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Objective:To analyze the lipid levels, adverse perinatal outcome and their correlation in Tibetan pregnant women in high altitudes in late pregnancy.Methods:Retrospective analysis was performed on clinical and laboratory data of 523 Tibetan singleton pregnant women who delivered after 28 weeks at the Department of Obstetrics and Gynecology, Chaya People's Hospital, Changdu City. The subjects were divided into three groups according to the altitude of their long-term residence, including altitude<3 500 m (Group A, n=161), altitude ≥3 500 m and <4 000 m (Group B, n=203) and altitude≥4 000 m (Group C, n=159). In addition, the subjects were also grouped into high TG group (TG≥3.23 mmol/L, n=80) and control group (TG<3.23 mmol/L, n=443). The baseline information, levels of lipid and perinatal outcome were compared among Group A,B and C, and also between the high TG and control group, respectively, using Mann-whitney U test, Kruskal-Wallis H test, LSD- t, Chi-square test, or Fisher exact test. Multivariate logistic regression analysis was also applied to analyze the correlation between hypertriglyceridemia and adverse perinatal outcome. Results:The maternal age, gravidity and parity, body mess index, blood pressure on admission and total cholesterol (TC), TG, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), TG/HDL-C ratio and LDL-C/HDL-C ratio in late pregnancy and the occurrence of adverse perinatal outcome did not show any significant differences among Group A, B and C (all P>0.05). However, the hemoglobin (Hb) level increased with the elevation of altitude as expected, and that in Group C was higher than that in Group A and B [121.0 g/L (108.0-132.0 g/L) vs 115.0 g/L (103.5-128.0 g/L) and 117.0 g/L (101.0-127.0 g/L), H=2.37 and 1.97, both P<0.05]. The proportion of women with hypertriglyceridemia, the high TG group, in late pregnancy was 15.3% (80/523), and no significant difference was found in HDL-C or Hb levels between the high TG and control group [1.7 mmol/L (1.5-2.0 mmol/L) vs 1.8 mmol/L (1.5-2.1 mmol/L), Z=－1.51;123.5 g/L (110.0-131.8 g/L) vs 117.0 g/L (104.0-128.0 g/L), Z=1.69; both P>0.05]. Higher rates of cesarean section [13.8% (11/80) vs 6.6% (29/443), χ2＝4.98], hypertensive disorders of pregnancy (HDP) [16.3% (13/80) vs 7.5% (33/443), χ2＝6.54], preeclampsia (PE) [8.8% (7/80) vs 1.6% (7/443), χ2＝13.37], hyperglycemia during pregnancy [11.3%( 9/80) vs 3.6% (16/443), χ2＝8.69], preterm birth (PB) [7.5% (6/80) vs 2.0% (9/443), χ2＝7.27], microsomia [5.0% (4/80) vs 0.9% (4/443), Fisher exact test] and neonatal asphyxia [8.8%(7/80) vs 2.5% (11/443), χ2＝8.01] were observed in the high TG group than in the control group (all P<0.05). Regarding the pregnant women at different altitude, TG was negatively correlated with Hb ( r=－0.17, P=0.037) only in Group C .Multivariate logistic regression analysis revealed higher risk of HDP ( OR=2.42,95% CI:1.17-5.00), PE ( OR=5.25, 95% CI:1.73-16.00), hyperglycemia during pregnancy ( OR=3.77, 95% CI:1.56-9.09), PB ( OR=4.33, 95% CI:1.42-13.22), microsomia ( OR=4.33, 95% CI:1.42-13.22), neonatal asphyxia ( OR=3.45, 95% CI:1.27-9.35) and fetal demise ( OR=4.94, 95% CI:1.01-24.21) in women with high TG level in late pregnancy (all P<0.05). Conclusions:There were no differences in adverse perinatal outcomes or serum lipid levels in late pregnancy among women living at different high altitudes. However, hypertriglyceridemia at the third trimester is closely associated with the incidence of HDP, PE, hyperglycemia during pregnancy, PB, microsomia, neonatal asphyxia and fetal demise in this group of women.
