Yonghua Hu

Waist circumference, body mass index and waist to hip ratio for prediction of the metabolic syndrome in Chinese

BACKGROUND AND AIMSnTo explore the ability of waist circumference (WC), body mass index (BMI) and waist to hip ratio (WHR) to predict two or more non-adipose components of the metabolic syndrome (MetS) among individuals aged 18-85 in North China.nnnMETHODS AND RESULTSnThis study is a cluster sample survey of 101,510 individuals, complete data are 75,788 subjects, 59,874 males and 15,914 females. Their ages were 51.9+/-12.7 years (males) and 48.7+/-11.5 years (females). Receiver operating characteristic (ROC) analysis was used to examine discrimination and find optimal cut off values of WC, BMI and WHR to predict two or more non-adipose components of MetS. The area under the ROC curve (AURC) for WC (0.694) and BMI (0.692) in females showed no difference. In males BMI (0.657) had a better discrimination than WC (0.634). WHR was weaker in both sexes. The optimal cut off value of WC in males (86.5 cm) was higher than in females (82.1cm); and that of BMI was about 24 kg/m(2) in both genders. The optimal cut off values of WC, BMI, and WHR, increased with age in both sexes.nnnCONCLUSIONSnBMI and WC are more useful than WHR for predicting two or more non-adipose components of MetS. Cut off values for WC in males, and those of BMI and WHR in both sexes are lower than that in present MetS criteria; WC in females is slightly higher. Cut off values of WC, BMI and WHR were increased with age in the Chinese.

Association of Genetic Polymorphisms and Age-Related Macular Degeneration in Chinese Population

PURPOSEnWe explored associations between age-related macular degeneration (AMD) and genetic variants of 10 genes in a nationwide Chinese population.nnnMETHODSnIn this multicenter case-control study, 535 AMD patients and 469 controls were recruited from 16 centers that spread from the north to the south of China. All participants underwent comprehensive eye examinations, and 40 single nucleotide polymorphisms (SNPs) of 10 genes were selected. DNA samples were genotyped with the MassArray system. The effect of the genotypes and haplotypes on AMD was assessed with logistic regression analysis, adjusted for age, sex, long-term residence, and family origin.nnnRESULTSnIn our study, 11 SNPs in complement H (CFH), 2 in age-related maculopathy susceptibility 2 (ARMS2), and 2 in high-temperature requirement factor A1 (HTRA1) were associated significantly with AMD. They were rs551397, rs800292, rs1329424, rs1061170, rs10801555, rs12124794, rs10733086, rs10737680, rs2274700, rs1410996, and rs380390 in CFH; rs10490924 and rs2736912 in ARMS2; and rs11200638 and rs3793917 in HTRA1. Three haplotypes in CFH, predisposed the patients significantly to AMD (P<0.001, P=0.001, and P<0.001, respectively). With the sample size of our study, no relationship was found for AMD and the SNPs tested in complement 3 (C3); serpin peptidase inhibitor, clade G, member 1 (SERPING1); vascular endothelial growth factor (VEGF); cholesterol ester transfer protein (CETP); lipoprotein lipase (LPL); hepatic lipase (LIPC); and metallopeptidase inhibitor 3 (TIMP3) genes.nnnCONCLUSIONSnGene variants in CFH, ARMS2, and HTRA1 contribute to AMD in the Chinese population.

Prevalence of cardiovascular disease and risk factors in a rural district of Beijing, China: a population-based survey of 58,308 residents

