RESUMEN
Studies seldom combine biological, behavioral and psychological factors to estimate coronary atherosclerotic heart disease (CHD) risk. Here, we evaluated the associations between these factors and CHD to develop a predictive nomogram to identify those at high risk of CHD. This case-control study included 4392 participants (1578 CHD cases and 2814 controls) in southeast China. Thirty-three biological, behavioral and psychological variables were evaluated. Following multivariate logistic regression analysis, which revealed eight risk factors associated with CHD, a predictive nomogram was developed based on a final model that included the three non-modifiable (sex, age and family history of CHD) and five modifiable (hypertension, hyperlipidemia, diabetes, recent experience of a major traumatic event, and anxiety) variables. The higher total nomogram score, the greater the CHD risk. Final model accuracy (as estimated from the area under the receiver operating characteristic curve) was 0.726 (95% confidence interval: 0.709-0.747). Validation analysis confirmed the high accuracy of the nomogram. High risk of CHD was associated with several biological, behavioral and psychological factors. We have thus developed an intuitive nomogram that could facilitate development of preliminary prevention strategies for CHD.
Asunto(s)
Aterosclerosis , Enfermedad Coronaria , Nomogramas , Anciano , Aterosclerosis/diagnóstico , Aterosclerosis/epidemiología , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/epidemiología , Femenino , Conductas Relacionadas con la Salud , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Persona de Mediana Edad , Medición de RiesgoRESUMEN
BACKGROUND: Coronary heart disease (CHD) is a complex disease caused by multi-factors and a major threat to human health. Circular RNAs (circRNAs) have critical roles in various biological processes and diseases. This study explores the independent role of circRNAs and their interaction with environmental factors in CHD. METHODS: A case-control study was conducted from March 2015 to September 2017 in Fuzhou, China. A total of 585 CHD patients and 585 gender- and age-matched healthy controls were enrolled. Questionnaire survey, health examination and molecular biology laboratory testing were conducted. Microarray technology and quantitative real-time polymerase chain reaction (PCR) were used to profile the expression levels of circRNAs. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to determine the diagnostic cut-offs. Multivariate logistic regression and multiplicative analysis were used to analyse the effects of environmental factors and hsa_circ_0008507, hsa_circ_0001946, hsa_circ_0000284 and hsa_circ_0125589 on CHD. RESULTS: The expression profile of circRNAs showed that 3423 circRNAs were differentially expressed at P < 0.05, but none pass multiple testing correction. qRT-PCR further confirmed the expression levels of hsa_circ_0008507, hsa_circ_0001946 and hsa_circ_0000284 in peripheral blood leukocytes in CHD cases were higher than those in non-CHD subjects (All p < 0.05). Hsa_circ_0008507 (OR = 1.29; 95% CI: 1.11-1.50), hsa_circ_0001946 (OR = 1.20; 95% CI: 1.01-1.42) and hsa_circ_0000284 (OR = 2.05; 95% CI: 1.32-3.19) were independent risk factors for CHD after controlling other common environmental risk factors. The AUC for hsa_circ_0008507, hsa_circ_0001946 and hsa_circ_0000284 was 0.75, 0.71 and 0.68, respectively. Compared with non-smoking individuals with low hsa_circ_0008507 expression, the smokers with high hsa_circ_0008507 expression showed the highest magnitude of OR in CHD risk. Additionally, a statistically significant multiplicative interaction was found between hsa_circ_0008507 and smoking for CHD. CONCLUSIONS: Hsa_circ_0008507, hsa_circ_0001946 and hsa_circ_0000284 were closely related to the occurrence and development of CHD. The combination of smoking and high hsa_circ_0008507 expression causes the occurrence and development of CHD.
