Expression and Clinical Significance of Long Non-Coding RNA PRAL in Patients with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression and clinical significance of long non-coding RNA PRAL in patients with multiple myeloma(MM).@*METHODS@#Clinical data of 60 MM patients and 60 healthy people with the same age(as controls) were selected. Real time-quantitative fluorescence PCR (RT-qPCR) was used to determine the expression levels of serum LncRNA PRAL in the patients and controls, and the relationship of its expression with the clinicopathological characteristics and prognosis of patients was analyed.@*RESULTS@#LncRNA PRAL expression in MM patients was significantly lower than that in healthy people (F=13.294, P<0.001). LncRNA PRAL expression correlated with D-S staging and ISS staging in MM patients. PAD efficacy was significantly improved in MM patients with high expression of LncRNA PRAL, and median survival time was significantly prolonged (P<0.05).@*CONCLUSION@#LncRNA PRAL expression decreases in MM patients, while MM patients with high expression of LncRNA PRAL can obtain better therapeutic efficacy and longer survival time.

The prospective study of association between C-reactive protein and hypertension in community population / 中华预防医学杂志

<p><b>OBJECTIVE</b>The aim was to explore the association between high-sensitivity C-reactive protein level at baseline and hypertension in follow-up periods in a Chinese cohort.</p><p><b>METHODS</b>We analyzed data from a cohort established in "Prevention of metabolic syndrome and multi-metabolic disorders in Jiangsu province" in April 2000. A follow-up investigation was carried out for those whose follow up time met 5 years in June 2006. A total of 2035 persons completed investigation and hs-CRP was tested. Subjects with normal baseline blood pressure were classified into four groups(514, 498, 515 and 508 subjects in each group) according to quartiles of hs-CRP level (<1.3, 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L). The relationship between the risk of hypertension and baseline level of hs-CRP were analyzed using Cox proportional hazards regression model.</p><p><b>RESULTS</b>The median of follow up time was 6.39 years among the 2035 subjects (926 males and 1109 females). Hypertension incidence was 2378/100 000 person-years, 2942/100 000 person-years, 3693/100 000 person-years and 4390/100 000 person-years in hs-CRP < 1.3, 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L groups respectively. Compared to the group of hs-CRP < 1.3 mg/L, the relative risk (RR) (95%CI) of hypertension in groups of hs-CRP 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L was 1.22 (0.87-1.72), 1.43 (1.03-2.00), 1.70 (1.21-2.41) respectively, adjusted for sex, age, baseline blood pressure, BMI, smoking, alcohol drinking, physical activity and family history of myocardial infarction and diabetes.When stratified by quartiles of baseline blood pressure, the incidence of hypertension in each group increased with level of hs-CRP.In the group whose baseline SBP < 110 mm Hg (1 mm Hg = 0.133 kPa) , compared to the group of hs-CRP < 1.3 mg/L, RR (95%CI) were 2.24 (1.32-4.03), 2.57 (1.57-4.57) and 3.57 (2.54-5.90) in hs-CRP 1.3-1.9, 2.0-3.2 and ≥ 3.3 mg/L groups respectively.In the group whose baseline DBP < 65 mm Hg, RR (95%CI) were 1.78 (1.03-3.24), 2.74 (1.63-4.93) and 4.13 (2.35-7.27) respectively.</p><p><b>CONCLUSION</b>Inflammation was an important process in the development of hypertension.</p>

Effects related to gene-gene interactions of peroxisome proliferator-activated receptor on essential hypertension / 中华流行病学杂志

Objective To explore the impact of the gene-gene interaction among the single nucleotide polymorphisms (SNPs) of peroxisome proliferator-activated receptor α/δ/γ on essential hypertension (EH).Methods Participants were recruited based on the previous work of the PMMJS (Prevention of Multiple Metabolic Disorders and Metabolic Syndrome in Jiangsu Province) cohort study in Jiangsu province of China.A total number of 820 subjects were randomly selected from the cohort and received gene polymorphism detection covered ten SNPs:PPARα/δ/γ (PPARα:rs 135539,rs 1800206 and rs4253778 ; PPARδ:rs2016520 and rs9794; PPARγ:rs 10865710,rs 1805192,rs4684847,rs709158 and rs3856806).Generalized Multifactor Dimensionality Reduction (GMDR)model was used to evaluate the association between gene-gene interaction among the ten SNPs and EH.Results After adjusting factors as gender,age,BMI,FPG,TG,HDL-C,high fat diet,low fiber diet and physical activity,results from the GMDR analysis showed that the best qualitative trait models were 7/9-dimensional model (EH:cross-validation consistency were 9/10 and 10/10,prediction accuracy were 0.5862 and 0.5885),5/9-dimensional model (SBP:cross-validation consistency were 10/10 and 8/10,prediction accuracy were 0.6055 and 0.6011),and 8/9-dimensional model (DBP:cross-validation consistency both were 10/10,prediction accuracy were 0.5926 and 0.5972),while the best quantitative trait models were 4/5-dimensional model (SBP:cross-validation consistency were 10/10 and 8/10,prediction accuracy were 0.6111 and 0.6072),and 5-dimensional model (DBP:cross-validation consistency were 9/10,prediction accuracy were 0.5753).Conclusion Interactions among ten SNPs of PPARs seemed to have existed and with significant impact on the levels of blood pressure.

