Xiaolan Lai

Genetic variations in CYP17A1, CACNB2 and PLEKHA7 are associated with blood pressure and/or hypertension in she ethnic minority of China

OBJECTIVES Two large-scale genome-wide association studies (GWAs) have identified multiple variants associated with blood pressure (BP) or hypertension. The present study was to investigate whether some variations were associated with BP traits and hypertension or even prehypertension in adult She ethnic minority of China. METHODS The population of the present study comprised 4460 (1979 males and 2481 females, respectively) unrelated she ethnic minority based on a cross-sectional study from Ningde City in Fujian province of China. There were 1692 hypertensives, 1600 prehypertensives and 1168 normotensive controls, respectively. We genotyped 7 variants in CYP17A1, PLEKHA7, CACNB2, ATP2B1, TBX3-TBX5, CSK-ULK3 and SH2B3 reported by the previous GWAs on Europeans. All analyses were performed in an additive genetic model. RESULTS As the minor allele of rs653178 in/near SH2B3 was very rare with the frequency of 0.018, we excluded this single nucleotide polymorphism (SNP) in the further analyses. Of the other 6 loci, linear regression analyses revealed that rs11191548 in CYP17A1 and rs11014166 in CACNB2 were significantly associated with systolic BP (β = -1.17, P = 0.002 and β = -0.50, P = 0.006, respectively), while only SNP rs11191548 was significantly associated with diastolic BP (β = -0.56, P=0.002) after adjusted by age, sex and BMI. Two variants in CACNB2 and PLEKHA7 were found to be significantly related to hypertension (odds ratios [OR] and (95% confidence interval [CI]): 0.79 (0.65-0.97) and 1.19 (1.01-1.41), respectively) in logistic regression analyses after adjusted by age, sex and BMI. In addition, we found that combined risk alleles of the 6 SNPs increased risk of hypertension in a stepwise fashion (P for trend < 0.001). However, none of the 6 SNPs was significantly associated with BMI or prehypertension status. While logistic analysis showed that subjects with cumulative risk alleles more than 9 had significantly higher risk for prehypertension (adjusted OR: 3.10, P < 0.001) compared with those with risk alleles less than 4. CONCLUSIONS We replicated that variations in CYP17A1, CACNB2 and PLEKHA7 were related to BP traits and/or hypertension in She population. In addition, although we failed to observe single gene associated with prehypertension, we first found that conjoint effect of multiple risk alleles on BP might increase the risk of progressing to prehypertension.

Association study of genetic variants of 17 diabetes-related genes/loci and cardiovascular risk and diabetic nephropathy in the Chinese She population.

Genetic determinations are important in type 2 diabetes (T2DM) pathology. We investigated associations between genetic variants of 17 diabetes‐related genes/loci, T2DM and diabetic complications in Chinese She subjects.

Association study of genetic variants of 17 diabetes-related genes/loci and cardiovascular risk and diabetic nephropathy in the Chinese She population (中国畲族人群17个糖尿病相关基因位点的遗传变异与心血管风险和糖尿病肾病的相关性)

Genetic determinations are important in type 2 diabetes (T2DM) pathology. We investigated associations between genetic variants of 17 diabetes‐related genes/loci, T2DM and diabetic complications in Chinese She subjects.

Analysis of the prevalence and risk factors of hypertension in the She population in Fujian, China.

Objectives: The aim of this study was to investigate the prevalence and epidemiological characteristics of hypertension in the Chinese She ethnic minority in Fujian province of China. After analyzing relevant risk factors of hypertension, we wanted to provide information for prevention and control of hypertension in this ethnic minority. Methods: Using the stratified and cluster methods, we randomly selected 5,350 She subjects for a questionnaire survey. Their weight, height and blood pressure were measured. Hypertension was defined as a mean systolic blood pressure of ≧140 mm Hg or a diastolic blood pressure of ≧90 mm Hg, or use of antihypertensive medication. SPSS 13.0 software was used for database building and the χ2 test for statistical analysis. Results: The number of patients with hypertension was 1,931 (prevalence 36.09%) and 71.15% of them (1,374 patients) were undiagnosed. The prevalence of hypertension increased with age and was associated with education levels, occupation, body mass index, smoking, salt intake levels and a lack of health concepts. Conclusions: The prevalence of hypertension in the She has grown rapidly, which is closely correlated with lifestyle and lack of health education of hypertension. The prevention and control of hypertension in the She is imperative, and the promotion of health education on hypertension can be improved to enhance awareness, prevention, and control of hypertension.

