Characteristics and occupational risk assessment of occupational silica-dust and noise exposure in ferrous metal foundries in Ningbo, China.

Introduction: To investigate the major existing occupational hazards and to assess the occupational health risks for ferrous metal foundries (FMFs) in Ningbo, China. Methods: Unified questionnaires were formulated to investigate the information on the basic situations, occupational hazards, and occupational health management for 193 FMFs in Ningbo. Furthermore, we used the semi-quantitative risk assessment model, which was developed by the International Council on Mining and Metals (ICMM), to assess occupational health risks for 59 of 193 the FMFs. Results: The casting process of FMFs in Ningbo was mainly divided into sand casting and investment casting, and silica-dust and noise were the major occupational hazards in both sand casting and investment casting foundries. Silica-dust mainly occurred in industries with such work as sand handling, modeling, falling sand, and sand cleaning, with the median of the permissible concentration-time weighted average (PC-TWA) was 0.80, 1.15, 3.52, 0.83 mg/m3, respectively. The noise mainly existed in industries with such work as sand handling, core making, falling sand, sand cleaning, cutting and grinding, and smelting with median of PC-TWA was 81.72 dB(A), 82.93 dB(A), 90.75 dB(A), 80.18 dB(A), 90.05 dB(A), 82.70 dB(A), respectively. In addition, the results of the ICMM assessment model indicated that 100 and 98.7% of the jobs exposed to silica-dust and noise in 59 FMFs have an "intolerable risk" level of risks of causing pneumoconiosis and noise deaf, respectively. Discussion: The hazard risk of silica-dust and noise is serious for FMFs in Ningbo. It is necessary to supervise enterprises to improve operating environmental conditions, accelerate the reduction of silica-dust and noise exposure risks, and promote the healthy and sustainable development of the foundry industry.

Non-communicable Disease-Related Sustainable Development Goals for 66 Belt and Road Initiative Countries.

BACKGROUND: Since 2015, the Global Burden of Disease Study (GBD) has measured progress in achieving health-related Sustainable Development Goals (SDGs) annually worldwide. Little is known about the status and attainment of indicators of non-communicable diseases (NCDs) by 65 countries from the Belt and Road Initiative (BRI) proposed by China in 2013. METHODS: Data from GBDs were used to estimate 24 NCD-related SDG indicators in BRI countries from 1990 to 2017. Each indicator was scored from 0 to 100 to compare multiple indicators over the study period. The natural log of the annual change in each location and year and weighted annual rates of change were used to generate projections for 2030. National-level estimates were determined by socio-demographic index (SDI) quintiles in BRI countries with more than 1 million inhabitants. RESULTS: In 2017, the median overall score of NCD-related SDG index for the 66 BRI countries was 60 points, ranging from 29 points in Afghanistan to 84 points in Israel. More than 80% of countries achieved the SDG 2030 maternal mortality (MM) rate target in 2017, and the national skilled birth attendance rate was above 99% in more than 59% countries. However, none of the BRI countries achieved the goal for children's overweight, modern methods of contraception, and universal health coverage. It was predicted that 80.4% of NCD-related SDG targets would be achieved in these countries by 2030. The overall score of NCD-related SDG index were positively associated with SDI quintiles. CONCLUSION: For many indicators, the achieved progress in many countries is less than the annual rate necessary to meet SDG targets, indicating that substantial efforts need to be made in the coming years. Progress should be accelerated through collaborations between countries, implementation of NCD prevention and control strategies, and monitoring of inequalities in NCD-related SDGs within populations.