BackgroundCardiovascular disease (CVD) is the leading cause of global disease burden. Although stroke was thought to be more prevalent than coronary heart disease (CHD) in Chinese, the epidemic pattern might have been changed in some rural areas nowadays. This study was to estimate up-to-date prevalence of CVD and its risk factors in rural communities of Fangshan District, Beijing, China.MethodsA cross-sectional population survey was carried out by stratified cluster sampling. A total of 58,308 rural residents aged over 40 years were surveyed by face-to-face interview and physical examination during 2008 and 2010. The standardized prevalence was calculated according to adult sample data of Chinas 5th Population Census in 2000, and the adjusted prevalence odds ratio (POR) was calculated for the association of CHD/stroke with its cardiovascular risk factors in multivariate logistic regression models.ResultsAge- and sex-standardized prevalence was 5.6% for CHD (5.2% in males and 5.9% in females), higher than the counterpart of 3.7% (4.7% in males and 2.6% in females) for stroke. Compared with previous studies, higher prevalence of 7.7%, 47.2%, 53.3% in males and 8.2%, 44.8%, 60.7% in females for diabetes, hypertension and overweight/obesity were presented accordingly. Moreover, adjusted POR (95% confidence interval) of diabetes, obesity, stage 1 and stage 2 hypertension for CHD as 2.51 (2.29 to 2.75), 1.53 (1.38 to 1.70), 1.13 (1.02 to 1.26) and 1.35 (1.20 to 1.52), and for stroke as 2.24 (1.98 to 2.52), 1.25 (1.09 to 1.44), 1.44 (1.25 to 1.66) and 1.70 (1.46 to 1.98) were shown respectively in the multivariate logistic regression models.ConclusionsHigh prevalence of CVD and probably changed epidemic pattern in rural communities of Beijing, together with the prevalent cardiovascular risk factors and population aging, might cause public health challenges in rural Chinese population.

Menopause with cardiovascular disease and its risk factors among rural Chinese women in Beijing: a population-based study.

OBJECTIVESnThis study was to explore the independent influence of menopause on cardiovascular disease (CVD) and its risk factors in rural Chinese females.nnnSTUDY DESIGNnThis cross-sectional population-based study enrolled 2245 premenopausal and 2498 postmenopausal women aged 40-59 years in Fangshan district, Beijing, China. Data was collected by face-to-face interview, physical examination and biochemical examination during 2009 and 2010. General liner models were employed to calculate age-adjusted means of cardiovascular risk factors (CRFs). The comparisons of CVD and it risk factors according to menopausal status, and calculation of adjusted odds ratios/coefficients and their 95% confidence intervals for the associations of quartiles of elapsed time since menopause and age at menopause with CVD and its risk factors was performed by multivariate logistic/liner regression models separately.nnnRESULTSnAfter adjustment for age and other confounders, no statistically significant association of menopause with CVD was observed in our participants; however, dyslipidemia prevalence and levels of waist-to-hip ratio, triglycerides, total cholesterol and low-density lipoprotein cholesterol were presented higher in postmenopausal group, compared to the premenopausal one (P<0.05). Compared to women who had been menopausal for less than1 year, those with the elapsed time since menopause of 2-3 years had higher CHD prevalence, higher triglycerides level and lower high-density lipoprotein cholesterol level (P<0.05).nnnCONCLUSIONSnPostmenopausal women in rural China had worse CRFs profile than the premenopausal ones, which implied menopause might aggravate the CRFs epidemic beyond effects of aging, and would increase the CVD burden during and after their middle ages.

The Fangshan/Family-based Ischemic Stroke Study In China (FISSIC) protocol

BackgroundThe exact etiology of ischemic stroke remains unclear, because multiple genetic predispositions and environmental risk factors may be involved, and their interactions dictate the complexity. Family-based studies provide unique features in design, while they are currently underrepresented for studies of ischemic stroke in developing countries. The Fangshan/Family-based Ischemic Stroke Study In China (FISSIC) program aims to conduct a genetic pedigree study of ischemic stroke in rural communities of China.Methods/DesignThe pedigrees of ischemic stroke with clear documentation are recruited by using the proband-initiated contact method, based on the stroke registry in hospital and communities. Blood samples and detailed information of pedigrees are collected through the health care network in the rural area, and prospective follow-up of the pedigrees cohort is scheduled. Complementary strategies of both family-based design and matched case-spousal control design are used, and comprehensive statistical methods will be implemented to ascertain potential complex genetic and environmental factors and their interactions as well.DiscussionThis study is complementary to other genetic pedigree studies of ischemic stroke, such as the Siblings With Ischemic Stroke Study (SWISS), which are established in developed countries. We describe the protocol of this family-based genetic epidemiological study that may be used as a new practical guideline and research paradigm in developing countries and facilitate initiatives of stroke study for international collaborations.