Diabetes and its chronic complications in the She ethnic minority group of China.

OBJECTIVE According to recent reports, the development of type 2 diabetes in China has soared at an alarming rate. However, most of the investigations were based on Han people, who account for the majority of people in China. Little is known about the prevalence of diabetes its chronic complications in the She people, who have their own traditional lifestyle and hereditable background, different from other Asian population. The present study investigated the prevalence of type 2 diabetes and associated risk factors in the adult population of She nationals. SUBJECTS AND METHODS A total of 5,385 participants entered into the analysis eventually, including 2,308 men and 3,077 women. An oral glucose tolerance test was performed in subjects without diagnosed diabetes. Liver function, cardiovascular risk (brachial-ankle pulse wave velocity, estimated glomerular filtration rate, and abnormal Minnesota codes findings), uric acid, and neuropathy were tested to assess the profiles of associated risks. RESULTS In general, the self-reported diabetes rate was 9.5%. After age and sex standardization, the prevalence of diabetes was 6.1% (6.7% for men and 5.7% for women) in She Chinese people. In logistic regression models, age, family history of diabetes, alcohol use, total cholesterol, and triglycerides were all significantly associated with the risk of diabetes in this cross-sectional study (all P<0.05). In all, 47.4% had cardiovascular risks, 19.4% had liver dysfunction, and 6.2% had hyperuricemia. For women, compared with the first quartile, log-transformed homeostasis model assessment for insulin resistance of the fourth quartile was significantly higher (P<0.05), and log-transformed homeostasis model assessment for β cells was also higher in the second, third, and fourth quartiles (all P<0.05). The prevalences of polyneuropathy in impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG/IGT, and diabetes mellitus (DM) were 16.1%, 13.1%, 18.6%, and 28.4% separately, which was higher than that in normal glucose tolerance. The prevalences of polyneuropathy in IFG/IGT and DM were higher than that in IGT. CONCLUSIONS The present study revealed that a total of 6.1% She people suffered from type 2 diabetes, which was lower than the average level of China, but the standardized prevalence of prediabetes was higher, 20.6%. Early peripheral neuropathy screening should be performed in the prediabetes population. The Toronto Clinical Neuropathy Scoring System is convenient to assess diabetic polyneuropathy in clinical practice and should be tested regularly for people in prediabetes. Liver dysfunction, headache, and insomnia, appearing before type 2 diabetes, should be assessed regularly to avoid deterioration.

Prevalence and Risk Factors Associated with Prehypertension and Hypertension in the Chinese She Population

Background: Little is known about the prevalence and cardiovascular risk factors for prehypertension and hypertension in the She ethnic minority population of Fujian province in China. Methods and Results: Between April 2009 and September 2009, 5,523 participants of She nationality aged between 20 and 80 years participated in this survey and 5,357 were eventually enrolled in analyses. The survey was carried out to assess blood pressure and cardiovascular risk factors. The prevalence of prehypertension and hypertension was 35.87 and 38.42%, respectively, in all participants. Only 26.63% of the subjects with hypertension were aware of their diagnosis. Multivariate logistic regression showed that age, gender, overweight/obesity, dyslipidemia and alcohol use were risk factors for prehypertension, and age, overweight/obesity, dyslipidemia, alcohol use, family history of hypertension and hyperuricemia were risk factors for hypertension. The clustering of 2 and ≥3 risk factors was in higher proportion for subjects with hypertension and prehypertension when compared with those with prehypertension and normotension, respectively. After adjusting for other confounding factors, multivariable logistic regression showed that the greater the number of clustering cardiovascular risk factors, the greater the odds ratios for prehypertension and hypertension are. Conclusion: Hypertension and prehypertension were common in the She population of Fujian province. Cardiovascular risk factors cluster during prehypertension and awareness of hypertension was minimal. Early lifestyle modifications could be advocated to prevent the transition from prehypertension to hypertension and cardiovascular disease.

