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  • Article: Common Polymorphism rs11191548 Near the CYP17A1 Gene Is Associated With Hypertension and Systolic Blood Pressure in the Han Chinese Population.
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    ABSTRACT: Background The single-nucleotide polymorphism (SNP) rs11191548, near the CYP17A1 gene, has been identified as being associated with hypertension and systolic blood pressure (SBP) in genome-wide association studies (GWAS) in a European population. The CYP17A1 gene encodes cytochrome P450c17alpha and plays an important role in the steroidogenic pathway, which includes mineralocorticoids. Methods We investigated the SNP rs11191548 in a case-control study of 1,102 subjects with essential hypertension (EH) and 1,109 normotensive controls. Results The SNP rs11191548 was significantly associated with hypertension in an additive genetic model (genotypes CC vs. TC vs. TT; odds ratio (OR) = 1.27 (95% CI, 1.10-1.47; P = 0.001)). The ORs of the TC vs. TT and CC vs. TT genotypes were 1.34 (95% CI, 1.10-1.63; P = 0.003) and 1.52 (95% CI, 1.10-2.12; P = 0.014), respectively. The risk C-allele was associated with increased SBP (βadj ± SEM = 1.307±0.515; P = 0.011) levels in the controls and decreased plasma renin activity (PRA) (βadj ± SEM = -0.053±0.016; P = 0.001) in the subjects with EH. In a stratified analysis of renin-angiotensin-aldosterone-system (RAAS)-related antagonists, the C-allele was significantly associated with decreased serum potassium (K) (βadj ± SEM = -0.093±0.028; P = 0.001) and PRA (βadj ± SEM = -0.067±0.023; P = 0.003) levels in patients with EH who were not taking RAAS-related antagonists. These results remained statistically significant after correction for multiple corrections. Conclusions The SNP rs11191548, near the CYP17A1 gene, was associated with hypertension and SBP in a Chinese Han population. The rs11191548 polymorphism was also related to lower PRA and K levels, suggesting that it has an effect on the enzymatic activity of CYP17A1.
    American Journal of Hypertension 04/2013; 26(4):465-72. · 3.18 Impact Factor
  • Article: Glycated Haemoglobin in Diagnosis of Diabetes Mellitus and Pre-diabetes among Middle-aged and Elderly Population: Shanghai Changfeng Study.
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    ABSTRACT: To investigate the optimal glycated haemoglobin (HbA1c) cut off points and evaluate the impact of HbA1c on diabetes and pre-diabetes in middle-aged and elderly population. Subjects were recruited from Shanghai Changfeng Study. A total of 1973 community-based participants (age ⋝45) without known diabetes underwent oral glucose tolerance test (OGTT) by using a 75-g oral glucose load and HbA1c was measured by using high performance liquid chromatography (HPLC). Subjects were classified as normal glucose tolerance (NGT), pre-diabetes(impaired glucose regulation, IGR) and new diagnosed diabetes (NDD) per 1999 WHO criteria. Two tests are compared with receiver operating characteristic curve (ROC). Among 1973 subjects, 271 (13.7%) were diagnosed as NDD and 474 (24.0%) as IGR by using OGTT. HbA1c was 5.7%±0.7% in this population. Use of 6.5% as the HbA1C cutoff point has sensitivity of 38.7% and specificity of 98.5%. We recommend 6.0% as a better cutoff value for diagnosis of diabetes in this population (AUC 0.829, 95% CI 0.798-0.860, P<0.001) with its sensitivity and specificity as 66.1% and 86.8%. For IGR, the results showed low sensitivity (44.9%) and specificity (66.7%) with an AUC of 0.571 for HbA1c when 5.8% was used as the cutoff point. Participants detected with HbA1c⋝6.0% were associated with nearly the same metabolic characteristics, including body mass index (BMI), blood pressure, lipid profile and urine albumin-creatinine ratio (uACR) compared with diabetic subjects detected by OGTT. The optimum HbA1c cutoff point for diabetes in our study population was lower than ADA criteria, and HbA1c may not be used to identify IGR.
    Biomedical and Environmental Sciences 03/2013; 26(3):155-62. · 1.35 Impact Factor
  • Article: Quantification of visceral adipose tissue using lunar dual-energy x-ray absorptiometry in asian chinese.
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    ABSTRACT: OBJECTIVE: To evaluate the new DXA VAT method on an Asian Chinese population by comparing to a reference method, computed tomography (CT). DESIGN AND METHODS: In total, 145 adult men and women volunteers, representing a wide range of ages (19 to 83 years) and BMI values (18.5 to 39.3 kg/m(2) ) were studied with both DXA and CT. RESULTS: The coefficient of determination (r(2) ) for regression of CT on DXA values was 0.947 for females, 0.891 for males and 0.915 combined. The 95% confidence interval for r was 0.940 to 0.969 for the combined data. The Bland-Altman test showed a VAT bias (CT as standard method) of 143 cm(3) for females and 379 cm(3) for males. Combined, the bias was 262 cm(3) with 95% limits of agreement of -232 to 755 cm(3) . While the current DXA method moderately overestimates the VAT volume for the study subjects, a further analysis suggested that the overestimation could be largely contributed to VAT movement due to breath-holding status. CONCLUSIONS: For Asian Chinese, VAT measured with DXA is highly correlated to VAT measured with CT. Validation of the DXA VAT tool using a reference method (e.g., CT) needs to carefully control the breath-holding protocol.