Neighborhood socioeconomic status and the prevalence of stroke and coronary heart disease in rural China: a population-based study

Background Lower neighborhood-level socioeconomic status (SES) is associated with an increased risk of vascular disease in developed countries. Aims This study aims to identify village- and individual-level determinants of stroke and coronary heart disease (CHD) in a rural Chinese population. Methods We analyzed data from a population-based survey of 14 424 rural Chinese adults aged over 40 years from 54 villages. Primary outcomes were stroke and coronary heart disease (CHD) prevalence. Village-level SES was determined from the Chinese governments official statistical yearbook. Individual-level characteristics were obtained by in-person interviews. Prevalence rate ratios (RRs) and 95% confidence intervals (95% CIs) were calculated using generalized linear mixed models with log-link function to explore associations of village-level SES and individual social, demographic, and cardiovascular risk factors with stroke or CHD. Variance was expressed using the median rate ratio (MRR) and interval rate ratio (IRR). Results Village accounted for significant variability in the prevalence of stroke (MRR = 1·70; 95% CI: 1·42–1·94; P < 0·05) and CHD (MRR = 1·59; 95% CI: 1·35–1·78, P < 0·05), with village-level income alone accounting for 10% and 13·5% of between-village variation in stroke and CHD, respectively. High-income villages were at higher risk of both stroke (RR = 1·69, 95% CI: 1·09–2·62) and CHD (RR = 1·63, 95% CI: 1·13–2·34) than lower-income villages. Among individual-level risk factors, hypertension was associated with a higher prevalence of stroke (RR = 2·33, 95% CI: 1·93–2·80) than CHD (RR = 1·58, 95% CI: 1·38–1·82), whereas obesity was only associated with CHD (RR = 1·43, 95% CI: 1·23–1·66). In addition, there was an interaction between age and income; residents of higher-income villages below age 60 had a higher prevalence of CHD (RR = 1·58, 95% CI: 1·15–2·18) but not stroke. Conclusions There were differences in vascular risk across rural villages in China, with higher lifetime stroke and CHD prevalence in higher-income villages. For CHD, neighborhood effects were stronger among younger residents of high-income villages. The results may have implications for public health interventions targeting populations at risk.

Passive smoking, cytochrome P450 gene polymorphisms and dysmenorrhea

Purpose This study investigated whether the association between passive smoking exposure and dysmenorrhea is modified by two susceptibility genes, CYP1A1MspI and CYP1A1HincII. Methods This report includes 1,645 (1,124 no dysmenorrhea, 521 dysmenorrhea) non-smoking and non-drinking newly wedding female workers at Anqing, China between June 1997 and June 2000. Multiple logistic regression models were used to estimate the associations of passive smoking exposure and genetic susceptibility with dysmenorrhea, adjusting for maternal age, BMI, age of menarche, education, vibration exposure, shift work, noise exposure, pregnancy history, perceived stress and physical laboring stress. Results In the passive smoking group, women who have C/C6235 genotype (ORxa0=xa01.8, 95% CIxa0=xa01.0–3.3) in CYP1A1MspI and Ile/Ile462 genotype (ORxa0=xa02.9, 95% CIxa0=xa01.1–7.7) in CYP1A1HincII was associated with an increased risk of dysmenorrhea. When stratified by women genotype, the adjusted OR of dysmenorrheal was 1.6 (95% CIxa0=xa01.2–2.1) for passive smoking group with Ile/Ile462 genotype, and 1.5 (95% CIxa0=xa01.0–2.1) with C/C6235 genotype, compared to non-passive smoking group, respectively. The data further showed that there was a significant combined effect between passive smoking and the CYP1A1 Msp1C/C6235 (ORxa0=xa01.5, 95% CIxa0=xa01.0–2.1), and HincII Ile/Ile462 (ORxa0=xa01.6, 95% CIxa0=xa01.2–2.1), respectively. Conclusion CYP1A1 MspI and HincII genotypes modified the association between passive smoking and dysmenorrhea.

Cohort Profile: The Fangshan Cohort Study of Cardiovascular Epidemiology in Beijing, China

Background Urbanizing rural areas in China face a rapidly growing cardiovascular disease burden. Epidemiologic studies and effective preventive strategies are urgently needed. Methods The Fangshan Cohort Study is a prospective study that began in 2008 and targets local residents aged 40 years or older living in 3 towns in the Fangshan district of Beijing. The baseline examination included a questionnaire on medical history, health knowledge, and behaviors related to cardiovascular disease, as well as physical and blood biochemical examinations. The questionnaire survey will be readministered every 2 years. A system for surveillance of mortality and morbidity of cardiovascular disease is under development. Results A total of 20 115 adults (6710 men and 13 405 women) were investigated at baseline (participation rate = 84.5%). The data indicate that overweight/obesity is a serious public health issue in Fangshan: average body mass index was 25.4 kg/m2 among men and 26.5 kg/m2 among women, and the prevalences of overweight and obesity were 43.6% and 10.3% among men and 47.0% and 17.7% among women. Conclusions The Fangshan Cohort Study will provide data on cardiovascular risk factors and disease profile, which will assist in developing appropriate prevention and control strategies for cardiovascular disease in rural Chinese communities.

