Rongjing Ding

Reliability and validity of a Chinese version of the HADS for screening depression and anxiety in psycho-cardiological outpatients

AIM The Hospital Anxiety and Depression Scale (HADS) has been used widely with cardiovascular patients. This study aims to examine the reliability and validity of a Chinese version of HADS among psycho-cardiological outpatients. METHODS One hundred psycho-cardiological outpatients were asked to complete the Chinese version of HADS and were then interviewed according to the Mini International Neuropsychiatric Interview, Version 5 (MINI). RESULTS According to the MINI, 38 outpatients were diagnosed with major depression and 15 outpatients were diagnosed with an anxiety disorder. Compared with the MINI diagnoses, the optimum cutoff value of the anxiety subscale (HADS-A) was six (6) with a sensitivity of 81.6%, specificity of 75.8%, positive predictive value (PPV) of 54.0% and negative predictive value (NPV) of 91.9%; at the optimum cutoff value of nine (9), the depression subscale (HADS-D) had a sensitivity of 80.0%, specificity of 92.9%, PPV of 52.2% and NPV of 96.1%. The Cronbachs alpha coefficients of the HADS-A and HADS-D subscales were 0.753 and 0.764, respectively. The areas under the ROC curves of the HADS-A and the HADS-D subscales, as compared to MINI diagnoses of anxiety and depression, were 0.81 (SE = 0.05, 95%CI: [0.73, 0.90]) and 0.86 (SE = 0.05, 95%CI: [0.77, 0.94]), respectively. CONCLUSIONS The HADS was found to be a reliable measurement tool for excluding depression and anxiety in psycho-cardiological outpatients.

Association of ADIPOQ gene polymorphisms and coronary artery disease risk: A meta-analysis based on 12 465 subjects

INTRODUCTION Coronary artery disease (CAD) is one of the most common cardiovascular diseases and is a major cause of morbidity and mortality worldwide. Various researchers have investigated the role of ADIPOQ gene in the risk of CAD, yet their results have been inconsistent. METHODS To evaluate the association between ADIPOQ genetic polymorphisms and CAD risk, relevant studies published before October 2011 were identified by searching PubMed and EMBASE. Studies were selected using previously defined criteria. The strength of the relationship between the four single nucleotide polymorphisms (SNPs) of the ADIPOQ gene and CAD risk was assessed using odds ratios (ORs). RESULTS A total of 12 465 subjects from 17 case-control studies were identified in the present study. Based on the relevant studies, it was determined that the risk of CAD was not associated with rs2241766 in any genetic model. Increased risk of CAD was associated with rs266729 in allele contrast (1.11, [1.03, 1.20]) and dominant genetic model (1.15, 95%CI: [1.05, 1.27]); increased risk of CAD was also associated with rs822395 in additive (1.63, 95%CI: [1.19, 2.22]) and recessive genetic model (1.71, 95%CI: [1.27, 2.30]). It was further determined that the rs1501299 polymorphism reduced the risk of CAD in the additive (0.80, 95%CI: [0.67, 0.94]) and recessive genetic model (0.81, 95%CI: [0.68, 0.95]). In the stratified analysis, significant associations were found in Asian subjects for rs266729 and in Caucasian subjects for rs1501299. CONCLUSION There is an association between ADIPOQ gene polymorphisms and CAD risk. Different SNPs of the ADIPOQ gene have different associations with CAD risk, and appear to increase risk in individuals of Asian ethnicity while decrease the CAD risk in Caucasians. However, the overall strength of association was mild to moderate.

Effects of high-intensity interval versus continuous moderate‑intensity aerobic exercise on apoptosis, oxidative stress and metabolism of the infarcted myocardium in a rat model

