them were classified as obesity by BMI. (2) The prevalence rates of cardiometabolic diseases were higher in individuals with elevated WC within each BMI category. (3) Compared with subjects with normal BMI and WC, the risk of ischemic cardiovascular disease increased by 38% (RR = 1.383, 95% CI 1.083 - 1.765) in overweight subjects with elevated WC and by 57% (RR = 1.570, 95% CI 1.226 - 2.010) in obese subjects with elevated WC. CONCLUSION: Combined measurements of BMI and WC provide a better prediction for the risk of cardiometabolic diseases and ischemic cardiovascular disease.

[Association between hypertensive left ventricular hypertrophy and cardiovascular events in adult Beijing residents: a cohort study].

OBJECTIVE: To analyze the impact of hypertensive left ventricular hypertrophy (LVH) on cardiovascular events (CVD) in adult Beijing residents. METHODS: CVD risk factor survey was conducted in 7023 Beijing residents aged 25 - 64 by a stratified-random sample design from 1984 to 1993 in three years interval. CVD events were followed up and the association of the hypertensive LVH and risk of CVD and total death was analyzed by multivariable Cox Regression Model. All subjects were followed up to December 2004. RESULTS: There were 211 non hypertensive LVH patients in the cohort and were excluded from the study. (1) There were 2240 hypertensive patients among 6812 subjects on baseline. The total prevalence of LVH was 11.8% (16.1% in male and 7.5% in female). (2) Compared to the group with normal blood pressure and without left ventricular hypertrophy, subjects with hypertensive LVH had significantly higher risk for acute coronary, acute stroke, total CVD and total death rate. The relative risks (RR) were 4.92 (95% CI: 2.3, 10.7), 4.2 (95% CI: 2.6, 7.0), 4.1 (95% CI: 2.6, 6.3) and 3.3 (95% CI: 2.0, 5.3), respectively. (3) Compared to the group with hypertension and without LVH, the group with hypertensive LVH had also significantly higher risk for acute stroke, total CVD and total death rate. The RR were 1.8 (95% CI: 1.1, 2.8), 1.7 (95% CI: 1.2, 2.3) and 1.7 (95% CI: 1.1, 2.7), respectively. (4) The population attribute risks (PAR) of hypertensive LVH to the incidents of acute CHD, acute stroke, total CVD and total death were 13.0%, 11.0%, 10.4% and 7.9%, respectively. CONCLUSIONS: Hypertensive left ventricular hypertrophy was an independent risk factor for long term risk of cardiovascular events and death.

[Serum triglyceride is an independent risk factor for acute coronary heart disease events in 35 - 64 years old Chinese-Chinese Multi-provincial Cohort Study.].

OBJECTIVE: To evaluate the association between serum triglyceride (TG) and the cardiovascular diseases (CVD) risk in Chinese population. METHODS: A total of 30, 378 men and women aged 35 - 64 years old were recruited in the Chinese-Chinese Multi-provincial Cohort Study (CMCS). The serum TG and other CVD risk factors were measured. All subjects were followed up annually or biannually for acute CVD events from 1992 to 2004. A Cox regression model was established to identify the association between TG and risk of CVD events. RESULTS: The accumulative incidence rate of acute coronary heart disease (CHD) events increased from 62.6/100 000 in the low TG groups to 168.4/100 000 in the high TG group divided by the quartile. TG was identified as an independent risk factor for CHD after adjustment for the confounding risk factors by a Cox regression model. Compared subjects with TG < 0.81 mmol/L, CHD risk increased 81% and 59% in subjects with TG 1.15 - 1.59 mmol/L and TG >/= 1.60 mmol/L, respectively (all P < 0.05). There was no significant association between TG level and the risks of hemorrhagic and ischemic stroke events (P > 0.05). CONCLUSION: Serum TG is an independent risk factor for acute CHD events in Chinese population aged 35 - 64.

[Impact of new criterion of glucose level on the prevalence of impaired fasting glucose and risk of ischemic cardiovascular diseases].

