Prevalence of hypertension and its associations with body composition across Chinese and American children and adolescents.

BACKGROUND: The age of onset of hypertension (HTN) is decreasing, and obesity is a significant risk factor. The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pressure are insufficiently studied. This study aimed to evaluate the prevalence of HTN in Chinese and American children and adolescents and to assess the relationship between various body composition indices and HTN. METHODS: Seven thousand, five hundred and seventy-three Chinese and 6239 American children and adolescents aged 8-18 years from the 2013-2015 China Child and Adolescent Cardiovascular Health study and the 2011-2018 National Health and Nutrition Examination Surveys were analyzed. Blood pressure and body composition (fat and muscle) were measured by trained staff. The crude prevalence and age-standardized prevalence rate (ASPR) of primary HTN and its subtypes [isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH)] were calculated based on 2017 American Academy of Pediatrics guidelines. Multivariable-adjusted linear regression coefficients and odds ratios (ORs) were calculated to assess the associations of body composition indicators with HTN, ISH and IDH. RESULTS: The ASPR of HTN was 18.5% in China (CN) and 4.6% in the United States (US), whereas the obesity prevalence was 7.4% and 18.6%, and the population attributable risk of HTN caused by overweight and obesity was higher in the US than in CN. Increased fat mass, muscle mass and body fat percentage mass were associated with a higher risk of HTN in both countries. The percent of muscle body mass had a protective effect on HTN and ISH in both countries [HTN (CN: OR = 0.83, 95% CI = 0.78-0.88; US: OR = 0.72, 95% CI = 0.64-0.81); ISH (CN: OR = 0.87, 95% CI = 0.80-0.94; US: OR = 0.71, 95% CI = 0.62-0.81)], and the protective effect was more common among children and adolescents with high levels of physical activity. CONCLUSIONS: The burden of HTN in Chinese children and adolescents was substantial and much greater than that in the US, and the contribution of obesity to HTN was higher in the US than in CN. Augmenting the proportion of muscle mass in body composition has a protective effect against HTN in both populations. Optimizing body composition positively influences blood pressure in children and adolescents, particularly those with high-level physical activity. Video abstract (MP4 149982 KB).

Associations between body mass index in different childhood age periods and hyperuricemia in young adulthood: the China Health and Nutrition Survey cohort study.

BACKGROUND: Few studies have evaluated the specific age period in childhood when the association of body mass index with adult hyperuricemia begins to be operative. This study aimed to examine the associations between body mass index in different childhood age periods and the risk of adult hyperuricemia in China. METHODS: The study cohort from the China Health and Nutrition Survey included 676 participants who were aged ≥ 18 years and had data on uric acid in 2009 with at least one measurement of body mass index in childhood surveys before 2009. There were 357, 365, 358, 427, and 432 observations in childhood age groups of ≤ 5 years, 6-9 years, 10-12 years, 13-15 years, and 16-18 years, respectively. Body mass index Z score was calculated based on 2000 Center for Disease Control and Prevention growth charts for the United States. RESULTS: Childhood body mass index Z scores measured at age ≤ 5 years, 6-9 years, 10-12 years, and 13-15 years had no statistical association with adult uric acid. In comparison, childhood body mass index Z scores measured at age 16-18 years were significantly associated with adult uric acid (ß = 11.539, P = 0.007), and the strength of association was stronger in girls (ß = 18.565, P = 0.002) than in boys (ß = 9.209, P = 0.087). In addition, childhood body mass index Z scores measured at age 16-18 years were significantly associated with an increased risk of adult hyperuricemia (odds ratio = 1.323, 95% confidence interval = 1.003-1.746, P = 0.048), but not for other age groups. CONCLUSION: The association between childhood body mass index and young adulthood hyperuricemia was influenced by childhood age.

[Risk of obesity-related gene polymorphism on the incidence and durative of childhood obesity].