A prospective study on the association between dynamic change of waist circumference and incident hypertension / 中华流行病学杂志

Objective To study the impact on dynamic change of waist circumference(WC) through follow-up data on the incidence of hypertension in several cohort groups.Methods In this prospective study,2778 free-hypertension subjects were recruited from a program “Prevention of Multiple Metabolic disorders and metabolic syndrome (MS) in Jiangsu province” (PMMJS) to evaluate the risk of hypertension in relation to WC dynamic change on normal WC or abnorminal obesity group.Dynamic change of WC was measured by WC D-value,which was expressed by data on the difference of WC between baseline and the first follow up.Study outcome was defined as incident hypertension during the first to the second follow up period in this study.The association between dynamic change of WC and incident hypertension was analyzed by using Cox proportional hazards regression model.Results There were 2778 participants,660 subjects developed hypertension during the follow-up,regardless of the normality of the baseline WC,the risk of hypertension increased across the tertiles of WC,while the incidence of hypertension was higher in non-control group than that in control group.In populations with abdominal obesity and normal WC at baseline,RRs (95％CI) of hypertension were 1.95 (1.19-3.19) and 2.38 (1.89-2.99) in subjects with abdominal obesity seen at the first follow up period,compared to subjects with normal WC in the same period.After adjustment for gender,age and other hypertension related risk factors,in populations with abdominal obesity and normal WC at baseline survey,RRs (95％ CI) of hypertension were 4.36 (1.69-9.74) and 1.44( 1.03-2.35 ) respectively,for the non-control group.Conclusion WC dynamic change was associated with hypertension,WC control while WC reduction was important for early prevention on hypertension.

Interaction of both hypertriglyceridemic waist and impaired fasting glucose on the incidence of diabetes mellitus / 中华流行病学杂志

Objective To study the use ofhypertriglyceridemic waist (HTGW) to predict the occurrence of diabetes.Also to independently study whether there was an interaction between HTGW and impaired fasting glucose impaired fasting glucose (IFG) on the cause of diabetes.Methods We undertook a cohort study based on data from the “Prevention of Multiple Metabolic Disorders and Metabolic Syndrome (MS) Study in Jiangsu Province,China”.We used the logistic regression model to analyze the relations between both HTGW,IFG and diabetes mellitus and to evaluate the multiplied interaction between HTGW and IFG to include product terms method.Counting additive interaction was carried out under the Excel Calculation Sheet,compiled by Anderson and his colleagues.Results After adjusted for general risk factors and baseline fasting plasma glucose (FPG),results showed that subjects with HTGW had a 2.10 (95％ CI:1.36-3.25) adjusted relative risk (HR) of developing a diabetes when compared with those individuals without HTGW at the baseline study.When IFG was stratified,participants with HTGW were significantly associated with diabetes,regardless of IFG.The multi-adjusted HRs of diabetes were 3.09 (1.70-5.61) and 2.09 (1.08-4.02),respectively.Compared to the participants with non-HTGW and their FPG level below the threshold,those having HTGW and their FPG level was above the threshold,had the highest adjusted HR values [12.05 (95％CI:6.89-21.07)].Data from the additive interaction analysis showed that RERI as 7.00 (95％ CI:0.49-13.51),AP as 0.57 (95％ CI:0.32-0.82) and SI as 2.66 (95％ CI:1.36-5.21).Conclusion HTGW could predict the occurrence of diabetes,independent from IFG while the presence of HTGW with IFG could have an additive interaction on the cause of diabetes.

