Relative children's lipid accumulation with hypertension in Chinese children and adolescents.

BACKGROUND: This study aimed to develop a novel indicator associated with hypertension in Chinese children and adolescents, the relative children's lipid accumulation product (RCLAP). METHODS: A cross-sectional study was conducted in 2018. A total of 683 students aged 8-15 years were recruited via a stratified cluster sampling Methods. Anthropometric indexes (waist circumference (WC), Body mass index (BMI), Waist-height ratio (WHtR), logarithm children LAP (LnCLAP), RCLAP per height (RCLAP-H)) were standardized using a z-score method (standardized variables: SWC, SBMI, SWHtR, SLnCLAP, SRCLAP-H). A logistic regression model was performed to evaluate the association of the above indicators with the outcome of hypertension. RESULTS: The overall prevalence of hypertension was 5.7% (5.5% in boys, 6.0% in girls). SWC ≥ P75, SBMI ≥ P75, SWHtR ≥ P75, SlnCLAP ≥ P75 and SRCLAP-H ≥ P75 significantly increased risk of hypertension, with odds ratios (OR) of 2.21 (95% confidence interval (CI): 1.13, 4.30), 2.30 (1.18, 4.49), 2.64 (1.35, 5.14), 4.43 (2.28, 8.61), and 4.49 (2.31, 8.71), respectively. CONCLUSION: RCLAP is a novel indicator associated with hypertension in Chinese children and adolescents, and it performs better than WC, BMI, WHtR and children LAP.

Relative Children's Lipid Accumulation Product Is a Novel Indicator for Metabolic Syndrome.

Background: The children's lipid accumulation product (CLAP) is associated with MS in Chinese children and adolescents. The aim of this study was to develop a more effective indicator, the relative children's lipid accumulation product (RCLAP) was evaluated for correlation with MS and the density of lipid accumulation. Methods: A stratified cluster sampling method was used to recruit 683 students aged 8-15 years in this study. The presence of MS was defined according to the NCEP-ATP III criteria. The participants' guardians signed informed consent before the medical examination. This study was approved by the Medical Ethics Committee of the Bengbu Medical College [(2015) No.003] and was conducted in accordance with the Declaration of Helsinki. Results: The overall prevalence of MS was 4.8% (male 6.6%, female 2.8%). After adjusting for sedentary activity time, relative children's lipid accumulation product per height (RCLAP-H) and relative children's lipid accumulation product per sitting height (RCLAP-SH) significantly increased the risk of MS in girls [OR (95% CI): 96.13 (11.11-831.97) and 96.13 (11.11-831.97), respectively]. After adjusting for ages and moderate-to-vigorous physical activity time, RCLAP-H, and RCLAP-SH significantly increased the risk of MS in boys [OR (95% CI): 171.75 (33.60-878.00) and 133.18 (27.65-641.39), respectively]. The AUCs of RCLAP-H and RCLAP-SH for predicting MS were 0.950, 0.948 in girls, and 0.952, 0.952 in boys, which were higher than BMI, WHtR, Tg/HDL-C, CLAP, and CLAP combining height, sitting height. Conclusions: The RCLAP-H and RCLAP-SH were more effective indicators for predicting MS than BMI, WHtR, Tg/HDL-C, and CLAP in children and adolescents.

Association of neighborhood greenness exposure with cardiovascular diseases and biomarkers.

AIM: Living in areas with neighborhood greenness may be associated with the incidence of cardiovascular diseases (CVDs). However, little evidence in this regard has emerged from developing countries. In the present study, we examined neighborhood greenness associated with CVDs and the lipid accumulation product (LAP) and pulse pressure (PP) in China. METHODS: We undertook our analysis using a community cross-sectional survey conducted in Longzihu District of Bengbu from July to August 2015. We measured triglyceride levels, waist circumference, and blood pressure. To assess exposure to neighborhood greenness, we used the average normalized difference vegetation index (NDVI) at 1,000-, 1,500-, and 2,000-m buffers in the participant community. We employed generalized mixed models to determine the association among neighborhood greenness, CVDs, LAP, and PP. We conducted stratified analysis by age, gender, income, and education. We assessed the potential mediating effects of road proximity and physical activity on greenness and CVDs, PP, and LAP. RESULTS: The highest tertiles of NDVI1500-m were steadily and significantly associated with lower odds of CVDs prevalence: the adjusted OR of such prevalence was 0.612 (95% CI, 0.462-0.811); higher NDVI was significantly associated with lower PP levels. The NDVI was strongly associated with CVDs prevalence among participants who were male and had high income. Ambient road proximity significantly mediated 9.7% of the estimated association between greenness and PP, there was no evidence of mediation effects for physical activity. CONCLUSIONS: Higher neighborhood greenness could have a beneficial effect on CVDs and biomarkers. There were higher associations between residential greenness and CVDs among male and higher-income individuals; road proximity partially mediated the observed association between greenness and PP.

