Publications by authors named "Jian Hou"

456 Publications

Associations of solid fuel use and ambient air pollution with estimated 10-year atherosclerotic cardiovascular disease risk.

Environ Int 2021 Sep 9;157:106865. Epub 2021 Sep 9.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address:

Background: Although exposure to ambient air pollution (AAP) increases the risk for arteriosclerotic cardiovascular disease (ASCVD), evidence on the association of solid fuel use with ASCVD and its association modified by ambient air pollution remains limited.

Methods: A total of 16,779 adults were derived from the Henan Rural Cohort Study. Concentrations of ambient air pollutants (PM, PM, PM, and NO) were estimated by a spatiotemporal model based on satellites data. Solid fuel use was assessed by a self-reported questionnaire. The associations of solid fuel use with high 10-year ASCVD risk and the modified association by exposure to air pollutants were explored using logistic regression models.

Results: There were positive associations of AAP exposure with high 10-year ASCVD risk among individuals with self-cooking. The joint associations between high AAP exposures and solid fuel use with high 10-year ASCVD risk were found. Compared to clean fuel user with low PM exposure, the odds ratios (ORs) and 95% confidence intervals (CIs) of high 10-year ASCVD risk was 1.25 (1.09, 1.42) for solid fuel user with low PM exposure, 1.93 (1.75, 2.12) for clean fuel user with high PM exposure, and 3.08 (2.67, 3.54) for solid fuel user with high PM exposure, respectively. Their additive effect on high 10-year ASCVD risk was observed (relative excess risk due to interaction (RERI): 0.90 (95 %CI: 0.50, 1.30), attributable proportion due to interaction (AP): 0.29 (95 %CI: 0.19, 0.40), and synergy index (SI): 1.77 (95 %CI: 1.38, 2.26)).

Conclusion: This study showed a synergistic effect of AAP and household air pollution reflected by solid fuel use on high 10-year ASCVD risk, suggesting that reducing solid cooking fuels and controlling air pollution may have a joint effect on public health improvement.
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http://dx.doi.org/10.1016/j.envint.2021.106865DOI Listing
September 2021

Identifying the predictive effectiveness of a genetic risk score for incident hypertension using machine learning methods among populations in rural China.

Hypertens Res 2021 Sep 3. Epub 2021 Sep 3.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.

Current studies have shown the controversial effect of genetic risk scores (GRSs) in hypertension prediction. Machine learning methods are used extensively in the medical field but rarely in the mining of genetic information. This study aims to determine whether genetic information can improve the prediction of incident hypertension using machine learning approaches in a prospective study. The study recruited 4592 subjects without hypertension at baseline from a cohort study conducted in rural China. A polygenic risk score (PGGRS) was calculated using 13 SNPs. According to a ratio of 7:3, subjects were randomly allocated to the train and test datasets. Models with and without the PGGRS were established using the train dataset with Cox regression, artificial neural network (ANN), random forest (RF), and gradient boosting machine (GBM) methods. The discrimination and reclassification of models were estimated using the test dataset. The PGGRS showed a significant association with the risk of incident hypertension (HR (95% CI), 1.046 (1.004, 1.090), P = 0.031) irrespective of baseline blood pressure. Models that did not include the PGGRS achieved AUCs (95% CI) of 0.785 (0.763, 0.807), 0.790 (0.768, 0.811), 0.838 (0.817, 0.857), and 0.854 (0.835, 0.873) for the Cox, ANN, RF, and GBM methods, respectively. The addition of the PGGRS led to the improvement of the AUC by 0.001, 0.008, 0.023, and 0.017; IDI by 1.39%, 2.86%, 4.73%, and 4.68%; and NRI by 25.05%, 13.01%, 44.87%, and 22.94%, respectively. Incident hypertension risk was better predicted by the traditional+PGGRS model, especially when machine learning approaches were used, suggesting that genetic information may have the potential to identify new hypertension cases using machine learning methods in resource-limited areas. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375 .
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http://dx.doi.org/10.1038/s41440-021-00738-7DOI Listing
September 2021

Association of Post-operative Systolic Blood Pressure Variability With Mortality After Coronary Artery Bypass Grafting.

Front Cardiovasc Med 2021 12;8:717073. Epub 2021 Aug 12.

Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

Blood pressure variability (BPV) has long been considered a risk factor for cardiovascular events. We aimed to investigate whether post-operative systolic BPV was associated with early and late all-cause mortality in patients undergoing coronary artery bypass grafting (CABG). Clinical variables and blood pressure records within the first 24 h in the post-operative intensive care unit stay from 4,509 patients operated on between 2001 and 2012 were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. BPV was measured as the coefficient of the variability of systolic blood pressure, and we compared patients in the highest quartile with patients in the other three quartiles. After full adjustment, patients in the highest quartile of BPV were at a higher risk of intensive care unit mortality (OR = 2.02, 95% CI: 1.11-3.69), 30-day mortality (OR = 1.92, 95% CI: 1.22-3.02), and 90-day mortality (HR = 1.64, 95% CI: 1.19-2.27). For 2,892 patients with a 4-year follow-up, the association between a higher post-operative BPV and the risk of 4-year mortality was not significant (HR = 1.17, 95% CI: 0.96-1.42). The results were supported by the comparison of survival curves and remained generally consistent in the subgroup analyses and sensitivity analyses. Our findings demonstrated that in patients undergoing CABG, a higher post-operative BPV was associated with a higher risk of early mortality while the association was not significant for late mortality. Post-operative BPV can support doctors in identifying patients with potential hemodynamic instability and making timely clinical decisions.
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http://dx.doi.org/10.3389/fcvm.2021.717073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387866PMC
August 2021

Does robotic-assisted unicompartmental knee arthroplasty have lower complication and revision rates than the conventional procedure? A systematic review and meta-analysis.

BMJ Open 2021 08 11;11(8):e044778. Epub 2021 Aug 11.

Department of Orthopedic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Jinan, People's Republic of China

Objective: We conducted this systematic review and meta-analysis of studies on patients who underwent unicompartmental knee arthroplasty (UKA) to compare the complication rates, revision rates and non-implant-specific complications between robotic-assisted and conventional UKA.

Design: Systematic review and meta-analysis.

Data Sources: The PubMed, Embase, Web of Science and Cochrane databases were searched up to 30 June 2020.

Eligibility Criteria: Case-control studies comparing robotic-assisted and conventional UKA.

Data Extraction And Synthesis: Data from all eligible articles were independently extracted by two authors. We analysed the differences in outcomes between robotic-assisted and conventional UKA by calculating the corresponding 95% CIs and pooled relative risks (RRs). Heterogeneity was assessed using the χ and I tests. All analyses were performed using the 'metafor' package of R V.3.6.2 software.