The optimal aerobic exercise training (AET) protocol for patients following myocardial infarction (MI) has remained under debate. The present study therefore aimed to compare the effects of continuous moderate-intensity training (CMT) and high-intensity interval training (HIT) on cardiac functional recovery, and to investigate the potential associated mechanisms in a post-MI rat model. Female Sprague Dawley rats (8-10 weeks old) undergoing MI or sham surgery were subsequently submitted to CMT or HIT, or kept sedentary for eight weeks. Prior to and following AET, echocardiographic parameters and exercise capacity of the rats were measured. Western blotting was used to evaluate the levels of apoptosis and associated signaling pathway protein expression. The concentrations of biomarkers of oxidative stress were also determined by ELISA assay. Messenger (m)RNA levels and activity of the key enzymes for glycolysis and fatty acid oxidation, as well as the rate of adenosine triphosphate (ATP) synthesis, were also measured. Compared with the MI group, exercise capacity and cardiac function were significantly improved following AET, particularly following HIT. Left ventricular ejection fraction and fraction shortening were further improved in the MI-HIT group in comparison to that of the MI-CMT group. The two forms of AET almost equally attenuated apoptosis of the post-infarction myocardium. CMT and HIT also alleviated oxidative stress by decreasing the concentration of malondialdehyde and increasing the concentration of superoxide dismutase and glutathione peroxidase (GPx). In particular, HIT induced a greater increase in the concentration of GPx than that of CMT. AET, and HIT in particular, significantly increased the levels of mRNA and the maximal activity of phosphofructokinase-1 and carnitine palmitoyl transferase-1, as well as the maximal ratio of ATP synthesis. In addition, compared with the MI group, the expression of signaling proteins PI3K, Akt, p38mapk and AMPK was significantly altered in the MI-CMT and MI-HIT groups. HIT was superior to CMT in its ability to improve cardiac function and exercise capability in a post-MI rat model. HIT was also superior to CMT with regard to attenuating oxidative stress and improving glucolipid metabolism of the post-MI myocardium.

ADIPOQ gene polymorphisms and cancer risk: a meta-analysis.

The results of studies investigating the association between ADIPOQ gene polymorphisms and risk of cancer have been inconsistent and often contradictory. The present meta-analysis was conducted in order to overcome the limitations of any individual study and to provide a more precise overall effect estimate. Relevant studies were identified by searching PubMed and Embase for articles published through May 2012. The strength of the relationship between the ADIPOQ gene and risk of cancer was assessed using odds ratios (ORs). Either a fixed-effects or a random-effects model was used to calculate the overall risk estimates. Fifteen studies were included and five SNPs were considered. A significant association was found between SNP rs2241766 and risk of cancer in the recessive genetic model (OR: 0.768, 95% CI: [0.626,0.942], P=0.011); a significant relationship was also found between SNP rs1501299 and risk of cancer in both an allele contrast (OR: 0.141, 95%CI: [0.113,0.176], P<0.001) and the dominant genetic model (OR: 0.904, 95%CI: [0.830,0.985], P=0.021); no association was found with the rs266729, rs822395, or rs822396 SNPs. Adjusted ORs were also considered, but no statistically significant association was found in homozygote contrasts for any of the five SNPs after adjustment. Our results suggest that two polymorphisms, SNP rs2241766 and SNP rs1501299, of the ADIPOQ gene may be associated with reduced risk of cancer. However, the overall strength of association is mild to moderate, and additional well-designed studies are needed to confirm the present conclusion.

Association between Self-Reported Global Sleep Status and Prevalence of Hypertension in Chinese Adults: Data from the Kailuan Community

Background: Assessment of sleep only by sleep duration is not sufficient. This cross-sectional study aimed to investigate the potential association of self-reported global sleep status, which contained both qualitative and quantitative aspects, with hypertension prevalence in Chinese adults. Methods: A total of 5461 subjects (4076 of them were male) were enrolled in the current study and were divided into two groups with the age of 45 years as the cut-off value. Sleep status of all subjects was assessed using the standard Pittsburgh Sleep Quality Index (PSQI). Hypertension was defined as blood pressure ≥140/90 mmHg in the current study. Results: After adjusting for basic cardiovascular characteristics, the results of multivariate logistic regression indicated that sleep status, which was defined as the additive measurement of sleep duration and sleep quality, was associated with hypertension prevalence in males of both age groups (odds ratio (OR) = 1.11, 95% confidence interval (CI), 1.07–1.15, p < 0.05; OR = 1.12, 95% CI, 1.08–1.15, p < 0.05) and in females aged ≤45years (OR = 1.10, 95% CI, 1.02–1.18, p < 0.05). As one component of PSQI, short sleep duration was associated with hypertension prevalence only in Chinese male subjects, but this association disappeared after the further adjustment of the other components of PSQI that measured the qualitative aspect of sleep. Conclusion: Association between sleep status and hypertension prevalence in Chinese adults varied by age and sex. Sleep should be measured qualitatively and quantitatively when investigating its association with hypertension.

