Wei-wei Chang

Life satisfaction, coping, self-esteem and suicide ideation in Chinese adolescents: a school-based study

PURPOSE To determine the prevalence and associated risk factors of suicidal ideation (SI) among junior, senior high and college school students. METHODS A total of 5249 students in Anhui Province of China participated in a self-administered anonymous survey. RESULTS Females were more likely to report SI than males (32.1% vs. 20.6%). Using binary logistic regression analysis, we found that being female, passive coping, lower family satisfaction, lower school satisfaction, lower living environment satisfaction and higher self-esteem were associated with an increased risk of SI. CONCLUSIONS This study suggested that SI was common among Chinese adolescents. Being female, high score of passive coping, lower family satisfaction, lower school satisfaction, lower living environment satisfaction and higher self-esteem were significantly associated with an increased risk of SI. There is an urgent need to take effective measures reducing the rate of SI among adolescents through collaboration among families, schools and society.

An updated meta-analysis of endothelial nitric oxide synthase gene: Three well-characterized polymorphisms with ischemic stroke

Polymorphisms in the endothelial nitric oxide synthase (eNOS) gene may influence the risk of ischemic stroke (IS), but the results are still debatable. A meta-analysis was performed to investigate the association between the eNOS gene polymorphisms in IS risk. Case-control studies on the association between the G894T, T-786C, and 4b/a polymorphisms and IS were searched up to July 2012, and the genotype frequencies in the control group were found to be consistent with the Hardy-Weinberg equilibrium (HWE). The effect summary odds ratio (OR) and 95% confidence intervals (CIs) were obtained. Meta-regression was used to explore the potential sources of heterogeneity. Funnel plots and Eggers test was used to estimate small study biases, and heterogeneity was assessed by chi-square-based Q-test and I(2) test. There were total 6537/6475 cases/controls for G894T, 3459/3951 cases/controls for 4b/a, and 2125/2673 cases/controls for T-786C polymorphism. For G894T and 4b/a, a significant association of 894T allele and 4a allele with increased risk of IS was found in Asians (TT+GT vs. GG: p<0.00001, OR=1.60, 95% CI=1.38-1.79, Pheterogeneity=0.11; aa+ba vs. bb: P<0.00001, OR=1.60, 95% CI=1.30-1.97, Pheterogeneity=0.02), but not in Caucasians (TT+GT vs. GG: P=0.60, OR=0.94, 95% CI=0.75-1.19, Pheterogeneity=0.002; aa+ba vs. bb: P=0.13, OR=0.81, 95% CI=0.62-1.06, Pheterogeneity=0.63). For T-786C polymorphism, there were no significant differences in genotype distribution between IS and control in Asians (CC+TC vs. TT: P=0.15, OR=1.14, 95% CI=0.95-1.37, Pheterogeneity=0.94) and in Caucasians (CC+TC vs. TT: P=0.72, OR=0.96, 95% CI=0.75-1.22, Pheterogeneity=0.53). This analysis provides strong evidence that the eNOS T-786C gene polymorphism is not associated with IS, the G894T and 4b/a polymorphisms might be associated with IS, at least in Asians.

Subclinical eating disorders in female medical students in Anhui, China: a cross-sectional study.

PURPOSE This cross-sectional study explored the prevalence of eating disorders (EDs) and possible associated factors (depressive symptoms, anxiety and BMI, etc) on EDs in female medical students in China. METHODS A total of 1,135 students in Wuhu, Anhui Province were sampled to participate in this survey. The survey collected sociodemographic data, depressive symptoms, anxiety and eating behaviors of students. RESULTS The students at risk for eating disorders were 2.17%. Eating disorder risk was more frequent in students with poor parents relationship, students with poor relationship with parents, students with high body mass index, students who were excessive focus on slimming propaganda, and students whose relatives have a diet. Also, the mean scores for the psychological factors of depression and anxiety were higher in students with eating disorder risk. A multiple linear regression model was produced depicting that depression, anxiety, high level of BMI, focusing on slimming propaganda, and dieting status among relatives were risk factors of having an eating disorder risk. CONCLUSIONS A significant fraction of female medical students in Anhui are at high risk of development of eating disorders. A comprehensive intervention focusing on family environment and emotion management should be designed to prevent occurrence of such disorders among medical students that would undoubtedly hamper the availability of dependable medical services in future.

Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and susceptibility to diabetic nephropathy in Chinese type 2 diabetic patients: a meta-analysis

Abstract The association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and diabetic nephropathy (DN) or diabetes mellitus (DM) risk has been widely reported, but the results are still debatable. To investigate the role of MTHFR C677T polymorphism on DM or DN, 13 separate studies in the Chinese population on the relation between MTHFR C677T polymorphism and DM or DN were analyzed by a meta-analysis. Five genetic models were used to estimate the association between MTHFR C677T polymorphism and the risk of DM or DN. Overall, our meta-analysis for DN versus healthy controls produced significant results for all genetic contrasts except for the co-dominant model (allele contrast: OR = 2.24, 95%CI: 1.88–2.65, p < 0.00001, Pheterogeneity = 0.49). However, the meta-analysis for DM versus healthy controls produced non-significant results for all contrasts (allele contrast: OR = 1.12, 95%CI: 0.92–1.35, p = 0.25, Pheterogeneity = 0.07). In addition, the meta-analysis for DM versus DN produced significant results for all contrasts (allele contrast: OR = 1.88, 95%CI: 1.65–2.15, p < 0.00001, Pheterogeneity = 0.83). The current meta-analysis suggested that MTHFR C677T polymorphism might influence DN risk, but not for DM in the Chinese population.

Meta-analysis of the transforming growth factor-β1 polymorphisms and susceptibility to Alzheimer's disease.

The association between transforming growth factor-β1 (TGF-β1) gene polymorphisms and Alzheimer’s disease (AD) risk has been widely reported, but results were somewhat controversial and underpowered. To derive a more precise estimation of the relationship between TGF-β1 polymorphisms and AD risk, we conducted a meta-analysis of all available case–control studies relating the T869C and/or C-509T polymorphisms of the TGF-β1 gene to the risk of developing AD. Eligible articles were identified by search of databases including Pub Med, Web of Science, the Chinese Biomedical Database (CBM), Chinese National Knowledge Infrastructure (CNKI) and the Wan Fang (Chinese) for the period up to March 2012. Finally, a total of 14 articles were identified, 10 with 1,657 cases and 6,971 controls for T869C polymorphism and 8 with 2,618 cases and 7,473 controls for C-509T polymorphism. The pooled ORs were performed for the allele contrasts, additive genetic model, dominant genetic model and recessive genetic model, respectively. Subgroup analysis was also performed by ethnicity. With respect to T869C and C-509T polymorphism, the combined results showed that there were no significant differences in genotype distribution between AD and control based on all studies. When stratifying for the race, there were also no statistically significant differences in genotype distribution between AD and controls. This meta-analysis did not provide an evidence of confirming association between the T869C and/or C-509T polymorphisms of the TGF-β1 gene and AD.

An updated meta-analysis of transforming growth factor-β1 gene: Three well-characterized polymorphisms with asthma

The association between TGF-β1 polymorphisms and asthma risk has been widely reported, but results were controversial. We performed this meta-analysis based on the Preferred Reporting Items for Systematic Reviews and meta-analyses statement (PRISMA). Electronic database of Pub Med, Web of Science, CBM, and CNKI were searched for eligible articles published up to September, 2013. The effect summary odds ratio (OR) and 95% confidence intervals were obtained. Finally, a total of 20 articles were identified, 17 studies with 3694 cases and 5613 controls for C-509T polymorphism, 7 studies with 1109 cases and 1098 controls for T869C polymorphism and 5 studies with 849 cases and 829 controls for G915C polymorphism. For C-509T, significant associations with asthma were found in Asians (TT+TC vs. CC: P=0.004, OR=1.43, 95%CI=1.12-1.81, Pheterogeneity=0.001) and in Caucasians (P=0.05, OR=1.16, 95%CI=1.00-1.34, Pheterogeneity=0.36). With respect to T869C, a small significant association was observed in overall analysis of allele contrasts(C vs. T: OR=1.14, 95%CI: 1.01-1.29, P=0.03) and homozygote comparison (CC vs. TT: OR=1.29, 95%CI: 1.00-1.65, P=0.05), but no significant risks were found among Caucasian population and Asian population. For G915C polymorphism, no significant association with asthma risk was demonstrated in overall analysis and subgroup analyses according to ethnicity for all genetic models. This meta-analysis suggested that TGF-β1 C-509T and T869C polymorphisms may be risk factors for asthma.

Problem behaviours of middle school students in eastern China and its associated factors

OBJECTIVE To investigate the problem behaviours of middle school students and its associated factors in Anhui province of China, and to provide a theoretical basis for promoting early health education. METHODS A cross-sectional survey was conducted and 4235 middle school students were measured by Prediction Test of Problem Children, Family Environment Scale - Chinese Version, Simple Coping Style Questionnaire, Psychological Sense of School Membership and general state questionnaire. RESULTS The prevalence of problem behaviours in our sample was 4.5%. Using binary logistic regression analysis, we found that family environment, school belonging, coping style, relationship with mother and classmate relationship were associated with problem behaviours of middle school students. CONCLUSIONS Poor family environment, poor sense of school belonging, passive acting style were significantly correlated with problem behaviours. There is an urgent need to improve problem behaviours through collaboration among families, schools and society.