OBJECTIVE: To evaluate the effect of lowering the fasting plasma glucose (FPG) cutoff point for the criterion of impaired fasting glucose (IFG) in the 2003 ADA guideline on the prevalence of IFG and risk of ischemic cardiovascular diseases (ICVD) associated with IFG in Chinese population. METHOD: A prospective study was carried out in 11 provinces from 1992 to 2003. The baseline survey was conducted according to the WHO-MONICA protocol for risk factor surveys. These subjects have been followed-up for coronary heart disease (CHD) and stroke since the baseline survey. The association between baseline FPG and ICVD (CHD and ischemic stroke) events in 30 378 subjects aged 35 - 64 years in the 10-year follow-up period was analyzed. RESULTS: (1) Lowering the criterion for diagnosing IFG to 5.55 mmol/L increased the prevalence of IFG from 6.9% to 21.6% in Chinese population aged 35 - 64 years. (2) As compared with the group of FPG less than 5.55 mmol/L, the prevalence of other traditional CVD risk factors increased in the FPG level of 5.55 - 6.05, 6.11 - 6.94 and 6.99 mmol/L or above. (3) Univariate analysis method showed that the 10-year accumulated incidence and relative risk for ICVD increased with the elevated baseline level of FPG. (4) After adjusting for age and other ICVD risk factors (including hypertension, lipid disorder, smoking and obesity) FPG level of 5.55 - 6.05 mmol/L showed an independently predictive value for ICVD in men (RR = 1.302, 95% CI = 1.021 - 1.660), but not in women (RR = 1.255, 95% CI = 0.887 - 1.776). Hypertension, low HDL-C, smoking (men) and central obesity (women) were more strongly associated with ICVD than glucose status. CONCLUSIONS: The newly defined IFG criterion (FPG 5.55 - 6.94 mmol/L) increased the prevalence of IFG by more than 2 times in Chinese population aged 35 - 64 years. The 10-year accumulated incidence and relative risk for ICVD increased with the elevated baseline level of FPG. The predictive value of hyperglycemia for ICVD was weaker than that of other traditional risk factors. Comprehensive intervention for multiple risk factors clustering should be strengthened to reduce the overall risk of CVD.

[Relationship between metabolic syndrome and 10-year risk for incident type 2 diabetes mellitus].

OBJECTIVE: To analyze the relationship of metabolic syndrome (MS) and its components at baseline to the 10-year incidence of diabetes mellitus. METHODS: An investigation on cardiovascular disease (CVD) risk factors, including questionnaire survey, physical examination, and laboratory examination, was carried out in the populations of 4154 subjects, aged 35 approximately 64, in 2 communities (Peking University and Capital Iron and Steel Company area) collected by cluster sampling in the year 1992, with a response rate of 82.0%, so as to obtain baseline data. In 2002 a follow-up survey was conducted among these same populations, aged 45 approximately 74 then with a response rate of 70.0%. Complete data were obtained from 2740 subjects during the 2 investigations. The data of 2659 subjects who were diagnosed as without diabetes mellitus type 2 (T2DM) during the baseline survey, 1177 males (44.3%) and 1482 females (55.7%), were analyzed. RESULTS: (1) 112 patients with T2DM were discovered during the follow-up survey with an incidence of 4.2%, the incidence being 5.0% in males and 3.6% in females. (2) The proportions of those with different MS components were higher among the T2DM patients than those without T2DM. The proportion of baseline high fasting glucose was 71.43% among those who were diagnosed as with T2DM during the follow-up survey. Of the MS components high fasting glucose had the highest proportion among the T2DM patients. (3) Adjusted for age and sex, the results using a logistic regression model showed that abdominal obesity, triglycerides and fasting glucose were the independent factors associated with T2DM in addition of blood pressure and HDL cholesterol. Among them, fasting glucose contributed mostly to T2DM with a relative risk (RR) of 7.14 (4.62, 11.03). (4) Compared with those without both MS and high fasting glucose, the relative risk of T2DM for persons with MS but without high fasting glucose was 2.91 times that for those without MS and with normal fasting glucose. CONCLUSION: MS is an independent indicator for incidence of T2DM. Among the MS components, high fasting glucose contributes mostly to T2DM; however, the prediction of MS for T2DM cannot be entirely explained by high fasting glucose. Those without high fasting glucose but with MS should take early intervention measures to prevent the incidence of T2DM.

