Xu Ma

The 1425G/A SNP in PRKCH Is Associated With Ischemic Stroke and Cerebral Hemorrhage in a Chinese Population

Background and Purpose— PRKCH (the gene encoding protein kinase C &eegr;) has a role in the pathogenesis of ischemic stroke. The 1425G/A SNP in PRKCH (rs2230500) is significantly associated with ischemic stroke in Japanese. The aim of the present study is to investigate the associations in ischemic stroke and other types of stroke in the Chinese population. Methods— A total of 1209 patients with stroke and 1174 controls were examined using a case–control methodology. The 1425G/A SNP in PRKCH was genotyped by allele-specific real-time PCR assay. Results— The 1425G/A SNP in PRKCH was significantly associated with both ischemic stroke (odds ratio [OR]=1.31; 95% confidence interval [CI], 1.08 to 1.60; P=0.0058) and cerebral hemorrhage (OR=1.94; 95% CI, 1.21 to 3.10; P=0.0054) under a dominant model. Even after age- and sex-adjustment, the significant associations remained (in ischemic stroke, for AA+AG versus GG, OR=1.37, 95% CI, 1.12 to 1.67, P=0.0019; in cerebral hemorrhage, for AA+AG versus GG, OR=1.96, 95% CI, 1.21 to 3.19, P=0.0064). Conclusions— The 1425G/A SNP in PRKCH increases the risk of both ischemic stroke and cerebral hemorrhage in the Chinese population.

Association of Two CETP Polymorphisms With HDL Levels in the Chinese Obese Population

The association of two cholesterol ester transfer protein (CETP) polymorphisms, D442G and TAQIB (B1→B2), with high‐density lipoprotein (HDL) levels in 932 Chinese obese individuals (BMI ≥ 27) was investigated in comparison with normal controls (BMI ≤ 24). Independent association was demonstrated for TAQIB minor allele B2 and CETP442 minor allele G with elevated HDL levels. The CETP D442G polymorphism was associated with a much greater increase in HDL levels in subjects with BMI exceeding 27 kg/m2 (+5.42 mg/dl, P = 0.0007) compared to normal controls (+1.97 mg/dl, P = 0.275), and the increase in HDL reached the highest level among subjects with BMI exceeding 30 kg/m2 (+6.80 mg/dl, P = 0.016). TAQIB showed significant association with HDL levels only in normal BMI subgroup (P = 0.0017). TAQIB significantly interacted with serum triglyceride (TG) on modulating HDL levels (P = 0.027). The TAQIB–TG interaction effect remained marginally significant after controlling for BMI (P = 0.057). We conclude that D442G polymorphism is associated with more HDL elevation in obesity. TAQIB interacts with serum TG on modulating HDL levels, and the interaction is partly independent of BMI.

Status of HBsAg seroprevalence in 15 million rural couples in China: a cross-sectional study

A cross-sectional analysis of prevalence of hepatitis B virus infection (HBV) among rural couples was conducted between 2010 and 2014. Serologic HBV markers, including hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), were tested. Primary outcome of interest comprised HBsAg positivity in couples (both positive: F+M+, only wife positive: F+M−, only husband positive: F−M+), and secondary outcome consisted of prevalence and risk factors of HBsAg positivity among husbands or wives. Of 14,816,300 couples included, 0.7% were F+M+; 6.3% were F−M+; 4.4% were F+M−, resulting in the overall seroprevalence of 11.4%. Individually, 6.1% were HBsAg positive with a higher rate seen in husbands (7.0%) than in wives (5.2%). Wife’s HBeAg(+)/HBsAg (+) (AOR = 2.61), HBeAg(−)/HBsAg (+) (AOR = 2.23), positivity of syphilis (AOR = 1.50), living in a high-risk region (AOR = 1.46) were significantly predictors of HBsAg positivity in husbands. Prevalence and predictors of HBsAg positivity in wives had similar results. Our data show a high burden and discordant pattern of HBV infection in rural couples, and partner’s double positivity of HBeAg and HBsAg was the most significant factor of HBV infection in couples. A comprehensive strategy that emphasizes vaccination and education is needed.

Association of Long-term Exposure to Airborne Particulate Matter of 1 μm or Less With Preterm Birth in China