Effect of exposure to low concentrations of benzene on miR-223 and miR-155 expression in peripheral blood lymphocytes / 预防医学

Objective @#To investigate the effect of exposure to low concentrations of benzene on miR-155 and miR-223 expression in peripheral blood lymphocytes among workers with benzene exposure. @*Methods @#A hundred male employees at a risk of exposure to benzene (the exposed group) were randomly sampled from two small metal products manufacturing enterprises and one medium-sized chemical raw material and chemical products manufacturing enterprise in Ningbo City, Zhejiang Province, and 60 age-matched male employees without benzene exposure were randomly selected as the unexposed group. Age, body mass index ( BMI ), smoking status, alcohol consumption, disease history, medication history and routine blood testing results of subjects were collected using a questionnaire survey. The 8-hour time weighted average concentration ( CTWA ) of benzene was measured in the workplace using thermal desorption gas chromatography, and the urine 8-hydroxy-2' deoxyguanosine ( 8-OHdG ) levels were determined using high-performance liquid-chromatography tandem mass spectrometry (HPLC-MS/MS). The miR-155 and miR-223 expression was quantified in peripheral blood lymphocytes using quantitative fluorescent reverse transcription-polymerase chain reaction assay, and the factors affecting miR-155 and miR-223 expression were identified using multivariable logistic regression analysis. @*Results @#The subjects in the exposed group had a mean age of ( 31.17±7.30 ) years, and were exposed to low concentrations of benzene ( CTWA, 0.05 to 0.30 mg/m3 ) , while the subjects in the unexposed group had a mean age of ( 32.52±6.15 ) years. There were no significant differences between the exposed and unexposed groups in terms of age, BMI, proportion of smokers or proportion of alcohol consumers ( P>0.05 ). There was no significant difference in the median relative miR-155 expression between the exposed and unexposed groups ( 0.953 vs. 1.293, P>0.05 ), and lower median relative miR-223 expression was quantified in the exposed group than in the unexposed group ( 0.540 vs. 1.433, P<0.05 ). Multivariable logistic regression analysis revealed that down-regulation of miR-223 expression correlated with exposure to benzene ( OR=2.719, 95%CI: 1.308-5.651 ). @*Conclusion @#Down-regulation of miR-223 expression may be associated with exposure to low concentrations of benzene.

Investigation on a family cluster of COVID-19 in Ningbo / 预防医学

Objective@#To report an investigation of a family cluster of coronavirus disease 2019 ( COVID-19 ) in Ningbo, so as to provide reference for the prevention and control measures.@*Methods@#According to the COVID-19 Prevention and Control Program ( fourth version ) , an epidemiological investigation was conducted to collect the demographic information, clinical features and exposure history, to find the close contacts, and to figure out the source and route of infection. @*Results@#Twelve confirmed cases and one asymptomatic case were reported. The attack rate was 16.05%. Among them, five were males and eight were females; the age ranged from 11 to 85 years old, with a median of 39 years old; most had mild symptoms. The incubation period was 2-13 days, with a median of 6.5 days. The first case ( Case 1 ) developed the symptoms on January 22, and had close contact with Zhang, an asymptomatic case, on January 20. Zhang was related to a cluster in the Buddhist assembly on January 19. Case 1, who caused the spread of the epidemic among family members, participated in several family visits and dinners from January 22 to 27 with other 24 families, resulting in six secondary cases and six third-generation cases. There were 54 close contacts except the family members, no infection was found. @*Conclusion@#This family cluster may result from the close contact with an asymptomatic case, and then spread within families through having dinners and living together.

Ambient air pollution and risk of type 2 diabetes in the Chinese.

We performed a time series analysis to investigate the potential association between exposure to ambient air pollution and type 2 diabetes (T2D) incidence in the Chinese population. Monthly time series data between 2008 and 2015 on ambient air pollutants and incident T2D (N = 25,130) were obtained from the Environment Monitoring Center of Ningbo and the Chronic Disease Surveillance System of Ningbo. Relative risks (RRs) and 95% confidence intervals (95% CIs) of incident T2D per 10 µg/m3 increases in ambient air pollutants were estimated from Poisson generalized additive models. Exposure to particulate matter < 10 µm (PM10) and sulfur dioxide (SO2) was associated with increased T2D incidence. The relative risks (RRs) of each increment in 10 µg/m3 of PM10 and SO2 were 1.62 (95% CI, 1.16-2.28) and 1.63 (95% CI, 1.12-2.38) for overall participants, whereas for ozone (O3) exposure, the RRs were 0.78 (95% CI, 0.68-0.90) for overall participants, 0.78 (95% CI, 0.69-0.90) for males, and 0.78 (95% CI, 0.67-0.91) for females, respectively. Exposure to PM10 and SO2 is positively associated with T2D incidence, whereas O3 is negatively associated with T2D incidence.