Impact of lifestyle and obesity to the risk of type 2 diabetes: a prospective study in Jiangsu province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the relative contribution of lifestyle and obesity to the risk of developing type 2 diabetes.</p><p><b>METHODS</b>All baseline survey data were based on the program Prevention of Multiple Metabolic Disorders and Metabolic Syndrome in Jiangsu Province (PMMJS) which was conducted during April 1999 to May 2004. In the baseline survey, 8685 participants were selected using multi-stage sampling method. Frem March 2006 to November 2007, 4582 participants who had been in the study for at least 5 years were included in the follow-up survey. A total of 3847 participants were followed and of them 3461 non-diabetic subjects were included in this analysis. High fat diet or not, low fiber diet or not, sedentary or not and occupational physical activity classification were defined as lifestyle variables and the incidence of type 2 diabetes at follow-up survey was defined as outcome variable. It was prospectively examined that the separate and joint association of lifestyle and obesity with the development of type 2 diabetes in subjects recruited from PMMJS, using logistic regression model.</p><p><b>RESULTS</b>A total of 162 incident cases of type 2 diabetes during 6.3 years of follow-up in total 3461 participants were documented. The incidence rate was 4.7%. After adjusted for sex, age, family history of diabetes, blood pressure, lipids and fast plasma glucose, risk of type 2 diabetes increased with lighter occupational physical activity (compared with vigorous group, moderate group aRR = 2.15, 95%CI: 1.26 - 3.68; light group aRR = 2.39, 95%CI: 1.12 - 4.87), sedentary lifestyle (aRR = 2.94, 95%CI: 1.90 - 4.54), low fiber diet (aRR = 1.58, 95%CI: 1.01 - 2.53), overweight (aRR = 1.33, 95%CI: 1.01 - 1.90) and obesity (aRR = 1.59, 95%CI: 1.07 - 3.75). In joint analysis of lifestyle and obesity, the impact of sedentary lifestyle (in BMI < 25 group, aRR = 3.42, 95%CI: 1.99 - 5.86; in BMI ≥ 25 group, aRR = 2.41, 95%CI: 1.13 - 5.12) and low fiber diet (in BMI < 25 group, aRR = 1.42, 95%CI: 0.81 - 2.54; in BMI ≥ 25 group, aRR = 2.63, 95%CI: 1.15 - 6.03) on diabetes were independent of overweight and obesity. When stratified by sedentary lifestyle or low fiber diet, there was no association between overweight/obesity and diabetes risk (sedentary aRR = 2.04, 95%CI 0.87 - 4.71, non sedentary aRR = 1.21, 95%CI: 0.82 - 1.78; non low fiber diet aRR = 1.26, 95%CI: 0.87 - 1.84, low fiber diet aRR = 1.88, 95%CI: 0.80 - 4.80).</p><p><b>CONCLUSION</b>Unhealthy lifestyle, overweight and obesity independently increase the risk of type 2 diabetes. The magnitude of risk contributed by sedentary lifestyle and low fiber diet are much greater than that imparted by overweight and obesity.</p>

Impact of dynamic change of waist circumference or body mass index in hypertension incidence / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the impact of dynamic change of waist circumference (WC) and body mass index(BMI) in two years on hypertension incidence in cohort populations.</p><p><b>METHODS</b>A perspective cohort study was conducted. The participants (5888 subjects) whose follow-time were 2 years or longer from the program Prevention of multiple metabolic disorders and metabolic syndrome (MS) in Jiangsu province were investigated. Amongst 5888 subjects, 4582 participants received the first follow-up investigation in January 2002. Among 4582 subjects who received first follow-up investigation and whose follow-time met 5 years, total 3847 participants received the second follow-up investigation in March 2006. Total 2778 free hypertension subjects were included in this analysis. Subjects with normal WC or BMI at baseline but abnormal WC or BMI at the first follow-up or subjects with abnormal WC or BMI both at baseline and the first follow-up were defined as non-control group. Subjects with abnormal WC or BMI at baseline but normal WC or BMI at the first follow-up or subjects with normal WC or BMI both at baseline and the first follow-up were defined as control group. The incidence of hypertension at second follow-up investigation was defined as the final variable(hypertension = 1, non-hypertension = 0). The association between dynamic change of WC or BMI and incident hypertension was analyzed by using Cox proportional hazards regression model. The OR, RR value and 95%CI were calculated through WC and BMI risk stratification.</p><p><b>RESULTS</b>Among 2778 participants without hypertension at baseline, 660 subjects developed hypertension. When both BMI difference value (D-value) and WC D-value were included in the regression model, WC D-value was associated with hypertension in both genders (males: OR = 1.04, 95%CI: 1.01 - 1.05; females: OR = 1.04, 95%CI: 1.02 - 1.06), but BMI D-value was not associated with hypertension in both men and women (males: OR = 1.04, 95%CI: 0.97 - 1.11; females: OR = 0.98, 95%CI: 0.93 - 1.03). Hypertension risk of WC non-control group was higher than that in WC control group in baseline normal and abnormal WC groups (normal baseline WC group: RR = 1.41, 95%CI: 1.01 - 2.39, abnormal baseline WC group: RR = 4.41, 95%CI: 1.66 - 9.80). But in baseline abnormal BMI group, there was no significant difference between BMI control and non-control group (RR = 1.33, 95%CI: 0.88 - 2.02). Whether BMI was controlled can not influence hypertension risk if WC was controlled (males: RR = 1.03, 95%CI: 0.36 - 2.96; females: RR = 1.02, 95%CI: 0.70 - 5.85), however, control WC could reduce hypertension risk obviously even though BMI was not controlled (males: RR = 4.03, 95%CI: 1.61 - 10.09; females: RR = 1.55, 95%CI: 1.13 - 3.60).</p><p><b>CONCLUSION</b>Both WC and BMI dynamic change were associated with change of hypertension. But reducing WC can decrease hypertension risk more than reducing BMI.</p>

