Susceptibility gene identification and risk evaluation model construction by transcriptome-wide association analysis for salt sensitivity of blood pressure.

BACKGROUND: Salt sensitivity of blood pressure (SSBP) is an intermediate phenotype of hypertension and is a predictor of long-term cardiovascular events and death. However, the genetic structures of SSBP are uncertain, and it is difficult to precisely diagnose SSBP in population. So, we aimed to identify genes related to susceptibility to the SSBP, construct a risk evaluation model, and explore the potential functions of these genes. METHODS AND RESULTS: A genome-wide association study of the systemic epidemiology of salt sensitivity (EpiSS) cohort was performed to obtain summary statistics for SSBP. Then, we conducted a transcriptome-wide association study (TWAS) of 12 tissues using FUSION software to predict the genes associated with SSBP and verified the genes with an mRNA microarray. The potential roles of the genes were explored. Risk evaluation models of SSBP were constructed based on the serial P value thresholds of polygenetic risk scores (PRSs), polygenic transcriptome risk scores (PTRSs) and their combinations of the identified genes and genetic variants from the TWAS. The TWAS revealed that 2605 genes were significantly associated with SSBP. Among these genes, 69 were differentially expressed according to the microarray analysis. The functional analysis showed that the genes identified in the TWAS were enriched in metabolic process pathways. The PRSs were correlated with PTRSs in the heart atrial appendage, adrenal gland, EBV-transformed lymphocytes, pituitary, artery coronary, artery tibial and whole blood. Multiple logistic regression models revealed that a PRS of P < 0.05 had the best predictive ability compared with other PRSs and PTRSs. The combinations of PRSs and PTRSs did not significantly increase the prediction accuracy of SSBP in the training and validation datasets. CONCLUSIONS: Several known and novel susceptibility genes for SSBP were identified via multitissue TWAS analysis. The risk evaluation model constructed with the PRS of susceptibility genes showed better diagnostic performance than the transcript levels, which could be applied to screen for SSBP high-risk individuals.

Changes in preventive care utilisation and its influencing factors among Chinese adults before and after the healthcare reform: cross-sectional evidence from the China Health and Nutrition Survey in 2004-2015.

OBJECTIVE: China launched its health reform in 2009. This study aimed to assess changes in preventive care utilisation (PCU) and its relationship with the healthcare reform. DESIGN: A cross-sectional study using demographic characteristics, socioeconomic status, environmental factors, and lifestyle and health status data of adults from five waves (2004-2015) of the China Health and Nutrition Survey (CHNS) was conducted. Multilevel mixed-effects logistic regression models were used. SETTING: Data were derived from urban and rural communities of nine provinces in China. PARTICIPANTS: Data were obtained from five waves of the CHNS, with 9960 participants in 2004, 9888 in 2006, 10 286 in 2009, 9709 in 2011, and 10 628 in 2015. OUTCOME: The primary outcome was PCU. RESULTS: PCU in 2004-2015 among adults was 3.29%, 3.13%, 3.77%, 4.95% and 2.73%, respectively. Whether before or after the health reform, having a history of disease and female gender were positive influencing factors of PCU. Before 2009, PCU was significantly associated with gender, income, medical insurance status and region. Age, medical insurance status, history of drinking and education level significantly affected PCU in 2009-2011. Having medical insurance was no longer a positive influencing factor of PCU, while high income had a negative effect on PCU, in 2011-2015. CONCLUSIONS: PCU from 2004 to 2015 was low and the health reform in China may lack sustainable effect on PCU. Further studies on how to ensure sustainability of PCU are necessary, and further reforms on preventive care services should be aimed at different ages, rural areas and participants without history of disease.

Association between Eating Out and Socio-Demographic Factors of University Students in Chongqing, China.

(1) Objective: We aimed to explore the current situation of eating out and the association with socio-demographic factors of university students in Chongqing, China. (2) Methods: We used self-administered questionnaires to collect information. There are 14 universities in Chongqing; four (Chongqing Medical University, Chongqing University, Chongqing Normal University, and Chongqing University of Science & Technology) were randomly selected. In each selected university, two disciplines were randomly selected. (3) Results: 4595 university students participated in the study. The frequency of eating out was relatively high. The frequency of eating out among females was higher than that among males during weekdays. The two main reasons for eating out were having an opportunity to meet friends (56.0%) and improving diet (39.6%). Bistros (61.7%) and hot-pot restaurants (41.1%) were the favorite places for eating out. Only 36.0% of the participants said they considered nutrition and food safety when selecting restaurants. The majority of the participants demonstrated a high demand for nutrition and food safety knowledge when eating out (77.7%). (4) Conclusions: The higher the monthly living expenses were, the higher the frequency of eating out was. An intervention strategy to reduce the frequency or change the behavior of eating out should be formulated by considering the students' perspectives.

Association between socioeconomic status (SES), mental health and need for long-term care (NLTC)-A Longitudinal Study among the Japanese Elderly.

This study was carried out to explore the relationship between the SES, mental health and the NLTC of the Japanese elderly, with the aim of providing useful information to lower the NLTC. A longitudinal survey was carried out in Tama City, Tokyo in 2001 and 2004. Data were collected from the urban-dwelling older adults, aged 65 years old and above, through self-reported questionnaires, which was participated by 7905 respondents (47.6% male and 52.4% female). Chi-square test, Kendall tau-b correlation analysis and structural equation modeling (SEM) were used to identify the association between SES, mental health and NLTC. The results of the SEM analysis indicated that mental health would exert a negative effect on NLTC for both the elderly men and the elderly women, while the effect was stronger for the elderly women; SES was significantly and negatively associated to NLTC, both for the elderly men and elderly women; a significant and positive relationship was observed between SES and mental health for both genders, but slightly stronger for the elderly men. These findings have implications for targeting the interventions that are aimed to delaying the NLTC and the financing of LTC system.

[Study on the risk factors of metabolic syndrome in Jiangsu province, China].

OBJECTIVE: To explore the associated risk factors of metabolic syndrome in Jiangsu province, China. METHODS: 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. RESULTS: 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. CONCLUSION: Metabolic syndrome has become a significant public health problem among the adults in Jiangsu province.

[Study on the comparison of three diagnostic criteria of metabolic syndrome in Jiangsu population].

OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.

[Study on the prevalence of metabolic syndrome among 35-74 year-olds in Jiangsu province].

OBJECTIVE: To describe the prevalence of metabolic syndrome (MS) in Jiangsu province, using IDF 2005 and ATP III 2005 definition. METHODS: 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. RESULTS: 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. CONCLUSION: 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.