Association of Blood Pressure With Stroke Risk, Stratified by Age and Stroke Type, in a Low-Income Population in China: A 27-Year Prospective Cohort Study

Association of stroke risk with new blood pressure criterion 2017 is unknown in China. We assessed the association between blood pressure (BP) values and stroke risk in a low-income population in Tianjin, China. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) values were categorized into five strata and strokes were recorded as stroke, ischemic stroke, and hemorrhagic stroke. Stroke risk was analyzed according to blood pressure stratum using Cox regression analysis. Overall, 4,017 residents (age, ≥18 years) were included in this prospective cohort study. Over a 27-year follow-up period (total, 86,515.78 person-years), 638 participants experienced first-ever strokes. The stroke risk was higher among individuals with SBPs ≥140 mmHg or DBPs ≥90 mmHg than among those with SBPs < 130 mmHg or DBPs < 80 mmHg (reference group), after adjusting for covariates. However, hemorrhagic stroke risk increased only in participants with SBPs ≥160 mmHg. The stroke risk increased for individuals < 65-years-old having BP values ≥130/80 mmHg and for individuals ≥65-years-old with BP values ≥160/90 mmHg. To reduce the stroke burden in China, target BP goals must be established for adults, with different targets for the middle-aged and the elderly segments of the population. These results are very important for guiding clinical practice and may be generalized to other developing countries experiencing rapid economic development and where transitions in the spectrum of prevalent diseases have occurred

Genome wide exploration of the origin and evolution of amino acids

Background: Even after years of exploration, the terrestrial origin of bio-molecules remains unsolved and controversial. Today, observation of amino acid composition in proteins has become an alternative way for a global understanding of the mystery encoded in whole genomes and seeking clues for the origin of amino acids. Results: In this study, we statistically monitored the frequencies of 20 alpha-amino acids in 549 taxa from three kingdoms of life: archaebacteria, eubacteria, and eukaryotes. We found that the amino acids evolved independently in these three kingdoms; but, conserved linkages were observed in two groups of amino acids, (A, G, H, L, P, Q, R, and W) and (F, I, K, N, S, and Y). Moreover, the amino acids encoded by GC-poor codons (F, Y, N, K, I, and M) were found to "lose" their usage in the development from single cell eukaryotic organisms like S. cerevisiae to H. sapiens, while the amino acids encoded by GC-rich codons (P, A, G, and W) were found to gain usage. These findings further support the co-evolution hypothesis of amino acids and genetic codes. Conclusion: We proposed a new chronological order of the appearance of amino acids (L, A, V/E/G, S, I, K, T, R/D, P, N, F, Q, Y, M, H, W, C). Two conserved evolutionary paths of amino acids were also suggested: A -> G -> R -> P and K -> Y.National Natural Science Foundation of China [20572061, 20732004]; Program for New Century Excellent Talents in University (NCET) of MO

Sex Differences in the Prevalence, Awareness, Treatment, and Control of Diabetes Mellitus Among Adults Aged 45 Years and Older in Rural Areas of Northern China: A Cross-Sectional, Population-Based Study

Aims: Diabetes mellitus (DM) has reached epidemic proportions among adults worldwide, with China having the world's largest population of individuals with the disease. Although the consequences of low rates of awareness, treatment, and control of DM are understood, sex-related differences in these rates remain unknown. We assessed sex-related differences in the prevalence, awareness, treatment, and control of DM in a low-income, rural population in China.Materials and Methods: Individuals ≥45 years old without cardiovascular disease were recruited into this study. The prevalence, awareness, treatment, and control of DM in both men and women were assessed after accounting for age, educational level, body mass index, and blood pressure.Results: A total of 3,725 participants (women, 58.8%) were included. A male preponderance in the prevalence of DM was found among individuals aged 45–54 years, whereas there was a female preponderance among patients aged 65–74 years and among those who were illiterate. Among individuals with >6 years of formal education, overweight individuals, and normotensive individuals, there was greater DM awareness among women than among men. There was also a higher DM treatment rate among overweight women than among overweight men. However, better disease control was observed among men than among women for individuals aged 55–64-years, those with 1–6 years of education, and those with stage II hypertension.Conclusions: These results suggest that DM awareness should be improved among men and that regular DM screening should be implemented for men, especially young men. In addition, disease education and management should be strengthened for elderly women, especially those with low levels of education. Further studies are necessary to explore this situation among a representative population sample in China in order to establish a valid protocol against DM

Determinants of Developing Stroke Among Low-Income, Rural Residents: A 27-Year Population-Based, Prospective Cohort Study in Northern China

