NRN1 and CAT Gene Polymorphisms, Complex Noise, and Lifestyles interactively Affect the Risk of Noise-induced Hearing Loss.

OBJECTIVE: The effects of interactions between genetic and environmental factors on the noise-induced hearing loss (NIHL) are still unclear. This study aimed to assess interactions among gene polymorphisms, noise metrics, and lifestyles on the risk of NIHL. METHODS: A case-control study was conducted using 307 patients with NIHL and 307 matched healthy individuals from five manufacturing industries. General demographic data, lifestyle details, and noise exposure levels were recorded. The Kompetitive allele-specific polymerase chain reaction (KASP) was used to analyze the genotypes of 18 SNPs. RESULTS: GMDR model demonstrated a relevant interaction between NRN1 rs3805789 and CAT rs7943316 (P = 0.0107). Subjects with T allele of rs3805789 or T allele of rs7943316 had higher risks of NIHL than those with the SNP pair of rs3805789-CC and rs7943316-AA (P < 0.05). There was an interaction among rs3805789, rs7943316, and kurtosis (P = 0.0010). Subjects exposed to complex noise and carrying both rs3805789-CT and rs7943316-TT or rs3805789-CT/TT and rs7943316-AA had higher risks of NIHL than those exposed to steady noise and carrying both rs3805789-CC and rs7943316-AA (P < 0.05). The best six-locus model involving NRN1 rs3805789, CAT rs7943316, smoking, video volume, physical exercise, and working pressure for the risk of NIHL was found to be the interaction (P = 0.0010). An interaction was also found among smoking, video volume, physical exercise, working pressure, and kurtosis (P = 0.0107). CONCLUSION: Concurrence of NRN1 and CAT constitutes a genetic risk factor for NIHL. Complex noise exposure significantly increases the risk of NIHL in subjects with a high genetic risk score. Interactions between genes and lifestyles as well as noise metrics and lifestyles affect the risk of NIHL.

Environmental exposure to lead and cadmium and hearing loss in Chinese adults: A case-control study.

Hearing loss is the second most common nonfatal problem affecting the Chinese population. Historical studies have suggested an association between exposure to heavy metals, such as cadmium and lead, and hearing loss. Few studies have investigated this relationship in the general population in China. We conducted a case-control study with 1008 pairs of participants from a cross-sectional epidemiological survey conducted in Zhejiang Province. A self-designed questionnaire was adopted to collect information on demographics, chronic diseases, lifestyles and environmental noise. Pure-tone averages of hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz were computed. Blood lead and cadmium levels were analyzed with an atomic absorption spectrometer. After adjusting for all other potential confounding factors, compared with the lowest blood cadmium quartile (0.00-0.53 µg/L), blood cadmium quartile 2 (0.54-0.92 µg/L), quartile 3 (0.93-1.62 µg/L) and quartile 4 (1.63-57.81 µg/L) exhibited significantly elevated risks for hearing loss, with odds ratios of 1.932 (95% CI: 1.356-2.751), 2.036 (95% CI: 1.423-2.914) and 1.495 (95% CI: 1.048-2.133), respectively (P-trend<0.001). However, an association of lead with hearing loss was not found. Young age (less than 60 years), male sex and current smoking were associated with increased blood cadmium concentration. Additionally, a positive association between blood cadmium and lead concentrations was found. Therefore, we conclude that exposure to environmental cadmium may be a risk factor for hearing loss among the general population in China.

Relationship between alcohol use, blood pressure and hypertension: an association study and a Mendelian randomisation study.

BACKGROUND: Past studies have found a strong relationship between alcohol drinking and human health. METHODS: In this study, we first tested the association of rs671 with alcohol use in 2349 participants in southeast China. We then evaluated the causal impact between alcohol use and cardiovascular traits through a Mendelian randomisation (MR) analysis. RESULTS: We found strong evidence for the association of rs671 in the ALDH2 gene with alcohol drinking (p=6.08×10-47; ORadj G=4.50, 95% CI 3.67 to 5.52). We found that female G carriers of rs671 had a higher proportion of non-drinkers than male G carriers (88.01% vs 38.70%). In non-drinkers, the female G allele frequency was higher than the male G allele frequency (71.1% vs 55.2%). MR analysis suggested that alcohol use had a causal effect on blood pressure (increasing 9.46 mm Hg for systolic blood pressure (p=9.67×10-4) and 7.50 mm Hg for diastolic blood pressure (p=9.62×10-5)), and on hypertension in men (p=0.011; OR =1.19, 95% CI 1.04 to 1.36) and in pooled samples (p=0.013; OR =1.20, 95% CI 1.04 to 1.39), but not in women. We did not observe a causal effect of alcohol use on body mass index and lipid levels; further studies are needed to clarify the non-causal relationship. CONCLUSIONS: Compared to never-drinkers, current and previous alcohol use had a causal effect on blood pressure and hypertension in pooled samples and in men. These results reflect Chinese culture which does not encourage women to drink.

