The association between sleep duration, snoring and prevalent type 2 diabetes mellitus with regard to gender and menopausal status: the CKB study in Zhejiang rural area, China.

AIMS: To evaluate the association between sleep duration, snoring and diabetes according to gender and menopausal status in rural China. METHODS: The data were part of the baseline survey of China Kadoorie Biobank, from a rural county in the south-east costal Zhejiang province. Participants including 24,027 men and 33,677 women aged 30-79 years were enrolled during 2004-2008. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for diabetes. RESULTS: Sleep duration was shown to have a U-shaped association with diabetes in women, in particular in postmenopausal women after adjustment for potential confounders. Compared with 7-h sleepers, ORs (95 % CIs) of sleep duration ≤5 and ≥10 h for diabetes were 1.32 (1.02-1.69) and 1.30 (1.03-1.65), respectively, in postmenopausal women (P for quadratic trend = 0.016). However, this U-shaped association was not obvious in men and premenopausal women. Frequently snoring was positively associated with diabetes in all participants. However, this association was not independent of socioeconomic status, health behaviors, obesity and chronic diseases. With increasing sleep duration, the proportion of frequently snoring increased in all participants (P trend <0.05). Postmenopausal women had 23 % (95 % CI 6-44 %) higher odds of diabetes compared with premenopausal women, and the duration of menopause had cumulative effects on diabetes. CONCLUSIONS: Short and long sleep durations were significantly associated with diabetes in postmenopausal women, independent of potential confounders. The proportion of frequently snoring had linear trend with sleep duration. Postmenopausal status and the duration of menopause increased the odds of diabetes.

Structural changes in exon 11 of MEF2A are not related to sporadic coronary artery disease in Han Chinese population.

BACKGROUND: A mutation in MEF2A (myocyte enhancer factor-2A) had been reported to be the first gene linked directly to coronary artery disease (CAD). However, an opposing opinion was proposed recently that MEF2A mutations are not a common cause of sporadic CAD. In this study, we screened exon 11 of the MEF2A gene in people of the Han nationality in China and finished some functional analysis of found variations. MATERIALS AND METHODS: A gene structural investigation of MEF2A in 257 CAD patients and 154 control individuals were developed in this study. Subsequently, typical MEF2A variations were cloned and expressed in HeLa or 293T cell line to illustrate whether found structure changes could influence the main biological functions of these proteins. At last, another set of gene structural screen was initialized to get more reliable conclusions. RESULTS: Totally 16 different variations were detected in exon 11 of this gene in the first set of gene structural screen. By cloning and expressing typical MEF2A proteins in cultured cells, all the acquired MEF2A variations had transcriptional activation capabilities and subcellular localization patterns similar to those of the wild-type protein. Further larger scale genetic screening also revealed that the reported genetic variations of MEF2A did not differ significantly between CAD patients and healthy controls. CONCLUSIONS: Our results reveal that structural changes of exon 11 in MEF2A are not involved in sporadic CAD in the Han population of China.

[Pathologic study of diabetic cardiomyopathy].

OBJECTIVE: To study the histopathologic features, differential diagnosis and pathogenesis of diabetic cardiomyopathy. METHODS: The clinicopathologic features of 40 autopsy cases of diabetes mellitus were studied. The hearts from another 40 cases of non-diabetic elderly deceased were used for comparison. RESULTS: In the 40 cases of diabetes studied, 36 cases (90.0%) showed microscopic myocardial cell death. Focal interstitial fibrosis was observed in 37 cases (92.5%). On the other hand, similar myocardial cell death and patchy interstitial fibrosis was seen in 8 cases (20.0%) and 9 cases (22.5%) of non-diabetic hearts, respectively. The difference between the two groups was statistically significant (P < 0.01). The mural thickness of intramyocardial blood vessels was significantly increased in diabetic group (20.6 microm +/- 4.2 microm) than in non-diabetic group (7.2 microm +/- 5.2 microm), P < 0.01.The myocardial changes in diabetic group however were similar to those in non-diabetic group with systemic hypertension. CONCLUSIONS: Pathologic diagnosis of diabetic cardiomyopathy relies on detailed histologic examination of heart tissue and clinical correlation of a long history of diabetes mellitus. Exclusion of other possible etiologies is also essential. The myocardial cell death observed may be due to the ischemic effect induced by diabetic microangiopathy in cardiac muscle.