Analysis of lipoprotein(a) level and related factors in healthy Tajik and Kazak adults in Xinjiang / 中华检验医学杂志

Objective:To investigate the distribution and related factors of lipoprotein(a) [Lp(a)] level in healthy Tajik and Kazak adults in China.Methods:A cross-sectional study was conducted from May to October 2021 and March to June 2022, and blood samples were collected from 2, 637 healthy Tajik adults [1 010 men, average age: (40.08±14.74) years; 1 627 women, average age: (38.27±12.90) years] in Tashkurgan Tajik Autonomous County and 1 911 healthy Kazak adults [720 men, average age: (42.10±12.26) years; 1 191 women, average age: (38.27±12.90) years] in Fuyun County of Xinjiang. Fasting blood glucose (FBG), creatinine (Cr), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and Lp(a) were measured. The distribution of Lp(a) levels in different sex and age groups was compared. The Lp(a) level of Tajik and Kazakh ethnic groups was compared by Mann-Whitney U test, and correlation factors of Lp(a) level were analyzed by multiple logistic regression. Results:The distribution of Lp(a) level in Tajik and Kazak population was skewed. Lp(a) levels of Tajik and Kazak ranged from the lowest 0.40 mg/L and 0.62 mg/L to the highest 1 229.40 mg/L and 2 108.58 mg/L, respectively, and the median Lp(a) level was 78.90 (38.60, 190.20) mg/L and 103.30 (49.57, 234.27) mg/L, respectively. Median Lp(a) level of Kazak was significantly higher than that of Tjik ( P<0.001). The median Lp(a) levels of Tajik males and females were similar: 77.45 (39.80, 187.10) mg/L and 79.90 (38.60, 192.30) mg/L ( P=0.948). The median Lp(a) levels of Kazakh males and females were also similar: 109.42 (50.49, 230.38) mg/L and 99.01 (49.11, 237.25) mg/L, respectively ( P=0.578). After pooling the data of Tajik and Kazak and adjusting for age, sex, BMI, smoking, drinking, blood pressure, blood glucose and other factors, Lp(a) level was correlated with ethnic (standard partial regression coefficient 0.066, P=0.008) and LDL-C level (standard partial regression coefficient 0.136, P<0.001). Conclusions:Lp(a) level in healthy Tajik and Kazak adults varied greatly among individuals, and Kazak residents had a higher Lp(a) level than Tajik residents. There was no significant sex difference in Lp(a) level among Tajik and Kazakh, and LDL-C and ethnicity are independent factors related to Lp(a) level.

Summary of the best evidence for maintaining lactation of very low birth weight infant mothers during separation / 中国实用护理杂志

Objective:To search, evaluate and integrate the best evidence for lactation maintenance of very low birth weight infant(VLBWI) mothers, and to provide evidence for lactation maintenance.Methods:Up to Date, BMJ best practice, Newborn Services Clinical Guidelines, ABM, NICE, OVID evidence-based database, NGC, Joanna Briggs Institute Library, Cochrane Library, Web of Science, PubMed, CNKI, CBM and Wanfang Data were retrieved by computer on the Maintenance of Mother′s Lactation in VLBWI: Guidelines, Systematic Evaluation, Expert Consensus/Opinions, Evidence Summary Literature screening, quality evaluation, evidence extraction and integration of documents which met the requirements.Results:A total of 10 articles were included, including 3 guidelines, 4 systematic reviews, 1 expert consensus and 2 expert opinions. A total of 41 evidences were summarized from 9 aspects, including lactation support, lactation initiation, lactation monitoring and the application of lactating agents.Conclusion:The evidence of lactation maintenance of VLBWI mothers is sufficient, which can provide a basis for medical staff to make clinical decisions.