Results: A total of 16 studies involving 50 024 patients were included in the final meta-analysis. We found that robotic-assisted UKA had fewer complications (RR: 0.52, 95% CI: 0.28 to 0.96, p=0.036) and lower revision rates (RR: 0.42, 95% CI: 0.20 to 0.86, p=0.017) than conventional UKA. We observed no significant differences in non-implant-specific complications between the two surgical techniques (RR: 0.80, 95% CI: 0.61 to 1.04, p=0.96). No publication bias was found in this meta-analysis.

Conclusions: This study provides evidence that robotic-assisted UKA has fewer complications and lower revision rates than conventional UKA; however, owing to important limitations, the results lack reliability, and more studies are required.

Prospero Registration Number: CRD42021246927.
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http://dx.doi.org/10.1136/bmjopen-2020-044778DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359483PMC
August 2021

Residential greenness attenuated associations of long-term exposure to air pollution with biomarkers of advanced fibrosis.

Environ Sci Pollut Res Int 2021 Aug 3. Epub 2021 Aug 3.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People's Republic of China.

Long-term exposure to air pollutants and residential greenness related to advanced fibrosis have been sparsely studied in low- and middle-income countries. A total of 29883 participants were selected from a cross-sectional survey of the Henan Rural Cohort. Concentrations of air pollutants (particulate matter with an aerodynamic diameter ≤ 1.0 μm (PM), ≤ 2.5 μm (PM), ≤ 10 μm (PM) and nitrogen dioxide (NO)) for participants were predicted by using a spatiotemporal model. Residential greenness of each participant was indicated by Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI). Independent and joint associations of air pollutants and residential greenness indices with prevalent advanced fibrosis reflected by fibrosis-4 score (FIB4), aspartate-to-platelet-ratio index (APRI) and ALT/AST ratio were analyzed by generalized linear mixed models and their interactive effect on prevalent advanced fibrosis were visualized by using the interplot method. Long-term exposure to PM, PM, PM and NO were positively related to FIB4 or APRI as well as prevalent intermediate-high advanced fibrosis; EVI was negatively related to FIB4 or APRI as well as prevalent intermediate-high advanced fibrosis. Negative associations of residential greenness indices (EVI or NDVI) with prevalent advanced fibrosis were decreased as increased air pollutants (PM, PM, PM or NO) (P < 0.05 for all). This study indicated that residential greenness may partially attenuate negative effect of long-term exposure to air pollutants related to increased prevalent intermediate-high advanced fibrosis, implying that residential greenness may be an effective strategy to reduce the burden of prevalent hepatic fibrosis and its related disease in association with exposure high levels of air pollutants. The Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699, http://www.chictr.org.cn/showproj.aspx?proj=11375 ).
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http://dx.doi.org/10.1007/s11356-021-15676-7DOI Listing
August 2021

Pharmacodynamic, pharmacokinetic, and phase 1a study of bisthianostat, a novel histone deacetylase inhibitor, for the treatment of relapsed or refractory multiple myeloma.

Acta Pharmacol Sin 2021 Aug 2. Epub 2021 Aug 2.

Department of Hematology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.

HDAC inhibitors (HDACis) have been intensively studied for their roles and potential as drug targets in T-cell lymphomas and other hematologic malignancies. Bisthianostat is a novel bisthiazole-based pan-HDACi evolved from natural HDACi largazole. Here, we report the preclinical study of bisthianostat alone and in combination with bortezomib in the treatment of multiple myeloma (MM), as well as preliminary first-in-human findings from an ongoing phase 1a study. Bisthianostat dose dependently induced acetylation of tubulin and H3 and increased PARP cleavage and apoptosis in RPMI-8226 cells. In RPMI-8226 and MM.1S cell xenograft mouse models, oral administration of bisthianostat (50, 75, 100 mg·kg·d, bid) for 18 days dose dependently inhibited tumor growth. Furthermore, bisthianostat in combination with bortezomib displayed synergistic antitumor effect against RPMI-8226 and MM.1S cell in vitro and in vivo. Preclinical pharmacokinetic study showed bisthianostat was quickly absorbed with moderate oral bioavailability (F% = 16.9%-35.5%). Bisthianostat tended to distribute in blood with V value of 0.31 L/kg. This distribution parameter might be beneficial to treat hematologic neoplasms such as MM with few side effects. In an ongoing phase 1a study, bisthianostat treatment was well tolerated and no grade 3/4 nonhematological adverse events (AEs) had occurred together with good pharmacokinetics profiles in eight patients with relapsed or refractory MM (R/R MM). The overall single-agent efficacy was modest, stable disease (SD) was identified in four (50%) patients at the end of first dosing cycle (day 28). These preliminary in-patient results suggest that bisthianostat is a promising HDACi drug with a comparable safety window in R/R MM, supporting for its further phase 1b clinical trial in combination with traditional MM therapies.
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http://dx.doi.org/10.1038/s41401-021-00728-yDOI Listing
August 2021

Polycyclic aromatic hydrocarbons induce endothelial injury through miR-155 to promote atherosclerosis.

Environ Mol Mutagen 2021 Aug 11;62(7):409-421. Epub 2021 Aug 11.

State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China.

Polycyclic aromatic hydrocarbons (PAHs) are considered as an external factor that induces atherosclerotic cardiovascular disease. Although miR-155 is known to be involved in cardiovascular disease, whether it is involved in PAH-induced arteriosclerosis remains unclear. We evaluated the effects of PAHs on vascularization, permeability, and miR-155 expression in HUVECs. We found that PAHs-induced sclerosis of HUVECs was characterized by increasing permeability, decreasing proliferation, and vascular lumen number. The expression of miR-155 was upregulated by PAHs treatment, and transfection with miR-155 inhibitor could reverse above effect of PAHs-induced sclerosis. Meanwhile, transcriptome sequencing revealed that 63 genes were downregulated in the group of PAHs treatment alone, and were then upregulated in the miR-155 inhibitor group. These genes were mainly involved in complement and coagulation cascades, cytokine-cytokine receptor interaction, TNF signaling pathway, and NF-kappa B signaling pathway. Among these 63 genes, SERPIND1 was directly targeted and regulated by miR-155. Further in vivo experiments in ApoE mice confirmed that PAH accelerates the development of arteriosclerosis by promoting the expression of miR-155 to downregulate the SERPIND1. Therefore, PAH exaggerates atherosclerosis by activating miR-155-dependent endothelial injury. This study provides a fundamental insight on the miR-155 mechanism for PAHs enhancing atherosclerosis and miR-155 potentially serving as a novel drug target.
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http://dx.doi.org/10.1002/em.22454DOI Listing
August 2021

Heritability Estimation and Environmental Risk Assessment for Type 2 Diabetes Mellitus in a Rural Region in Henan, China: Family-Based and Case-Control Studies.

Front Public Health 2021 8;9:690889. Epub 2021 Jul 8.

Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China.