A prospective study on the association between control of blood pressure and incidence of type 2 diabetes mellitus / 中华流行病学杂志

Objective To investigate the relationship on the effect of blood pressure (BP) control and the incidence of new diabetes mellitus (DM) in a follow-up study. Methods In this prospective study,non-diabetic subjects (n=3146,41% men) were recruited from the program "Prevention of Multiple Metabolic disorders and metabolic syndrome (MS) in Jiangsu province" (PMMJS) to evaluate the risk of DM in relation to BP control program on both healthy or hypertensive patients. Results During the follow-up period,102 subjects developed diabetes. In both healthy or hypertensive patients gropes,the incidence rates of diabetes increased along with the increase of either systolic or diastolic BP and were significantly higher in subjects who had become hypertension (5.6%) or patients with uncontrolled (7.1%) BP at baseline survey than in those who had maintained normal BP (1.9%) or with controlled BP at baseline surbey (2.2%). After adjusted for age,sex and other diabetes-related risk factors at baseline study,the aRR of diabetes incidence for subjects with normal BP at baseline who became hypertension (1.84,95%CI: 1.00-3.63) was higher than who maintained normal BP (1.90,95% CI: 1.03-3.74) after the follow-up program,and hypertensive patients with uncontrolled BP was higher than those with controlled BP. When adjusted for baseline MS,the aRR (95% CI) for subjects with normal BP at baseline who had developed hypertension was 1.70 (0.99-2.78) compared those remained normal BP levels after the follow-up program,and 1.90 (1.04-3.75) for hypertensive patients with uncontrolled BP when compared with those whose BP had been under control. Conclusion When the BP level had been effectively under control,the risk of deveploping a type 2 diabetes could be reduced.

Differential diagnosis of metastasis from non-metastatic lymph nodes in cervical cancers: pilot study of diffusion weighted imaging with background suppression at 3T magnetic resonance / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diffusion weighted imaging with background suppression (DWIBS) is potentially useful in detecting metastatic lymph nodes. This study aimed to evaluate the efficacy of DWIBS at 3T magnetic resonance (MR) for diagnosing metastatic lymph nodes in cervical cancer.</p><p><b>METHODS</b>This retrospective study included 25 patients with cervical cancer who underwent MR examination and were treated by hysterectomy and lymphadenectomy. The metastatic and non-metastatic lymph nodes were histologically proven by operation. Apparent diffusion coefficient (ADC) values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of all the identifiable lymph nodes were measured and compared.</p><p><b>RESULTS</b>Twenty-five primary tumor lesions, 17 metastatic lymph nodes and 140 non-metastatic lymph nodes were pathologically confirmed in 25 cases with cervical cancer. The difference of ADC values between primary tumor lesions, metastatic and non-metastatic lymph nodes were statistically significant (F = 7.93, P = 0.001). There was no statistically significant difference between primary tumor lesions of cervical cancer and metastatic lymph nodes (t = -0.75, P = 0.456), and the difference between primary tumor lesions and non-metastatic lymph nodes was statistically significant (t = 4.68, P < 0.001). The ADC values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of metastatic and non-metastatic lymph nodes were (0.86 ± 0.36) × 10(-3) mm(2)/s vs. (1.12 ± 0.34) × 10(-3) mm(2)/s, (1.51 ± 0.41) cm vs. (1.19 ± 0.36) cm, (1.16 ± 0.35) cm vs. (0.77 ± 0.22) cm, 0.78 ± 0.17 vs. 0.68 ± 0.19 respectively, and statistically significant difference existed between two groups.</p><p><b>CONCLUSIONS</b>DWIBS at 3T MR has the distinct advantages in detecting pelvic lymph nodes of cervical cancer. Quantitative measurement of ADC values could reflect the degree of restriction of diffusion of metastatic and non-metastatic lymph nodes. The combination of size and ADC value would be useful in the accurate diagnosis of metastatic lymph nodes.</p>

