[Association of KCNJ5 gene rs3740835(C/A) and rs2604204(A/C) polymorphism with unilateral and bilateral primary aldosteronism].

OBJECTIVE: To assess the association between polymorphisms of rs3740835(C/A) and rs2604204(A/C) in KCNJ5 gene with the susceptibility to unilateral and bilateral primary aldosteronism (PA). METHODS: A total of 1043 subjects were studied, which included 83 unilateral PA patients,142 bilateral PA patients and 818 essential hypertensive(EH) patients. The polymorphism of KCNJ5 gene at rs3740835(C/A) and rs2604204(A/C) position were analyzed with a TaqMan genotyping technique. RESULTS: Frequencies of A allele and AA+AC genotype at rs3740835(C/A) in unilateral PA group were significantly higher than EH group (P < 0.05). However, the above frequencies did not show a statistical significance between bilateral PA group and EH group (P > 0.05). No statistical difference was detected in the distribution of alleles or genotypes at rs2604204 (A/C) between unilateral PA and EH group or between bilateral PA and EH group. Haplotypic frequencies of C-A and A-A in unilateral PA group were significantly higher and lower than EH group, respectively. However, there was no statistical difference in the haplotype distribution between bilateral PA and EH groups. CONCLUSION: Rs3740835(C/A) polymorphism may be associated with unilateral PA but not with bilateral PA. rs2604204(A/C) polymorphism is not associated with either unilateral or bilateral PA. Haplotype C-A and A-A may respectively be susceptibility factor and protective factor for unilateral PA. No haplotype has been found to associate with bilateral PA.

[An association study of six-transmembrane protein of prostate 2 gene with metabolic index and tumour necrosis factor in Uygur population].

OBJECTIVE: To explore the relationship between genetic polymorphisms of six-transmembrane protein of prostate 2 (STAMP2) and metabolic index, TNFα in Xinjiang Uygur population. METHODS: STAMP2 gene functional regions were sequenced in Uygur Xinjiang population diagnosed as metabolic syndrome. Patients were divided into the following three groups by their TNFα concentration: the high level group (TNFα ≥ 7.95 µg/L, n = 313), the moderate level group (TNFα >5.34- < 7.95 µg/L, n = 268) and the low level group ( ≤ 5.34 µg/L, n = 313) . The selected representative variations were genotyped by TaqMan-PCR in 894 Uygur individuals. The association of the genetic variations of STAMP2 gene with metabolic index and TNFα was analyzed. RESULTS: Three representative variations were genotyped, including rs8122, rs1981529 and rs34741656. The genotype distribution and allele frequencies of rs8122 and rs1981529 were statistically different among the three groups (P < 0.05), while no difference was observed with rs34741656 (P > 0.05). By ANOVA analysis, statistical difference was showed between the rs1981529 polymorphism AA and AG in the concentration of TNFα (P < 0.05) . None of the polymorphisms was significantly associated with TC, HDL-C, LDL-C and TG (P > 0.05). CONCLUSION: Two STAMP2 gene polymorphisms, rs8122 and rs1981529 are associated with the concentration of TNFα in Xinjiang Uygur population.

[Association study of PRDM16 gene polymorphisms with essential hypertension in Xinjiang Uygur population].

OBJECTIVE: To assess the association of polymorphisms of PR domain containing 16 gene (PRDM16) with essential hypertension in ethnic Uygur population from Xinjiang, China. METHODS: Functional regions of the PRDM16 gene were sequenced in 48 Uygur subjects with essential hypertension selected from 480 hypertensive patients and 819 normotensive controls. Representative variations were genotyped with TaqMan-PCR method. Association of variations of PRDM16 gene with hypertension was analyzed. RESULTS: For the 4 genotyped representative variations (rs2236518, rs2282198, rs2493292 and rs870171), no significant difference in genotype distribution and allele frequencies has been found between the patient and control groups (P>0.05). By ANOVA analysis, none of the polymorphisms was significantly associated with systolic or diastolic blood pressure (P>0.05). Nor was significant difference in haplotypic frequencies between the two groups detected (P>0.05). CONCLUSION: We have found no association between the four polymorphisms (rs2236518, rs2282198, rs2493292 and rs870171) of the PRDM16 gene with essential hypertension in ethnic Uygur population from Xinjiang.