The prevalence of type 2 diabetes mellitus (T2DM) varies greatly in different regions and populations. This study aims to assess the heritability and environmental risk factors of T2DM among rural Chinese adults. Thousand five hundred thirty three participants from 499 extended families, which included 24 nuclear families, were recruited in the family-based study to assess the heritable risk of T2DM. Heritability of T2DM was estimated by the Falconer method. Using conditional logistic regression model, couple case-control study involving 127 couples were applied to assess the environmental risk factors of T2DM. Compared with the Henan Rural Cohort, T2DM was significantly clustered in the nuclear families (OR: 8.389, 95% CI: 5.537-12.711, < 0.001) and heritability was 0.74. No association between the heredity of T2DM and sex was observed between the extended families and the Henan Rural Cohort. Besides, results from the couple case-control study showed that physical activity (OR: 0.482, 95% CI: 0.261-0.893, = 0.020) and fat intake (OR: 3.036, 95% CI: 1.070-8.610, = 0.037) was associated with T2DM, and the proportion of offspring engaged in medium and high physical activity was higher than that of mothers in mother-offspring pairs. People with a family history of T2DM may have a higher risk of developing T2DM, however, there was no difference in genetic risk between males and females. Adherence to active physical activity and low fat intake can reduce the risk of T2DM.
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http://dx.doi.org/10.3389/fpubh.2021.690889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295650PMC
August 2021

Association of eating out frequency and other factors with serum uric acid levels and hyperuricemia in Chinese population.

Eur J Nutr 2021 Jul 23. Epub 2021 Jul 23.

Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.

Purpose: A significant shift in meal pattern with frequent eating out was closely associated with multiple chronic outcomes, but with limited evidence on hyperuricemia. We aimed to explore the associations between eating out and serum uric acid (SUA) as well as hyperuricemia.

Methods: A total of 29,597 participants were recruited from the Henan Rural Cohort Study. A validated food frequency questionnaire (FFQ) was used to collect dietary data, including the frequency of eating out. Linear regression models were used to examine the association of eating-out frequency with SUA and BMI. Logistic regression and restricted cubic spline were performed to assess the association and dose-response relationship between eating-out frequency and hyperuricemia. The mediation effect of BMI between eating out and the risk of hyperuricemia was evaluated.

Results: Eating out was significantly associated with higher SUA levels in the total population and males (P < 0.001). Multivariate-adjusted odds ratios (ORs) with 95% confidence interval (CIs) of hyperuricemia were 1.26 (1.09, 1.46) for the total population and 1.18 (1.00, 1.40) for males (≥ 7 times/week vs 0 time/week). A non-linear positive dose-response relationship between eating-out frequency and hyperuricemia was observed. Furthermore, BMI played a partial mediating role in the relationship between eating out frequency and hyperuricemia, which explained 30.7% in the total population and 44.8% in males.

Conclusion: Our findings indicated that eating out was associated with increased SUA levels and elevated hyperuricemia risk in rural China, especially in males. Moreover, the relationship was partly mediated by BMI.

Clinical Trials: ChiCTR-OOC-15006699 (2015-07-06).
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http://dx.doi.org/10.1007/s00394-021-02634-9DOI Listing
July 2021

Mesenchymal Stem Cell-Derived Exosomes Induced by IL-1β Attenuate Urethral Stricture Through Let-7c/PAK1/NF-κB-Regulated Macrophage M2 Polarization.

J Inflamm Res 2021 13;14:3217-3229. Epub 2021 Jul 13.

Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China.

Background: Urethral stricture is a clinical challenge for both patients and clinicians. Post-traumatic urethral stricture is associated with formation of scar tissue caused by excessive inflammation. The aim of this study is exploring potential therapeutic strategies for this condition.

Methods: In vivo experiments on New Zealand rabbits and in vitro experiments on THP-1 monocytes and urethral fibroblasts were performed to investigate the effects on post-traumatic urethral stricture of exosomes isolated from IL-1β-treated mesenchymal stem cells (Exo-MSCs) and the role of macrophage M2 polarization in this process. Additionally, related signaling and mechanism behind were explored.

Results: In a New Zealand rabbit model of post-traumatic urethral stricture, injection of Exo-MSCs significantly reduced urethral stricture and collagen fiber accumulation compared with Exo-MSCs. Addition of Exo-MSCs to THP-1 monocytes in vitro induced M2 macrophage polarization, which, in turn, inhibited activation of urethral fibroblasts and synthesis of collagen. Mechanistically, Exo-MSCs were found to contain high levels of the microRNA let-7c, and luciferase reporter assays showed that let-7c interacted with the 3'UTR of PAK1 mRNA. Transfection of THP-1 cells with a let-7c mimic downregulated PAK1 expression and inhibited activation of the NF-κB signaling pathway.

Conclusion: These results support a role for let-7c-containing Exo-MSCs in reducing urethral stricture via inhibition of PAK1-NF-κB signaling, M2 macrophage polarization, and differentiation of urethral myofibroblasts.
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http://dx.doi.org/10.2147/JIR.S308405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8286124PMC
July 2021

Imported human norovirus in travelers, Shanghai port, China 2018: An epidemiological and whole genome sequencing study.

Travel Med Infect Dis 2021 Sep-Oct;43:102140. Epub 2021 Jul 13.

Shanghai International Travel Healthcare Center, Shanghai Customs District PR China, Shanghai, 200335, China. Electronic address:

Background: Global mobility of the population has accelerated spread of the Human Norovirus (HuNoV), with long-distance travel in enclosed spaces increasing the opportunity for viral outbreaks. However, surveillance of HuNoV transmission is still lacking, especially in cross-border transportation.

Method: From 533 self-reported patients, 83 swab samples (15.6%) tested positive for HuNoV by RT-qPCR. Positive samples were sequenced using next-generation sequencing (NGS). Epidemiological investigation and whole genome analysis were then conducted.

Results: Most cases occurred in February and March, with large outbreaks involving more than 34 people. A total of 74 HuNoV sequences that could be genotyped were obtained, with near-complete genomes (>7 kb) accounting for most sequences (57/74). A total of 19 different genotypes of viral whole genome sequences were included. The first whole genome sequence of GII.9[P7] was obtained. Rarely reported genotypes including GI.3[P10], GI.3[P13], GII.7[P7], GII.8[P8], and GIX.1[GII.P15] were sequenced and assembled successfully. Four possible sources of virus outbreaks in China were traced. Beyond HuNoV, whole genome sequences of food-borne viruses including Salivirus, Kobuvirus, and Enterovirus were obtained in further assembly.

Conclusions: Surveillance of the etiology and epidemiology of HuNoV global spread through travelers will improve pre-travel health advice, empirical treatment, and estimates of vaccine-preventable diseases.
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http://dx.doi.org/10.1016/j.tmaid.2021.102140DOI Listing
July 2021

Manipulation of surface charges of oil droplets and carbonate rocks to improve oil recovery.

Sci Rep 2021 Jul 15;11(1):14518. Epub 2021 Jul 15.