Although strokes are the leading cause of death and disability in many countries, China still lacks long-term monitoring data on stroke incidence and risk factors. This study explored stroke risk factors in a low-income, rural population in China. The study population was derived from the Tianjin Brain Study, a population-based stroke monitoring study that began in 1985. This study documented the demographic characteristics, past medical histories, and personal lifestyles of the study participants. In addition, physical examinations, including measurements of blood pressure (BP), height, and weight, were performed. Hazard ratios (HRs) were estimated for the risk factors for all subtypes of stroke using multivariate Cox regression analyses. During the study with mean following-up time of 23.16 years, 3906 individuals were recruited at baseline, and during 27 years of follow-up, 638 strokes were documented. The multivariate Cox regression analyses revealed a positive correlation between age and stroke incidence. Limited education was associated with a 1.9-fold increase in stroke risk (lowest vs. highest education level). Stroke risk was higher among former smokers than among current smokers (HR, 1.8 vs. 1.6; both, P < 0.05). Moreover, stroke risk was significantly associated with sex (HR, 1.8), former alcohol drinking (HR, 2.7), baseline hypertension (HR, 3.1), and overweight (HR, 1.3). In conclusion, this study identified uncontrollable (sex and age) and controllable (education, smoking, alcohol drinking, hypertension, and overweight) risk factors for stroke in a low-income, rural population in China. Therefore, it is critical to control BP and weight effectively, advocate cessation of smoking/alcohol drinking, and enhance the education level in this population to prevent increase in the burden of stroke in China

Methane conversion to methanol using Au/ZSM-5 is promoted by carbon

The oxidation of methane using molecular oxygen as the terminal oxidant, over a Au/ZSM-5 catalyst, has been previously shown to produce methanol and acetic acid as products. We now show that this reaction is significantly enhanced by the addition of a range of carbon additives. Isotopic 13C-labeled studies and corresponding investigation into the activity of the carbon materials alone reveal that nearly all the methanol produced is derived from methane oxidation, with a negligible contribution attributed to the carbon additives, while further study identified carbon as the primary source of acetic acid, which was observed as a minor product. Gas phase CO is not observed as a product in the reaction of Au/ZSM-5 with CH4 + O2, and in reactions with added CO, not all the CO is converted. We, therefore, conclude that the effect observed with the carbon additive is not due to the in situ production of gas phase CO as a reaction intermediate. Rather, we postulate that the effect derives from the oxidation of the surface of the carbon in the aqueous reaction mixture and the interaction of the oxidized carbon surface with Au/ZSM-5. The reactivity of carbon in this reaction at 240 °C is unexpected, and the presence of water is required to observe the effect

Malnutrition Defined by Geriatric Nutritional Risk Index Predicts Outcomes in Severe Stroke Patients: A Propensity Score-Matched Analysis

Background: Malnutrition’s prognostic impact in patients with severe stroke requiring ICU admission is not well known. This study aimed to assess the nutritional status of severe stroke patients using the geriatric nutritional risk index (GNRI) and examine the association of GNRI with mortality in that population. Methods: We identified 1145 severe stroke patients requiring ICU admission from the Medical Information Mart for Intensive Care (MIMIC-III) database and divided them into low GNRI (≤98) or high GNRI (>98) groups. We used a propensity score matching (PSM) method to reduce confounding. Cox proportional hazards regression and restricted cubic splines were used to elucidate the association between GNRI and mortality. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Results: A total of 397 (35%) patients were in the low GNRI group (at risk of malnutrition). After PSM, patients in the low GNRI group still suffered higher mortality compared with the high GNRI group at 28 days (27.9 vs. 20.8%), 90 days (35.5 vs. 25.7%), and 1 year (43.4 vs. 30.9%) (p < 0.05). A low GNRI was significantly associated with an increased mortality (HR: 1.38, 95% CI 1.03–1.86 in 28 days; HR: 1.45, 95% CI 1.11–1.89 in 90 days; HR: 1.51, 95% CI 1.19–1.92 in 1 year). Sensitivity analyses yielded consistent results. Restricted cubic splines showed a progressively decreasing risk of mortality with increasing GNRI scores up to 110, approximately. Conclusion: Severe stroke patients with malnutrition experienced an increased risk of death compared to those without malnutrition. GNRI, as a simple and practical nutritional screening tool, can be used as a routine approach to the nutritional status of stroke patients

Prevalence of and Risk Factors for Cognitive Impairment Among Elderly Without Cardio- and Cerebrovascular Diseases: A Population-Based Study in Rural China