The optimal cutoff point of waist-to-hip ratio for screening Uyghur population aged 35 years and over at high-risk of cardiovascular diseases in Xinjiang / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the appropriate waist-to-hip ratio (WHR) cutoffs to identify people at high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.</p><p><b>METHODS</b>The cardiovascular risk survey (CRS) in Xinjiang was conducted from October 2007 to March 2010, using 4-stagestratified random sampling method and 14 618 representative participated this survey, and the questionnaire survey, anthropometric data, blood pressure, serum total cholesterol, triglyceride, low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) and fasting glucose were measured. A total of 4 657 participants aged 35 years and over with complete anthropometric data were analyzed. The sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of different WHR levels predicting risk factors of cardiovascular disease were calculated. The analysis method of ROC curve was used to determine the optimum cut-off point of WHR predicting risk factors of cardiovascular disease.</p><p><b>RESULTS</b>(1) There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia, low HDL-C level, and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in male participants (P < 0.01 or 0.05), LDL-C level was similar among groups in males (P = 0.139). There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in female participants (all P < 0.01), and there were no significantly differences in prevalence of high LDL-C level and low HDL-C level among groups in females (both P > 0.05). (2) ROC analysis for hypertension, dyslipidemia, diabetes and ≥ 2 of these risk factors suggested a WHR cutoff of 0.92 for men and 0.90 for women as the optimal cutoff value for predicting high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.</p><p><b>CONCLUSION</b>Higher WHR cutoffs are needed for screening people at high risk of cardiovascular disease among Uygur population aged 35 years and over in Xinjiang.</p>

Study on the appropriate cutoff points of waist-hip-ratio for Kazakh people over 35 years of age, in Xinjiang / 中华流行病学杂志

<p><b>OBJECTIVE</b>The aim of this study was to identify the appropriate cutoffs for waist-hip-ratio (WHR) for Kazakh adults at high risk of cardiovascular diseases in Xinjiang.</p><p><b>METHODS</b>A Cardiovascular Risk Survey (CRS) study was carried out from October 2007 to March 2010, with 14 618 representative participants selected, including 4 094 Kazakhs. Complete data on 4 004 participants were gathered. The age span of the participants was from 35 to 88 years old with the mean age as 48.60 years. Anthropometric data, blood pressure, serum concentration of serum total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and fasting glucose were documented. Prevalence rate, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each WHR values were calculated.</p><p><b>RESULTS</b>1) The prevalence rates of hypertension, hypertriglyceridemia were high, also with higher WHR seen in both men and women. 2) The prevalence of hypercholesterolemia was high with higher WHR seen in women. 3) The shortest distances in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥ 2 of these risk factors suggested that the WHR cutoffs were 0.92 or 0.91 for men and 0.86 or 0.85 for women.</p><p><b>CONCLUSION</b>Higher cutoff for WHR was needed in the identification of patients over 35 at high risk of cardiovascular disease among Kazakh population.</p>

Association of serum concentrations of total testosterone with coronary heart disease in the postmenopausal women / 中华老年医学杂志

Objective To study the association between serum concentrations of total testosterone levels and coronary heart disease (CHD) in the postmenopausal women. Methods The study was designed as a case-control study.394 postmenopausal female patients were selected from Cardiology Center of the First Affiliated Hospital of Xinjiang Medical University.The case group included 183 women patients with CHD aged (62.7±8.0) years,the control group,211 women with normal coronary aged (60.0 ± 8.8) years. Blood samples were collected to determine total testosterone,fasting glucose and lipid profile. CHD severity was expressed as the numbers of coronary arteries that had a stenosis ≥50％.According to the level of testosteron,all cases were divided into 4 groups by interquartile range method:Q1＜3.5 nmol/L(n=190),3.5 nmol/L≤Q2 ＜10.4 nmol/L(n=64),10.4 nmol/L≤Q3 ＜26.0 nmol/L(n=120) and Q4≥26.0 nmol/L(n=20).The association between the serum total testosterone levels and severity of coronary atherosclerosis was analyzed. Results The average total testosterone was higher in case group than in control group[(10.4 ± 24.3 ) nmol/L vs. ( 6.9 ± 17.4 ) nmol/L,Z =0.79,P =0.555].In Quantitative adjusted models,higher levels of total testosterone had strong correlation with CHD,Q4 incidence of CHD (75.0％,15 cases) was significantly higher than Q1 (46.8％,89 cases),Q2 (40.6％,26 cases)and Q3 (44.2％,53 cases) (x2 =7.69,P=0.048).After adjustment for other risk factors,women in the top quartile of total testosterone levels had a more than 3-fold increase in odds of CHD(OR=3.47,95％CI:1.06-11.32,P＜0.05).In addition,the serum concentrations of total testosterone level were significantly associated with the severity of CHD (F=12.94,P＜0.05). Conclusions Higher levels of total testosterone may be associated with high prevalence and severity of CHD as an independent factor in postmenopausal women.