Comparison of Body-Image Dissatisfaction Among Chinese Children and Adolescents at Different Pubertal Development Stages.

BACKGROUND: Body-image dissatisfaction among children and adolescent has become increasingly serious, and may be the result of staged differences in the puberty-development process. The aim of this study was to compare differences in body-image dissatisfaction among children and adolescents at different pubertal stages. METHODS: A total of 574 students aged 8-15 years were recruited from two nine-year schools via stratified cluster sampling, their secondary sex characteristics and external genital development examined, and body-image cognition surveyed using the teenage body-image annoyance questionnaire. This questionnaire covers body-shape, gender, sexual organ, and appearance dissatisfaction. Lower scores indicate a more negative body image. RESULTS: Total, gender, and appearance-dissatisfaction scores in girls were significantly lower than in boys (P<0.05); however, sexual organ-dissatisfaction scores in girls were significantly higher than in boys (P<0.05). Girls' gender-dissatisfaction scores before breast development Tanner II were higher than those after menarche (P<0.05); however, girls' sexual organ-dissatisfaction scores before breast development Tanner II were significantly higher than those after menarche (P<0.05). CONCLUSION: The girls were more dissatisfied with their gender and appearance than the boys, and the boys were more dissatisfied with their sexual organs than the girls. The girls were more dissatisfied with their sexual organs before breast development Tanner II and more dissatisfied with their gender after menarche.

Elevated glycosylated hemoglobin levels and their interactive effects on hypertension risk in nondiabetic Chinese population: a cross-sectional survey.

BACKGROUND: Abnormal glucose metabolism has been suggested to be involved in the development of hypertension. This study investigated the effect of the association and potential interaction of glycosylated hemoglobin (HbA1c) and other factors on the risk of hypertension among Chinese nondiabetic adults. METHODS: As a cross-sectional survey, the current work deployed a questionnaire survey, anthropometric tests, and biochemical measures for each of the eligible participants. The HbA1c levels were quantified and grouped by quartiles. Correlations between HbA1c and hypertension, isolated systolic hypertension (ISH), and isolated diastolic hypertension (IDH) risk were investigated by logistic analyses. For evaluating the interactive effects, the parameters of relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated, respectively. RESULTS: In the current study, 1462 nondiabetic subjects were enrolled. In total, the prevalence rates of hypertension, ISH and IDH were 22.4, 9.6 and 4.5%, respectively. When HbA1c levels were grouped by quartile, it was revealed that the prevalence rates of hypertension and ISH were substantially elevated across groups (Pfor trend < 0.001). In the multivariable logistic regression analyses, in comparison with the first quartile of HbA1c, the normalized OR for hypertension risk was 1.90 (95% CI: 1.28-2.80) for the highest quartile. Also, the risk of ISH was significantly increased with HbA1c level in the highest quartile relative to in the bottom quartile (OR: 2.23,95% CI:1.47-3.71). However, no significant relationship between the HbA1c level and IDH risk was observed (OR: 1.78, 95% CI: 0.82-3.84). Eventually, it was demonstrated from the interactive effect analysis that HbA1c significantly interacted with abdominal obesity (RERI: 1.48, 95% CI: 0.38-2.58; AP: 0.37, 95% CI: 0.14-0.60 and SI: 1.96, 95% CI: 1.06-3.62) and family history of hypertension (AP: 0.37, 95% CI: 0.05-0.70) in influencing the risk of hypertension in nondiabetic participants. CONCLUSION: Higher HbA1c levels significantly enhanced the risk of hypertension and ISH, but not IDH among Chinese nondiabetic adults. Moreover, the risk of hypertension was also aggravated by the upregulated HbA1c in a synergistic manner alongside abdominal obesity and family history of hypertension.

Association and Interaction Analysis of Lipid Accumulation Product with Impaired Fasting Glucose Risk: A Cross-Sectional Survey.

