Male-female differences in the genetic regulation of t-PA and PAI-1 levels in a Ghanaian population.

Tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) directly influence thrombus formation and degradation, and have been identified as risk factors for thromboembolic disease. Prior studies investigated determinants of t-PA and PAI-1 expression, but mainly in Caucasian subjects. The aim of this study was to identify the contributions of genetic and other factors to inter-individual variation in plasma levels of t-PA and PAI-1 in a large-scale population-based sample from urban West Africa. t-PA, PAI-1 and several demographic, anthropometric, and metabolic parameters were measured in 992 residents of Sunyani, the capital of the Brong-Ahafo region of Ghana. In addition, nine gene polymorphisms associated with components of the renin-angiotensin and fibrinolytic systems were determined. We found that BMI, systolic and diastolic blood pressure, total cholesterol, glucose, and triglycerides were all significant predictors of t-PA and PAI-1 in both females and males. In addition, a significant relationship was found between the PAI-1 4G/5G (rs1799768) polymorphism on PAI-1 levels in females, the TPA I/D (rs4646972) polymorphism on t-PA and PAI-1 in males, the renin (rs3730103) polymorphism on t-PA and PAI-1 in males, the ethanolamine kinase 2 (rs1917542) polymorphism on PAI-1 in males, and the renin (rs1464816) polymorphism on t-PA in females and on PAI-1 in males. This study of urban West Africans shows that t-PA and PAI-1 levels are determined by both genetic loci of the fibrinolytic and renin-angiotensin systems and other factors often associated with cardiovascular disease, and that genetic factors differ between males and females.

Psychosocial outcomes of HIV illness in male and female African American clients.

With the rapid growth of HIV infection among African Americans, the issue of how medical problems relate to psychological functioning in the black community population has acquired new meaning and urgency for health care policy. To develop effective strategies to meet the mental health needs of infected African Americans we need a better understanding of the pattern of Association between HIV and psychological distress. The objective of this study is to test several hypotheses that predict depression and anxiety in black adults infected with HIV. Our conceptual model is derived from learned helplessness theory (Seligman, 1975), the concept of perceived coherence (Antonovsky, 1980; Lewis & Gallison, 1989), and social support theory (Cohen & Willis, 1985). Instruments used in the study include: The Center for Epidemiological Studies-Depression (CES-D) Scale (Radloff, 1977), the Anxiety Scale (Lewis, Firsich, and Parsell, 1979), and the Perceived Coherence Scale (Lewis, 1989). Data were obtained from 255 HIV infected black males and females (age > or = 18) who sought support, counseling, and maintenance services from one of three HIV care and referral centers in the Mid-South. The results of the study emphasize the relative importance of perceived physical symptoms over stage of illness for psychological functioning among African American adults with HIV. Further, the findings also demonstrate the potential importance of perceived coherence for psychological functioning. Black clients who reported higher perceived coherence, regardless of the stage of illness or level of HIV symptoms, had lower anxiety and depression. Significant gender differences in depression are also observed and implications are drawn for strategies to address HIV related mental health care needs of African Americans.