Relationship between a novel polymorphism of C5L2 gene C698T and type 2 diabetes in Uygur population of Xinjiang region / 中华内分泌代谢杂志

Objective To investigate the relationship between a novel polymorphism of C5L2 gene and type 2 diabetes mellitus (T2DM) in Uygur population from Xinjiang region.Methods A novel single nucleotide polymorphism(SNP),698C＞T(P233L) was found using a polymerase chain reaction direct-sequencing method.C5L2 gene 698C ＞ T variant from 252 patients with T2DM and 747 healthy control subjects was detected by polymerase chain reaction and restriction fragment length polymorphism.Result Heterozygote carriers of the 698CT genotype were more frequent among T2DM patients than that among controls (0.107 vs 0.036,x2 =18.576,P＜0.01) in the Uygur population. After adjustment of confounding factors such as sex,age,smoking,alcohol consumption,and hypertension,as well as serum levels of triglyceride,total cholesterol,low-density lipoproteincholesterol,and high-density lipoprotein-cholesterol,the difference remained significant ( P＜0.01,OR =3.373,95％ CI 1.736-6.553 ).Conclusion The CT genotype of the C5L2 gene might be a risk factor of T2DM in Uygur nationality population in Xinjiang.

Relationship between peripheral artery disease and metabolic syndrome among Kazakh adults lived in Xinjiang Yili prefecture / 中华全科医师杂志

Objective To investigate prevalence and risk factors of peripheral artery disease (PAD), metabolic syndrome (MS) and peripheral artery disease complicated with metabolic syndrome among Kazakh adults lived in Xinjiang Yili prefecture. Methods Four-stage cluster sampling method was used to select adults aged 35 years and over for the study from six cities and prefectures of Xinjiang. All the participants were interviewed with questionnaire to collect their demographic characteristics. Physical checksup and blood biochemical measurements were performed for all of them, as well as blood pressure was measured in their lower legs and arms to calculate ankle brachial pressure index ( ABPI), a ratio of the blood pressure in the lower legs to that in the arms. Only data of Kazakh adults in Yili prefecture were analyzed in this paper, including prevalence and risk factors for PAD and MS, as well as their relationship.The patients with PAD were divided into two groups, one complicated with MS and the other without it Logistic regression analysis was used to identify potential risk factors for PAD and MS and their combination.Results A total of 1365 adult Kazakh people were surveyed. Prevalence of MS was 23.7 percent, 30.4 percent for men and 19.0 percent for women, respectively, and that of PAD was 9. 4 percent, 7.0 percent for men and 11.0 percent for women, respectively. Mean age in patients of PAD complicated with MS was older than that in those without MS (t=-5.348, P＜0.01). Risk of PAD complicated with MS in Kazakh people associated with gender ( men), age, systolic pressure, diastolic pressure and blood glucose level.(P＜0.05). Conclusions Both prevalence of PAD and MS are significantly higher among Kazakh people in Yili prefecture of Xinjiang, and increase with age. Prevalence of PAD is significantly higher in those with MS than that in those without MS. Risk factors of PAD complicated with MS include gender(men), age,systolic pressure, diastolic pressure and blood glucose level.

Prevalence of metabolic syndrome, its components and hyperuricemia among Kazakh people in Xinjiang Uighur autonomous region / 中华全科医师杂志