A prospective study on the association between lipid accumulation product or body mass index and diabetes / 中华流行病学杂志

Objective To measure the association between lipid accumulation product (LAP) or body mass index (BMI) and diabetes. Methods In this prospective study, subjects were recruited and followed up for more than five years from the program "Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province" (PMMJS). A total number of 3598 people participating in the follow-up program, with complete information. Incidence rates of diabetes and relative risk in different levels of LAP and BMI were compared and analyzed. Areas under the receiver operation characteristic curve for obesity indicators such as LAP, BMI, waist circumference (WC), waist-to-hip ratio (WHR) in predicting diabetes of cohort population were calculated. Results The number and the cumulative incidence of diabetes increased with the LAP levels in both men and women. After adjusting for age and other traditional risk factors on diabetes, the adjusted risk ratios (aRR) value of diabetes were 4.33(1.34-14.01) for men and 5.04(2.06-12.34) for women, between the highest and the lowest level of LAP groups. When further adjusted for BMI, the aRR value decreased to 3.15 (1.13-8.80) for men and 4.84(2.16-10.84) for women. The number and the cumulative incidence of diabetes also increased with the BMI levels in both men and women but not significantly as the LAP showed, and the aRR values were 1.34 (0.61-2.93) for men and 1.69 (0.91-3.06) for women in the highest level of BMI group, when compared with the lowest level group. Again, when further adjusted for LAP, the aRR values decreased to 1.23 (0.59-2.69) for men and 1.39(0.74-2.60) for women. The area under the ROC curve(AUC) for the four kinds of obesity indicators in predicting diabetes in the descending order were LAP, WHR, WC, BMI in both men and women. Conclusion LAP seemed more associated to diabetes than to BMI. When comparing with weight gain, diabetes might be more closely associated with the lipid accumulation product.

A comparison between the metabolic syndrome score and the Framingham risk score in the prediction of cardiovascular disease / 中华流行病学杂志

Objective To compare metabolic syndrome(MS)score with the 10-year-Framingham risk score(FRS)to predict the occurrence of cardiovascular disease(CVD).Methods MS score for prediction of CVD was developed based on the 10-year FRS.Cox proportional hazard model and receiver-operating characteristic(ROC)curves were used to compare the predictive effects,based on data from a cohort study on the prevention of multiple metabolic disorders and MS in Jiangsu province.Results Area under the curve(AUC)increased after changing MS components into continuous variables.AUC of MS score/MS components aggregation was 0.70/0.65,P＜0.05 and sensitivity of MS score/MS components aggregation was 80.5%/74.4% for a given specificity.After mutually adjusted risk factors of MS score and the FRS,when age was exclusively excluded,AUC of the FRS decreased from 0.78 to 0.65(P＜0.05).However,when age was included,the AUC of MS score increased to 0.78(sensitivity of MS score including the age/the FRS:90.2% vs.87.8 %);In Cox proportional hazards multiple risk factors analysis,MS score including age appeared greater association with CVD than FRS on the same exposed subjects.Conclusion The new developed MS score with age included was a valid tool for predicting CVD and its predictive ability was as good as the FRS.

A comparison of applicability in three diagnostic criteria of metabolic syndrome in Jiangsu population / 中华预防医学杂志

<p><b>OBJECTIVE</b>To compare the applicability of the three diagnostic criteria for metabolic syndrome (MS) proposed by the International Diabetes Federation (IDF) in 2005, Adult Treatment Panel III of National Cholesterol Education Program (NCEP-ATP III) in 2005 and Chinese Diabetes Socie (CDS) in 2004.</p><p><b>METHODS</b>Based on the findings of cohort study of multiple metabolic disorders and metabolic syndrome (1971 cases) in Jiangsu province, MS was diagnosed according to these three definitions respectively, and by calculating the sensitivity, specificity, and ROC curve distance, those with lower false positive and false negative rates were identified as to detecting cardio vascular diseases (CVD) and type 2 diabetes mellitus (T2DM). While, through Cox regression analysis, to compare their relative risk (RR) and 95% confidential interval (CI) was wade.</p><p><b>RESULTS</b>Among three diagnostic criteria, the specificity by CDS of MS was higher than the other criteria (83.52%, 76.36%, 89.57%; 85.02%, 78.67%, 92.28%), however the sensitivity of CDS of MS was low (40.82%, 29.47%). When using CDS, over 50 percent of diagnosis might be missed. ATP III definition corresponded to the shortest distance in ROC curve, namely, at the diagnostic criteria, the rates of false positive and false negative for identifying clustering of CVD and T2DM were minimum (0.4369; 0.5777). The incidence of CVD [5.59 (2.62 - 11.92) vs 2.90 (1.41 - 5.93)], T2DM [3.36 (1.92 - 5.79) vs 1.97 (1.16 - 3.34)] was significantly higher in cases of ATP III+/IDF-than ATP III+/IDF+, as compared with ATP III-/IDF-.</p><p><b>CONCLUSION</b>Among three diagnostic criteria, the ATP III definition of the MS should be the most applicable diagnostic criteria for MS in Jiangsu population.</p>