Asunto(s)
Enfermedad Coronaria/genética , Interacción Gen-Ambiente , ARN Circular/genética , Fumar/efectos adversos , Anciano , Índice de Masa Corporal , Estudios de Casos y Controles , China/epidemiología , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/epidemiología , Femenino , Perfilación de la Expresión Génica , Marcadores Genéticos , Humanos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/epidemiología , Análisis de Secuencia por Matrices de Oligonucleótidos , ARN Circular/sangre , Medición de Riesgo , Factores de Riesgo , Fumar/epidemiologíaRESUMEN
BACKGROUND: The present study sought to explore the relationship of common cardiovascular disease risk factors and noncoding RNAs with essential hypertension (EH). METHODS: A total of 402 EH patients and 402 gender- and age-frequency matched healthy controls were enrolled in this study. Each participant received a questionnaire survey, physical examination and laboratory tests. Quantitative real-time polymerase chain reaction (qPCR) was performed to assess relative expression levels of six noncoding RNAs (NR_027032, NR_034083, NR_104181, miR-126, miR-143 and miR-145) in peripheral blood leucocytes. Multiple logistic regression analysis was used to estimate the risk of having EH between hypertensive and non-hypertensive patients. RESULTS: Analysis showed that participants with anxiety, high body mass index, abdominal obesity and family history of hypertension had higher risk for EH, whereas those with bland diet and occupational physical activities had lower risk for EH. qPCR assays showed that NR_027032 (P = 0.015) and NR_034083 (P = 0.004) were significantly reduced in EH patients compared with controls, whereas NR_104181 (P = 0.007), miR-143 (P = 0.005) and miR-145 (P = 0.015) were significantly elevated. After controlling the cardiovascular risk factors, multivariate analysis showed that lower expression levels of NR_034083 and higher expression levels of NR_104181 and miR-143 were risk factors for EH. CONCLUSIONS: EH is a result of environmental and epigenetic factors. Strikingly, NR_034083, NR_104181 and miR-143 may be correlated with the risk for EH development; therefore, epigenetic markers could be used to measure hypertension levels to help elucidate the pathogenesis of EH.
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Hipertensión Esencial/genética , Leucocitos/química , ARN no Traducido/genética , Adulto , Anciano , Estudios de Casos y Controles , China/epidemiología , Comorbilidad , Epigénesis Genética , Hipertensión Esencial/sangre , Hipertensión Esencial/diagnóstico , Hipertensión Esencial/epidemiología , Femenino , Marcadores Genéticos , Predisposición Genética a la Enfermedad , Humanos , Estilo de Vida , Masculino , MicroARNs/sangre , MicroARNs/genética , Persona de Mediana Edad , Fenotipo , Factores Protectores , ARN no Traducido/sangre , Factores de RiesgoRESUMEN
OBJECTIVE: To understand the main environmental factors of hypertension, and to explore the relationship between hypertension and leukocyte long noncoding RNA. METHODS: A case-control study was conducted in a hospital in Fuzhou City by using stratified random sampling method between Nov. 2014 and Jun. 2015 including 382 essential hypertension patients and 382 control subjects. The related surveys included questionnaire investigation, physical examination and laboratory detection. Real-time PCR method was used to compare the expression of long non-coding RNA( NR_104181 and NR_027032) in the case group with that of in the control group. Multiple factor Logistic regression was used to analyze the association of environmental factors, long noncoding RNA and the risk of hypertension. RESULTS: Multiple factor Logistic regression analysis revealed that the main risk factors of hypertension included: salty diet( OR = 1. 732, 95% CI 1. 204-2. 493), anxiety( OR = 1. 746, 95% CI 1. 326-2. 298), BMI ≥ 24( OR = 1. 475, 95% CI 1. 030-2. 111), abdominal obesity( OR = 1. 836, 95% CI 1. 229-2. 742), family history of hypertension( OR = 3. 004, 95% CI 2. 118-4. 261). The main protective factor of hypertension included: physical activity( OR = 0. 776, 95% CI0. 620-0. 972). Wilcoxon rank sum test indicated that: The expression level of NR_104181 in hypertension was higher than that in control group, the difference was statistically significant( P < 0. 05). The expression level of NR_027032 in hypertension was lower than that in control health group, the difference was statistically significant( P < 0. 05). Multiple factor Logistic regression analysis showed that controlling for salty diet, anxiety, abdominal obesity and physical activity, peripheral blood leukocytes NR_104181 high expression( OR = 2. 658, 95% CI 1. 109-6. 370), NR_ 027032 low expression( OR = 0. 179, 95% CI 0. 057-0. 560) were possibly related to the risk of hypertension. CONCLUSION: Hypertension is the result of environmental factors and genetic factors, and lncRNA may be associated with the risk of hypertension.