Does Body Mass Index and Height Influence the Incident Risk of Ischemic Stroke in Newly Diagnosed Type 2 Diabetes Subjects?

OBJECTIVE: To estimate the incident risk of ischemic stroke (IS) in newly diagnosed type 2 diabetes (T2D) subjects according to different body mass index (BMI) and height categories. METHODS: A total of 25,130 newly diagnosed T2D subjects were included in this study. All T2D subjects were enrolled consecutively from the Chronic Disease Surveillance System (CDSS) of Ningbo. Standardized incidence ratio (SIR) and its 95% confidence interval (95% CI) stratified by BMI categories and height quartiles were used to estimate the incident risk of IS in T2D subjects. RESULTS: In total, 22,795 subjects completed the follow-up. Among them, 1268 newly diagnosed IS cases were identified, with 149,675 person-years. The SIRs of normal BMI (18.5-24.0 kg/m2), overweight (24.0-28.0 kg/m2), and obese (≥28.0 kg/m2) in overall subjects were 2.56 (95% CI 1.90-3.13), 2.13 (95% CI 1.90-3.13), and 1.87 (95% CI 1.29-2.43), respectively (P trend < 0.01), comparing to the general population of Ningbo. For each 1 kg/m2 increment in BMI, the SIR was 0.948 (95% CI 0.903-0.999). For height quartiles, the SIRs of male subjects in quartile 1 (<160 cm), quartile 2 (161-165 cm), quartile 3 (165-170 cm), and quartile 4 (≥171 cm) were 2.27 (95% CI 1.99-2.56), 2.01 (95% CI 1.67-2.45), 1.37 (95% CI 1.05-1.68), and 0.91 (95% CI 0.40-1.32), respectively (P trend < 0.01). While for female subjects, the SIRs in quartile 1 (<155 cm), quartile 2 (156-160 cm), quartile 3 (161-165 cm), and quartile 4 (≥166 cm) were 3.57 (95% CI 3.11-3.49), 2.96 (95% CI 2.61-3.31), 1.94 (95% CI 1.51-2.36), and 1.71 (95% CI 0.95-2.47), respectively (P trend < 0.01). CONCLUSION: Compared to the general population of Ningbo, T2D subjects had a higher incident risk of IS. Furthermore, the IS incident risk was not only higher in newly diagnosed T2D subjects with normal BMI but also lower in taller newly diagnosed T2D subjects.

Risk of all-cause and CHD mortality in women versus men with type 2 diabetes: a systematic review and meta-analysis.

OBJECTIVE: Previous studies have shown sex-specific differences in all-cause and CHD mortality in type 2 diabetes. We performed a systematic review and meta-analysis to provide a global picture of the estimated influence of type 2 diabetes on the risk of all-cause and CHD mortality in women vs men. METHODS: We systematically searched PubMed, EMBASE and Web of Science for studies published from their starting dates to Aug 7, 2018. The sex-specific hazard ratios (HRs) and their pooled ratio (women vs men) of all-cause and CHD mortality associated with type 2 diabetes were obtained through an inverse variance-weighted random-effects meta-analysis. Subgroup analyses were used to explore the potential sources of heterogeneity. RESULTS: The 35 analyzed prospective cohort studies included 2 314 292 individuals, among whom 254 038 all-cause deaths occurred. The pooled women vs men ratio of the HRs for all-cause and CHD mortality were 1.17 (95% CI: 1.12-1.23, I2 = 81.6%) and 1.97 (95% CI: 1.49-2.61, I2 = 86.4%), respectively. The pooled estimate of the HR for all-cause mortality was approximately 1.30 in articles in which the duration of follow-up was longer than 10 years and 1.10 in articles in which the duration of follow-up was less than 10 years. The pooled HRs for all-cause mortality in patients with type 2 diabetes was 2.33 (95% CI: 2.02-2.69) in women and 1.91 (95% CI: 1.72-2.12) in men, compared with their healthy counterparts. CONCLUSIONS: The effect of diabetes on all-cause and CHD mortality is approximately 17 and 97% greater, respectively, for women than for men.