EXPEC Advanced Research Center, Saudi Aramco, Saudi Arabia.

This work investigates the effect of the surface charges of oil droplets and carbonate rocks in brine and in surfactant solutions on oil production. The influences of the cations in brine and the surfactant types on the zeta-potentials of both oil droplets and carbonate rock particles are studied. It is found that the addition of anionic and cationic surfactants in brine result in both negative or positive zeta-potentials of rock particles and oil droplets respectively, while the zwitterionic surfactant induces a positive charge on rock particles and a negative charge on oil droplets. Micromodels with a CaCO nanocrystal layer coated on the flow channels were used in the oil displacement tests. The results show that when the oil-water interfacial tension (IFT) was at 10 mN/m, the injection of an anionic surfactant (SDS-R1) solution achieved 21.0% incremental oil recovery, higher than the 12.6% increment by the injection of a zwitterionic surfactant (SB-A2) solution. When the IFT was lowered to 10 mM/m, the injection of anionic/non-ionic surfactant SMAN-l1 solution with higher absolute zeta potential value (ζ+ ζ) of 34 mV has achieved higher incremental oil recovery (39.4%) than the application of an anionic/cationic surfactant SMAC-l1 solution with a lower absolute zeta-potential value of 22 mV (30.6%). This indicates that the same charge of rocks and oil droplets improves the transportation of charged oil/water emulsion in the porous media. This work reveals that the surface charge in surfactant flooding plays an important role in addition to the oil/water interfacial tension reduction and the rock wettability alteration.
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http://dx.doi.org/10.1038/s41598-021-93920-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282872PMC
July 2021

Interaction between testosterone and obesity on hypertension: A population-based cross-sectional study.

Atherosclerosis 2021 08 24;330:14-21. Epub 2021 Jun 24.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address:

Background And Aims: We aimed to evaluate the effects of serum testosterone, obesity and their interaction on blood pressure (BP) parameters and hypertension among Chinese rural adults.

Methods: A total of 6199 adults were recruited from the Henan Rural Cohort Study. Serum testosterone was measured by liquid chromatography-tandem mass spectrometry. Logistic regression and linear regression were used to evaluate the association between testosterone, hypertension and BP parameters (including systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP)). A generalized linear model was performed to identify the interactive effects of testosterone and obesity on hypertension.

Results: High levels of serum testosterone were associated with a lower prevalence of hypertension in males (odds ratio (OR): 0.69, 95% confidence interval (CI): 0.53, 0.89). After stratification by obesity, observed associations were only found in non-obese males. Each one-unit increase in ln-testosterone was associated with a 1.23 mmHg decrease in SBP, 0.97 mmHg decrease in DBP, and 1.05 mmHg decrease in MAP among males. Moreover, interactive effects between testosterone and obesity on hypertension and BP parameters were found, indicating that protective effects of serum testosterone on hypertension and BP parameters were counteracted and accompanied by increased values of obesity-related indicators in males, and additional testosterone increased BP parameters and prevalence of hypertension at high levels of waist-to-hip ratio and waist-to-height ratio in females.

Conclusions: Elevated levels of serum testosterone were associated with decreased BP parameters and prevalent hypertension in males, and obesity modifying effects of serum testosterone on BP parameters and hypertension.
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http://dx.doi.org/10.1016/j.atherosclerosis.2021.06.906DOI Listing
August 2021

Residential greenness and atherosclerotic cardiovascular disease risk in a rural Chinese adult population.

Ecotoxicol Environ Saf 2021 Oct 30;222:112458. Epub 2021 Jun 30.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address:

Residential greenness may be beneficial for cardiovascular health, but the evidence is still scarce, especially in developing countries. This study aimed to assess the associations between exposure to residential greenness and 10-year atherosclerotic cardiovascular disease (ASCVD) risk in a large rural Chinese adult population. This was a cross-sectional study based on 31,162 participants aged 35-74 years with complete data on predictors of the 10-year ASCVD risk from the Henan Rural Cohort Study. The satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were used to quantify residential greenness in a buffer radius of 500 m, 1000 m, and 3000 m. The high 10-years ASCVD risk was defined as the estimated risk ≥10% based on prediction equations from the China-PAR Project for Chinese populations. Multivariable-adjusted logistic regression models were performed to estimate the associations of greenness exposures with high 10-year ASCVD risk, and mediation analyses were employed to the potential mediators. For per interquartile range (IQR) increase in NDVI, NDVI, NDVI, EVI, EVI, and EVI, the adjusted OR (95% CI) of high 10-years ASCVD risk was 0.828 (0.793-0.866), 0.850 (0.817-0.885), 0.823 (0.792-0.855), 0.848 (0.809-0.889), 0.863 (0.826-0.901), 0.843 (0.805-0.883), respectively. Strong associations of NDVI and EVI with high 10-years ASCVD risk were found among participants with lower education level and lower averaged monthly income. The associations of greenness exposures with high 10-year ASCVD risk were partially explained by particulate matter with an aerodynamic diameter ≤1 µm, BMI, and physical activity. Enhancing residential greenness exposure may be beneficial for reducing the high 10-year ASCVD risk in rural Chinese adults.
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http://dx.doi.org/10.1016/j.ecoenv.2021.112458DOI Listing
October 2021

Associations of mixture of air pollutants with estimated 10-year atherosclerotic cardiovascular disease risk modified by socio-economic status: The Henan Rural Cohort Study.

Sci Total Environ 2021 Nov 18;793:148542. Epub 2021 Jun 18.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address:

Background: Low socio-economic status (SES) and exposure to single-air pollutant relate to increased prevalent atherosclerotic cardiovascular diseases (ASCVD), however, interactive effect between SES and exposure to single- or multiple-air pollutants on high 10-year ASCVD risk remains unclear.

Methods: A total of 31,162 individuals were derived from the Henan Rural Cohort Study. Concentrations of air pollutants (particulate matter with an aerodynamic diameter ≤ 1.0 μm (PM), ≤2.5 μm (PM) or ≤10 μm (PM), nitrogen dioxide (NO)) were assessed using a spatiotemporal model based on satellites data. Independent and joint associations of SES, single- and multiple- air pollutants with high 10-year ASCVD risk were evaluated using logistic regression models, quantile g-computation and structural equation models. The interactive effects of SES and exposure to single- or multiple air pollutants on high 10-year ASCVD risk were visualized by using Interaction plots.

Results: Exposure to single air pollutant (PM, PM, PM or NO) related to increased high 10-year ASCVD risk among individuals with low education level or personal average monthly income, compared to the ones with high education level or personal average monthly income. Furthermore, similar results of exposure to mixture of air pollutants with high 10-year ASCVD risk were observed. Positive interactive effects between low SES and exposure to high single air pollutant or the mixture of air pollutants on high 10-year ASCVD risk were observed.

