Yintao Chen

A Body Shape Index and Body Roundness Index: Two new body indices for detecting association between obesity and hyperuricemia in rural area of China.

OBJECTIVE The first objective was to examine whether A Body Shape Index (ABSI) and Body Roundness Index (BRI) can identify hyperuricemia in rural China. The second aim was to compare the relative strength of association between anthropometric indices and hyperuricemia. METHODS A total of 11,345 participants were involved in this cross-sectional study. Obesity measurements included BMI, WC, WHtR, ABSI and BRI. According to the statistical distribution of serum uric acid (SUA), we split our study population in sex-specific tertiles of SUA. RESULTS After adjusting for confounding variables, BRI (linear regression: 0.170; AUC: 0.641; OR: 1.459) showed more powerful predictive ability for hyperuricemia than BMI (linear regression: 0.151; AUC: 0.630; OR: 1.108), while having a similar predictive power for hyperuricemia as WHtR (linear regression: 0.191; AUC: 0.656; OR: 1.067) and WC (linear regression: 0.209; AUC: 0.658; OR: 1.047) in the female group, but not in the male group. However, ABSI (A) (linear regression: 0.089 for women, 0.121 for men; AUC: 0.589 for women, 0.578 for men; OR: 1.027 for women, 1.034 for men) and ABSI (B) (linear regression: 0.118 for women, 0.121 for men; AUC: 0.607 for women, 0.578 for men; OR: 1.049 for women, 1.034 for men) had the lowest predictive power for hyperuricemia in both sex categories. CONCLUSIONS ABSI, BRI, BMI, WC and WHtR were all significantly associated with hyperuricemia in both sexes. In addition, BRI rather than ABSI showed a superior predictive ability for identifying hyperuricemia than BMI in female and similar capabilities as those of WC and WHtR in the female, but not in the male gender.

Visceral Adiposity Index and Lipid Accumulation Product Index: Two Alternate Body Indices to Identify Chronic Kidney Disease among the Rural Population in Northeast China

We aimed to compare the relative strength of the association between anthropometric obesity indices and chronic kidney disease (CKD). Another objective was to examine whether the visceral adiposity index (VAI) and lipid accumulation product index (LAPI) can identify CKD in the rural population of China. There were 5168 males and 6024 females involved in this cross-sectional study, and 237 participants (2.12%) suffered from CKD. Obesity indices included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), VAI and LAPI. VAI and LAPI were calculated with triglyceride (TG), high-density lipoprotein (HDL), BMI and WC. VAI = [WC/39.68 + (1.88 × BMI)] × (TG /1.03) × (1.31/ HDL) for males; VAI = [WC/36.58 + (1.89 × BMI)] × (TG/0.81) × (1.52/HDL) for females. LAPI = (WC-65) × TG for males, LAPI = (WC-58) × TG for females. CKD was defined as an estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73 m2. The prevalence of CKD increased across quartiles for WHtR, VAI and LAPI. A multivariate logistic regression analysis of the presence of CKD for the highest quartile vs. the lowest quartile of each anthropometric measure showed that the VAI was the best predictor of CKD in females (OR: 4.21, 95% CI: 2.09–8.47, p < 0.001). VAI showed the highest AUC for CKD (AUC: 0.68, 95% CI: 0.65–0.72) and LAPI came second (AUC: 0.66, 95% CI: 0.61–0.70) in females compared with BMI (both p-values < 0.001). However, compared with the traditional index of the BMI, the anthropometric measures VAI, LAPI, WC, and WHtR had no statistically significant capacity to predict CKD in males. Our results showed that both VAI and LAPI were significantly associated with CKD in the rural population of northeast China. Furthermore, VAI and LAPI were superior to BMI, WC and WHtR for predicting CKD only in females.