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Objective:To study the relationship between maternal hemoglobin concentration, anemia rate in the third trimester and the altitudes, pregnancy outcomes among pregnant women in Tibet rural areas.Methods:This prospective study collected clinical and laboratory data of 390 Tibetan pregnant women who delivered after 28 gestational weeks at Chaya People's Hospital, Changdu city, Tibet autonomous region, from May 2020 to March 2021. Blood routine examination was performed at admission and 24-72 h postpartum using an automatic hematologic analyzer. According to the hemoglobin standard adjusted for altitude by World Health Organization (WHO), the association between pregnancy outcomes and maternal hemoglobin levels and anemia rate before and after adjustment were analyzed using Mann-Whitney U one-way analysis of variance, Chi-square, Pearson correlation, and Spearman correlation tests. Results:(1) In these women, the mean actual hemoglobin concentration in the third trimester was (121±16) g/L, and the prevalence of anemia and microcytic hypochromic anemia was 23.8% (93/390) and 20.3% (79/390), respectively. (2) After adjustment, the mean hemoglobin concentration was (93±17) g/L, and the prevalence of anemia and microcytic hypochromic anemia was 84.4% (329/390) and 30.5% (119/390), respectively. (3) Actual hemoglobin levels showed an increasing tendency as the altitude rose. At the altitude of 3 000-3 500 m, >3 500-4 000 m, and >4 000 m, the mean hemoglobin levels were (118±15) g/L, (119±17) g/L, and (124±16) g/L, respectively ( Ftrend=7.38, P=0.007). However, the prevalence of anemia and microcytic hypochromic anemia did not differ significantly between different altitude ( P>0.05). (4) Corrected hemoglobin levels were negatively associated with the altitude ( r=－0.31, P<0.001). At the altitude of 3 000~3 500 m, 3 500~4 000 m and >4 000 m, the mean corrected hemoglobin levels were (100±15) g/L, (92±17) g/L, and (87±18) g/L, respectively ( Ftrend=30.36, P<0.001). The prevalence of anemia increased with altitude ( χ2trend=15.44, P<0.001), but no association was observed between microcytic hypochromic anemia and altitudes ( P>0.05). (5) No association was found between actual or corrected anemia in the third trimester and adverse pregnancy outcomes, nor the hemoglobin level before or after adjustment and neonatal birth weight. Conclusions:In Tibet rural areas, the mean actual hemoglobin level in pregnant women tends to increase with the altitude. However, the prevalence of anemia and microcytic hypochromic anemia remains high and more attention should be paid to iron supplementary during pregnancy. After adjusting hemoglobin concentration based on WHO standard, more women were diagnosed as having anemia during pregnancy in this area, and the applicability of the diagnostic criteria for Tibetan residents requires further investigations.
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Objective To explore the gene frequency of apolipoprotein A5(APOA5)-1131T>C single nucleotide polymorphisms and its relationship with the fat contents of adult Tibetans in Tibet and Han nationality population in Liaoning province.Methods In 100 Tibetan nationality(the study group) and 100 Han nationality individuals(the control group), the polymorphism of apoa5-1131T>C genotypes was detected by polymerase chain reaction-restricted fragments length polymorphism(PCR-RFLP), and fat contents were got by using bioelectrical impedance measurement.Results Results of fat contents of body, trunk and limbs(left upper limbs, left lower limbs, right upper limbs, right lower limbs and total limbs) were respectively below:① There was significant difference between male TC+CC genotype and TT genotype of Tibetan nationality.There was significant difference between male TT genotype of Tibetan nationality and of Han nationality.② There was significant difference between female TT genetype of Tibetan nationality and of Han nationality except result of the body fat contents.③ There was significant difference between the trunk and total limbs fat contents in male TT genotype, and male TC+CC genotype of Tibetan nationality and of Han nationality, and female TT genotype of Tibetan nationality.Conclusion APOA5 gene-1131T>C affects the body fat contents of Tibetans and Han nationality population, and APOA5 gene-1131T>C probably affects lipopexia in trunk.
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Objective To measure and compare the expression profdes of plasma miRNA between Tibetan and Han nationality.Methods Plasma samples were taken from 246 healthy Tibetans and 128 Han individuals.The randomly selected 50 Tibetan and Han plasma samples were pooled respectively and the levels of 754 miRNAs were examined using a TaqMan Low Density Array.Two markedly differentially expressed miRNAs,miR-130a-3p and miR-629-5p,were verified in all the plasma samples by individual qRT-PCR.Results The Low Density Array results showed that the correlation coefficient of expression profiles of plasma miRNA for the Tibetan and Han population was 0.592.Compared with Han population,the expression levels of 139 miRNAs were distinctly different,in Tibetan (62 up-regulated and 77 down-regulated).The levels of miR-130a-3p and miR-629-5p were further verified to be significantly higher in the plasma from Tibetans than those in the plasma from Han population [(467 ± 27.30) × 10-5 vs (236 ± 9.69) × 10-5,p ＜ 0.01;(14.67 ±0.94) × 10-5 vs(7.58 ± 0.52) × 10-5,P ＜ 0.01] by qRT-PCR assay.Conclusion There may be marked difference of plasma miRNA expression profile between Tibetan and Han nationality.The influence of the nationality factors on miRNA profiles should be taken into account in the application of miRNAs in clinical detection in the future.
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Objective To explore the psychological status of nursing students of Tibetan and Han nationality.Method The questionnaire of Symptom Checklist 90(SCL-90)was distributed to 120 nursing students of Tibetan and Han nationality by random sampling.Results SCL-90 total scores of Tibetan nursing students and Han nursing students were(136.96±30.76)and (129.78±28.99),respectively.There was a statistically significant difference(P<0.001).The scores of Tibetan nursing students was higher than that of Han nursing students on factors of somatization,force symptoms,sensitivity to social relations,depression, hostility,paranoid and psychosis,but the scores of Han nursing students were higher than Tibetan nursing students on factors of anxiety and terror,with significant significance(P<0.01).The results of SCL-90 showed that the scores of somatization,force symptoms,sensitivity to social relations depression,paranoid and hostility in the Tibetan nursing students of 1st grade were significantly higher than those in the Hannrusing students of the 1st grade score(P<0.05).The score of force symptoms,depression and psychosis in the Tibetan nursing students of 2nd grade were significantly higher than those in the Han nursing students of 2nd grade (P<0.05).The scores on force symptoms,sensitivity to social relations,depression and anxiety in Tibetan nursing students of the 3rd grade were higher than those in the Han nursing students of the 3rd grade(P<0.05).Conclusion Tthe psychological status of Tibetan nursing students is outstanding in contrast to Han nursing studetns,and Tibetan nursing students were given directed intervention of mental health problem according to their risk factors.