OBJECTIVE: To examine the impact of single nucleotide polymorphisms(SNPs)in obesity-related genes on the incidence and durative of obesity in childhood and adolescence. METHODS: Based on the Beijing Child and Adolescent Metabolic Syndrome (BCAMS) Study, 780 school children aged 6 to 16 years were followed-up in 2010, and assessed for body size parameters. Venipuncture blood samples were collected after a 12-hour overnight fast. Genomic DNA was isolated from peripheral blood white cells under the salt fractionation method. SNPs were genotyped by ABI 5700 real time PCR(FTO rs9939609)and TaqMan Allelic Discrimination Assays with the GeneAmp 7900 Sequence Detection System(Applied Biosystems,Foster City, CA, USA) (FTO rs6499640, FAIM2 rs7138803,NPC1 rs1805081, MC4R rs17782313, BDNF rs6265, GNPDA2 rs10938397). Both overweight and obesity were diagnosed by the Chinese age- and sex- specific body mass index(BMI) cutoffs. Two independent sample t-test, Chi-square test and multiple logistic regression analysis were performed. RESULTS: During the 6 years follow-up period, the incidence of obesity in the total sample 8.5%, and 65.1% individuals had persisted their obese status. The genotypes of the SNPs except BDNF rs6265 were in Hardy-Weinberg equilibrium in each group (P > 0.05). The incidence rates of obesity increased with FTO rs9939609 TT,TA and AA genotypes(χ(2) for trend = 8.030, P < 0.05). In the non-obese sub-cohort, after adjusted for sex, age at the initial time of follow up and residential area, when compared with children carrying FTO rs9939609 T-allele, a significantly relative risk of obesity was observed for children carrying the rs9939609 A-allele(OR = 2.42, 95%CI:1.31-4.47, P = 0.005). In the obese sub-cohort, FTO rs9939609 A-allele was significantly associated with durative of obesity (OR = 1.72, 95%CI:1.07-2.77, P = 0.026). However, no statistical significant associations were seen between other SNPs(FTO rs6499640, FAIM2 rs7138803, NPC1 rs1805081, MC4R rs17782313, GNPDA2 rs10938397)and the incidence or durative of obesity(all P > 0.05). The genetic risk score was associated with the risk of occurrence of obesity(OR = 16.42, 95% CI:3.59-75.10, P < 0.001) after adjusted for residential area, sex, age at the initial time of follow up and baseline BMI. CONCLUSION: We confirmed the association of FTO rs9939609 with incidence and durative of obesity in children. Early intervention was recommended on the high risk individuals who carrying more risk alleles in obesity-related genes.

[Association between obesity in childhood and hypertension incidence: a prospective cohort study].

OBJECTIVE: To explore the impact of obesity level and the level change in childhood on hypertension incidence. METHODS: A perspective cohort study was conducted. As part of Beijing Child and Adolescent Metabolic Syndrome Study, 2189 aged 6 - 16 year non-hypertensive children was followed up in December, 2010. In this study, height, weight, waist circumference (WC) and blood pressure was measured at follow-up, and body mass index (BMI) and WC was respectively used to assess overweight, obesity and abdominal obesity. Non-conditional logistic regression was used to evaluate the association between baseline obesity status, change of obesity status and hypertension incidence. OR and 95%CI were computed in the model using obese status as dummy variable and hypertension at follow up visit as dependent variable. RESULTS: The total hypertension incidence of 1184 subjects during 6 years follow-up was 19.9% (236/1184). The hypertension incidence in male (23.2%, 149/643) was higher than that in female (16.1%, 87/541) (χ(2) = 9.257, P = 0.002). The hypertension incidence of non-overweight, overweight and obese children at baseline was 8.7% (45/519), 19.3% (35/181) and 32.4% (156/484) respectively (χ(2) = 9.332, P < 0.001), and the incidence of non-obese and abdominal obese children at baseline was respectively 10.3% (63/613) and 30.7% (173/567) (χ(2) = 77.753, P < 0.001). Hypertension incidence in the baseline obesity group was higher than the non-overweight (BMI: OR = 4.9, 95%CI: 3.4 - 7.0) and non-obese group (WC: OR = 3.9, 95%CI: 2.8 - 5.3). The hypertension incidence increased with the follow-up BMI/WC level, based on the same baseline level of BMI and WC. The hypertension risk increased to 0.21 and 0.07 times respectively with elevation of baseline BMI level by 1 kg/m(2) and WC level by 1 cm, and OR (95%CI) were 1.21 (1.16 - 1.26) and 1.07 (1.05 - 1.09), respectively. Similarly, the hypertension risk increased 0.16 and 0.05 times respectively with the elevation of BMI level change by 1 kg/m(2) and 1 cm, and OR (95%CI) were 1.16 (1.11 - 1.22) and 1.05 (1.03 - 1.07), respectively. CONCLUSION: Obesity and increased obesity level change in childhood can increase the risk of incident hypertension.

