Association Between Sleep Quality and Hypertension in Chinese Adults: A Cross-Sectional Analysis in the Tianning Cohort.

Background: Poor sleep quality is becoming very common in a developed society and relates to many health disorders. However, the association between sleep quality and hypertension has not been well studied in Chinese adults. Methods: Blood pressure was measured and sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) for 5167 participants (mean aged 51±15 years, 41.5% males) in the Tianning Cohort. A logistic regression model was constructed to examine the association between sleep quality, as well as its components, and hypertension, adjusting for age, sex, education level, current smoking, current drinking, physical activity, obesity, glucose, and blood lipids. Results: After multivariate adjustment, a higher score Of the PSQI was significantly associated with an increased risk of prevalent hypertension (OR=1.03, P=0.018). Compared to participants with normal sleep (the PSQI score <5), those with a poor sleep quality (the PSQI score ≥5) had a 17% increased risk of prevalent hypertension (OR=1.17, P=0.042). Three of the seven components of sleep quality, such as subjective sleep quality (OR=1.17, P=0.001), sleep latency (OR=1.11, P=0.010), and sleep disturbances (OR=1.19, P=0.004), were also significantly associated with prevalent hypertension. Conclusion: Poor sleep quality is increasingly prevalent in developed societies and may be related to an increased risk of hypertension in Chinese adults. The underlying causality is waiting to be studied.

Soluble Corin Predicts the Risk of Cardiovascular Disease: A 10-Year Follow-Up Study.

Background: As a key enzyme of the natriuretic peptides system, corin may participate in the development of cardiovascular disease (CVD). Its level in circulation predicted CVD recurrence in patients with myocardial infarction and heart failure, but no study examined this prediction in general populations. Objectives: This study sought to examine the prospective association between corin and CVD in a community-based population of Chinese adults. Methods: The Gusu cohort included 2,498 participants (mean age 53 years, 39% men) who were free of CVD at baseline. Serum corin was measured by enzyme-linked immunosorbent assay kits at baseline and CVD events were followed every 2 years for all participants. A competing-risks survival regression model was used to examine the association between serum corin and CVD. Results: During 10 years of follow-up, 210 participants developed CVD including 88 stroke events. A higher serum corin (after log-transformation) at baseline was significantly associated with an increased risk of CVD (HR: 1.88; P = 0.019) and stroke (HR: 3.19; P = 0.014). Analysis using categorical serum corin (in quartiles) showed that participants in the highest quartile had a 62% and 179% increased risk for CVD (HR: 1.62; P = 0.024) and stroke (HR: 2.79; P = 0.004), respectively, compared with those in the lowest quartile. We did not find a significant association between serum corin and coronary heart disease. Conclusions: A higher serum corin at baseline predicted a higher risk of CVD events and stroke, but not coronary heart disease, in Chinese adults, independent of conventional risk factors. Serum corin may be a predictor for stroke but the underlying mechanism needs further investigation.

Elevated Uric Acid Mediates the Effect of Obesity on Hypertension Development: A Causal Mediation Analysis in a Prospective Longitudinal Study.

Objective: Although elevated uric acid is associated with obesity and considered a predictor of hypertension, the causal linkage between the three metabolic conditions is not very clear. We aim to examine whether elevated uric acid mediates the effects of obesity on hypertension development. Methods: A total of 1984 participants (mean aged 53 years, 62.10% female) with repeated measurements of obesity, blood pressure, and uric acid 4 years apart in the Gusu cohort were included. We first applied cross-lagged panel analysis and bidirectional association analysis to delineate the temporal association between obesity and hyperuricemia. Then, a causal mediation model was constructed to further examine the causal role of hyperuricemia in the linkage between obesity and hypertension. Age, sex, education, cigarette smoking, alcohol consumption, fasting blood glucose, and lipids were adjusted. Results: The cross-lagged panel analysis demonstrated that the relationship from baseline obesity to follow-up hyperuricemia was stronger than that from baseline hyperuricemia to follow-up obesity (ß: 0.09 vs 0.06, P<0.01 for BMI, ß: 0.13 vs 0.07, P<0.01 for WC). Bidirectional association analysis found that baseline obesity predicted the risk of incident hyperuricemia (OR = 1.09, P<0.01 for BMI, OR = 1.05, P<0.01 for WC), but the other directional association was not statistically significant (all P>0.05). The causal mediation analysis found that hyperuricemia partially mediated the association of baseline BMI (mediate proportion: 3.09%, 95% CI: 0.97%~6.00% for SBP, 3.74%, 95% CI: 1.55%~7.00% for DBP) and baseline WC (mediate proportion: 5.56%, 95% CI: 2.01%~11.00% for SBP, 5.81%, 95% CI: 2.59%~10.00% for DBP) with follow-up blood pressures. Conclusion: Obesity preceded hyperuricemia and the latter partially mediated the relationship between obesity and hypertension, independent of behavioral and other metabolic factors.