Prevalence of primary aldosteronism in hypertensive subjects with hyperglycemia.

The aim of this study was to examine the prevalence of primary aldosteronism (PA) in hypertensive patients with hyperglycemia. Two hundred and thirty-two hypertensive patients with hyperglycemia were screened for PA. Fifty-four subjects with an aldosterone/rennin activity ratio >20 ng/dL per ng/mL/hour underwent a saline loading test. Primary aldosteronism was present in 22.4% of patients with a plasma aldosterone concentration >5 ng/dL and 11.6% of those with plasma aldosterone concentrations >10 ng/dL. There were 14.0%-23.0% patients with PA in the diabetes mellitus group, 2.3%-23.3% in the impaired glucose tolerance group, and 9.1% in the impaired fasting glucose group. Primary aldosteronism is common in hypertensive individuals with hyperglycemia.

[A study of relationship between obstructive sleep apnea-hypopnea syndrome in hypertension and insulin].

OBJECTIVE: To investigate the association between the obstructive sleep apnea-hypopnea syndrome (OSAHS) in hypertension and insulin. METHODS: A total of 521 patients were divided into 4 groups according to apnea-hypopnea index and OSAHS degrees. The control group (group I), mild OSAHS group (group II), moderate OSAHS group (group III) and severe OSAHS group (group IV) had 89 patients, 194 patients, 118 patients and 120 patients respectively. RESULTS: The BMI [(30.4 ± 3.8) kg/m(2)], apnea-hypopnea index (AHI, 3.8 ± 0.1), Fasting insulin (FIns) [(3.08 ± 0.26) mU/L] and insulin resistance (2.43 ± 0.27) of patients in severe OSAHS group were significantly higher than that of in the control, mild OSAHS group and moderate OSAHS group (P < 0.01). The levels of saturation of minimum oxygen from skin of patients in severe OSAHS group was significantly lower (MSpO(2)) than in that of the control, mild OSAHS group and moderate OSAHS group. Multiple linear regression analysis showed that fasting plasma insulin and insulin resistance was positive correlation with apnea-hypopnea index, while they also negatively associated with saturation of minimum oxygen. CONCLUSIONS: FIns and insulin resistance strongly associate with AHI and levels of saturation of minimum oxygen from skin. Hypertensive patients with OSAHS have more chances to suffer with insulin resistance.

[Etiology analysis for hospitalized hypertensive patients: 10 years report from the department of hypertension (1999 - 2008)].

OBJECTIVE: To analyze etiology of hospitalized hypertensive patients in the department of hypertension from 1999 to 2008. METHODS: This retrospective study was performed to analyze the etiology of hospitalized hypertensive patients in department of hypertension and to show the distribution change of hypertension from 1999 to 2008. RESULTS: (1) There were 5867 (75.1%) patients with essential hypertension and 1942 (24.9%) patients with secondary hypertension (SH). (2) The prevalence rate of SH increased significantly during the 10 years (χ(2) = 387.621, P < 0.001) and was higher in 2008 than in 1999 (39.3% vs. 9.5%, P < 0.05). The prevalence of obstructive sleep apnea syndrome (OSAS) and primary aldosteronism (PA) in 2008 increased 38.3 and 1.8 times respectively than in 1999 (χ(2) = 304.025, P < 0.001; χ(2) = 42.845, P < 0.001) and other SH remained unchanged. (3) The prevalence of PA complicated with OSAS increased significantly in recent five years (χ(2) = 26.376, P < 0.001). Incidence of OSAS was 23.9% in PA patients and incidence of PA was 6.7% in OSAS patients. CONCLUSIONS: With the insights gained on hypertension mechanism and the development of new diagnostic technology, percent of diagnosed SH increased remarkably in recent years in hospitalized hypertensive patients in our department of hypertension. OSAS and PA are the leading causes of SH.

Higher levels of plasma TNF-alpha and neuropeptide Y in hypertensive patients with obstructive sleep apnea syndrome.