Associations of Genetic Variations in ABCA1 and Lifestyle Factors with Coronary Artery Disease in a Southern Chinese Population with Dyslipidemia: A Nested Case-Control Study.

Coronary artery disease has become a major health concern over the past several decades. We aimed to explore the association of single nucleotide polymorphisms (SNPs) in the ATP-binding cassette subfamily A member 1 (ABCA1) and lifestyle factors with coronary artery disease (CAD) in dyslipidemia. This nested case-control study included 173 patients with CAD and 500 matched control individuals (1:3, case: control) from a district in southern China. We collected medical reports, lifestyle details, and blood samples of individuals with dyslipidemia and used the polymerase chain reaction-ligase detection reaction method to genotype the SNPs. The CC genotype of the additive and recessive models of rs4149339, together with regular intake of fried foods or dessert, increased the risk of CAD (adjusted odd ratio (OR) = 1.91, p = 0.030; adjusted OR = 1.97, p = 0.017; adjusted OR = 1.80, p = 0.002; adjusted OR = 1.98, p = 0.001). The AT + AA genotype of the dominant model of rs4743763 and moderate/heavy physical activity reduced the risk of CAD (adjusted OR = 0.66, p = 0.030; adjusted OR = 0.44, p = 0.001). The CT + CC genotype of the dominant model of rs2472386 reduced the risk of CAD only in males (adjusted OR = 0.36, p = 0.001). The interaction between rs4149339 and rs4743763 of ABCA1 and haplotype CTT (comprising rs4149339, rs4743763, and rs2472386) appeared to increase the risk of CAD (relative excess risk due to interaction (RERI) = 3.19, p = 0.045; OR = 1.49, p = 0.019). Polymorphisms of rs4149339, rs4743763 and rs2472386 in ABCA1 and three lifestyle factors (physical activity, fried food intake, and dessert intake) were associated with CAD in people with dyslipidemia in southern China. These results provide the theoretical basis for gene screening and the prevention of chronic cardiovascular diseases.

An ensemble-based likelihood ratio approach for family-based genomic risk prediction.

OBJECTIVE: As one of the most popular designs used in genetic research, family-based design has been well recognized for its advantages, such as robustness against population stratification and admixture. With vast amounts of genetic data collected from family-based studies, there is a great interest in studying the role of genetic markers from the aspect of risk prediction. This study aims to develop a new statistical approach for family-based risk prediction analysis with an improved prediction accuracy compared with existing methods based on family history. METHODS: In this study, we propose an ensemble-based likelihood ratio (ELR) approach, Fam-ELR, for family-based genomic risk prediction. Fam-ELR incorporates a clustered receiver operating characteristic (ROC) curve method to consider correlations among family samples, and uses a computationally efficient tree-assembling procedure for variable selection and model building. RESULTS: Through simulations, Fam-ELR shows its robustness in various underlying disease models and pedigree structures, and attains better performance than two existing family-based risk prediction methods. In a real-data application to a family-based genome-wide dataset of conduct disorder, Fam-ELR demonstrates its ability to integrate potential risk predictors and interactions into the model for improved accuracy, especially on a genome-wide level. CONCLUSIONS: By comparing existing approaches, such as genetic risk-score approach, Fam-ELR has the capacity of incorporating genetic variants with small or moderate marginal effects and their interactions into an improved risk prediction model. Therefore, it is a robust and useful approach for high-dimensional family-based risk prediction, especially on complex disease with unknown or less known disease etiology.

[The adolescent physical exercise behavior-psychological measurement scale on the Chinese version and its reliability and validity study].

OBJECTIVE: To develop a suitable physical exercise behavior-psychological scale for the Chinese adolescents and to evaluate its validity and reliability. METHODS: A total of 3600 junior students were recruited and tested through multistage sampling method. Reliability was assessed, using Cronbach's α and split-half reliability; while exploratory factor analysis and confirmatory factor analysis were used to test its validity, with entries-dimension correlation coefficient (IIC), correlation coefficient between the scores and the dimension, the dimension of correlation coefficient test content validity. RESULTS: The internal consistency reliabilities for total scale score (Cronbach's α = 0.888), Cronbach's α of four domains were 0.880, 0.706, 0.552 and 0.839, respectively. The four-domain split-efficacy reliabilities were ranged between 0.559 and 0.876. Data from the exploratory factor analysis revealed the following dimensions: the entries were all inclusive; the cumulative contribution rate was more than 40%. RESULTS: from the confirmatory factor analysis showed that the absolute fit measures of GFI = 0.972, AGFI = 0.958, RMSEA = 0.032 (90%CI: 0.030 - 0.034) could satisfy the condition while the model fit was better. The results of IIC showed: in the four dimensions, and the contained entries between Spearman correlation coefficient range were 0.396 - 0.700, 0.470 - 0.709, 0.696 - 0.771 and 0.665 - 0.813, while other dimensions from weak to moderate relationships, the r value range was from 0.386 to 0.935. With the change of the phase changing process, decision balance, self-efficacy scores were differently prompting the health-related intervention periodically and pertinently. CONCLUSION: The reliability and validity of the 'Adolescent physical exercise behavior-psychological scales (Chinese version) ' were good, and could be used to measure the adolescent's physical training behavior-psychological conditions.