Association and interaction between the components of metabolic syndrome and cardiovascular disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the association and interaction between the components of metabolic syndrome (MS) and cardiovascular disease (CVD).</p><p><b>METHOD</b>In this cohort study, participants (total 3598, male 1451) were recruited and followed up for five years from the program "prevention of multiple metabolic disorders and MS in Jiangsu province". We used modified Asian criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) to define the presence of MS. COX regression was used to analyze the association between the MS and its components with CVD; both the multiplication of blood pressure (BP) and 2, 3, or 4 other components of MS in the logistic regression model and the estimation of the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (S) and 95% confidence intervals (95%CI) were used to evaluate the interactions between the components of MS.</p><p><b>RESULTS</b>After adjustment for traditional CVD risks, the adjusted risk ratio (aRR) of CVD was 2.49 (95%CI: 1.59 - 3.90) in the MS group compared with the non-MS group at baseline. The aRRs of MS components to CVD were as follows: 1.44 (95%CI: 0.88 - 2.37) for waist circumference; 2.84 (95%CI: 1.73 - 4.68) for BP; 1.31 (95%CI: 0.83 - 2.07) for low high density lipoprotein; 1.84 (95%CI: 1.19 - 2.85) for triglyceride; 1.55(95%CI: 0.98 - 2.45) for fasting plasma glucose, respectively. BP was the single component significantly related to CVD (aRR = 2.58, 95%CI: 1.55 - 4.29). The risk of CVD was significantly increased (aOR = 4.47, 95%CI: 2.35 - 8.51) when BP was combined with 2, 3 or 4 other components of MS in the participants.</p><p><b>CONCLUSIONS</b>Only BP is an independent CVD risk factor in the components of MS, the risk of CVD was significantly increased when BP was combined with other components of MS in this cohort.</p>

A prospective study on the association between dyslipidemia and hypertension / 中华流行病学杂志

Objective To discuss the risks of hypertension development with relation to the level of lipid variables among populations who had normal blood pressure at baseline study. Methods In April 2000, under the support of project "prevention of metabolic syndrome and multi-metabolic disorders in Jiangsu province", a cohort study was performed to obtain the baseline data among 8685 persons from age 34 to 74. In June of 2006, a follow-up investigation was carried out among those who had been in the study for 5 years after the baseline study started. 2603 persons who met the selection criteria and showed normal blood pressure during baseline study, were recruited in this investigation. The interval from the baseline to the follow-up studies was 6.38 years on average. Relationship between the risk of developing hypertension and the baseline level of lipid variables were analyzed. Results Relations between baseline lipid levels and the incidence of hypertension during the follow-up was discovered. In gender and age adjusted model, the lipid variables were all associated with hypertension(Wend test, P<0.01). In multivariable-adjusted model, HDL-C [aRR=0.71 (95%CI: 0.61-0.99)], non-HDL-C [αRR=1.28 (95%CI: 1.14-1.83)], TC/HDL-C ratio[aRR=1.41 (95%CI: 1.25-2.03)] and TG [αRR=1.49(95%CI: 1.30-2.13)] were again associated with hypertension (trend test, P<0.05). Even the αRR was much weakened after the baseline SBP, DBP were adjusted with Cox model, the significant relation of hypertension to HDL-C, TC/HDL-C ratio and TG still existed. Excluding the two factors of obesity (BMI≥28) and diabetes which had been recognized in marked linking with hypertension, lipid variables were still associated with hypertension. Conclusion Dyslipidemia might occur before being hypertensive. Hypertension was associated with HDL-C, TC/HDL-C and TG or even exclusion of obesity, diabetes and factors of smoking and drinking or baseline level of SBP, DBP were adjusted.