Association of the lipoprotein lipase gene T+495G polymorphism with central obesity and serum lipids in a twin study.

PURPOSEnThe lipoprotein lipase (LPL) gene polymorphism is possibly involved in the pathophysiology of central obesity and dyslipidemia. The aim of this study was to investigate the association of LPL gene T+495G polymorphism with central obesity and serum lipids.nnnMETHODSnA total of 961 adult twin pairs were enrolled from the program of Chinese Twin Registry, between 2001 and 2002. We used 90 cm of waist circumference in male and 80 cm in female as cut-off values of central obesity. The LPL gene T+495G polymorphism was analyzed with the use of genomic polymerase chain reaction and HindIII-restriction fragment length polymorphism. Two statistical methods were performed to test the effect of T+495G polymorphism of LPL gene on the relation between central obesity and lipid levels: one was the generalized estimating equation model for all twin pairs and the other was co-twin matched case-control analysis in 82 central obesity discordant monozygotic twin pairs.nnnRESULTSnIn male twins, central obesity was significantly associated with serum lipids except for high-density lipoprotein (HDL). In female twins, obesity twins had significantly higher levels of triglyceride (TG) and TG/HDL than nonobesity twins. There was no significant association between T+495G polymorphism and lipid levels for all twins, although +495G allele carrier was related with 6.7% decrease of TG was observed only in female twins. The interactions of T+495G polymorphism and central obesity were not found for TG, HDL, and TG/HDL. In central obesity discordant monozygotic twin pairs, central obesity was significantly related with 24.2%, 26.1%, and 4.1% increase of TG ,TG/HDL, and TC, respectively, in +495T/T genotype.nnnCONCLUSIONSnThese results suggest no association and interaction of T+495G polymorphism with central obesity and serum lipids for all twin pairs. Meanwhile, a modest genetic-environmental effect of T+495G polymorphism and central obesity was found in discordant monozygotic twin pairs. Therefore, the +495T/T genotype may be an independent risk factor associated with central obesity and lipids level. However, the role of LPL gene T+195G polymorphism in central obesity and dyslipidemia is complex and remains controversial. This hypothesis needs further investigation.

FC06-02 A different DNA methylation profile is obtained from a recently published MZ study of psychiatry

Aim To get a more robust DNA methylation profile from the data given by a published article of a MZ study of psychiatry. Method Considering the relevance of birth weight with DNA methylation profiles, we reanalyzed the data from the paper of Mill etc. (DOI: 10.1002/ajmg.b.30316) with rearrangement of the group order within twin pair, prior if lighter in birth weight. Statistical methods used are including mean, correlation and paired-samples t-test (considering twins’ particularity). Results We calculated twin difference by lighter twins methylation percentage minus that of heavier twin. The mean of CpG1 methylation differences is -7.08% while -7.17% for CpG2. The two means have no statistical significant difference in a paired-samples t-test (t=0.027, p=0.979, 2-tailed). These results are different from the original paper: 10.3% for CpG1 and 16.1% for CpG2, which are statistical significantly different (t=-2.792, p=0.018, 2-tailed). Besides, we found that in the lighter twin group, the methylation percentage are statistical significantly different between CpG1 and CpG2 (t=2.627, p=0.024, 2-tailed). As to correlation analysis, we got a slightly different result: correlation between MZ differences in two sites is weaker after rearrangement (r=0.875, while r=0.913 before arrangement, both p Conclusion According to our study, the results imply that twin differences may not be the only thing worthy of investigation. Different patterns among CpGs in certain kinds of subgroups should also need attention. We need conduct a robust data analysis strategy in our researches on the epigenetic aspects of psychiatry, where monozygotic twins have a favorable utility.