Early repolarization pattern in the general population: Prevalence and associated factors

OBJECTIVES To evaluate the prevalence of early repolarization pattern (ERP) in the general rural Chinese population and identify the contributing risk factors. METHODS A cross-sectional study of 11,956 permanent residents of Liaoning Province ≥35y of age was conducted between January and August 2013 (response rate 85.3%). ERP was diagnosed if there was J-point elevation of ≥0.1mV in ≥2 leads in the inferior (II, III, aVF) or lateral (I, aVL, V4-6) territory, or both. Risk factors for ERP were evaluated with a stepwise logistic regression analysis. RESULTS The overall prevalence of ERP was 1.3%, and it was higher in men than women (2.6 vs. 0.2%, P<0.001), decreasing with increasing age. Percent of ERP positive in lateral leads, inferior, and both was 73.0%, 15.3%, and 11.7%, respectively. Stepwise logistic regression demonstrated that independent clinical factors for ERP included age (odds ratio [OR] 0.68; P<0.001), male sex (OR 17.09; P<0.001), systolic blood pressure (SBP) (OR 0.77; P=0.022), stroke (OR 0.14; P=0.055), RR interval (OR 1.27; P=0.001), QTc interval (OR 0.76; P=0.008), QRS duration (OR 0.67; P=0.001), Cornell voltage (OR 0.28; P<0.001), and Sokolow-Lyon voltage (OR 2.03; P<0.001). CONCLUSIONS Although the prevalence of ERP in general rural Chinese population is low, younger age, male sex, lower SBP, non-stroke history, longer RR interval, shorter QTc interval, shorter QRS duration, lower Cornell voltage, and higher Sokolow-Lyon voltage are independent risk factors.

Metabolically healthy obesity also has risk for hyperuricemia among Chinese general population: A cross-sectional study

INTRODUCTION The metabolically healthy obese (MHO) refers to obese individuals with a favorable metabolic profile. It is unknown whether metabolically healthy status in persons with obesity or overweight decreases the risk of hyperuricemia. This study aims to explore the association of MHO with risk of hyperuricemia. METHODS We performed a cross-sectional study including 11,435 (5300 men and 6135 women) general population aged ≥35 years in Liaoning Province. Anthropometric measurements, laboratory examinations and self-reported information on lifestyle factors were collected by trained personnel. Metabolically healthy overweight/obesity was defined according to body mass index and ATP-III criterion of metabolically healthy status. Hyperuricemia was defined as SUA ≥7mg/dl (420mmol/L) in men or ≥6mg/dl (360mmol/L) in women. Logistic regression analyses were performed to explore the association between overweight/obesity with different metabolic status and risk of hyperuricemia. RESULTS Among total subjects, 470 (4.2%) were metabolically healthy obese (MHO) and 1567 (14.0%) were metabolically unhealthy obese (MUO). For metabolically healthy female participants, the prevalence of hyperuricemia with overweight was similar to with a normal BMI (2.5% vs. 3.1%, P=0.314). Multivariate logistic regression analyses showed that MHO (OR=2.48, 95% CI: 1.81-3.41) and MUO (OR=4.81, 95% CI: 3.97-5.83) were significantly associated with hyperuricemia. However, the odds ratio in females with metabolically healthy overweight was 0.85 (95% CI: 0.53-1.37). CONCLUSIONS Metabolically healthy might decline the risk of hyperuricemia, but overweight and obesity with metabolically healthy had also strong associations with hyperuricemia, except in females with metabolically healthy overweight.

The Protective Role of the TOPK/PBK Pathway in Myocardial Ischemia/Reperfusion and H2O2-Induced Injury in H9C2 Cardiomyocytes

T-LAK-cell-originated protein kinase (TOPK) is a PDZ-binding kinase (PBK) that was recently identified as a novel member of the mitogen-activated protein kinase (MAPK) family. It has been shown to play an important role in many cellular functions. However, its role in cardiac function remains unclear. Thus, we have herein explored the biological function of TOPK in myocardial ischemia/reperfusion (I/R) and oxidative stress injury in H9C2 cardiomyocytes. I/R and ischemic preconditioning (IPC) were induced in rats by 3-hour reperfusion after 30-min occlusion of the left anterior descending coronary artery and by 3 cycles of 5-min I/R. Hydrogen peroxide (H2O2) was used to induce oxidative stress in H9C2 cardiomyocytes. TOPK expression was analyzed by western blotting, RT-PCR, immunohistochemical staining, and immunofluorescence imaging studies. The effects of TOPK gene overexpression and its inhibition via its inhibitor HI-TOPK-032 on cell viability and Bcl-2, Bax, ERK1/2, and p-ERK1/2 protein expression were analyzed by MTS assay and western blotting, respectively. The results showed that IPC alleviated myocardial I/R injury and induced TOPK activation. Furthermore, H2O2 induced TOPK phosphorylation in a time-dependent manner. Interestingly, TOPK inhibition aggravated the H2O2-induced oxidative stress injury in myocardiocytes, whereas overexpression relieved it. In addition, the ERK pathway was positively regulated by TOPK signaling. In conclusion, our results indicate that TOPK might mediate a novel survival signal in myocardial I/R, and that its effect on anti-oxidative stress involves the ERK signaling pathway.