Potatoes Consumption and Risk of Type 2 Diabetes: A Meta-analysis.

BACKGROUND: Evidence of increased type 2 diabetes (T2D) risk associated with potatoes consumption is equivocal. We aimed to perform a meta-analyses on the association between potatoes consumption and T2D risk in prospective cohort studies. METHODS: Studies published prior to 31 Aug 2016 were identified in PubMed, EMBASE, and Web of Science. Pooled relative risks (RR) and 95% confidence intervals (95%CI) based upon the highest vs. lowest category of potatoes consumption in each study were calculated in meta-analysis using random-effects models. Dose-response meta-analysis was fitted using generalized least squares regression in order to quantify the association between potatoes consumption and T2D risk. RESULTS: The pooled RR comparing the highest vs. lowest category of potato consumption was 1.077 (95%CI: 1.005, 1.155). Dose-response meta-analysis revealed T2D risk increased 3.5% (RR=1.035, 95% CI: 1.004-1.067) for additional three serving per week serving of potato. The pooled RR comparing the highest vs. lowest category of French fries consumption was 1.362 (95%CI: 1.004, 1.850). Dose-response meta-analysis indicated T2D risk increased 18.7% (RR = 1.187, 95% CI: 1.067-1.321) for additional three serving per week of French fries. CONCLUSION: This meta-analysis support a significant positive association between high potatoes consumption and risk of T2D, especially the consumption of French fries.

Effects of the interaction between glycated haemoglobin genetic risk score and postpartum weight reduction on glycaemic changes: A gene-weight interaction analysis.

AIM: To investigate the effects of the interaction between glycated haemoglobin (HbA1c) genetic risk score and weight changes during and after pregnancy (postpartum weight reduction and gestational weight gain) on long-term glycaemic changes in the largest cohort of women with a history of gestational diabetes mellitus (GDM). METHODS: This was a retrospective cohort using the baseline data from the Tianjin Gestational Diabetes Mellitus Prevention Programme. A genetic risk score was established by combining 10 HbA1c-related single-nucleotide polymorphisms, which were identified by genome-wide association studies. General linear regression models were applied to evaluate the effect of interaction between HbA1c genetic risk score and weight changes during and after pregnancy (postpartum weight reduction and gestational weight gain) on glycaemic changes. RESULTS: 'A total of 1156 women with a history of GDM were included in this respective cohort study. Statistical differences in pre-pregnancy weight, pre-delivery weight and postpartum weight were evidenced across different groups of postpartum weight reduction. After adjusting for covariates, statistical significance for changes in HbA1c level was only observed in the postpartum weight reduction <5 kg/y group (P = 0.002), and a significant effect of interaction between HbA1c genetic risk score and postpartum weight reduction on long-term changes in HbA1c was evidenced (P interaction = 0.01). In women with postpartum weight reduction ≥8 kg/y, those with a lower HbA1c genetic risk score had a greater decrease in HbA1c level. CONCLUSIONS: HbA1c genetic risk score interacts with postpartum weight reduction to affect long-term changes in HbA1c levels among women with a history of GDM.

Does body mass index and adult height influence cancer incidence among Chinese living with incident type 2 diabetes?