GST polymorphisms are associated with hepatocellular carcinoma risk in Chinese population.

AIM: To investigate the association between GSTM1 and GSTT1 polymorphisms and the risk of hepatocellular carcinoma (HCC) in Chinese population. METHODS: Literature databases including PubMed, ISI web of science and other databases were searched. Pooled odds ratio (OR) and 95% CI were calculated using random- or fixed- effects model. Subgroup analysis and sensitivity analysis were also performed. RESULTS: Nineteen studies of GSTM1 (2660 cases and 4017 controls) and 16 studies of GSTT1 (2410 cases and 3669 controls) were included. The GSTM1/GSTT1 null genotypes were associated with increased risk of HCC in Chinese population (for GSTM1, OR = 1.487, 95% CI: 1.159 to 1.908, P = 0.002; for GSTT1, OR = 1.510, 95% CI: 1.236 to 1.845, P = 0.000). No publication bias was detected. In subgroup analysis, glutathione S-transferases polymorphisms were significantly associated with HCC risk among the subjects living in high-incidence areas, but not among the subjects living in low-incidence areas. CONCLUSION: The present meta-analysis suggests that GSTM1/GSTT1 null genotypes are associated with increased risk of HCC in Chinese population.

Trends in blood pressure and hypertension among Chinese children and adolescents: China Health and Nutrition Surveys 1991-2004.

OBJECTIVE: To observe the trends in blood pressure (BP) and prevalence of hypertension among Chinese children and adolescents. METHODS: Data were extracted from the China Health and Nutrition Survey conducted from 1991 to 2004; 8247 children and adolescents aged 6-17 years were selected for this study. Multivariate linear regression analysis and multivariate logistic regression analysis were performed to evaluate the secular trends in BP levels and prevalence of hypertension, respectively. RESULTS: During the study period, there was an upward trend in BP in Chinese children and adolescents. After adjustment for gender, age and weight status, the prevalence of pre-hypertension and hypertension increased dramatically from 1991 to 2004, with average relative increases of 6.38% and 8.13% in children and adolescents, respectively. Overweight was strongly associated with pre-hypertension and hypertension in comparison with normal weight, with odds ratios (95% confidence intervals) of 2.21 (1.58-3.11) and 4.13 (3.32-5.13), respectively. CONCLUSION: BP levels and prevalence of hypertension increased dramatically among Chinese children and adolescents from 1991 to 2004.

Association of glutathione S-transferases polymorphisms (GSTM1 and GSTT1) with senile cataract: a meta-analysis.

PURPOSE: Glutathione S-transferase (GST) polymorphisms have been considered risk factors for the development of senile cataract. However, the results are not consistent. In this study, the authors conducted a meta-analysis to assess the association between GSTM1 and GSTT1 null genotypes and the risk for senile cataract. METHODS: Published literature from PubMed, EMBASE, and other databases were retrieved. All studies evaluating the association between GSTM1/GSTT1 polymorphisms and senile cataract were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed- or random-effects model. RESULTS: Eleven studies on GSTM1 (1871 cases and 1267 controls) and five studies on GSTT1 (1180 cases, 706 controls) were included. Overall analysis showed that the association between GSTM1 null genotype and risk for senile cataract is not statistically significant (OR, 1.39; 95% CI, 0.99-1.94; P = 0.054) and that the association between GSTT1 null genotype and risk for senile cataract is not significant (OR, 1.09; 95% CI, 0.87-1.36; P = 0.454). Subgroup analysis showed that the association between GSTM1 null genotype and risk for senile cataract is statistically significant in Asians (OR, 1.66; 95% CI, 1.03-2.67; P = 0.039) but not in Caucasians (OR, 1.21; 95% CI, 0.74-1.96; P = 0.443). Similar results were observed for the association between GSTT1 null genotype and risk for senile cataract. CONCLUSIONS: The present meta-analysis suggested that GSTM1 and GSTT1 null genotypes are associated with increased risk for senile cataract in Asian populations but not in Caucasian populations. Given the limited sample size, the finding on GST polymorphisms merits further investigation.