Diabetes mellitus is an independent risk factor for atrial fibrillation in a general Chinese population

To explore the association between atrial fibrillation (AF) and diabetes mellitus in a general Chinese population, and the influence of hypertension.

Factors affecting the quality of life among Chinese rural general residents: a cross-sectional study

OBJECTIVES The brief version of the World Health Organizations Quality of Life Instrument (WHOQOL-BREF) is widely used for evaluating the personal subjective quality of life (QOL) of patients and particular populations. However, in the absence of sufficient studies among the general population, normative data for WHOQOL-BREF remain scarce. To fill this gap, the present study explored more sociodemographic and health-related factors affecting the QOL. STUDY DESIGN In total, 11,351 participants aged ≥35 years in rural areas of Liaoning Province were screened with a stratified cluster multistage sampling scheme in 2012-2013. Anthropometric measurements, laboratory examinations, and self-reported information on disease history were collected by trained personnel. Depression symptoms were assessed using the Patient Health Questionnaire-9. METHODS Stepwise multiple linear regression was used to explore the association between multiple factors and QOL. RESULTS Females and single/widowed subjects had lower QOL scores than males and married/cohabiting subjects, respectively. Total QOL scores and scores for each domain decreased as age increased, but a positive correlation was found between age and the environmental domain score. Participants with higher annual incomes, education levels, and activity levels had higher QOL scores. In the regression model, the coefficient for stroke was -2.17 (95% confidence interval [CI] -2.64, -1.71) for the total QOL score. For a one-level increase in depression level, the total QOL score decreased by 5.62 (95% CI -5.83 to -5.42), physical domain score decreased by 1.63 (95% CI -1.69 to -1.58), and psychological domain score decreased by 1.81 (95% CI -1.87 to -1.75). CONCLUSIONS Socio-economic status including marital status is highly related to QOL. Regarding chronic diseases, stroke is an important factor of QOL and depressive symptoms have a strong negative relationship with QOL.

Validity of cardiometabolic index, lipid accumulation product, and body adiposity index in predicting the risk of hypertension in Chinese population

ABSTRACT Objectives: Adiposity, defined by higher cardiometabolic index (CMI), lipid accumulation product (LAP), and body adiposity index (BAI), has conferred increased metabolic risk. However, the incremental utility of CMI, LAP, and BAI in association with prevalent hypertension has not been well described in a population-based setting. We hypothesized that CMI, LAP, and BAI would provide important insight into hypertension risk. Methods: Blood pressure (BP), fasting lipid profiles, and anthropometric parameters were recorded in a cross-sectional study of 11,400 participants (mean age, 54 years; 53% women) from China. Logistic regression models were used to assess associations of CMI, LAP, and BAI with prevalent hypertension. BAI was evaluated according to hip (cm)/[height (m)1.5]-18; LAP was calculated separately for men [(WC-65) × TG] and women [(WC-58) × TG]; and CMI was defined by TG/HDL-C × waist-to-height ratio. Results: CMI, LAP, and BAI were independently correlated with higher SBP and DBP, with nonstandardized (B) coefficients ranging from 1.827 to 4.590 mmHg and 1.475 to 2.210 mmHg (all P < 0.001). After adjustment for hypertension risk factors and potential confounders, CMI, LAP, and BAI, modeled as continuous measures, carried hypertension odds (95% CI) of 1.356 (1.259–1.459), 1.631 (1.501–1.771), and 1.555 (1.454–1.662) in women, respectively, per SD increment. In men, each SD increase in CMI, LAP, and BAI experienced a 31%, 65%, and 53% higher hypertension risk, respectively. Moreover, among women, the odds ratio (95% CI) for hypertension were 2.318 (1.956–2.745), 3.548 (2.985–4.217), and 3.004 (2.537–3.557) in the 4th quartile vs the first quartile of CMI, LAP, and BAI, respectively. For men, the corresponding figures were 2.200 (1.838–2.635), 3.892 (3.238–4.677), and 3.288 (2.754–3.927), respectively. Conclusion: Measurements of CMI, LAP, and BAI provide a more complete understanding of hypertension risk related to variation in body fat distribution and pinpoint hypertensive participants in great risk of cardiovascular disease in the future.