Association among serum uric acid, cardiovascular risk, and arterial stiffness: A cross-sectional study in She ethnic minority group of Fujian Province in China

Objectives: To investigate the association between serum uric acid levels, cardiovascular risk, and arterial stiffness in She ethnic minority in South China’s Fujian Province. Methods: 5109 participants aged 20–79 yr were enrolled in analysis. Tpeak-Tend interval (Tp-e), QT interval, and height of the R wave in lead aVL (aVLR) were measured on 12-lead electrocardiogram (ECG), and Minnesota code-indicated major abnormal ECG MA-ECG was used as a risk indicator of cardiovascular disease. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Results: Longer Tp-e interval, greater Tp-e/QT ratio, and higher aVLR were observed in the highest quartile of uric acid level. The incidence of MA-ECG was gradually increased from lowest to highest quartile of serum uric acid in males (p for trend <0.01). After adjusting traditional cardiovascular risk factors, multivariate analysis revealed that the fourth quartile of serum uric acid level was independently associated with MA-ECG in males [odds ratios (OR) (95% confidence interval): 2.129 (1.376-3.295)] but not in females. Serum uric acid was also associated with abnormal baPWV, when adjusted for atherogenic confounders. Compared with the lowest serum uric acid quartile, the OR (95% confidence interval) of the second, third, and fourth quartile were 1.920 (1.246-2.957), 1.650 (1.064-2.558), and 2.501 (1.600-3.908) in males. Conclusion: Among China’s She ethnic minority, uric acid level was independently related to arterial stiffness assessed by baPWV in both genders. The evaluation of uric acid level was related to higher cardiovascular risk in males but not in females.

Cardiovascular disease (CVD) risk, insulin resistance and β-cell function in prehypertension population of China

OBJECTIVE To explore the cardiovascular disease (CVD) risk in prehypertensive subjects and evaluate whether high blood pressure (BP) is associated with insulin resistance (IR) and β-cell dysfunction. METHODS A total of 2949 people aged 20-94 years old were selected in Fujian province of China. We assessed CVD risk using Minnesota code-indicated major abnormal electrocardiography (MA-ECG) and presence of microalbuminuria in all population. IR/sensitivity and β-cell function indices were derived from an oral glucose tolerance test. RESULTS Prehypertensives with systolic/diastolic BP (SBP/DBP) 130-139/85-89 mm Hg had significant higher risk of MA-ECG and presence of microalbuminuria compared with normotensives (odds ratio [OR]: 1.483, 95% confidence interval [CI]: 1.016-2.165 and OR: 1.613, 95% CI: 1.142-2.277, respectively). In non-diabetic subjects, we found that prehypertensives and hypertensives had significant higher HOMA-IR and lower Matsudas insulin sensitivity index compared with normotensives. There was a slightly decreased trend in β-cell function assessed by disposition index (DIo) across the BP categories, when adjusted with age and BMI. The slight decline of DIo remained between hypertension and normotension, after additional adjustments were made, but the reduction of DIo lost statistic significance between prehypertension and normotension. CONCLUSIONS Prehypertensives with SBP/DBP 130-139/85-89 mm Hg have higher CVD risk than normotensives. Prehypertension and hypertension are both in IR condition, however, what is more important is that early β-cell dysfunction may exists in hypertension to some extent, while for prehypertension the compensation of β-cell function may be appropriate.

Relationship between gestational fasting plasma glucose and neonatal birth weight, prenatal blood pressure and dystocia in pregnant Chinese women

Little is known about the optimal cut‐off point of fasting plasma glucose for the diagnosis of gestational diabetes mellitus for pregnant Chinese women. This study investigates the relationship between gestational fasting plasma glucose and several variables: neonatal birth weight, prenatal blood pressure and dystocia rate of pregnant women. In this study, we hoped to provide a useful tool to screen gestational diabetes mellitus in pregnant Chinese women.

Association study of genetic variants of 17 diabetes-related genes/loci and cardiovascular risk and diabetic nephropathy in the Chinese She population (中国畲族人群17个糖尿病相关基因位点的遗传变异与心血管风险和糖尿病肾病的相关性): Genetic variants and diabetic nephropathy

Genetic determinations are important in type 2 diabetes (T2DM) pathology. We investigated associations between genetic variants of 17 diabetes‐related genes/loci, T2DM and diabetic complications in Chinese She subjects.