Reaffirmation and classifcation of the areas with highwater iodine and the endemíc areas of íodine excess goiter in Jiansu Provice / 中国地方病学杂志

Objective To affirm and calssify the arsas with high water iodine and the endemic areas of indline excess goiter in Jiangsu Privince accirding to mational standard.Methods A cross section survey was condueted in 2005 at township level in Fenxian,Tongshan,Suining,Pizhou counties in Xuzhou municipal and Chuzhou district in Huai'an municipal in Jiangsu Province One sample of dringing well water from five directions in the five villages located dircetions of every township namely east west south north and central.was tested for its water iodine concentration.If the sample number sas less than 5 in one village,then all the well water would be tested Endemic stutas of iodine excess goiter was investigated in those townships whose menian water iodine comcentration was between 150 to 300 μg/L Then status was affirmed and reclassifed according.to National Criteria GB/T 19280-2003 Results In all 158 tawnships from the 6 counties the median of water iodine concentration in 79 townships were over 150 μg/L with 32 townships in the range of 150 to 300μg/L In those 32 townships 9 met the criteria of area of high water iodine 23 accorded with that of encemic areas of iosine excess goiter 16 had stopped the supply of non-iodzed salt in advace,but 16 newly detected areas were still served with iodized salt Four were 300 μg/L Conctusions Iodized salt intervention should be stopped in all townships with the problems of high water iodine and the endmic areas of iodine excess goter in order to prevent the possible hazards due to double intade.

Study on the association between polymorphism of TAP1 637 A/G alleles polymorphism and metabolic syndrome / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the effect of the transporter 1 associated with antigen processing (TAP1) gene 637 A/G polymorphism on the risk of metabolic syndrome(MS).</p><p><b>METHODS</b>A case-control study was conducted on 138 based-community patients (68 males and 70 females, 61.31 +/- 11.00 years old) diagnosed as MS with 162 healthy subjects (74 males and 88 females, 48.73 +/- 11.66 years old) came from the same origin as cases. The allele polymorphisms TAP1 637 A/G was examined by the specificity restriction fragment length polymorphism-polymerase chain reaction(RFLP-PCR) method with genomic DNA. The effect of TAP1 637 A/G polymorphisms on MS were analyzed by multivariable unconditional logistic regression models.</p><p><b>RESULTS</b>The TAPI 637 A/G allele genotypes frequencies (83.3%, 16.7%) contribution in control group were consistent with the distribution predicted by Hardy-Weinberg equilibrium (chi2 = 1.46, P > 0.05). TAP1 637 G allele genotypes frequencies (26.1%) of cases were significantly higher than controls (16.7%) with P = 0.005. There were significant differences of AA (58.0%), AG (31.9%) and GG (10.1%) genotypes in cases than controls, AA (68.5%). AG (29.6%) and GG (1.9%) for recessive model and addictive model after age was adjusted with P value as 0.006 and 0.044, but no significant differences for dominant model (P = 0. 298). Results from recessive model with OR = 6.62, 95% CI :1.73-25.31, Addictive model with OR = 1.56, 95% CI:1.01-2.41 and one-way ANOVA analysis showed that systolic blood pressure(SBP) and diastolic blood pressure (DBP) levels of GG genotype were significantly higher than AA or AG genotype (P < 0.05) whereas no significantly statistical differences for other clinical characteristics.</p><p><b>CONCLUSION</b>The TAP1 637 allele A to G alteration or genotype AA to GG and AG to GG alterations could increase the risk of MS significantly, especially for SBP and DBP levels, and this positive association results might be helpful to support the biological role of TAP1 in MS but in need of larger sample size to provide more powerful evidences.</p>

Study on C-reactive protein and the risk factors of traditional coronary heart disease / 中华流行病学杂志

<p><b>OBJECTIVE</b>To ascertain the relationship between C-reactive protein (hs-CRP) and risk factors of traditional coronary heart disease (CHD) in a sampled population from Jiangsu province of China.</p><p><b>METHODS</b>Using data derived from a project on multiple metabolic disorders and metabolic syndrome in Jiangsu province, a cross-sectional study was carried out. Criteria was set as: CRP level categories from 1 to 2.99 mg/L, and greater than 3 mg/L, to explore the relationship between different category of CRP and risk factors of traditional coronary heart disease which would include body mass index (BMI), cigarette smoking, high blood pressure, blood glucose, total cholesterol level, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) level, physical activity etc.</p><p><b>RESULTS</b>The attack rate of high CRP increased with the degree of risk factors related to traditional coronary heart disease. However, when hs-CRP fell between 1-2.99 mg/L, part of the traditional risk factors would display significance. Significance increased in high CRP related to grading was observed across the Framingham heart score (quintiles). Data from the logistic regression analysis showed that: when hs-CRP (> or =3 mg/L), the OR of BMI, TG, high blood pressure, HDL-C, cigarett smoking, blood glucose all appeared statistical significance whereas hs-CRP between 1-2.99 mg/L, the OR of trational CHD risk factors did not show statistical significance but 60.98% of the males and 59.02% of the females would have high hs-CRP incriminate traditional CHD risk factors.</p><p><b>CONCLUSION</b>As the close relationship between traditional CHD risk factors and hs-CRP was seen, the role of hs-CRP in estimating the risk of CHD was limited, despite the origin of data, either from clinical or from cohort study.</p>