Conclusion: Positive association of low SES with high 10-year ASCVD risk was amplified by exposure to high levels of single air pollutant or a mixture of air pollutants, implying that individuals with low SES may more susceptible to air pollution-related adverse health effect.
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http://dx.doi.org/10.1016/j.scitotenv.2021.148542DOI Listing
November 2021

Long-term exposure to particulate matter and residential greenness in relation to androgen and progesterone levels among rural Chinese adults.

Environ Int 2021 08 4;153:106483. Epub 2021 May 4.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address:

Background: Population-based studies on the associations of long-term exposure to particulate matter (PM) with androgen and progesterone are still scant. Residential greenness is benefits health by promoting physical activity, reducing air pollution, and improving mental health, but it remains unclear whether it is related to androgen and progesterone levels among humans.

Aims: This study aimed to explore the individual and interactive effects of PM and residential greenness on serum testosterone and progesterone levels among rural Chinese adults.

Methods: A total of 6017 subjects were recruited from the baseline of the Henan Rural Cohort Study in 2016. Serum testosterone and progesterone were measured with liquid chromatography-tandem mass spectrometry. Particulate matters (PM) (PM, PM, and PM) were assessed by machine learning algorithms. Residential greenness was assessed using the normalized difference vegetation index (NDVI) within 500-m, 1000-m, and 3000-m buffers around participants' residences. The effects of air pollutants and residential greenness and their interaction on serum testosterone and progesterone levels were assessed using linear mixed-effects models with township as a random intercept.

Results: After adjusting for potential confounding factors, a 1 μg/m increase in PM or PM was associated with a 0.037 or 0.030 ng/ml increase in serum testosterone, respectively, in females and with a 0.111 or 0.182 ng/ml decrease in serum progesterone, respectively, in males. A 1 μg/m increase in PM, PM or PM was associated with a 0.222, 0.306, or 0.295 ng/ml decrease in serum progesterone, respectively, among females. Moreover, a 0.1-unit increase in NDVI was associated with a 0.310 ng/ml increase in serum testosterone and a 0.170 ng/ml increased in serum progesterone in males, as well as with a 0.143 ng/ml increase in serum progesterone in females. Interaction effects of PM and residential greenness on serum testosterone and progesterone levels were observed, indicating that the effects of residential greenness on serum testosterone and progesterone were modified by high levels of PM. In addition, physical activity significantly mediated 2.92% of the estimated association between greenness and testosterone levels.

Conclusions: Our study suggested that long-term exposure to PM was positively associated with serum testosterone in males but negatively associated with progesterone levels in both genderssin. In addition, positive associations of residential greenness with serum testosterone and progesterone levels were observed, but they were modified by high levels of PM. Furthermore, the estimated effects of residential greenness on testosterone levels were partly mediated by physical activity.
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http://dx.doi.org/10.1016/j.envint.2021.106483DOI Listing
August 2021

Neutrophil gelatinase-associated lipocalin: a potential predictor of embolic events in endocarditis.

Ann Thorac Surg 2021 May 4. Epub 2021 May 4.

Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China. Electronic address:

Background: As the complication of infective endocarditis (IE), embolic events (EE) are associated with increased mortality and morbidity. However, there are no reliable indicators to predict embolism. The aim of this study was to evaluate neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker to identify IE patients at high risk of embolism.

Methods: We conducted a prospective observational study of IE patients from January 2018 to December 2020. Plasma NGAL levels were measured in 88 IE patients (37 patients with EE and 51 patients without EE), 91 noninfectious heart valve disease (HVD) patients, and 20 healthy blood donors by ELISA. Native valve tissue was obtained from 16 IE patients and 16 HVD patients. Western blot and immunohistochemical staining were performed to detect NGAL and matrix metalloproteinas-9 (MMP-9).

Results: Higher levels of NGAL were observed in IE patients than HVD patients (P<0.001) or healthy blood donors (P<0.01). In addition, NGAL levels were higher in IE patients with EE compared to those without EE (P<0.001). Receiver operating characteristic analysis demonstrated that NGAL acted as a potential EE predictor with the cutoff value of 166.78 ng/ml. IE patients with higher NGAL levels were significantly related to more severe native valve morphologic changes. NGAL was co-localized with MMP-9, and their expression in the valves of IE patients was higher than those of HVD patients.

Conclusions: NGAL is a potential predictor of EE in IE. This may be attributed to its potency of increasing the proteolytic activity of MMP-9, which leads to valve morphologic impairment.
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http://dx.doi.org/10.1016/j.athoracsur.2021.04.060DOI Listing
May 2021

Melatonin ameliorates myocardial injury by reducing apoptosis and autophagy of cardiomyocytes in a rat cardiopulmonary bypass model.

PeerJ 2021 15;9:e11264. Epub 2021 Apr 15.

Department of Cardiac Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

Background: Myocardial injury is a frequent complication after cardiac surgery with cardiopulmonary bypass (CPB). This study aimed to test the hypothesis that melatonin could attenuate myocardial injury in a rat CPB model.

Methods: Eighteen male Sprague-Dawley rats were randomly divided into three groups,  = 6 for each group: the sham operation (SO) group, CPB group and melatonin group. Rats in the SO group underwent cannulation without CPB, rats in CPB group intraperitoneal injected an equal volume of vehicle daily for 7 days before being subjected to CPB and rats in melatonin group intraperitoneal injected 20 mg/kg of melatonin solution daily for 7 days before being subjected to CPB. After 120 min for CPB, the expression levels of plasma interleukin (IL) -6, IL-1β, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), creatine kinase (CK) -MB and cardiac troponin T (cTnT) were measured. Reactive oxygen species (ROS) were detected by dihydroethidium (DHE). Apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) staining. Mitochondrial damage and autophagosomes were detected by electron microscopy. Apoptosis inducing factor (AIF) was detected by immunofluorescence. The expression of B cell lymphoma/leukemia2 associated X (Bax), B cell lymphoma/leukemia 2 (Bcl-2), cytochrome C (Cyto-C), cleaved caspase-9, AKT, p-AKT, signal transducer and activator of transcription 3 (STAT3), p-STAT3, LC3, P62, mechanistic target of rapamycin kinase (mTOR), p-mTOR and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were determined using western blotting.

Results: Melatonin significantly decreased the levels of IL-1β, IL-6, MDA, CK-MB and cTnT and increased the levels of SOD and GSH-Px, all of which were altered by CPB. Melatonin reduced cardiomyocyte superoxide production, the apoptosis index and autophagy in cardiomyocytes induced by CPB. The AKT, STAT3 and mTOR signaling pathways were activated by melatonin during CPB.

Conclusion: Melatonin may serve as a cardioprotective factor in CPB by inhibiting oxidative damage, apoptosis and autophagy. The AKT, STAT3 and mTOR signaling pathways were involved in this process.
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http://dx.doi.org/10.7717/peerj.11264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053380PMC
April 2021

Association of , a Gene Involved in Strigolactone Signaling, with Yield Contributing Traits in Wheat.