BACKGROUND: We investigated the site-specific cancer incidence risks among participants living with newly diagnosed type 2 diabetes (T2D) in relation to body mass index (BMI) and height. METHODS: The sample consisted of 25,130 participants living in Ningbo (China) who were newly diagnosed with T2D between 01/01/2006 and 12/31/2007 but without cardiovascular disease or cancer diagnoses at baseline. Follow-up of the sample was from 01/01/2008 to 12/31/2014. Cancer incidence stratified by BMI categories and quartiles of height were analyzed using standardized incidence ratios (SIR; the ratio of observed to the expected number of diagnosed cases) with 95% confidence intervals (95%CI). RESULTS: Follow-up included 22,795 participants, 155,845 person-years and 1063 cancer diagnoses. Compared with the general population of Ningbo, SIRs of all-cancer were 2.19 (95% CI: 2.01-2.37) for males and 1.80 (95% CI: 1.64-1.96) for females. The all-cancer SIRs for participants in the normal BMI category was 1.13 (95% CI: 1.00-1.38). By comparison, the SIRs for the overweight and obese groups were 0.62 (95% CI: 0.26-0.95) and 0.35 (95% CI: 0.03-0.71), respectively. Besides, higher participants had higher all-cancer SIRs. For males, SIRs were 1.08 (95% CI: 0.88-1.27) and 2.41 (95% CI: 2.05-2.78) in the lowest and highest quartiles of height, respectively. For females, SIRs were 1.03 (95% CI: 0.72-1.35) and 2.01 (95% CI: 1.66-2.58) in the lowest and highest quartiles of height, respectively. CONCLUSION: In this sample of participants living with newly diagnosed T2D, cancer incidence was higher among those who were taller, but also lower among those with higher BMI.

Elevation of PTPN1 promoter methylation is a significant risk factor of type 2 diabetes in the Chinese population.

The present study aimed to investigate the contribution of DNA methylation of the protein tyrosine phosphatase, non-receptor type 1 (PTPN1) gene to the susceptibility to type 2 diabetes (T2D). Peripheral blood mononuclear cells (PBMCs) were collected from 97 patients with T2D and 97 age- and gender-matched controls. DNA methylation of the PTPN1 gene promoter was evaluated by bisulfite pyrosequencing. Independent sample t-tests were used to compare the differences in the PTPN1 promoter and other phenotypes between the patients with T2D and the controls. The results indicated a significant correlation between PTPN1 promoter methylation and the risk of T2D. Additionally, a breakdown analysis by gender revealed that PTPN1 methylation was associated with an increased risk of T2D in females. Furthermore, low-density lipoprotein (r=-0.183, P=0.046) and total cholesterol (r=-0.310, P=0.001) were inversely associated with PTPN1 methylation in females. In conclusion, the results indicate that elevated PTPN1 promoter methylation is a risk factor for T2D in the female Chinese population.

Genetic variation of habitual coffee consumption and glycemic changes in response to weight-loss diet intervention: the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial.

Background: Coffee consumption has been associated with glucose metabolism and risk of type 2 diabetes.Objective: We examined whether the genetic variation determining habitual coffee consumption affected glycemic changes in response to weight-loss dietary intervention.Design: A genetic risk score (GRS) was calculated based on 8 habitual coffee consumption-associated single nucleotide polymorphisms. We used general linear models to test changes in glycemic traits in groups randomly assigned to high- and low-fat diets according to tertiles of the GRS.Results: We observed significant interactions between the GRS and low compared with high dietary fat intake on 6-mo changes in fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) (P-interaction = 0.023 and 0.022, respectively), adjusting for age, sex, race, physical activity, smoking, alcohol, seasonal variation, and baseline values of the respective outcomes. Participants with a higher GRS of habitual coffee consumption showed a greater reduction in fasting insulin and a marginally greater decrease in HOMA-IR in the low-fat diet intervention group.Conclusions: Our data suggest that participants with genetically determined high coffee consumption may benefit more by eating a low-fat diet in improving fasting insulin and HOMA-IR in a short term. This trial was registered at clinicaltrials.gov as NCT00072995 and NCT03258203.