[Correlation between serum uric acid and insulin resistance].

OBJECTIVE: To assess the correlation between serum uric acid and insulin resistance in natural population of Beijing. METHODS: 1 056 people without-diabetes, 460 males and 596 females, aged 35-64 was selected from the natural population in Beijing using stratified-random sampling method. Serum uric acid, fasting blood glucose, insulin and other metabolic parameters were measured. The insulin activity index (IAI) was calculated to assess insulin resistance. RESULTS: The natural logarithm of IAI was decreased with the elevation of serum uric acid level (F = 47.884, P < 0.001). The prevalence of insulin resistance increased with the elevation of uric acid level, from 13.8% in quartile 1 to 33.9% in quartile 4. Compared to the quartile 1, the odds ratio (OR) of the quartile 2 for prevalence of insulin resistance was 1.935; the OR of the quartile 3 was 1.590; the OR of the quartile 4 was 2. 088. Uric acid was independently correlated with insulin resistance after adjustment for sex, age and main components of metabolic syndrome (MS). CONCLUSION: Serum uric acid is correlated with insulin resistance in Beijing natural population after adjustment of sex, age, and the main components of MS.

[Risk factors comparison in Chinese patients developing acute coronary syndrome, ischemic or hemorrhagic stroke: a multi-provincial cohort study].

OBJECTIVE: To observe the risk factors characteristic of patients developing acute coronary syndrome, ischemic or hemorrhagic stroke in a Chinese population aged 35 - 64 (n = 30 378). METHOD: This prospective study was carried out in 11 provinces in China from 1992 to 2003. The association between baseline risk factors and events in the 10-year follow-up period was analyzed. RESULTS: (1) A total of 809 events were recorded during the follow up period and 227 with acute coronary syndrome, 582 with stroke (ischemic 419, hemorrhagic 146, undefined 17) and the 10-year cumulative person-year incidence rates were 114/100,000, 209/100,000 and 73/100,000 for acute coronary syndrome, acute ischemic stroke and acute hemorrhagic stroke, respectively. (2) Rate of having > or = 1 modifiable risk factors was significantly higher in event group than that in subjects without events (89% vs. 64.7%, P < 0.01). (3) Sorted by intensity, the sequence of independently risk factors obtained from multivariate analysis for acute coronary syndrome were hypertension, smoking, hypercholesterolemia and low-HDL-C; for acute ischemic stroke event were hypertension, diabetes, low-HDL-C, smoking and obesity; for acute hemorrhagic stroke was hypertension. CONCLUSION: The morbidity for cardiovascular diseases is higher in Chinese population with various traditional risk factors than those without or having fewer traditional risk factors and there are various distinct independent risk factors pattern in patients with different cardiovascular diseases subtypes.

[Serum total cholesterol and 10-year cardiovascular risk in a Chinese cohort aged 35-64 years].

OBJECTIVE: To evaluate the association between serum total cholesterol (TC) and the risk of cardiovascular diseases (CVD) in subjects aged 35-64 years. METHODS: This prospective study was performed from 1992 to 2002 in 11 provinces of China and the association between baseline TC level and the development of cardiovascular diseases was analyzed in 30 384 subjects aged 35-64 years using Cox multivariate proportional hazards regression. RESULTS: (1) Compared with the group of TC < 3.64 mmol/L (140 mg/dl), multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD, including CHD and ischemic stroke) increased continuously with increasing TC level. (2) TC level was positively related to the occurrence of ischemic stroke, but not to hemorrhagic stroke. The risk of CHD increased by 74% (RR = 1.743) and the risk of ischemic stroke increased by 12% (RR = 1.119) in the group with TC > or = 5.72 mmol/L compared with the group with TC < 5.72 mmol/L (220 mg/dl). (3) High serum cholesterol was responsible to 5.9% of ICVD, 11.7% of the acute CHD and 2.9% of the acute stroke. (4) At each TC level, the 10-year risk of ICVD increased in the presence of other risk factors. CONCLUSION: Starting from TC of 3.64 mmol/L, the risk of ICVD increases continuously with increasing TC level. Multiple risk factor intervention should be strengthened to reduce the overall risk of CVD.