Int J Mol Sci 2021 Apr 3;22(7). Epub 2021 Apr 3.

Key Laboratory of Crop Gene Resources and Germplasm Enhancement, Institute of Crop Science, Chinese Academy of Agricultural Sciences, Beijing 100081, China.

Tillering is a crucial agronomic trait of wheat; it determines yield and plant architecture. Strigolactones (SLs) have been reported to inhibit plant branching. D14, a receptor of SLs, has been described to affect tillering in rice, yet it has seldomly been studied in wheat. In this study, three homoeologous genes, , , and , were identified. , , and were constitutively expressed, and had a higher expression level in most tissues. TaD14 proteins were localized in both cytoplasm and nucleus. An SNP and a 22 bp insertion/deletion (Indel) at the exon regions of were detected, forming three haplotypes, namely , , and . Due to the frameshift mutation in the coding region of , the interaction of 4D-HapII with TaMAX2 and TaD53 was blocked, which led to the blocking of SL signal transduction. Based on the two variation sites, two molecular markers, namely and , were developed. Association analysis suggested that haplotypes of were associated with effective tillering number (ETN) and thousand kernel weight (TKW) simultaneously in four environments. The favorable haplotype underwent positive selection in global wheat breeding. This study provides insights into understanding the function of natural variations of and develops two useful molecular markers for wheat breeding.
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http://dx.doi.org/10.3390/ijms22073748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038469PMC
April 2021

Identifying windows of susceptibility to essential elements for semen quality among 1428 healthy men screened as potential sperm donors.

Environ Int 2021 10 25;155:106586. Epub 2021 Apr 25.

Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Rd, Wuhan 430030, Hubei Province, China. Electronic address:

Background: Essential elements such as iron (Fe), cobalt (Co), copper (Cu), zinc (Zn), selenium (Se), rubidium (Rb), strontium (Sr), and molybdenum (Mo) are necessary for reproductive health. However, their associations with human semen quality remain inconclusive.

Objectives: To investigate the associations of urinary Fe, Co, Cu, Zn, Se, Rb, Sr, and Mo concentrations with semen quality in healthy men screened as potential sperm donors and identify critical windows of susceptibility.

Methods: 1428 healthy men provided 3766 urine and 6527 semen samples, which were measured for urinary essential element concentrations and sperm quality parameters, respectively. Linear mixed models and cubic spline curves were used to evaluate associations between urinary essential elements and semen quality. Multiple informant models were used to identify potential critical windows of susceptibility.

Results: Linear mixed models and cubic spline curves showed positive dose-response relationships between urinary Zn and sperm concentration and total count and between urinary Mo and total sperm count [all False Discovery Rate (FDR) adjusted p-value for trend < 0.05]. In the multiple-element linear mixed models, the men in the highest versus lowest quartiles of urinary Zn and Mo had a higher sperm concentration of 17.5% (95% CI: 2.8%, 34.2%; p-value for trend = 0.006) and total sperm count of 18.3% (95% CI: 1.4%, 38.0%; p-value for trend = 0.027), respectively. Urinary Zn was also positively associated with total sperm count in a dose-dependent manner (p-value for trend = 0.036), though the percentile difference in total sperm count between men in the highest and lowest quartile was not statistically significant (16.4%, 95% CI: -1.7%, 37.9%). These associations appeared to be stronger when urinary Zn and Mo were measured at 0-9 days before the date of semen examination (i.e., corresponding to epididymal storage).

Conclusions: Higher urinary Zn and Mo, particularly during the period of epididymal storage, were associated with greater sperm production.
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http://dx.doi.org/10.1016/j.envint.2021.106586DOI Listing
October 2021

A Gel Polymer Electrolyte Reinforced Membrane for Lithium-Ion Batteries via the Simultaneous-Irradiation of the Electron Beam.

Membranes (Basel) 2021 Mar 19;11(3). Epub 2021 Mar 19.

Department of Energy Engineering, Dankook University, Cheonan 31116, Korea.

In this research, a series of innovative and stable cross-linked gel polymer reinforced membranes (GPRMs), were successfully prepared and investigated for application in lithium-ion batteries. Herein, a gel directly within the commercial polyethylene (PE) separator is supported via electron-beam simultaneous irradiation cross-linking of commercial liquid electrolyte and poly(ethylene glycol) methacrylate (PEGMA) oligomers. The physical and electrochemical properties of the GPRMs were characterized by SEM, TEM, mechanical durability, heating shrinkage, and ion conductivity, etc. The GPRMs demonstrated excellent mechanical durability and high ion conductivity compared with traditional PE membranes. Moreover, coin-typed cells were assembled and cycle performance was also studied compared with same-typed cells with commercial PE membrane and liquid electrolyte. As a result, the coin-typed cells using GPRMs also showed a relatively good efficiency on the 50th cycles at a high 1.0 C-rate. These GPRMs with excellent properties present a very promising material for utilization in high-performance lithium-ion batteries with improved safety and reliability.
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http://dx.doi.org/10.3390/membranes11030219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003521PMC
March 2021

Systemic immune-inflammation index and incident cardiovascular diseases among middle-aged and elderly Chinese adults: The Dongfeng-Tongji cohort study.

Atherosclerosis 2021 04 20;323:20-29. Epub 2021 Feb 20.

Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. Electronic address:

Background And Aims: Systemic immune-inflammation index (SII) has been recently investigated as a novel inflammatory and prognostic marker. SII may be used as an indicator reflecting the progressive inflammatory process in atherosclerosis, although its link to incident cardiovascular disease (CVD) has not been examined in previous studies. This study aims to prospectively assess the association of SII with incident CVD and its main subtypes in Chinese adults.

Methods: Using data from the Dongfeng-Tongji cohort study, 13,929 middle-aged and older adults with a mean age of 62.56 years (range 35-91 years), who were free of CVD and cancer, were included for analysis. The baseline study was conducted in Shiyan city, Hubei province from 2008 to 2009. The SII was calculated as platelet count (/L) × neutrophil count (/L)/lymphocyte count (/L). Cox regression models were used to examine the associations of SII with incident CVD, including stroke and coronary heart disease (CHD).

Results: Over a median 8.28 years (maximum 8.98 years) of follow-up, 3386 total CVD cases, including 801 stroke cases and 2585 total CHD cases, were identified. In multivariable Cox regression analyses, higher levels of log-transformed SII were significantly associated with total stroke (HR 1.224, 95% CI 1.065-1.407) and ischemic stroke (HR 1.234, 95% CI 1.055-1.442). For those participants with the highest quartiles of SII versus the lowest quartiles of SII, the HRs were 1.358 (95% CI 1.112-1.658) for total stroke, 1.302 (95% CI 1.041-1.629) for ischemic stroke, and 1.600 (95% CI 1.029-2.490) for hemorrhagic stroke.