Importance Airborne particulate matter pollution has been associated with preterm birth (PTB) in some studies. However, most of these studies assessed only populations living near monitoring stations, and the association of airborne particulate matter having a median diameter of 1 &mgr;m or less (PM1) with PTB has not been studied. Objective To evaluate whether PM1 concentrations are associated with the risk of PTB. Design, Setting, and Participants This national cohort study used National Free Preconception Health Examination Project data collected in 324 of 344 prefecture-level cities from 30 provinces of mainland China. In total, 1 300 342 healthy singleton pregnancies were included from women who were in labor from December 1, 2013, through November 30, 2014. Data analysis was conducted between December 1, 2016, and April 1, 2017. Exposures Predicted weekly PM1 concentration data collected using satellite remote sensing, meteorologic, and land use information matched with the home addresses of pregnant women. Main Outcomes and Measures Preterm birth (<37 gestational weeks). Gestational age was assessed using the time since the first day of the last menstrual period. Cox proportional hazards regression analysis was used to examine the associations between trimester-specific PM1 concentrations and PTB after controlling for temperature, seasonality, spatial variation, and individual covariates. Results Of the 1 300 342 singleton live births at the gestational age of 20 to 45 weeks included in this study, 104 585 (8.0%) were preterm. In fully adjusted models, a PM1 concentration increase of 10 &mgr;g/m3 over the entire pregnancy was significantly associated with increased risk of PTB (hazard ratio [HR], 1.09; 95% CI, 1.09-1.10), very PTB as defined as gestational age from 28 through 31 weeks (HR, 1.20; 95% CI, 1.18-1.23), and extremely PTB as defined as 20 through 27 weeks’ gestation (HR, 1.29; 95% CI, 1.25-1.34). Pregnant women who were older (30-50 years) at conception (HR, 1.13; 95% CI, 1.11-1.14), were overweight before pregnancy (HR, 1.13; 95% CI, 1.11-1.15), had a rural household registration (HR, 1.09; 95% CI, 1.09-1.10), worked as farmers (HR, 1.10; 95% CI, 1.09-1.11), and conceived in autumn (HR, 1.48; 95% CI, 1.46-1.50) appeared to be more sensitive to PM1 exposure than their counterparts. Conclusions and Relevance Results from this national cohort study examining more than 1.3 million births indicated that exposure to PM1 air pollution was associated with an increased risk of PTB in China. These findings will provide evidence to inform future research studies, public health interventions, and environmental policies.

Prevalence of chronic hepatitis B and status of HBV care among rural women who planned to conceive in China

Globally, one third of prevalent chronic hepatitis B (CHB) virus infection (HBV) occurred in China. Assessing the prevalence of CHB infesction and status of HBV-related services among pre-conception women will provide insight into risks of mother to child transmission (MTCT). A cross-sectional analysis of data from the National Free Pre-pregnancy Checkups (NFPC) program in 2010–2014 was conducted. A standardized questionnaire which collected demographic information and enzyme-linked immunosorbent assays (ELISA) which tested serological HBV markers were applied. A total of 16,051,850 rural women aged 15–49 years were included. 5.2% of women were infected with CHB, among whom, 28.6% were also hepatitis B e antigen (HBeAg) positive. The most CHB concentrated places were distributed in southeastern coastal provinces. Women born after 1992 did not experience a higher level of vaccine-induced immunity compared to those born before 1992. Nine in ten rural women with CHB were not aware of their HBV status and a very small proportion of women (0.22%) had received antiviral treatment. Our data demonstrated an overall high-intermediate burden of CHB. Heterogeneity of geographic distribution, high proportion of HBeAg, insufficient awareness of HBV status, and low access to HBV treatment are challenges for preventing the MTCT.

Effect of airborne particulate matter of 2.5 μm or less on preterm birth: A national birth cohort study in China

BACKGROUND Most evidences regarding ambient PM2.5 or PM10 (particulate matter of median aerodynamic diameter ≤2.5 μm or ≤10 μm) and preterm birth (PTB) come from western countries which has relatively low PM pollution exposure, and the results are still inconsistent. This study aims to examine whether exposure to high concentrations of PM2.5 or PM10 was associated with PTB (<37 weeks) and near term birth (37-38 weeks). METHOD We established a birth cohort with 1,280,524 singleton pregnancies who delivered from Dec 1st, 2013 to Nov 30th, 2014 and matched their home address to PM2.5 and PM10 concentrations which were predicted with machine learning methods based satellite remote sensing, meteorological and land use information. Cox proportional hazard regression models were used to analyze the associations between PTB and exposure of PM2.5 or PM10, after controlling for individual level covariates. RESULTS Exposure to PM2.5 or PM10 during pregnancy increases the risk of PTB and near term birth [e.g., Hazard ratios: 1.09 (95% CI: 1.09, 1.10), 1.08 (95% CI: 1.07, 1.08), 1.01 (95% CI: 1.01, 1.02), and 1.09 (95% CI: 1.08, 1.10) for each 10 μg/m3 increase in PM2.5 for the 1st, 2nd, 3rd trimester and over the entire pregnancy, respectively]. The effects appeared to be stronger among women who come from rural areas, worked as farmers, were overweight before conception, whose mate was smoking during pregnancy, and conceived in autumn. CONCLUSION This study provides clear evidence that exposure to PM2.5 or PM10 during pregnancy increases the risk of PTB and near term birth. Public policies regarding improvement of air quality would produce great health benefit by reducing the burden of preterm birth.