Comparisons of serum miRNA expression profiles in patients with diabetic retinopathy and type 2 diabetes mellitus.

OBJECTIVES:: The aim of this study was to compare the expression levels of serum miRNAs in diabetic retinopathy and type 2 diabetes mellitus. METHODS:: Serum miRNA expression profiles from diabetic retinopathy cases (type 2 diabetes mellitus patients with diabetic retinopathy) and type 2 diabetes mellitus controls (type 2 diabetes mellitus patients without diabetic retinopathy) were examined by miRNA-specific microarray analysis. Quantitative real-time polymerase chain reaction was used to validate the significantly differentially expressed serum miRNAs from the microarray analysis of 45 diabetic retinopathy cases and 45 age-, sex-, body mass index- and duration-of-diabetes-matched type 2 diabetes mellitus controls. The relative changes in serum miRNA expression levels were analyzed using the 2-ΔΔCt method. RESULTS:: A total of 5 diabetic retinopathy cases and 5 type 2 diabetes mellitus controls were included in the miRNA-specific microarray analysis. The serum levels of miR-3939 and miR-1910-3p differed significantly between the two groups in the screening stage; however, quantitative real-time polymerase chain reaction did not reveal significant differences in miRNA expression for 45 diabetic retinopathy cases and their matched type 2 diabetes mellitus controls. CONCLUSION:: Our findings indicate that miR-3939 and miR-1910-3p may not play important roles in the development of diabetic retinopathy; however, studies with a larger sample size are needed to confirm our findings.

Comparisons of serum miRNA expression profiles in patients with diabetic retinopathy and type 2 diabetes mellitus

OBJECTIVES: The aim of this study was to compare the expression levels of serum miRNAs in diabetic retinopathy and type 2 diabetes mellitus. METHODS: Serum miRNA expression profiles from diabetic retinopathy cases (type 2 diabetes mellitus patients with diabetic retinopathy) and type 2 diabetes mellitus controls (type 2 diabetes mellitus patients without diabetic retinopathy) were examined by miRNA-specific microarray analysis. Quantitative real-time polymerase chain reaction was used to validate the significantly differentially expressed serum miRNAs from the microarray analysis of 45 diabetic retinopathy cases and 45 age-, sex-, body mass index- and duration-of-diabetes-matched type 2 diabetes mellitus controls. The relative changes in serum miRNA expression levels were analyzed using the 2-ΔΔCt method. RESULTS: A total of 5 diabetic retinopathy cases and 5 type 2 diabetes mellitus controls were included in the miRNA-specific microarray analysis. The serum levels of miR-3939 and miR-1910-3p differed significantly between the two groups in the screening stage; however, quantitative real-time polymerase chain reaction did not reveal significant differences in miRNA expression for 45 diabetic retinopathy cases and their matched type 2 diabetes mellitus controls. CONCLUSION: Our findings indicate that miR-3939 and miR-1910-3p may not play important roles in the development of diabetic retinopathy; however, studies with a larger sample size are needed to confirm our findings.

The Incidence and Mortality of Cervical Cancer in Ningbo during 2006-2014, China.