Association of Sleep Duration, Sleep Quality and Shift-Work Schedule in Relation to Hypertension Prevalence in Chinese Adult Males: A Cross-Sectional Survey

Background: Previous studies indicated that measurement of sleep only by duration and quality may be biased. This study aimed to investigate the interactive association of self-reported sleep duration, quality and shift-work schedule with hypertension prevalence in Chinese adult males. Methods: A total of 4519 Chinese adult males (≥18 years) were enrolled into the cross-sectional survey. Sleep attributes were measured from the responses to the standard Pittsburgh Sleep Quality Index and relevant questions in a structured questionnaire survey. The association of sleep duration, quality and shift-work schedule with hypertension prevalence was analyzed using multivariate logistic regression, considering the interaction between them or not. Results: Taking the potential interaction of the three aspects of sleep into consideration, only short sleep duration combined with poor sleep quality was found to be related to hypertension prevalence in Chinese adult males (odds ratio (OR): 1.74, 95% confidence interval (CI): 1.31–2.31), which could be modified by occasional and frequent shift-work schedule (OR: 1.43, 95% CI: 1.05–1.95; OR: 1.97, 95% CI: 1.40–2.79). Conclusions: Short sleep duration was not associated with the prevalence of hypertension in Chinese adult males unless poor sleep quality exists, which could be further modified by shift-work schedule. Assessment of sleep by measuring sleep duration only was not sufficient when exploring the association of sleep with hypertension.

Association between prevalence of hypertension and components of metabolic syndrome: the data from Kailuan community

Abstract This study aimed to investigate the potential association between prevalence of hypertension and components of metabolic syndrome (MetS) in general population of North China. A cross-section survey was conducted from September to December 2013 in Kailuan community of a Northern China city, Tangshan. Anthropometric measurements, blood tests and questionnaire surveys were administered to a total of 4675 subjects enrolled in this study. In this study, hypertension was defined as blood pressure>140/90 mmHg or medication for previously diagnosed hypertension. The definition of MetS adapted the IDF/AHA/NHLBI criteria. The prevalence of hypertension among population with or without individual or clustered components of MetS was compared and the respective contribution of every component of MetS to prevalence of hypertension was analyzed using multivariate logistic analysis. The overall prevalence of hypertension was 31.6% in enrolled subjects. People with components of MetS such as central obesity, elevated TG, high blood pressure, and abnormal glucose metabolism had a higher prevalence of hypertension compared with those without. The prevalence of hypertension in people with 0, 1, 2, 3, 4, and 5 components of MetS was 18.4%, 27.8%, 32.6%, 35.6%, 43.9%, and 54.7% (p < 0.05), respectively. After adjusting for age, gender, BMI, smoking and alcohol drinking, the prevalence of hypertension was significantly correlated with the following component of MetS including central obesity (OR 1.23 (1.04–1.46), p < 0.05), elevated TG (OR 1.21 (1.03–1.43), p < 0.05), high blood pressure (OR 3.34 (2.86–3.90), p < 0.05), and abnormal glucose metabolism (OR 1.23 (1.04–1.45), p < 0.05). Components of MetS could significantly contribute to the development of hypertension. Overall lifestyle improvement and control of metabolic associated risk factors should be the cornerstone of hypertension control in China.

Impact of Anemia and Dual Antiplatelet Therapy on Mortality in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents.

The objective was to assess the impact of baseline anemia on all-cause mortality and whether 12-month dual antiplatelet therapy (DAPT) affects 1-year mortality linked to anemia in patients after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). 4109 enrolled patients divided into three groups based on their pre-procedural hemoglobin (Hb) level: Hb < 100 mg/L represented moderate-severe anemia; 100 mg/L ≤ Hb < 120 mg/L for women and 100 mg/L ≤ Hb < 130 mg/L for men represented mild anemia; Hb ≥ 120 mg/L for women and Hb≥130 mg/L for men represented no anemia. DAPT medications were prescribed when patients were discharged. There were significant differences in 30-day and 1-year mortality between moderate-severe anemia and no anemia patients (HR 8.05, 95% CI 1.46 to 44.33, P = 0.017; HR 3.93, 95% CI 1.11 to 13.98, P = 0.034), and in long-term mortality between anemia and no anemia groups (HR 1.82, 95% CI 1.17 to 2.83, P = 0.008 for mild anemia; HR 3.19,95% CI 1.29 to 7.86, P = 0.012 for moderate-severe anemia). There was not significant interaction between 12-month DAPT and anemia on mortality in anemic patients (P for interaction > 0.05). Anemia shows association with increased all-cause mortality in patients undergoing PCI. Twelve-month DAPT does not show synergy with anemia to increase the risk of all-cause 1-year mortality in anemic patients after PCI.

Response to Huang et al. Comments on Lu et al. Association between Self-Reported Global Sleep Status and Prevalence of Hypertension in Chinese Adults: Data from Kailuan Community. Int. J. Environ. Res. Public Health 2015, 12, 488-503

We thank Huang et al. [1] for their interest in reading our article and their time in writing their comments on our work [2]. Our response to their concerns are as follows:[...]