[Evaluation on the effects of an education program regarding the sedentary behavior among school-aged children using Transtheoretical Model].

OBJECTIVE: To evaluate the outcome of a health education program on sedentary behavior among primary and secondary school children through Transtheoretical Model. METHODS: Five primary schools and four middle schools were selected and students from grade 3 to 5 in primary schools and grade 1 to 2 in middle schools were selected to take part in the program, as control and intervention groups respectively. Corresponding intervention measures were provided to the intervention group, with phase, process and level of changing on sedentary behavior measured for both groups during the follow-up period. Comparison to the above items on the two groups was measured statistically. RESULTS: Behavior among the intervention group was gradually changed regarding: phase contemplation, preparation and maintenance, with the proportions in phase action and maintenance higher than the control group. After carrying out of intervention programs, the sedentary time on weekdays between the two groups did not show significant differences. However, the sedentary time on weekends of intervention group was (2.53 ± 1.62) hours, significantly lower than the hours from the baseline survey (2.84 ± 1.82) and the control group (2.78 ± 1.72) respectively. During the follow-up period, the average score of intervention group in the changing process was (2.98 ± 0.77), higher than the control group (2.80 ± 0.81). At the same time, the average score of intervention group in the process of changing, decisional balance (pros) and self-efficacy were 2.98 ± 0.77, 3.06 ± 0.75 and 3.13 ± 0.72, respectively, all higher than data from the baseline survey. In the control group, the process of changing and the average score on self-efficacy had improved. CONCLUSION: The corresponding intervention program seemed to have played a significant role among the school-aged children on their sedentary behavior during the weekend but no significant difference was found in the weekdays.

[Research on the behavior of fruit and vegetable intake in adolescents with Transtheoretical Model].

OBJECTIVE: To study the current situation and factors influencing the behavior of fruit and vegetable intake in adolescents, and to discuss health education strategy related to the behavior. METHODS: 1677 students were selected from primary school and middle school in urban area of Hangzhou by a multistage sampling method. The behavior of fruit and vegetable intake was surveyed by questionnaires of the patient-centered assessment and counseling for exercise plus nutrition project (PACE+) for adolescent-scale of fruit and vegetable consumption, and analyzed by Transtheoretical Model on the servings of intake, the stage of change, process of change, decisional balance and the current status of self-efficacy. RESULTS: The average intake of fruit and vegetable in adolescents was (3.21 +/- 1.50) servings per day ("one serving" means 100 g cooked vegetable or 100 g fruit). The behavior of consuming fruit and vegetable in most of the adolescents was in the contemplation stage, accounting for 36.91% (619/1677). The process of behavior change, decisional balance (Pros) and self-efficacy existed a positive correlation with the process of stage (r(process) = 0.38, r(decisional balance (Pros)) = 0.26, r(self-efficacy) = 0.33, t values were 16.78, 11.02 and 14.31, P < 0.05). The servings of fruit and vegetable intake existed a positive correlation with stage transition and self-efficacy (beta(stage transition) = 0.665, t = 35.07, P < 0.05; beta(self-efficacy) = 0.050, t = 2.63, P < 0.05), and existed a negative correlation with decisional balance (Cons) (beta(decisional balance (Cons)) = -0.051, t = -2.84, P < 0.05). CONCLUSION: Fruit and vegetable intake of these adolescents are under the recommended dietary intake. Along with behavior stage development and self-efficacy improvement, the intake of fruit and vegetable also increased correspondingly. Intervention strategies should aim at improving the awareness of adolescents on the health benefits of fruit and vegetable intake and promoting their confidence to reach the recommended servings.

[A cross-sectional study on the changes in dietary behavior stages in resident].

OBJECTIVE: To explore the possibility of applying the concept of various stages of dietary behavior changes in Hangzhou residents. METHODS: The dietary behavior was surveyed and analyzed in 1 388 Hangzhou residents with 18 year-old and older using the various dietary behavior change model model and stages of change. RESULTS: The proportion of Hangzhou residents with unhealthy dietary behavior was high and associated with gender and education level. The changes of dietary behavior could be divided into 5 stages, i.e. preintention, intention, preparation, action and maintenance. These stages of change happen consecutively. The changes of unhealthy dietary behavior do not match the improvement of health knowledge. Although a significant proportion of the residents understand that it is unhealthy to eat too much fat, pickles and high salt food, there are only a few of them really take action to reduce the consumption of these foods and to consume more milk, fruit and vegetable. CONCLUSIONS: There are multiple factors that affect the changes of dietary behavior in people. The changes of dietary behavior occur in various consecutive stages. Different intervention measures should be applied to people in different dietary behavior changes.