BACKGROUND: The purpose of this study was to investigate the incidence and mortality rates of cervical cancer during 2006-2014 in Ningbo, China. METHODS: A retrospective study involved 3418 newly diagnosed cervical cancer cases and 854 death cases were performed. All cases were registered in Cancer Registry Center of Ningbo Centers for Disease Control and Prevention. Results were expressed as standardized age-specific cancer incidence/mortality rates with confidence intervals. All P-values presented were two-sided and the statistical significance was set at P<0.05. RESULTS: The crude incidence rate was 34.35 per 100000 in females aged 50-54 years. Females aged 80-84 years had the highest crude mortality rates, which were 12.91 per 100000. The average age-standardized incidence and mortality rates by Chinese Standard Population were 6.29 and 1.49 per 100000, respectively. The average age-standardized incidence and mortality rates by World Standard Population were 8.02 and 1.91 per 100000, respectively. The incidence trend graph showed that annual percent change (APC) increased rapidly by 30.2% (P<0.01) during 2006-2014, while the mortality trend graph indicated a rapid increase in mortality annually by 8.8% (P<0.01) during 2006-2014. CONCLUSION: We observed an increased trend for both incidence and mortality rates of cervical cancer in Ningbo during 2006 to 2014, which indicated the urgent need for free regular screening for high-risk populations by the government.

Determinants of hyperhomocysteinemia in healthy and hypertensive subjects: A population-based study and systematic review.

AIMS: Hyperhomocysteinemia (HHcy) is known to increase the risk of many diseases. Factors influencing HHcy in healthy and hypertensive subjects remain under-researched. METHODS: A large population-based study was conducted in 60 communities from Shenzhen, China. Responses to standardized questions on lifestyle factors and blood samples were collected from all participants after a 12-h overnight fast. Multiple linear and multivariate logistic regressions were used to explore risk factors for HHcy. Results were then compared to those from a systematic review of English-language articles listed in Pubmed, EBSCOhost, Web of Science, Embase and Cochrane libraries that investigated HHcy risk factors in healthy and hypertensive subjects. RESULTS: A total of 1586 healthy (Male/Female = 642/944) and 5935 hypertensive subjects (Male/Female = 2928/3007) participated in our population-based study. In logistic regression analyses, age, BMI and creatinine (Cr) were risk factors, while being female, fruit intake and physical activity were protective factors for HHcy in healthy subjects. In hypertensive subjects, seven [age, smoking, salt intake, systolic blood pressure (SBP), uric acid, triglycerides (TG), and Cr] and four [female, fruit intake, total cholesterol (TC), and glucose] factors were associated with higher and lower HHcy respectively. The review of 71 studies revealed that potential risk factors for Hcy included nutritional, physiologic, lifestyle habits, ethnicity, genetics, interactions between gene-environment, gene-gene, gene-nutritional, environment-environment, nutritional-nutritional. CONCLUSION: Our study indicates the potential importance of increasing folic acid and vitamin B supplementation, daily fruit and vegetable intake, regular exercise and refraining from tobacco smoking and alcohol consumption as preventive strategies for Hcy.

The Association between GSTM1, GSTT1 Genetic Variants and Gastric Carcinoma Susceptibility in Chinese: A Systematic Review Article.

BACKGROUND: Glutathione S-transferases (GSTs) have been investigated as potential carcinoma susceptible genes. However, the relationship between GSTs (GSTM1, GSTT1) variants and gastric carcinoma (GC) risk has been controversial in Chinese population. METHODS: A comprehensive literature search strategy (PubMed, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, Wan fang Database, etc.) was launched. Crude odds ratios (ORs) and confidence intervals (95% CI) were applied to estimate the strength of the association. RESULTS: Significant associations between GSTs genetic polymorphisms and GC were evidenced under random-effects model (OR GSTM1 =1.56, 95% CI: 1.39 to 1.76, I2=50.7%, P<0.0001; OR GSTT1 =1.24, 95% CI: 1.10 to 1.39, I2=43.6%, P=0.014; OR GSTM1-GSTT1 =1.51, 95% CI: 1.26 to 1.81, I2=59.7%, P=0.004). The pooled ORs were not qualitatively changed when any single study was omitted by sensitivity analysis. CONCLUSION: Our results indicated an increased GC risk in Chinese population with GSTM1 and GSTT1 null genotype and GSTM1-GSTT1 dual null genotype. Further multi-center studies are needed to investigate the gene-gene and gene-environment interactions on the susceptibility of GC.