N-Phenyl-substituted poly(benzimidazole imide)s with high glass transition temperature and low coefficient of thermal expansion.

To obtain high thermostable materials for flexible display substrates, a series of copoly(benzimidazole imide)s was prepared using 5-amine-2-(4-aminobenzene)-1-phenyl-benzimidazole (N-PhPABZ) and 6(5)-amino-2-(4-aminobenzene)-benzimidazole (PABZ). Incorporating N-phenyl groups effectively healed the brittleness of the poly(benzimidazole imide)s (PBIIs) derived from pyromellitic dianhydride (PMDA), and the resultant homo- and copoly(benzimidazole imide)s displayed an outstandingly high glass transition temperature (T g > 450 °C) and a low coefficient of thermal expansion (CTE < 10 ppm K-1). Furthermore, the influence of removing intermolecular hydrogen bonds on the properties of these poly(benzimidazole imide)s was systematically analyzed. These data provide a feasible method to prepare superheat-resistant poly(benzimidazole imide)s without H-bonding.

Association between CORIN methylation and hypertension in Chinese adults.

BACKGROUND: Corin, a physical activator of atrial natriuretic peptide, has been associated with hypertension with unclear mechanisms. Here, we aimed to examine whether CORIN gene methylation was involved in the underlying molecular mechanisms. METHODS: DNA methylation levels of CORIN were measured by target bisulfite sequencing using genomic DNA isolated from peripheral blood mononuclear cells in 2498 participants in the Gusu cohort (discovery sample) and 1771 independent participants (replication sample). We constructed a mediation model with DNA methylation as the predictor, serum corin as the mediator, and hypertension as the outcome, adjusting for covariates. Multiple testing was controlled by false discovery rate (FDR) approach. RESULTS: Of the 9 CpGs assayed, hypermethylation at all CpGs were significantly associated with a lower level of blood pressure in the discovery sample and eight associations were also significant in the replication sample (all FDR-adjusted p<0.05). Serum corin mediated approximately 3.07% (p=0.004), 6.25% (p=0.002) and 10.11% (p=0.034) of the associations of hypermethylation at one CpG (Chr4:47840096) with systolic and diastolic blood pressure, and hypertension, respectively. All these mediations passed the causal inference test. CONCLUSIONS: These results suggest that hypermethylation in the CORIN gene is associated with a lower odds of prevalent hypertension and may be involved in the role of corin in blood pressure regulation.

NPPA Promoter Hypomethylation Predicts Central Obesity Development: A Prospective Longitudinal Study in Chinese Adults.

INTRODUCTION: Atrial natriuretic peptide plays a potential role in obesity with unclear molecular mechanisms. The objective of this study was to examine the association between its coding gene (natriuretic peptide A [NPPA]) methylation and obesity. METHODS: Peripheral blood DNA methylation of NPPA promoter was quantified at baseline by targeted bisulfite sequencing for 2,497 community members (mean aged 53 years, 38% men) in the Gusu cohort. Obesity was repeatedly assessed by body mass index (BMI) and waist circumference (WC) at baseline and follow-up examinations. The cross-sectional, longitudinal, and prospective associations between NPPA promoter methylation and obesity were examined. RESULTS: Of the 9 CpG loci assayed, DNA methylation levels at 6 CpGs were significantly lower in participants with central obesity than those without (all p < 0.05 for permutation test). These CpG methylation levels at baseline were also inversely associated with dynamic changes in BMI or WC during follow-up (all p < 0.05 for permutation test). After an average 4 years of follow-up, hypermethylation at the 6 CpGs (CpG2 located at Chr1:11908348, CpG3 located at Chr1:11908299, CpG4 located at Chr1:11908200, CpG5 located at Chr1:11908182, CpG6 located at Chr1:11908178, and CpG8 located at Chr1:11908165) was significantly associated with a lower risk of incident central obesity (all p < 0.05 for permutation test). CONCLUSIONS: Hypomethylation at NPPA promoter was associated with increased future risk of central obesity in Chinese adults. Aberrant DNA methylation of the NPPA gene may participate in the mechanisms of central obesity.

Associations Between Trajectory of Different Blood Pressure Components in Pregnancy and Risk of Adverse Birth Outcomes - A Real World Study.