[Association between serum uric acid and triglyceride in a Chinese community].

OBJECTIVE: To Study the association between the level of serum uric acid and triglyceride in a Chinese population. METHODS: In 1999, a cross-sectional study was carried out in a natural population of Beijing, using stratified-random sampling method. Serum uric acid and triglyceride were measured in 1239 subjects. RESULTS: The prevalence of hypertriglyceridemia significantly increased with increased level of serum uric acid among both the men and women. After adjusting BMI, HOMA index and alcohol consumption level with stratified methods, the incidence of hypertriglyceridemia increased with increasing level of basal serum uric acid in different levels of BMI, HOMA index and alcohol consumption. After adjusting gender, age, BMI, HOMA index, total cholesterol, smoking and alcohol consumption, the results of multivariate logistic regression analyses indicated that the odds ratio for hypertriglyceridemia as compared with the lowest quartile of serum uric acid was 1.26 (P = 0.28) for the second quartile, 1.88 (P = 0.002) for the third quartile, and 3.36 (P < 0.001) for the highest quartile. CONCLUSIONS: Serum uric acid level was strongly associated with triglyceride independent of age, genders, smoking, alcohol consumption, obesity and insulin resistance.

[The effect of lipoprotein lipase (LPL) polymorphism on plasma LPL concentration and triglyceride].

OBJECTIVE: To study the effect of lipoprotein lipase (LPL)-HindIII and PvuII polymorphisms on preheparin plasma LPL concentration and triglyceride. METHODS: A cross-sectional study was carried out in a general population of Beijing in 1999, using stratified-random sampling method. LPL-HindIII and PvuII polymorphism and preheparin plasma LPL concentration were determined in 670 individuals aged 45 - 64. RESULTS: (1) The frequencies of H1H1, H1H2, and H2H2 genotypes were 0.646, 0.322, and 0.031 respectively; and the frequencies of P1P1, P1P2, and P2P2 genotypes were 0.410, 0.472, and 0.118 respectively. The distribution of genotypes and that of alleles were homogeneous in both sexes. (2) The plasma LPL concentrations of the 12 type heterozygotes (H1H2 and P1P2) and those of the 22 type (H2H2 and P2P2) homozygotes were all higher than that of the 11 type homozygotes (H1H1 and P1P1) (all P < 0.01). And the LPL concentration varied greatly among different individuals of the same genotype. (3) Smoking, alcohol consumption, BMI, and waist level influenced LPL concentration more significantly in the H1H1 and P1P1 homozygotes and P1P2 heterozygotes. Multivariate analysis showed that smoking and obesity were independent influencing factors of serum LPL concentration (both P < 0.01). (4) The prevalence rate of hypertriglyceridemia was significantly different among different genotypes, the 11 type homozygotes having the highest rate, and the 22 type homozygotes having the lowest. In the same genotype, along with the increase of the serum LPL concentration the prevalence of hypertriglyceridemia decreased (P < 0.05). CONCLUSION: LPL-HindIII and PvuII polymorphisms are determinants of plasma LPL concentration. This genetic effect can be modified by some environmental factors, such as smoking and obesity.

[Association between the metabolic syndrome and free fatty acid].