AIMS: Lipid accumulation product (LAP) is put forward as a powerful marker showing the accumulation of visceral fat. The present study is aimed at (i) analyzing the predictive performances of LAP in the identification of impaired fasting glucose (IFG) in Chinese population and (ii) exploring the potentially interactive effect between LAP and other factors on IFG risk. METHODS: Analysis was conducted on the data obtained from a community-based cross-sectional survey in Chinese population, and all the participants enrolled were required to complete a face-to-face questionnaire survey and related health checks. Then, for the purpose of comparing predictive values between LAP and conventional obesity indices for IFG, relevant analysis was carried out on the receiver operating characteristic (ROC) curve. The assessment of interactive effects was conducted by employing the three indicators as follows: (1) RERI (the relative excess risk due to interaction), (2) AP (attributable proportion due to interaction), and (3) SI (synergy index). RESULTS: A total of 1777 participants (748 males and 1029 females) were involved in the final analysis. It was finally obtained that the prevalence rate of IFG was 14.1% in total, 15.5% for males and 13.1% for females, respectively. In logistic regression analysis, individuals with LAP levels in the fourth quartile had a significant higher risk of getting IFG in comparison with that of the lowest quartile (crude OR: 4.58, 95% CI: 3.01-6.98; adjusted OR: 3.81, 95% CI: 2.33-6.23). In addition, it was indicated by the ROC curve analysis that LAP showed a better performance in discriminating IFG risk than BMI in both males (Z = 2.20, P = 0.028) and females (Z = 2.13, P = 0.033). However, LAP displayed a higher predictability in comparison with WC only in females (Z = 2.07, P = 0.038), but not in males (Z = 0.18, P = 0.860). Furthermore, LAP and family history of diabetes were able to impose significant synergistic interaction on the risk of IFG, which was indicated by all the parameters in females (RERI: 2.52, 95% CI: 0.19-4.84; AP: 0.47, 95% CI: 0.20-0.74; SI: 2.39, 95% CI: 1.17-4.87) and males (RERI: 2.18, 95% CI: 0.08-4.73; AP: 0.43, 95% CI: 0.07-0.79; SI: 2.15, 95% CI: 1.03-5.45). However, none of the indicators showed significant interaction between LAP and smoking on the risk of IFG in females (RERI: 0.92, 95% CI: -2.79-4.63; AP: 0.20, 95% CI: -0.50-0.92; SI: 1.37, 95% CI: 0.42-4.52). Meanwhile, there was also no significant interaction between LAP and smoking on the risk of IFG in males as indicated by the value of SI (2.22, 95% CI: 0.80-6.21). CONCLUSION: It was concluded that LAP was significantly related to a higher risk of IFG in Chinese population, and its performance was superior to that of conventional obesity indices, especially in females. Apart from that, LAP with family history of diabetes may have an interactive effect that can impose a great influence on the development of IFG.

Dysregulation of the miR-325-3p/DPAGT1 axis supports HBV-positive HCC chemoresistance.

BACKGROUND: Chemotherapeutic resistance in hepatitis B virus (HBV)-positive hepatocellular carcinoma (HCC) patients is an unfortunate side effect of standard chemotherapy. This situation necessitates a better understanding of the molecular pathways underlying HBV + HCC chemoresistance in order to aid the development of novel chemotherapeutic targets. METHODS: We generated two doxorubicin (DOX)-resistant HBV + HCC sublines HepG2.2.15 and Huh7-1.3. qRT-PCR was used to evaluate dysregulation in hexosamine pathway genes in chemosensitive and chemoresistant HBV + HCC cell lines in vitro. Western blots, luciferase reporter assays, and in vivo xenograft tumor studies were conducted to reveal the role of the miRNA-325-3p/DPAGT1 axis in HBV + HCC chemoresistance. RESULTS: The hexosamine pathway gene dolichyl-phosphate N-acetylglucosamine phosphotransferase 1 (DPAGT1) was found to be upregulated in both DOX-resistant cell lines. Enhancing DPAGT1 activity significantly improved the survival of DOX-resistant cells. Silencing or pharmacological inhibition of DPAGT1 inhibited xenograft tumor growth under DOX-treated conditions. DPAGT1 upregulation was associated with higher levels of stemness-related markers and ATP-binding cassette (ABC) drug efflux transporters in DOX-resistant cell lines. miR-325-3p was found to negatively modulate DPAGT1 expression and phenocopied the effects of DPAGT1 silencing in vitro and in vivo. In HBV + HCC patients treated with transarterial chemoembolization (TACE), high and low levels of tumor DPAGT1 and miR-325-3p expression, respectively, were associated with a poor chemotherapeutic response. CONCLUSIONS: Our findings provide novel insights into the role of miR-325-3p/DPAGT1 axis dysregulation in supporting HBV + HCC chemoresistance.

Systematic Meta-analysis Revealed an Association of PGC-1α rs8192678 Polymorphism in Type 2 Diabetes Mellitus.