BACKGROUND: High blood pressure during pregnancy has been suggested to be associated with adverse birth outcomes (ABO), but it is unclear how different blood pressure changes and the extent of the effect. Therefore, we aimed to investigate the association between blood pressure trajectories (systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP)) of pregnant women and ABO in a real-world study. MATERIAL AND METHODS: Leveraging 28,679 pregnant women and their fetuses from a register-based cohort from January 1, 2010, to December 31, 2019. Blood pressure trajectories were estimated by package "traj" in R software using real-world blood pressure data of routine antenatal care examinations. Logistic regression models were applied to examine the association between trajectories of different blood pressure components (SBP, DBP, MAP, and PP) during pregnancy and the risk of ABO. RESULTS: Trajectories of all blood pressure components were identically labeled as low-stable, moderate-increasing, moderate-decreasing and high-stable. After adjusting for confounding factors, compared with pregnant women with the low-stable pattern, pregnant women with a high-stable or moderate-increasing pattern had a significantly increased risk of developing adverse birth outcomes. Pregnant women with a moderate-decreasing pattern had no significant increased risk of ABO but had a lower risk of adverse birth outcomes than those with a moderate-increasing pattern. The trajectories crossed at 17-20 weeks of gestation for all blood pressure components. CONCLUSION: Our study results indicated that reduction and maintenance of blood pressure to a low level of less than 110 mmHg for SBP and 65 mmHg for DBP after 20 weeks of gestation would benefit prevention of adverse birth outcomes, regardless of the level of blood pressure at early pregnancy.

3D Printing of Lightweight Polyimide Honeycombs with the High Specific Strength and Temperature Resistance.

Lightweight structures are often used for applications requiring higher strength-to-weight ratios and lower densities, such as in aircraft, vehicles, and various engine components. Three-dimensional (3D) printing technology has been widely used for lightweight polymer structures because of the superior flexibility, personalized design, and ease of operation offered by it. However, synthesis of lightweight polymeric structures that possess both high specific strength and glass transfer temperature (Tg) remains an elusive goal, because 3D printed polymers with these properties are still very few in the market. For example, 3,3',4,4'-biphenyl tetracarboxylic dianhydride (BPDA) and p-phenylenediamine (PDA)-type (UPILEX-S type) polyimides show exceptional thermal stability (Tg up to ≈400 °C) and mechanical properties (tensile strength exceeding 500 MPa) and are the first choice if extremely high temperatures of 400 °C or even higher (depending on the duration) are required, which hampers their processing using existing 3D printing techniques. However, their processing using existing 3D printing techniques is hampered due to their thermal resistance. Herein, a 3D printing approach was demonstrated for generating complex lightweight BPDA-PDA polyimide geometries with unprecedented specific strength and thermal resistance. The simple aqueous polymerization reaction of BPDA with water-soluble PDA and triethylamine (TEA) afforded the poly(amic acid) ammonium salt (PAAS) hydrogels. These PAAS solutions showed clear shear thinning and thermo-reversibility, along with high G' gel-state moduli, which ensured self-supporting features and shape fidelity in the gel state. Postprinting thermal treatment transformed the PAAS precursor to BPDA-PDA polyimide (UPILEX-S type). The resulting layer-by-layer deposition onto lightweight polyimide honeycombs in the form of triangular, square, and hexagonal structures showed tailorable mechanical strength, exceptional compressive strength-to-weight ratio (highest up to 0.127 MPa (kg m-3)-1), and remarkable thermoresistance (Tg approximately 380 °C). These high-performance 3D printed polyimide honeycombs and unique synthetic techniques with general structures are potentially useful in fields ranging from automotive to aerospace technologies.

Association Between Serum Furin and Fasting Glucose: A Cross-Sectional Study in Chinese Adults.

Background: Furin has been associated with glucose metabolic phenotypes in small sampled clinical studies. However, this association has not yet been studied in Chinese. Here, we aimed to examine the association between serum furin and fasting glucose in Chinese adults. Methods: Serum furin and fasting plasma glucose were assayed for 2,172 participants (mean aged 53 years, 38% men) in the Gusu cohort. A median regression model was applied to examine the association between serum furin and fasting glucose, adjusting for age, sex, education level, cigarette smoking, alcohol drinking, obesity, blood pressure, and lipids. To facilitate data interpretation, the association between serum furin and prevalent diabetes was also examined. Results: Serum furin was negatively associated with fasting glucose (ß=-0.18, P<0.001 for log-furin). In participants with diabetes, serum furin was significantly lower than those with normal glucose (median: 0.90 ng/mL vs. 1.05 ng/mL, P=0.001). Compared with participants in the highest quartile of serum furin, those in the lowest quartile had 42% and 80% increased risk of prevalent prediabetes (OR=1.42, 95%CI: 1.05-1.92, P=0.023) and diabetes (OR=1.80, 95%CI: 1.13-2.91, P=0.015), respectively. Conclusions: Serum furin was negatively associated with prediabetes and diabetes in Chinese adults. Our findings suggest that serum furin may be a risk factor or a biomarker of diabetes.