Contribution of non-traditional lipid profiles to reduced glomerular filtration rate in H-type hypertension population of rural China

Abstract Background: Despite current interest in the unfavourable impact of non-traditional lipid profiles on cardiovascular disease, information regarding its relations to reduced glomerular filtration rate (GFR) in H-type hypertension population has not been systemically elucidated. Methods: Analyses were based upon a cross-sectional study of 3259 participants with H-type hypertension who underwent assessment of biochemical, anthropometric and blood pressure values. Reduced GFR was considered if meeting estimated GFR <60 ml/min/1.73 m2. Results: A stepwise multivariate regression analysis indicated that non-traditional lipid parameters remained as independent determinants of estimated GFR (all p < .001). In multivariable models, we observed a 50%, 51%, 31%, and 24% higher risk for decreased GFR with each SD increment in TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C levels, respectively. The highest quartile of TC/HDL-C, TG/HDL-C and LDL-C/HDL-C ratios carried reduced GFR odds (confidence intervals) of 5.50 (2.50 to 12.09), 6.63 (2.58 to 17.05) and 2.22 (1.15 to 4.29), respectively. Conclusions: The relative independent contribution of non-traditional lipid profiles, as indexed by TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, towards reduced GFR putting research evidence at the very heart of lipoprotein-mediated renal injury set a vital example for applying a clinical and public health recommendation for reducing the burden of chronic kidney disease. KEY MESSAGES Non-traditional lipid profiles has been linked with the occurrence of cardiovascular disease, but none of the studies that address the effect of non-traditional lipid profiles on reduced GFR risk in H-type hypertension population has been specifically established. A greater emphasis of this study resided in the intrinsic value of TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C that integrate atherogenic and anti-atherogenic lipid molecules to predict the risk of reduced GFR among H-type hypertension population and provide insight into the pathophysiology of subsequent cardio-cerebrovascular outcomes. In a large Chinese H-type hypertension adults, the relative independent contribution of non-traditional lipid profiles, as indexed by TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, towards reduced GFR putting research evidence at the very heart of lipoprotein-mediated renal injury set a vital example for applying a clinical and public health recommendation for reducing the burden of CKD.

The prevalence and predictors of metabolically healthy obesity in obese rural population of China: a cross-sectional study

Abstract Till now, no evidence illustrates the prevalence and predictors of metabolically healthy obesity (MHO) in rural areas of China. The objective of this study was, firstly, to examine the prevalence of MHO in rural areas of China, and identify contributing determinants of MHO, Secondly, to comprehensively investigate to the different characteristics between MHO and metabolically unhealthy obesity (MUO). We conducted a population-based cross-sectional study of 2037 participants with obesity in rural Liaoning Province during 2012–2013. Obesity was defined as BMI ≥28 kg/m2 and metabolically healthy was defined as not having the metabolic syndrome. The prevalence of MHO was 23.1%, and significantly decreased with advancing age in female group. However there was no significant tendency with advancing age in male group. Independent determinant factors for MHO were age <55 years (odds ratio [OR] 1.659; p = .001), non-current smoking (OR 1.397; p = .038), pre-menopause (OR 1.648; p = .030) and non-hyperuricemia (OR 2.317; p < .001), whereas race, gender, diet score, current drinking, marriage, sleep duration, hyperhomocysteinemia, levels of physical activity, annual income and educational status were not significant contributors. In conclusion, we found that age <55 years, non-current smoking, pre-menopause and non-hyperuricemia were identified as independent determinant factors for MHO in this population.