BACKGROUND: Genome-wide association study (GWAS) provides an unprecedented opportunity to reveal substantial genetic contribution to type 2 diabetes mellitus (T2DM) and glycemic identification of allelic heterogeneity and population-specific genetic variants, yet it also faces difficulty due to the vast amount of potential confounding factors and limited availability of clinical data. To identify responsible susceptibility loci and genomic polymorphism for T2DM and glycemic traits, we have systematically investigated a genome-wide association study related to T2DM. Although GWAS has captured many common genetic variations, which are related to T2DM, each risk allele (RA) of single-nucleotide polymorphisms (SNPs) at these loci is not conclusive. Therefore, it is common to present a combination of several SNPs to infer T2DM risk, yet it is still insufficient to be deterministic. To streamline the identification of a deterministic genetic variation in T2DM, we developed this meta-analysis as a showcase to comprehensively identify the association between cumulative RAs and T2DM risk by combining different studies in reported literature and databases. After all, we identified that PGC-1α rs8192678 polymorphism can be considered as a potentially deterministic biomarker in T2DM risk. Previous studies have potentially linked PGC-1α rs8192678 polymorphism to type 2 diabetes mellitus (T2DM) risk, but the results remain inconsistent in different populations and are not conclusive. We developed a new meta-analysis approach to systematically identify the association between PGC-1α rs8192678 polymorphism and T2DM, and we have comprehensively assessed different ethnic groups to validate our findings. METHODS: We performed comprehensive information retrieval and knowledge discovery meta-analysis by searching extensively published literature and different electronic databases to acquire eligible studies for the above association study. We developed a method to use pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) in five genetic models (allelic, dominant, recessive, homozygous, and heterozygous genetic models) to identify the relationship among ethnicity subgroup analyses comprehensively. RESULTS: We identified 20 eligible studies consisting of 16,182 subjects (8,038 cases and 8,144 controls) in our meta-analysis. PGC-1α rs8192678 polymorphisms of all subjects showed a significant association with T2DM susceptibility under all genetic models: allelic (OR: 1.24, 95% CI: 1.13-1.35), dominant (OR: 1.27, 95% CI: 1.14-1.42), recessive (OR: 1.24, 95% CI: 1.14-1.36), homozygous (OR: 1.40, 95% CI: 1.20-1.64), and heterozygous (OR: 1.20, 95% CI: 1.06-1.35). In the subgroup analysis, we identified a significant association between PGC-1α rs8192678 polymorphism and T2DM in the Caucasian and Indian populations under all genetic models we investigated. This is the most comprehensive study of the subject to date. CONCLUSION: Our development of meta-analysis revealed that the minor allele (A) carriers, especially AA genotype carriers, can lead to risk of T2DM in the Caucasian and Indian populations. This is the first report that such risk has been confirmed. Our finding shed new light into the genetic alteration in T2DM.

Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China.

BACKGROUND: Individuals with prehypertension are at higher risk of developing hypertension and cardiovascular diseases, while the interaction between factors may aggravate prehypertension risk. Therefore, this study aimed to evaluate the risk factors for prehypertension in Chinese middle-aged and elderly adults, and explore the potentially interactive effect of evaluated factors. METHODS: All the participants that came from a community based cross-sectional survey were investigated in Bengbu, China, by being interviewed with a questionnaire. Body mass index (BMI), Waist circumference (WC) and lipid accumulation product (LAP) that reflect participants' obesity were also calculated. In addition, logistic regression model was applied to explore the risk factors of prehypertension, followed by the assessment of the interactive effects between risk factors on prehypertension by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS: A total of 1777 participants were enrolled in this study, among which the prevalence of normtension, prehypertension and hypertension were 41.70%, 33.93% and 24.37% respectively. According to the multivariate logistic regression analysis, age (OR: 1.01, 95%CI: 1.00-1.02), smoking (OR: 1.67, 95%CI: 1.22-2.29), family history of cardiovascular diseases (OR: 1.52, 95%CI: 1.14-2.02), general obesity (OR: 1.51, 95%CI: 1.15-1.97) and LAP (OR: 2.58, 95%CI: 1.76-3.80) were all defined as the major factors that significantly related with the risk of prehypertension. When identifying prehypertension risk, the receiver-operating characteristics (ROC) curves (AUC) analysis indicated that LAP performed better than BMI in males (Z = 2.05, P = 0.03) and females (Z = 2.12, P = 0.03), but was superior to WC only in females (Z = 2.43, P = 0.01). What is more, there were significant interactive effects of LAP with family history of cardiovascular diseases (RERI: 1.88, 95%CI: 0.25-3.51; AP: 0.44, 95%CI: 0.20-0.69; SI: 2.37, 95%CI: 1.22-4.60) and smoking (RERI: 1.99, 95%CI: 0.04-3.93; AP: 0.42, 95%CI: 0.17-0.67; SI: 2.16, 95%CI: 1.68-4.00) on prehypertension risk. The value of AP (0.40, 95%CI: 0.03-0.77) also indicated a significant interaction between family history of cardiovascular diseases and smoking on prehypertension. CONCLUSION: Prehypertension is currently prevalent in Chinese adults. This study indicated that age, family history of cardiovascular diseases, smoking, general obesity and LAP were significantly related with prehypertension risk. Furthermore, interactive effects on risk of prehypertension had been demonstrated in this study as well, which would help researchers to build strategy against prehypertension more comprehensively and scientifically.