Association between NPPA promoter methylation and hypertension: results from Gusu cohort and replication in an independent sample.

BACKGROUND: Atrial natriuretic peptide (ANP), one of the main members of the natriuretic peptides system, has been associated with hypertension and related complications, but the underlying molecular mechanisms are not very clear. Here, we aimed to examine whether DNA methylation, a molecular modification to the genome, of the natriuretic peptide A gene (NPPA), the coding gene of ANP, was associated with hypertension. METHODS: Peripheral blood DNA methylation of NPPA promoter was quantified by target bisulfite sequencing in 2498 community members (mean aged 53 years, 38% men) as a discovery sample and 1771 independent participants (mean aged 62 years, 54% men) as a replication sample. In both samples, we conducted a single CpG association analysis, followed by a gene-based association analysis, to examine the association between NPPA promoter methylation and hypertension, adjusting for age, sex, education level, cigarette smoking, alcohol consumption, obesity, fasting glucose, and lipids. Multiple testing was controlled by the false discovery rate approach. RESULTS: Of the 9 CpG loci assayed, hypermethylation at 5 CpGs (CpG1, CpG3, CpG6, CpG8, and CpG9) was significantly associated with a lower odds of prevalent hypertension in the discovery sample, and one CpG methylation (CpG1 located at Chr1:11908353) was successfully replicated in the replication sample (OR = 0.82, 95%CI 0.74-0.91, q = 0.002) after adjusting for covariates and multiple testing. The gene-based analysis found that DNA methylation of the 9 CpGs at NPPA promoter as a whole was significantly associated with blood pressure and prevalent hypertension in both samples (all P < 0.05). CONCLUSIONS: DNA methylation levels at NPPA promoter were decreased in Chinese adults with hypertension. Aberrant DNA methylation of the NPPA gene may participate in the mechanisms of hypertension.

Enhanced High-Temperature Dielectric Properties of Poly(aryl ether sulfone)/BaTiO3 Nanocomposites via Constructing Chemical Crosslinked Networks.

Heat-resistant and crosslinked polymers/ceramic composites have been prepared and investigated for enhancing high-temperature dielectric properties to adapt the development of advanced electric and electronic systems. Here, a series of crosslinkable heat-resistant poly(arylene ether sulfone)s (DPAES) with large dipole units of -SO2 - are designed and synthesized as matrix, which are blended with BaTiO3 (BT) nanoparticles to fabricate crosslinked polymer composites for boosting high-temperature dielectric properties. The results show that BT/c-DPAES possess great dielectric stability at measured frequency and temperature. Meanwhile, the discharged energy density and efficiency of BT/c-DPAES composites are higher than that of BT/DPAES at high temperatures, e.g., 10 vol% BT/c-DPAES has a discharged energy density of 1.7 J cm-3 and efficiency of 73%, increasing by 42% and 128% in contrast to BT/DPAES, respectively. The enhanced high-temperature energy storage properties can be attributed to the construction of a crosslinked polymer network, reducing leakage current density of composites.

Microalbuminuria mediates the association between serum uric acid and elevation of blood pressure: a longitudinal analysis in the Gusu cohort.

OBJECTIVES: Although hyperuricemia, microalbuminuria, and hypertension are highly correlated, their temporal relationship is largely unknown. We aimed to examine whether microalbuminuria mediated the association between hyperuricemia and hypertension. METHODS: Leveraging a longitudinal cohort including 1981 Chinese adults who had blood pressures, urinary albumin to creatinine ratio (UACR), and uric acid measured twice 4 years apart, we examined the temporal relationships among hyperuricemia, microalbuminuria, and hypertension by cross-lagged panel analysis followed by a causal mediation analysis to confirm the temporal consequence. Age, sex, education level, cigarette smoking, alcohol consumption, obesity, blood glucose, and lipids were adjusted. RESULTS: The cross-lagged panel analysis demonstrated that the relationship from baseline UACR to follow-up uric acid was significantly smaller than that from baseline uric acid to follow-up UACR (ß: 0.010 vs. 0.054, P < 0.001). The relationships from baseline blood pressures to follow-up UACR were also significantly smaller than that from baseline UACR to follow-up blood pressures (ß: 0.031 vs. 0.092, P < 0.001 for systolic and ß: 0.015 vs. 0.096, P < 0.001 for diastolic). The causal mediation analysis found that UACR partially mediated the association of baseline uric acid with follow-up SBP (mediate proportion: 9.14%, 95% CI: 1.58-23.00%) and DBP (mediate proportion: 7.38%, 95% CI: 1.05-19.00%). CONCLUSION: Microalbuminuria may follow elevated uric acid and partially mediate its effect on future risk of hypertension in Chinese adults.