Resistant hypertension is always fount to be accompanied with obstructive sleep apnea syndrome (OSAS). Previous studies assumed inflammation participated in OSAS and hypertension. The fact that tumor necrosis factor a (TNF-alpha) was related to OSAS, while neuropeptide Y (NPY) was related to hypertension, was widely reported separately. To investigate the involvement of TNF-alpha and NPY simultaneously in hypertension accompanied with OSAS, 417 subjects who underwent the polymonograph and blood pressure measurement were consecutively selected. Plasma TNF-alpha and NPY levels were determined in normotensive with OSAS (n = 113), hypertensive without OSAS (n = 73), hypertensive with OSAS (n = 134), and those of controls (n = 97), respectively. A significant increase of plasma TNF-alpha and NPY were both observed in hypertensive subjects with or without OSAS, the highest level of TNF-alpha and NPY were in hypertension with the OSAS group. TNK-alpha, NPY, and neck circumference contributed to OSAS and hypertension as risk factors in the logistic regression model. Neck circumference was impacted by apnea/hyponea index, mean diastolic blood pressure, and TNF-alpha level, which was indicated via the multiple linear model. The present study indicated a positive interplay between plasma TNF-alpha, NPY, hypertension, and OSAS in the Han population of Xinjiang. Although there is evidence that inflammation plays a role in the pathophysiology of hypertension and OSAS, clear evidence is still lacking, and raises the dilemma of the hen and the egg. Further studies are needed to clarify the role of inflammation in the pathogenesis of hypertension with OSAS, in which neck size should be considered as a linked independent factor.

The prevalence of hypertension, obesity and dyslipidemia in individuals of over 30 years of age belonging to minorities from the pasture area of Xinjiang.

BACKGROUND: The prevalence of population-wide hypertension, obesity and dyslipidemia has not been well studied in the pasture area of Xinjiang. The present epidemiological study was performed to determine the prevalence of hypertension, obesity and dyslipidemia in minority populations from the pasture area of Xinjiang and to discuss the potential risk factors for hypertension. METHODS: A population-based, cross-sectional study in the Xinjiang pasture area was performed which included 2251 participants aged over 30 years (90.33% participation rate) of whom 71.26% were Kazaks. Several risk factors were considered: hypertension (defined as systolic or diastolic blood pressure or both of at least 140/90 mmHg measured on one occasion or treatment for hypertension) overweight/obesity (body mass index > or = 25 kg/m2) alcohol intake, smoking/tobacco use and dyslipidemia. Outcomes were prevalence of hypertension, obesity and dyslipidemia and the associated risk factors of hypertension detected by multivariate logistic regression analysis taking into account various metabolic and lifestyle characteristics. RESULTS: The prevalence of hypertension, overweight/obesity and dyslipidemia in all participants from the pasture area of Xinjiang was 51.9%, 47.9% and 49.2% respectively. Independently, the prevalence and awareness of hypertension was 52.6% and 15.3% among Kazaks (n = 1604), 54.6% and 14.1% among Uygurs (n = 418), 39.5% and 16.1% among Mongolians (n = 81) and 43.9% and 18.2% among non-Xinjiang-born Han immigrants (n = 148). The prevalence of overweight/obesity in Kazaks, Uygurs, Mongolians and Han immigrants was 46.7%, 48.9%, 62.5% and 50.3%, respectively. The prevalence of dyslipidemia in the four ethnic groups mentioned was 53.5%, 34.8%, 49.3% and 47.3%, respectively. The mean blood pressure in all participants was 136/86 mmHg (pre-hypertensive), the mean BMI was 24.7 kg/m2. Based on multiple logistic regression analysis, the significant risk factors for hypertension were age [1.07(1.06-1.09), P < 0.0001], overweight/obesity [overweight: 1.61(1.22-2.13), p = 0.0007; obesity: 1.95 (1.33-2.87), p = 0.0007], hypercholesterolemia [1.30(1.15-1.47), p < 0.0001] and an alcohol intake of over 30 g/day [2.22(1.43-3.45), p = 0.0004]. CONCLUSIONS: The considerably high prevalence of hypertension, overweight/obesity and dyslipidemia among the minority population aged over 30 from the pasture area of Xinjiang calls for effective preventive measures. Age, increased body mass index, hypercholesterolemia and > or =30 g/d alcohol intake can be counted as risk factors for hypertension, but further genetic or environmental clarification would be desirable to explain the unusually high prevalence of the conditions mentioned above.