Objective To study prevalence of metabolic syndrome (MS) , it's components and hyperuricemia (HUA) among Kazakh people in Xinjiang Uighur autonomous region, China. Methods A cross-sectional survey was conducted among Kazakh people aged 35 years and over in seven prefectures of Xinjiang, including Urumqi, Kelamayi (Karamay) , Fukang, Tulufan (Turpan), Hetian (Hotan) , Aletai (Altay) and Yili during October 2007 to March 2010, with a four-stage cluster sampling, the total sample size were 4094. Through the methods of questionnaire survey, physical examination, biochemical examination and so on, to study prevalence of MS in HUA and it's components by blood biochemical examinations. Results A total of 3915 Kazakh adult people, equal number of men and women, were surveyed, with a response rate of 95. 63 percent. Overall prevalence of HUA was 3. 96 percent( 155/3915 ) , 6.02 percent for men and 2. 03 percent for women(114/1894 and 41/2021) , respectively, with statistically significant difference ( P ＜ 0.05 ). Prevalence of MS was 39.47 percent in those with HUA and 22. 53 percent in those without HUA (45/114 and 401/1780), respectively (P ＜ 0.01). Among women, prevalence of MS was 46. 34 percent in those with HUA and 16. 11 percent in those without HUA( 19/41 and 319/1980), respectively (P＜0. 01). Prevalence of high blood pressure, hypertriglyceridemia, lower blood high-density lipoprotein cholesterol (HDL-C) and central obesity were 59.65 percent, 42.11 percent,32.46 percent, 7. 89 percent and 79. 82 percent in those with HUA, respectively, with prevalence of hyperglyceridemia and central obesity significantly higher than in those of non-HUA ( P ＜ 0. 05 ). Among women, prevalence high blood pressure, hypertriglyceridemia, lower blood HDL-C and central obesity were 48.78 percent, 39.02 percent, 41.46 percent, 2.44 percent and 78.05 percent, respectively, in HUA group, with prevalence of hyperglyceridemia, lower blood HDL-cholesterol and central obesity significantly higher than in those of non-HUA ( P ＜ 0. 05 ). Conclusions Prevalence of MS was higher in Kazakh people suffered with HUA than those without HUA, as well as prevalence of components of MS, suggesting that prevention and treatment for HUA is necessary, which can reduce MS and its components in the region.

Epidemiological survey of hyperuricemia and gout in Xinjiang adult population / 中华内分泌代谢杂志

Four-stage selected random samples were used to analyze the prevalence and distributing feature of hyperuricemia and gout in 13 559 Han,Uighur,and Hazakh adults in Xinjiang. The prevalence of hyperuricemia was 11.00%,3.27%,and 3.94% respectively in Han,Uighur,and Hazakh populations,and 1.32%, 0.65%,and 0.70% for gout,with statistically significant difference among three groups(all P＜0.05). No-conditional logistic regression analysis showed that nationality,body mass index,renal function,and serum lipid were risk factors of hyperuricemia,while female and physical activity were protective factors. Eating seafood and animal visceral organs were independent risk factors of hyperuricemia in Han population. Eating animal visceral organs and drinking alcohol were independent risk factors of hyperuricemia in Hazakh population.

Association between matrix metalloproteinase-9 polymorphism (-1562C ＞ T/R279Q) and acute coronary syndrome in Uygur nationality of Xinjiang Autonomous Region of China / 中华急诊医学杂志

Objective To investigate the association between matrix metalloproteinase-9 (MMP-9) gene polymorphism (-1562C ＞ T/R279Q) and acute coronary syndrome (ACS) in Uygur nationality of Xinjiang Autonomous Region of China. Methods A total of 352 patients with ACS including 213 patients with unstable angina pectoris and 139 patients with acute myocardial infarction evidenced by using coronary arteriography and 421 control subjects were recruited in this study. The MMP-9-1562C ＞ T and R279Q genotypes were detemined by using PCR-RFLP method. The relationship between the polymorphism in the MMP-9 gene and the severity of coronary arterial stenosis was analyzed. All polymorphisms were determined for confimation with Hardy-Weinberg expectations in both groups separately. Differences in distributions of genotypes and alleles between two groups were analyzed with x2 test. The association between the MMP-9 polymorphisms and the risk of ACS was estimated by odds ratio(Ors) and their 95% confidence intervals (CIs), and the comprehensive evaluation of the factors associated with ACS was determined by using multifactor logistic regression. P ＜ 0. 05 was considered to be statistically significant. Results The genotype frequencies for CT + TT genotypes and T allele were 25.9 and14.5 percent in ACS subjects and 15.7 and 8.4 percent in control subjects, respectively. The genotype frequencies were different significantly between the two groups (x2 = 12.26,P ＜ 0.01;x2 = 14.15,P ＜ 0.01, respectively). No relationship between R279Q polymorphism and ACS was found in this study ( P ＞ 0.05). The multifactor logistic regression analysis showed that the T allele carrier (CT + TT) significantly increased the risk of ACS compared with the CC genotype ( OR = 1.791,95 % CI: 1. 088 - 2.951, P = 0.022) after adjustment for tradition risk factors. The frequencies for CT + TT and CC genotypes of the -1562C ＞ T polymorphism were not statistically different among ACS patients with one, two and three or more significantly diseased vessels ( x2 = 1.15, P = 0.56). Conclusions The findings suggest that the polymorphism in MMP-9 gene promoter (-1562C ＞ T) is associated with the susceptibility to the ACS. The T allele might be an independent risk factor for the ACS. But the -1562C ＞ T polymorphism may not be useful as a predictor of the severity of coronary arterial stenosis. The R279Q polymorphism of MMP-9 gene was not significantly associated with ACS in this studied population.