Conclusions: SII may serve as a useful marker to elucidate the role of the interaction of thrombocytosis, inflammation, and immunity in the development of cerebrovascular diseases in the middle-aged and elderly population.
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http://dx.doi.org/10.1016/j.atherosclerosis.2021.02.012DOI Listing
April 2021

Screening and identification of a novel FHL2 mutation by whole exome sequencing in twins with familial Waldenström macroglobulinemia.

Cancer 2021 Jun 25;127(12):2039-2048. Epub 2021 Mar 25.

Department of Hematology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Background: Waldenström macroglobulinemia (WM) is a rare chronic B-cell lymphoma. Familial clustering of WM has been observed over the years. However, little is known about the contribution of inherited genetic variants to familial WM cases.

Methods: The authors performed whole exome sequencing (WES) of germline DNA samples from twins, one diagnosed with WM and the other diagnosed with immunoglobulin M monoclonal gammopathy of undetermined significance, and their healthy siblings. Bioinformatics analysis of public biological databases was used to identify the most relevant familial WM candidate from WES. Transcript expression and protein levels of the familial WM candidate were evaluated in the WM patient and 2 unaffected members of the kindred.

Results: Among the 10 shared candidate mutations in the twins, the authors identified a novel heterozygous germline mutation in four and a half LIM domains protein 2 (FHL2; c.G226A, p.V76M) as a familial WM-associated mutation. FHL2 appeared to be connected with reported signaling pathways and disease-driving genes such as IL6 and HCK in WM. In addition, the authors found reduced FHL2 messenger RNA and protein expression in peripheral blood samples from the patient with WM in comparison with the healthy siblings.

Conclusions: Taken together, these findings indicate that an FHL2 mutation may play an important role in familial WM, and they provide new screening possibilities for familial cases.

Lay Summary: Familial clustering in Waldenström macroglobulinemia (WM) has been observed over the years. The authors performed whole exome sequencing of germline DNA samples from twins, one diagnosed with WM and the other diagnosed with immunoglobulin M monoclonal gammopathy of undetermined significance, and their healthy siblings. Among the 10 shared candidate mutations in the twins, a novel heterozygous germline mutation in four and a half LIM domains protein 2 (FHL2; c.G226A, p.V76M) was identified as the most relevant familial WM candidate through bioinformatics analysis of a public database. Also, messenger RNA and protein expression of FHL2 was significantly lower in peripheral blood mononuclear cells of the WM patient in comparison with the healthy siblings, and this suggested that the function of FHL2 was impaired when mutated.
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http://dx.doi.org/10.1002/cncr.33454DOI Listing
June 2021

Long-term exposure to air pollutants enhanced associations of obesity with blood pressure and hypertension.

Clin Nutr 2021 04 4;40(4):1442-1450. Epub 2021 Mar 4.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address:

Although obesity reflected by BMI can enhance the association of air pollution with increase blood pressures (BP) and prevalent hypertension in susceptible population, there remains lack evidence on interactive effects of different obesity indices and air pollutants on BP and prevalent hypertension in rural adults. 39,259 individuals were recruited from the Henan Rural Cohort. Concentrations of air pollutants (PM, PM, PM and NO) were evaluated by a spatio-temporal model based on satellites data. Independent associations of air pollutants and obesity reflected by BMI, WC, WHR, WHtR, BFP and VFI on BP indicators (SBP, DBP, MAP and PP) and prevalent hypertension were analyzed by linear regression and logistic regression models, respectively. Furthermore, their additive effects were quantified by RERI, AP and S. Six obesity indices enhanced the associations of four air pollutants and BP indicators. Individuals with high PM concentrations plus obesity classified by BMI, WC, WHR, WHtR, BFP and VFI had a 4.18-fold (95% CI: 3.86, 4.53), 3.58-fold (95% CI: 3.34, 3.84), 3.53-fold (95% CI: 3.28, 3.81), 4.02-fold (95% CI: 3.72, 4.35), 3.89-fold (95% CI: 3.59, 4.23), 3.87-fold (95% CI: 3.62, 4.14) increase in prevalent hypertension, respectively, compared to non-obese individuals with low PM concentrations; similar results were observed for combined effect of PM, PM or NO and obesity indices on prevalent hypertension. The significant values of RERI, AP and S indicated additive effects of air pollutants and obesity indices on hypertension. Obesity amplified the effects of exposure to high levels of air pollutants on increased BP values and prevalent hypertension, implying that obese individuals may be susceptible to elevate BP and prevalent hypertension in relation to air pollution exposure. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699, http://www.chictr.org.cn/showproj.aspx?proj=11375).
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http://dx.doi.org/10.1016/j.clnu.2021.02.029DOI Listing
April 2021

Long-term exposure to PM and PM is associated with serum cortisone level and meat intake plays a moderation role.

Ecotoxicol Environ Saf 2021 Jun 16;215:112133. Epub 2021 Mar 16.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address:

Background: Although short-term exposure to particulate matter (PM) was associated with increased glucocorticoids (GCs) levels, available evidence on associations of long-term exposure to PM and GCs levels is still scant. Previous studies has showed that meat intake is associated with sex hormones levels, but it is unknown whether meat intake is associated with GCs levels. Furthermore, the role of meat intake in the associations between PM and GCs levels remains unclear.

Aims: The aims of this study were to explore the associations of long-term exposure to PM and GCs levels among Chinese rural adults, and the role of meat intake in these associations.

Materials And Methods: A total of 6223 subjects were recruited from the Henan Rural Cohort Study. Serum GCs levels were measured with liquid chromatography-tandem mass spectrometry. The concentrations of PM (PM and PM) for each subject were assessed with machine learning algorithms. The food frequency questionnaire (FFQ) was used to obtain each participant' information on meat intake. The effects of PM and meat intake on GCs levels were assessed using generalized linear models. In addition, modification analyses were performed to identify the role of meat intake played in the associations of PM with serum GCs levels.

Results: Per 1 μg/m increment in PM or PM concentration was associated with a 0.364 ng/ml (95% confidence interval (CI): 0.234, 0.494) or 0.227 ng/ml (95%CI: 0.110, 0.343) increase in serum cortisone, respectively. In addition, the moderation effects of total meat intake and red meat intake on the associations of long-term exposure to PM or PM with serum cortisone were observed (P < 0.05), indicating that individuals who had high levels of PM or PM and meat intake were more susceptible to have a higher state of serum cortisone.

Conclusions: Our findings suggested that long-term exposure to PM or PM was associated with serum cortisone. Moreover, meat intake was found to be a significant moderator in the association of PM or PM with serum cortisone levels.
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http://dx.doi.org/10.1016/j.ecoenv.2021.112133DOI Listing
June 2021

Preoperative Lymphocyte-to-Monocyte Ratio as a Prognostic Predictor of Long-Term Mortality in Cardiac Surgery Patients: A Propensity Score Matching Analysis.

Front Cardiovasc Med 2021 22;8:639890. Epub 2021 Feb 22.