Need for clarification of data in the recent meta-analysis about cytotoxic T-lymphocyte associated antigen 4 gene polymorphism and type 1 diabetes mellitus.

We read with great interest the recent article “Association of cytotoxic T-lymphocyte associated antigen 4 gene polymorphism with type 1 diabetes mellitus: A meta-analysis” published in the 2012 issue of “Gene” (Tang et al., 2012). The meta-analysis by Tang et al. (2012) included 63 case–control studies on the association between CTLA-4 polymorphisms (+49A/G, CT60A/G and −318 C/T) and type 1 diabetes mellitus (T1DM), which suggested that A49G and CT60 polymorphisms in CTLA-4 gene are associated with an increased risk of T1DM. It is an interesting study. Nevertheless, there are some comments related to this article that we would like to raise. First, a meta-analysis should include as much information as possible. Using the same search strategy and end-of-search date as those of Tang et al., we have located eight other relevant case–control studies on the association between CTLA-4 polymorphisms and T1DM in the PubMed database, which have not been included in the meta-analysis even though they satisfied the search criteria (Ban et al., 2001; Dallos et al., 2008; Genc et al., 2004; Guja et al., 2002; Howson et al., 2007; Marron et al., 1997; Stene et al., 2010; Zhernakova et al., 2005). Although available data could be obtained from these eight studies to calculate the odds ratios (OR) with confidence intervals (CI), the authors omitted them. Second, evidence indicated that only the larger study should be included for the analysis when some publications contain the same or overlapping data (Little et al., 2002). There are three studies performed by Douroudis et al. (2009), Haller et al. (2004), and Haller et al. (2007), from the same population. The study by Douroudis et al. carried out in 2009 (Douroudis et al., 2009) including 404 cases and 725 controls was larger than the study by Haller et al. performed in 2004 (Haller et al., 2004) involving 69 cases and 158 controls and the study by Haller

Tumour necrosis factor-related apoptosis-inducing ligand expression in patients with diabetic nephropathy

Objective: The objective of this study was to evaluate the expression profile of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) in patients with diabetic nephropathy (DN). Methods: A total of 126 Chinese subjects were enrolled in this study, including 42 patients with diabetes mellitus (DM), 42 patients with DN and 42 healthy controls. Real-time polymerase chain reaction was performed to analyze levels of TRAIL mRNA in peripheral blood mononuclear cells (PBMCs). Serum levels of soluble TRAIL (sTRAIL) and various cytokines were detected with a commercially available enzyme-linked immunosorbent assay kit. Results: Compared with the control group, the levels of TRAIL mRNA in PBMCs and sTRAIL in sera were both significantly decreased in the DM and DN patients (P < 0.05). Conversely, levels of interleukin (IL)-1, IL-6, tumour necrosis factor-α and monocyte chemotactic protein-1 were higher in the DN group than in the control group. Serum levels of TRAIL positively correlated with TRAIL mRNA levels in all of the subjects examined (P < 0.05). Conclusions: These results provide support and a theoretical basis for further research of TRAIL in regard to the pathogenesis of DN.

Association between TNF-a promoter -308G/A polymorphism and essential hypertension in the Asian population: A meta-analysis

Objective: The results of studies on the association between tumor necrosis factor-a -308G/A (TNF-a -308G/A) polymorphism, and susceptibility to essential hypertension are controversial. To derive a more precise estimation, we conducted a meta-analysis of all similar articles. Methods: The summary effect odds ratios and 95% confidence intervals were obtained. Funnel plots and Egger’s test were used to estimate publication bias, and heterogeneity was assessed by the chi-square-based Q-test and I2 test. Results: Nine studies (with 1437 cases and 1487 controls) were included. In the overall analysis, the combined results showed that there were significant differences in genotype distribution between essential hypertension cases and controls, AA+GA versus GG (OR = 1.53, 95% CI: 1.25–1.88, p < 0.00001). In the stratified analysis by country, we found that essential hypertension cases had a significantly higher frequency of AA+GA versus GG (OR = 1.47, 95% CI: 1.18–1.81, p = 0.0004) than control in the Asian population. Conclusions: This meta-analysis supports previous findings that TNF-a -308G/A polymorphism may increase the risk of essential hypertension, at least in the Asian population.