This study aimed to evaluate the prevalence of cognitive impairment and the distribution of its risk factors among residents aged ≥60 years without cardiovascular and cerebrovascular diseases in rural areas of northern China screened with the Chinese version of the Mini-Mental State Examination (MMSE). Between 2012 and 2013, a questionnaire survey was conducted to collect basic information from participants. Cognitive function was assessed using the MMSE. In the univariate analysis, risk factors for cognitive disorders were female sex, low education and central obesity, while drinking was found to be a protective factor. In the multivariate analysis, risk factors were old age (odds ratio [OR], 1.888; 95% confidence interval [CI]: 1.256–2.838; P = 0.002 for the 70-year-old group compared with the 60-year-old group; OR, 3.593; 95% CI, 2.468–5.230; P < 0.001 for the ≥75-year-old group compared with the 60-year-old group), low education (OR, 3.779; 95% CI: 2.218–6.440; P < 0.001 for the illiterate group compared with the group with ≥9 years of education; OR, 1.667; 95% CI, 1.001–2.775; P = 0.05 for the group with less than primary school compared with the group with ≥9 years of education), and higher blood pressure (BP; OR, 1.655; 95% CI: 1.076–2.544; P = 0.002 for individuals with stage III hypertension compared with those with normal BP). These findings suggest that it is crucial to manage and control level of BP, and improve educational attainment in order to reduce the prevalence and burden of cognitive impairment among low-income residents in rural China

Associations between Serum Vitamin A and Metabolic Risk Factors among Eastern Chinese Children and Adolescents

Vitamin A, a fat-soluble essential vitamin, is implicated in a large range of physiological processes. Up to now, the associations between vitamin A and metabolic syndrome (MetS) or other metabolic risk factors are controversial in children and adolescents. Thus, we aimed to dig into the relationship of vitamin A with MetS and many other metabolic risk factors. This was a cross-sectional study derived from the China National Nutrition and Health Surveillance of Children and Lactating Mothers. A total of 3025 school-aged (7–17 years) children and adolescents were selected by applying multistage stratified cluster random sampling methods in the Jiangsu Province of eastern China. Through enquiry survey, anthropometric measurement and laboratory examination, relevant information and blood biochemical indexes of the participants were collected in this study. MetS was identified according to the modified criteria of the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III). Multivariate logistic analysis and the generalized additive model (GAM) were used to analyze the relationship between vitamin A and various metabolic risk factors. The overweight, obesity and MetS prevalence of children and adolescents in this study was 14.0%, 11.9% and 5.1%, respectively. The risk of prevalent MetS, general obesity, high low-density lipoprotein (LDL), high total cholesterol (TC) and hyperuricemia increased with vitamin A in a dose-dependent way. Logistic regression analysis showed that serum vitamin A Z scores were positively associated with MetS and central obesity, elevated blood pressure (BP) and elevated triglyceride (TG). Sex stratification analysis showed that both in male and female participants, the risk of prevalent MetS, general obesity, high LDL, high TC and hyperuricemia still increased with vitamin A levels. MetS was at a high prevalence level in children and adolescents in Jiangsu that were 7–17 years old. Vitamin A was positively associated with obesity, MetS, dyslipidemia and hyperuricemia. More public health measures and new visions should focus on the effects of retinol on children and adolescents

Multilevel Analysis of the Nutritional and Health Status among Children and Adolescents in Eastern China

We aimed to identify multiple nutritional health problems and the relevant factors among children and adolescents aged 7–17 years. This study was part of the China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016–2017, conducted in Jiangsu Province in eastern China. After sampling, 3025 school-age children and adolescents were enrolled into this study. Demographic information collections and anthropometric measurements were conducted by trained local Center for Disease Control and Prevention (CDC) staff. Venous blood in the amount of 6 mL was drawn from each participant in the morning and used for testing biochemical and nutritional indicators. Multivariate logistic regression analysis and Poisson regression analysis were used for overnutrition- and undernutrition-related disorders to test relevant personal, parental, and household factors. The prevalence of wasting, overweight, and obesity was 5.5%, 14.8%, and 12.7%, respectively. Metabolic syndrome (MetS) was prevalent among 5.1% of participants. Among the study participants, 29.5% had hyperuricemia. The overall prevalence of high low-density lipoprotein (LDL) and high total cholesterol (TC) of all participants was 4.8% and 7.4%, respectively. 0.9% of the participants had vitamin A deficiency (VAD) and 14.6% had marginal vitamin A deficiency; 25.1% had vitamin D deficiency (VDD) and 54.5% had inadequate vitamin D levels. Anemia was present in 4.0% of all participants. The prevalence of zinc deficiency was 4.8%. Demographic characteristics, behavioral characteristics, parents’ characteristics, and family characteristics were associated with these multiple malnutrition disorders. The double burdens of malnutrition, which includes overnutrition- and undernutrition-related diseases, were prevalent among the school-age children and adolescents in Jiangsu Province in eastern China. There were various factors related to different nutritional problems. Thus, health education focusing on behavior intervention and nutrition education are necessary in containing nutritional problems among children