Department of Cardiac Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

To evaluate the prognostic value of the preoperative lymphocyte-to-monocyte ratio (LMR) in patients who underwent cardiac surgery. Clinical data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. The optimal cutoff value of LMR was determined by X-tile software. The Cox proportional hazard model was applied for the identification of independent prognostic factors of 4-year mortality and survival curves were estimated using the Kaplan-Meier method. In order to balance the influence of potential confounding factors, a 1:1 propensity score matching (PSM) method was performed. A total of 1,701 patients were included. The X-tile software indicated that the optimal cutoff value of the LMR for 4-year mortality was 3.58. After PSM, 489 pairs of score-matched patients were generated. The Cox proportional hazard model showed that patients with an LMR < 3.58 had a significantly higher 4-year mortality than patients with an LMR ≥ 3.58 in the entire cohort (HR = 1.925, 95%CI: 1.509-2.456, < 0.001) and the PSM subset (HR = 1.568, 95%CI: 1.2-2.05, = 0.001). The survival curves showed that patients with an LMR < 3.58 had a significant lower 4-year survival rate in the entire cohort (71.7 vs. 88.5%, < 0.001) and the PSM subset (73.2 vs. 81.4%, = 0.002). A lower LMR (<3.58) was associated with a higher risk of 4-year mortality and can serve as a prognostic predictor of the long-term mortality in cardiac surgery patients.
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http://dx.doi.org/10.3389/fcvm.2021.639890DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937643PMC
February 2021

Genetic Risk Score Increased Discriminant Efficiency of Predictive Models for Type 2 Diabetes Mellitus Using Machine Learning: Cohort Study.

Front Public Health 2021 17;9:606711. Epub 2021 Feb 17.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.

Previous studies have constructed prediction models for type 2 diabetes mellitus (T2DM), but machine learning was rarely used and few focused on genetic prediction. This study aimed to establish an effective T2DM prediction tool and to further explore the potential of genetic risk scores (GRS) via various classifiers among rural adults. In this prospective study, the GRS for a total of 5,712 participants from the Henan Rural Cohort Study was calculated. Cox proportional hazards (CPH) regression was used to analyze the associations between GRS and T2DM. CPH, artificial neural network (ANN), random forest (RF), and gradient boosting machine (GBM) were used to establish prediction models, respectively. The area under the receiver operating characteristic curve (AUC) and net reclassification index (NRI) were used to assess the discrimination ability of the models. The decision curve was plotted to determine the clinical-utility for prediction models. Compared with the individuals in the lowest quintile of the GRS, the HR (95% CI) was 2.06 (1.40 to 3.03) for those with the highest quintile of GRS ( < 0.05). Based on conventional predictors, the AUCs of the prediction model were 0.815, 0.816, 0.843, and 0.851 via CPH, ANN, RF, and GBM, respectively. Changes with the integration of GRS for CPH, ANN, RF, and GBM were 0.001, 0.002, 0.018, and 0.033, respectively. The reclassifications were significantly improved for all classifiers when adding GRS (NRI: 41.2% for CPH; 41.0% for ANN; 46.4% for ANN; 45.1% for GBM). Decision curve analysis indicated the clinical benefits of model combined GRS. The prediction model combined with GRS may provide incremental predictions of performance beyond conventional factors for T2DM, which demonstrated the potential clinical use of genetic markers to screen vulnerable populations. The Henan Rural Cohort Study is registered in the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375.
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http://dx.doi.org/10.3389/fpubh.2021.606711DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925839PMC
May 2021

Treatment of relapsed and refractory multiple myeloma: recommendations from the International Myeloma Working Group.

Lancet Oncol 2021 03;22(3):e105-e118

Rigshospitalet, Copenhagen University, Copenhagen, Denmark.

This Policy Review presents the International Myeloma Working Group's clinical practice recommendations for the treatment of relapsed and refractory multiple myeloma. Based on the results of phase 2 and phase 3 trials, these recommendations are proposed for the treatment of patients with relapsed and refractory disease who have received one previous line of therapy, and for patients with relapsed and refractory multiple myeloma who have received two or more previous lines of therapy. These recommendations integrate the issue of drug access in both low-income and middle-income countries and in high-income countries to help guide real-world practice and thus improve patient outcomes.
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http://dx.doi.org/10.1016/S1470-2045(20)30756-7DOI Listing
March 2021

Health-related quality of life and its related factors in coronary heart disease patients: results from the Henan Rural Cohort study.

Sci Rep 2021 Mar 3;11(1):5011. Epub 2021 Mar 3.

School of Nursing and Health, Zhengzhou University, No. 100 Kexue Road, Zhengzhou, 450001, People's Republic of China.

The aims were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific scores in patients with coronary heart disease (CHD). A total of 1247 patients with CHD from the Henan Rural Cohort Study (n = 39,259) were included in this study. The Chinese version of the European Quality of Life Five Dimension Five level scale (EQ-5D-5L) and Visual Analogue Scale (VAS) were used to evaluate HRQoL in patients with CHD. Tobit regression, generalized linear models and binary logistic regression were applied to determine the potential factors influencing the EQ-5D utility, as well as each domain, and the VAS. CHD patients had lower per capita monthly actual income, and higher rates of diabetes mellitus, stroke, anxiety and poor sleep quality, which significantly decreased EQ-5D index and VAS scores. In addition, sex, older age, education, not having a spouse, ever drinking alcohol, a high-fat diet, physical activity, hypertension and depression affected the various domain-specific EQ-5D scores in CHD patients. CHD patients in rural areas have a lower HRQoL. Factors associated with the EQ-5D index, including each domain, and the VAS need attention. CHD patients in rural areas need to be managed systematically.
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http://dx.doi.org/10.1038/s41598-021-84554-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930256PMC
March 2021

Independent and combined associations of solid-fuel use and smoking with obesity among rural Chinese adults.

Environ Sci Pollut Res Int 2021 Mar 1. Epub 2021 Mar 1.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.

Although solid-fuel use or smoking is associated with obesity measured by body mass index (BMI), research on their interactive effects on general and central obesity is limited. Data of 20,140 individuals in the Henan Rural Cohort Study was examined the independent and combined associations of solid-fuel use and smoking with prevalent obesity, which was measured by BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), and visceral fat index (VFI). Multiple adjusted logistic regression models showed that the OR (95% CI) of prevalent obesity measured by BMI associated with exposure to solid fuels alone or with smoking was 0.78 (0.70, 0.86) or 0.46 (0.32, 0.66), compared with neither smoking nor solid-fuel exposure. Similar results had been found in other obese anthropometric indices and in the results of linear regression analysis. The results indicated that solid-fuel use and smoking have a synergistic effect on reduction in obesity indices. The effects of household air pollution from solid-fuel use and smoking on obesity should be considered when exploring the influencing factors of obesity.
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http://dx.doi.org/10.1007/s11356-021-13081-8DOI Listing
March 2021
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