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Exposición a Riesgos Ambientales/efectos adversos , Hipertensión/genética , Obesidad Abdominal/epidemiología , ARN Largo no Codificante/genética , Estudios de Casos y Controles , China/epidemiología , Humanos , Obesidad Abdominal/diagnóstico , Obesidad Abdominal/etnología , Reacción en Cadena en Tiempo Real de la Polimerasa , Factores de RiesgoRESUMEN
BACKGROUND: To investigate the effects of a single dose of metformin (MF) on endothelium-dependent vasodilatation and serum antioxidant and free fatty acid levels in patients with primary hypertension (PH) after an acute glucose load. MATERIALS AND METHODS: Patients with untreated PH were randomized to a no-metformin group (PH, n = 34) and a metformin group (PH+ MF, n = 28) who received a single dose of 500 mg metformin before testing. Healthy volunteers (n = 31) served as a control group. Brachial artery endothelium-dependent flow-mediated vasodilatation (FMD) was determined at 0, 1, 2 and 3 h after glucose load. Levels of serum superoxide dismutase (SOD), total antioxidant capacity (T-AOC), anti-superoxide anion free radical (AntiO2) and free fatty acids (FFA) were measured. RESULTS: The FMD in the PH group decreased significantly 1 h after glucose load (PH: 10.9 ± 2.9% vs 13.67 ± 3.42% before glucose load). Metformin inhibited the effects of glucose load on FMD. At 1 h after acute glucose load, the concentrations of SOD, T-AOC and AntiO2 in the PH group decreased significantly compared with their fasting levels, and metformin inhibited the acute glucose load-induced decline in SOD and T-AOC levels. CONCLUSIONS: Metformin can prevent transient endothelial dysfunction caused by acute glucose load in patients with PH.
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Arteria Braquial/efectos de los fármacos , Endotelio Vascular/efectos de los fármacos , Glucosa , Hipertensión/fisiopatología , Hipoglucemiantes/farmacología , Metformina/farmacología , Adulto , Antioxidantes/metabolismo , Arteria Braquial/fisiopatología , Estudios de Casos y Controles , Endotelio Vascular/fisiopatología , Ayuno , Ácidos Grasos no Esterificados/sangre , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Hipertensión/sangre , Masculino , Persona de Mediana Edad , Superóxido Dismutasa/sangre , Vasodilatación/efectos de los fármacosRESUMEN
INTRODUCTION: This study investigated the effects of combined glucose and fat load on glucose and lipid metabolism, as well as on vascular endothelial function, in hypertensive patients. METHODS AND RESULTS: A total of 98 hypertensive patients were randomly divided into 3 groups that received an oral fat tolerance test (OFTT), an oral glucose tolerance test (OGTT) or a combined oral glucose and fat tolerance test (OGFTT). Endothelium-dependent flow-mediated brachial artery dilation (FMD) was measured by vascular ultrasound and was used as an indicator of vascular endothelial function. There were no significant differences in demographics or clinical characteristics among the 3 groups before the study. Immediately after the OGFTT, the serum triglyceride levels and the area under the curve for serum glucose in the OGFTT group were not significantly different from those in the other 2 groups. However, the 1-hour FMD in the OGFTT group was significantly reduced compared with that of the OGTT group (5.45 ± 0.75 versus 9.46 ± 1.32, P < 0.05), and the 4-hour FMD in the OGFTT group was also significantly reduced compared with the OFTT group (8.56 ± 1.09 versus 9.76 ± 2.00, P < 0.05). CONCLUSION: A combined glucose and fat load has a cumulative effect on vascular endothelial dysfunction in hypertensive patients.