Study on the risk factors of metabolic syndrome in Jiangsu province, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the associated risk factors of metabolic syndrome in Jiangsu province, China.</p><p><b>METHODS</b>Using identical protocol and questionnaire, an epidemiological study was carried out in a population of 5888 adults in 12 counties in Jiangsu. Anthropometric test and blood sampling were conducted at the time of interview. IDF (2005) was used as the diagnostic criteria of metabolic syndrome . The prevalence and age-standardized prevalence of metabolic syndrome were calculated. Univariate and multivariate logistic regression model were used to identify associated risk factors.</p><p><b>RESULTS</b>The prevalence and age-standardized prevalence of metabolic syndrome in Jiangsu were 19.07% (11.10% in males and 25.72% in females) and 17.48% (11.49% in males, 22.86 % in females), respectively. Among the potential risk factors of metabolic syndrome as gender, age, education level, occupation, income, physical activity, smoking, alcohol drinking, disease family history, data from univariate and multivariate logistic regression analyses suggested that gender (OR = 1.91), age (OR = 1.15), physical inactivity (OR = 1.94), with hypertension family history (OR = 1.99) and with obesity family history (OR = 6.24) could significantly increase the risk of disease development.</p><p><b>CONCLUSION</b>Metabolic syndrome has become a significant public health problem among the adults in Jiangsu province.</p>

Study on the prevalence of metabolic syndrome among 35-74 year-olds in Jiangsu province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the prevalence of metabolic syndrome (MS) in Jiangsu province, using IDF 2005 and ATP III 2005 definition.</p><p><b>METHODS</b>Multistage cluster sampling method was used and the participants were interviewed by trained health workers under a structured questionnaire. The number of research subjects was 5888. Fasting plasma glucose (FPG), blood lipids, body mass index, blood pressure (BP) of all sample population (5888 subjects) were measured.</p><p><b>RESULTS</b>The prevalence of MS was 17.48% by IDF 2005 definition and 21.95% by ATP lII 2005 definition. Women had higher prevalence than men (P < 0.01). The prevalence of MS increased with age. Abrupt increase of the prevalence started at age of 50 in women. The prevalence varied by education, marital status, occupation and income. People from the urban and the south had a higher prevalence than from the rural and from the northern part of the country. The most common combination of MS individual components were 1) central obesity, dislipidemia and high BP; 2) central obesity, dislipidemia, high BP and high FPG.</p><p><b>CONCLUSION</b>The prevalence of MS was high in Jiangsu province. Clustering of MS components was common. It is necessary to discuss the cut-off points of central obesity for the waist circumference diagnostic criteria of MS in Chinese population. The importance of prevention of MS should be strengthened both by health professionals and the government.</p>

Study on the comparison of three diagnostic criteria of metabolic syndrome in Jiangsu population / 中华流行病学杂志

<p><b>OBJECTIVE</b>To compare the significance of the application in Jiangsu population using the diagnostic criteria for metabolic syndrome(MS) proposed by the IDF in 2005, ATP III in 2005 and CDS in 2004.</p><p><b>METHODS</b>Based on the populations in Jiangsu province from a project of Multiple Metabolic Disorders and MS, the study was conducted including 5888 cases, with data of plasma glucose, lipid profile, blood pressure, serum insulin etc. MS was diagnosed and compared according to these three definitions respectively.</p><p><b>RESULTS</b>The age-adjusted MS prevalence rates were 17.48%, 21.95% and 9.59% according to the IDF(2005), ATP III (2005) and CDS (2004) respectively. The agreement in the diagnosis of MS using ATP III (2005) and CDS(2004) definitions was 85.11%, and the agreement in the diagnosis of MS using IDF(2005) and CDS definitions was 87.35%. The agreement in the diagnosis of MS using IDF (2005) and ATP III (2005) definitions was 95.14%. The MS subjects diagnosed by the ATP III (2005) was 1.26 higher than subjects diagnosed by the IDF(2005) definition. The ratios of prevalence rates of high waist circumference(WC), MS_IDF (2005) and MS_ATP III (2005) was 2.17, 1.99 and 1.54 in sex ratio (woman to man).</p><p><b>CONCLUSION</b>The agreement in the diagnosis of MS using the IDF(2005) and ATP III (2005) definition was higher than using CDS(2004) and other two definitions. For diagnosing MS, the cut off of WC in IDF(2005) and ATP III (2005) seemed not appropriate and the diagnostic criteria used for ATP III (2005) (waist circumference of man 85 cm, woman 80 cm) could identify more MS.</p>