OBJECTIVE: To explore the association of free fatty acid (FFA) with the metabolic syndrome (MS) and its components. METHODS: A cross-sectional study on cardiovascular risk factors was carried out in a natural population of Beijing in 1999, recruited by a stratified-random sampling method. The association of FFA with MS and its components was analyzed in a sample of 997 subjects aged 35-64 years. RESULTS: (1) The prevalence of MS increased with FFA level. (2) After adjustment for age, sex, smoking, alcohol consumption, body mass index (BMI) and insulin resistance index using a multi-variable logistic regression, FFA was significantly associated with MS. The odds ratio (OR) for the second, third, and fourth quartiles of FFA was 3.1, 3.1 and 4.1, respectively (all P < 0.001). (3) FFA correlated significantly with triglycerides (TG), glucose, systolic blood pressure, diastolic blood pressure, and waist circumference in the correlation analysis (all P < 0.001). The strongest correlation was found between FFA and TG, but no significant correlation was found between FFA and high-density lipoprotein cholesterol (HDL-C). (4) After adjustment for other factors in the logistic regression, FFA was significantly associated with central obesity, hypertriglyceridemia, hypertension, and hyperglycemia, but not with low HDL-C. (5) After adjustment for FFA, BMI and other factors, insulin resistance was also associated with central obesity, hypertriglyceridemia, low HDL-C, and hyperglycemia, but not hypertension. CONCLUSION: FFA was associated with MS and four of the five components of MS, i.e. central obesity, hypertriglyceridemia, hypertension, and hyperglycemia. It is suggested that FFA be one of the underlying pathogenic factors or risk factors for MS. FFA and insulin resistance may lead to MS through different but synergistic mechanisms.

Associations between serum potassium and sodium levels and risk of hypertension: a community-based cohort study.

OBJECTIVE: Several studies have examined the relationships between dietary potassium and sodium and hypertension, but few have evaluated the association between serum potassium or sodium and risk of incident hypertension. We therefore investigated the associations between serum potassium and sodium and risk of incident hypertension in a Chinese community-based population. METHODS: A total of 839 normotensive individuals without cardiovascular disease from the Chinese Multi-Provincial Cohort Study who took part in the baseline examination in 2007-2008 and the follow-up survey in 2012-2013 were included in this study. Odds ratios (OR) and 95% confidence intervals (95%CI) for baseline serum potassium and sodium in relation to the risk of new-onset hypertension were evaluated using multivariate logistic regression models. RESULTS: During five years of follow-up, 218 (26.0%) individuals progressed to hypertension. Logistic regression adjusting for multiple confounders showed that every 1 mEq/L increment in baseline serum potassium level was associated with a 75% increased risk of hypertension (OR: 1.75; 95%CI: 1.01-3.04; P = 0.04). Compared with adults with serum potassium level of 4.20-4.79 mEq/L, adults with level ≥ 4.80 mEq/L had an 84% increased risk of hypertension (OR: 1.84; 95%CI: 1.14-2.96; P = 0.01). There was no significant association between serum sodium and risk of hypertension (OR: 0.96; 95%CI: 0.89-1.04; P = 0.33). CONCLUSIONS: Baseline serum potassium level, but not baseline serum sodium level, was positively related to the risk of incident hypertension in the Chinese population.

[A prospective study of relationship between blood pressure and 10-year cardiovascular risk in a Chinese cohort aged 35-64 years].

OBJECTIVE: To provide epidemiological data for the revision of The National Guideline for Prevention and Treatment of Hypertension through the analysis of the association between blood pressure (BP) and the risk of cardiovascular diseases (CVD) in a cohort aged 35-64 years. METHODS: A prospective study was carried out in 11 provinces from 1992 to 2002. The association between BP and CVD (CHD and stroke) was analyzed in 31728 subjects aged 35 - 64 years. RESULTS: (1) Compared with BP < 110/75 mmHg, the risk of CVD increased 1 time (RR=2.09), 2 times (RR=3.23), and 10 times (RR=11.81) when BP was 120-129/80-84 mmHg, 140-149/90-94 mmHg, and > or = 180/110 mm Hg, respectively. (2) The risk of acute CHD for subjects with stage 2 hypertension was 2.3 times of those with optimal BP, whereas the risk of ischemic stroke and hemorrhagic stroke was 4.9 times and 11.7 times, respectively. (3) 36.1% of all CVDs, 44.0% of the acute stroke and 23.7% of the acute CHD were attributable to hypertension. (4) In each BP level, the 10-year risk of CVD increased with the increased number of other risk factors. CONCLUSIONS: The risk of CVD increases with BP continuously from BP of 110/75 mmHg. Therefore, the cutpoint of the diagnostic criteria for hypertension is arbitrary. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce the overall risk of CVD.