Association of Serum Glucocorticoids with Various Blood Pressure Indices in Patients with Dysglycemia and Hypertension: the Henan Rural Cohort Study / 生物医学与环境科学（英文）

Objective@#To our knowledge, no definitive conclusion has been reached regarding the relationship between glucocorticoids and hypertension. Here, we aimed to explore the characteristics of glucocorticoids in participants with dysglycemia and hypertension, and to analyze their association with blood pressure indicators.@*Methods@#The participants of this study were from the Henan Rural Cohort study. A total of 1,688 patients 18-79 years of age were included in the matched case control study after application of the inclusion and exclusion criteria. Statistical methods were used to analyze the association between glucocorticoids and various indices of blood pressure, through approaches such as logistic regression analysis, trend tests, linear regression, and restricted cubic regression.@*Results@#The study population consisted of 552 patients with dysglycemia and hypertension (32.7%). The patients with co-morbidities had higher levels of serum cortisol ( @*Conclusions@#Serum deoxycortisol was positively correlated with systolic blood pressure, pulse pressure, mean arterial pressure, mean blood pressure, and mean proportional arterial pressure. Glucocorticoids (deoxycortisol and cortisol) increase the risk of hypertension in people with dysglycemia, particularly in those with T2DM.

Association of TCF7L2 and GCG Gene Variants with Insulin Secretion, Insulin Resistance, and Obesity in New-onset Diabetes / 生物医学与环境科学（英文）

This cohort study was designed to evaluate the association of transcription factor 7-like 2 (TCF7L2) and proglucagon gene (GCG) variants with disordered glucose metabolism and the incidence of type 2 diabetes mellitus (T2DM) in a rural adult Chinese population. A total of 7,751 non-T2DM participants ⋝18 years old genotyped at baseline were recruited. The same questionnaire interview and physical and blood biochemical examinations were performed at both baseline and follow-up. During a median 6 years of follow-up, T2DM developed in 227 participants. After adjustment for potential contributory factors, nominally significant associations were seen between TT genotype and the recessive model of TCF7L2 rs7903146 and increased risk of T2DM [hazard ratio (HR)=4.068, 95% confidence interval (CI): 1.270-13.026; HR=4.051, 95% CI: 1.268-12.946, respectively]. The TT genotype of rs7903146 was also significantly associated with higher fasting plasma insulin level and the homeostasis model assessment of insulin resistance in case of new-onset diabetes. In addition, the TCF7L2 rs290487 TT genotype was associated with abdominal obesity and the GCG rs12104705 CC genotype was associated with both general obesity and abdominal obesity in case of new-onset diabetes.

Multilevel regression analysis on region duster and risk factors of hypertension in the Chinese adult population / 中华流行病学杂志

Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.

The application of artificial neural networks to predict individual risk of essential hypertension / 中华流行病学杂志

Objective To establish models to predict individual risk of essential hypertension and to evaluate and explore new forecasting methods. Methods To select data of 3054 community residents from a epidemiological survey and divided them into 4 : 1 (2438 cases and 616 cases) ratio in accordance with the balance of age and sex to filter variables, and to establish, test and evaluate the prediction models. Using artificial neural network (ANN) and logistic regression analysis to establish models while applying ROC to evaluate the prediction models. Results Forecast results of the models applying to the test set proved that ANN had lower specificity but better veracity and sensitivity than logistic regression.In particular, the Youden's index of the ANN2 came up to 0. 8399 which was distinctly higher than the other two models.When the area was under the ROC curve of logistic regression, the ANN1 and ANN2 models equaled to 0. 732±0. 026,0. 900±0. 014 and 0. 918±0. 013 respectively, which proved that the ANN model was better in the prediction about individual health risk of essential hypertension. Conclusion Our results showed that ANN method seemed better than logistic regression in terms of predicting the individual risk from hypertension thus supplied a new method to solve the forecast of individual risk.

Evaluation on the highly active anti-retroviral therapy in 181 AIDS patients / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the clinical effect under highly active anti-retroviral therapy (HAART) in AIDS patients and for improving the curative effect and prognosis.</p><p><b>METHODS</b>Epidemiological method was used from five aspects to describe the post-treatment clinical symptoms of 181 AIDS patients in Suizhou, and to evaluate the change of virus load and immune function of 79 AIDS patients. Data was doubly recorded by Epi Data and database was set up by SPSS 13.0 for analysis.</p><p><b>RESULTS</b>The effective powers of anomal-fever, cough, diarrhoea, lymphadenectasis, weight drop, erythra, mycotic infection were 81.39%, 85.00%, 84.62%, 81.89%, 82.86%, 66.07% and 45.45% respectively. CD4+ T lymphocyte count rose obviously after treatment, with an averag of 276 x 10(6) cells/ml (65 x 10(6)-824 x 10(6) cells/ml), an 129 x 10(6) cells/ml increase in three months and was 294 x 10(6) cells/ml (102 x 10(6)-750 x 10(6) cells/ml) in six months. The count change of CD4+ T lymphocyte between 3 months and 6 months did not show sigificant difference. The number of deaths among drug withdrawals was 14, with a case fatality rate as 29.79%; while the number of deaths among non-drug withdrawals was 3, with the case fatality rate as 2.24%.</p><p><b>CONCLUSION</b>Results through this study showed that HAART could obviously improve the clinical symptom of AIDS patients, and to increase the number of virus load. Improving the compliance could also reduce the case fatality rate.</p>