[Etiology analysis of 628 patients with refractory hypertension].

OBJECTIVE: To analyze the etiology of 628 patients with refractory hypertension and to observe the disease distribution with respect to gender and different age groups. METHODS: In this study, clinical data of 628 refractory hypertensives who hospitalized in our hospital from September 1997 to December 2005 were retrospectively analyzed. RESULTS: (1) There were 80.1% (503/628) patients with essential hypertension, 18.9% (119/628) with secondary hypertension (SH) while diagnosis was not clear in 1.0% (6/628) patients. Renovascular hypertension (33.6%) and obstructive sleep apnea syndrome (23.5%) were the major causes of SH. The highest prevalence rate of endocrine hypertension was primary aldosteronism (13.5%). (2) There were significantly more male patients than female patients with essential hypertension, SH, renal hypertension, obstructive sleep apnea syndrome, primary aldosteronism while the incidence of pheochromocytoma in female was significantly higher than that in male patients (all P < 0.05). The incidence of renovascular hypertension was similar between male and female patients. (3) SH occurred more often in young patients (33.1%) than in aged patients (13.8%, P < 0.05). CONCLUSION: Our data from this patient cohort showed that SH, especially renovascular hypertension and obstructive sleep apnea syndrome are major causes for refractory hypertension in young patients and primary aldosteronism was the commonest reason of endocrine hypertension in youth and middle-aged patients with refractory hypertension.

[The relationship between dyslipemia and the polymorphism of angiotensin II type 1 receptor gene in hypertensive Kazakans of Xinjiang.].

OBJECTIVE: To investigate the relationship between dyslipidemia and the polymorphism of angiotensin II type 1 receptor (AT(1)R) gene A1166C in hypertensive Kazakans of Xinjiang area. METHODS: Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) methods were used to detect the A1166C polymorphism of AT(1)R gene of 296 hypertensive and 198 normotensive Kazakans. Biochemical parameters were measured by autochemical emalyzer. RESULTS: (1) The TC and LDL-C levels are significantly higher in hypertension group than those in normotensive controls [TC: (4.91 +/- 1.19) mmol/L vs. (4.43 +/- 1.20) mmol/L; LDL-C: (3.36 +/- 1.01) mmol/L vs. (2.94 +/- 1.30) mmol/L, P < 0.001). (2) In hypertension group, TC and LDL-C are related to A1166C polymorphism of AT(1)R gene and TC and LDL-C of AC carriers are significantly higher than AA carriers (P < 0.05). CONCLUSION: The dyslipidemia is related to A1166C polymorphism of AT(1)R gene in hypertensive Kazakans.

[Analysis of etiology of the patients with hypertension from the People's Hospital of Xinjiang Uygur Autonomous Region].

OBJECTIVE: To analyze the etiology of the patients with hypertension from the People's Hospital of Xinjiang Uigur Autonomous Region, and to investigate the distribution of hypertension in gender and different ages. METHODS: From September 1997 to December 2005, the data of 4642 patients with hypertension was retrospective studied. RESULTS: (1) Of all the patients, 85.24% were essential hypertension (EH) and 14.76% were secondary hypertension (SH). Higher prevalence of sleep apnea syndrome (42.92%) and anxiety (15.04%) was found in secondary hypertension. The highest prevalence of primary aldosteronism (12.12%) was found in endocrine hypertension. (2) The male patients with hypertension were more than the female ones, and the incidence of EH, sleep apnea syndrome (SAS) and primary aldosteronism was higher in male patients than female ones, and the following was less than female: anxiety, pheochromocytoma and renovascular hypertension. (3) Among the patients with SH, 21.9% were found in youth, and 9.85% in aged. CONCLUSION: For the young, SH should be excluded, especially SAS and anxiety should be screened and differentiated. The highest prevalence of endocrine hypertension is primary aldosteronism in young and middle-aged male. The prevalence of pheochromocytoma in female is higher than that of male.