Association between genetic polymorphism in the promoter region of heme oxygenase-1 and myocardial infarction in patients from Uighur ethnics of Xinjiang Autonomous Region / 中华急诊医学杂志

Objective To investigate the association between acute myocardial infarction (AMI) and the (GT)n repeat sequence polymorphism in promoter region of heme oxygenase-1 (HO-1) , and to study the influence of serum bilirubin on AMI as well for HO-1 as a rate-limiting enzyme of bilirubin production in patients from Uighur national minority. Method Totally 287 patients with AMI evidenced by coronary arteriography admitted from January 2006 to June 2008 were eligible for being studied, and another 190 healthy subjects without anomaly in coronary arteriography, and with normal findings in physical examination and in variety of biochemical assays were enrolled as controls. Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDL-C), serum bilirubin were detected. Polymerase chain reaction-nondenaturing polyacrylamide gel electrophoresis was used to detect HO-1 promoter (GT)n repeat polymorphism, and at the same time the serum bilirubin was determined. The group representation of samples was tested with HardyWeinberg balance test. Differences in distributions of genotypes and alleles between AMI patients and control subjects were analyzed using Chi-square test. Comprehensive evaluation of the factors associated with myocardial infarction using multi-factor Logistic regression analysis. P < 0.05 was considered as significantly different. Results Body mass index, triglyceride, high density lipoprotein cholesterol and the proportion with hypertension in myocardial infarction group was significantly higher than those in control group ( P < 0.01) . The X~2 values of HO-1genotype distribution in the myocardial infarction group and the control group were 2.09 and 0.05, respectively (P > 0.05), consist with the results of Hardy-Weinberg balance test. The HO-1 genotype was classified into three groups, L/L, L/S and S/S. The L/L genotype frequency (35.5%) and L-allele frequency (57.8%) in AMI group and in control group showed statistically significant differences, respectively (X~2 = 11.65, P = 0.001; X~2= 11.32, P = 0.003). The bilirubin level of L/L genotype significantly decreased compared with that of S/S, L/S genotype ( P all < 0. 001) . Logistic regression analysis showed that body mass index, high blood pressure,triglycerides, blood bilirubin and HO-1 gene polymorphism are risk factors of myocardial infarction. Conclusions To the Xinjiang Uighur ethics, HO-1 promoter ( GT) n repeat polymorphism and the occurrence of myocardial infarction are relevant. People with L allele genotype have lower serum bilirubin and higher risk of myocardial infarction.

Association of polymorphism of the prostacyclin synthase gene with myocardial infarction in Uigur population of Xinjiang / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association between the polymorphism of the prostacyclin synthase gene and Uigur patients with myocardial infarction in Xinjiang.</p><p><b>METHODS</b>Three hundred and ten patients with myocardial infarction (MI) and 306 healthy control subjects were detected by polymerase chain reaction and restriction fragment length polymorphism. The serum 6-keto-PGF(1alpha ) was detected with radioimmunoassay kit in all subjects.</p><p><b>RESULTS</b>The genotype distributions of the control group and MI group were in the Hardy-Weinberg equilibrium(chi (2)= 0.442, 1.867, P> 0.05). The frequencies of CC, CA and AA were 0.70, 0.26 and 0.03 in the MI group and 0.62, 0.32 and 0.06 in the controls. There was significant difference in frequencies of CC genotype and C allele but no difference in frequencies of CA and AA genotypes between the controls and the MI cases. There was significant difference in serum 6-keto-PGF(1alpha ) level between the MI group and control group (P< 0.05), as well as among the three genotypes (P< 0.05). In the cases with CC genotype the serum 6-keto-PGF(1alpha ) level was lower than that of others (P< 0.05).</p><p><b>CONCLUSION</b>The CC genotype and C allele of the prostacyclin synthase gene might be a risk factor of MI in Uigur population in Xinjiang, which may lead to the decreased serum 6-keto-PGF(1alpha ) level.</p>