    Obesity 02/2013; · 4.28 Impact Factor
  • Article: Low-grade albuminuria is associated with carotid atherosclerosis in normotensive and euglycemic Chinese middle-aged and elderly adults: The Shanghai Changfeng Study.
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    ABSTRACT: BACKGROUND: Microalbuminuria is associated with cardiovascular disease (CVD). We investigated whether low-grade albuminuria (LGA) is independently associated with the carotid intima-media thickness (CIMT) and carotid plaques in normotensive and euglycemic Chinese middle-aged and elderly adults. METHODS: A total of 1341 normotensive and euglycemic participants (489 males and 852 females; mean age, 57.7 years) with normal urinary albumin-to-creatinine ratios (UACRs) (<30 μg/mg) were enrolled from the Changfeng Study. A standard interview, anthropometric measurements and laboratory analyzes were performed for each participant. Bilateral CIMTs were measured using ultrasonography, and the presence of carotid plaques was assessed. The urinary albumin excretion rate was measured using an early morning urine sample to determine the UACR. RESULTS: The median UACRs were 4.2 (interquartile range, 2.9-6.0) μg/mg and 5.6 (interquartile range, 4.0-8.2) μg/mg for male and female subjects, respectively. Compared with subjects with UACRs in the first and second tertiles, subjects of both genders with UACRs in the third tertile had greater CIMTs. After adjusting for conventional CVD risk factors and the glomerular filtration rate (GFR), male and female participants with UACRs in the third tertile for each gender had a 1.696-fold and 1.911-fold increased risk, respectively, of carotid plaques relative to those in the lowest tertiles. The logUACR was positively associated with the CIMT (β = 0.068 in males, P = 0.001; and β = 0.034 in females, P = 0.012) after adjusting for conventional CVD risk factors and the GFR. The multiple logistic regression analysis showed that a 1-unit increase in the logUACR corresponded to an odds ratio (OR) of having a carotid plaque that was 1.875 (95% confidence interval (CI) 1.103-3.538; P = 0.022) and 2.389 (95% CI 1.244-4.391; P = 0.01) for male and female subjects, respectively, after adjusting for all potential confounders. CONCLUSIONS: These results suggest that the UACR is independently associated with carotid atherosclerosis in normotensive and euglycemic Chinese individuals and that even when well below the current microalbuminuria threshold, LGA contributes to the risk of atherosclerosis.
    Atherosclerosis 02/2013; · 3.79 Impact Factor
  • Article: [Liver disease spectrum in hospitalized type 2 diabetes and related risk factors analysis of non-alcoholic fatty liver disease].
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    ABSTRACT: To explore the liver disease spectrum in patients with type 2 diabetes (T2DM) and the risk factors of non-alcoholic fatty liver disease (NAFLD). From September 2009 to October 2011, 1069 hospitalized patients with T2DM in Department of Endocrinology and Metabolism were involved in the study. The history informations, results of laboratory examination, hepatic ultrasound and hepatic proton magnetic resonance spectum ((1)H MRS) of all patients were collected to analysis. (1) The detectable rate of raised liver enzymes in T2DM patients was 28.7% (307/1069), composed mainly of NAFLD (39.4%, 121/307). After excluding the factors such as alcoholic abuse, viral hepatitis, the detect rate of raised liver enzymes in T2DM patients was 26.9% (185/688). (2) The detectable rate of fatty liver by ultrasound in T2DM patients was 56.7% (500/882), composed mainly of NAFLD (72.6%, 363/500), and the detectable rate of NAFLD was 58.0% (363/626). (3) The detectable rate of fatty liver by hepatic (1)H MRS was 72.8% (227/312), composed mainly of NAFLD (69.6%, 158/227). The detectable rate of NAFLD was 69.6% (158/227). (4) Of the three methods for diagnosing NAFLD, (1)H MRS had the highest detectable rate, followed by ultrasound, and the hepatic enzymes was the lowest. Set the hepatic (1)H MRS as gold diagnosing standrd of NAFLD, the combination of hepatic enzymes and ultrasound increase the sensitivity. The optional cut-off points of ALT were 19.7 U/L (male, ROCAUC = 0.689, P < 0.01) and 17.0 U/L (female, ROCAUC = 0.727, P < 0.01). (5) Logistic stepwise regression analysis showed sex, BMI, hemoglobin, fasting C-peptide and uric acid (OR = 3.803, 1.195, 1.037, 2.896, 1.011, all P < 0.05) were positively correlated with NAFLD, and diabetes duration (OR = 0.948, P < 0.05) was positively correlated with NAFLD independently. The detectable rate of fatty liver was high in T2DM which was composed mainly of NAFLD. High abnormal liver enzymes detectable rate indicated that NAFLD with T2DM are prone to NASH.
    Zhonghua yi xue za zhi 01/2013; 93(4):270-4.

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