Multi-micronutrient supplementation during pregnancy for prevention of maternal anaemia and adverse birth outcomes in a high-altitude area: a prospective cohort study in rural Tibet of China.

Anaemia during pregnancy, characterised by Hb <110 g/l, is a specific risk factor for adverse maternal and perinatal outcomes in developing countries. The objective of this study was to determine the effectiveness of daily antenatal supplementation with multiple micronutrients (MMN) compared with folic acid (FA) on the occurrence of anaemia among pregnant women and their infants' health in a high-altitude area. A prospective cohort study was carried out in two rural counties in Tibet from 2007 to 2012. A total of 1149 eligible pregnant women were allocated daily supplementation with FA in one county and MMN containing a recommended allowance of twenty-three vitamins and minerals in another county starting ≤24 weeks of gestation and continuing until delivery. Compared with the FA group, prenatal supplementation with MMN was significantly associated with reduced odds of anaemia in the third trimester. This was demonstrated in the primary outcome, with an adjusted OR (AOR) of 0·63; 95 % CI 0·45, 0·88 and P=0·007 and also reduced odds of preterm delivery (AOR: 0·31; 95 % CI 0·15, 0·61; P=0·001). There was no difference between MMN and FA groups in mean birth weight (adjusted mean difference: 36·78; 95 % CI -19·42, 92·98 g; P=0·200), whereas MMN supplementation significantly reduced the odds of low-birth weight (LBW) babies (AOR: 0·58; 95 % CI 0·36, 0·91; P=0·019). In conclusion, the antenatal MMN supplementation in rural Tibet is associated with a reduction of maternal anaemia in the third trimester, and may potentially decrease the risk of preterm delivery and LBW babies

Polymorphisms of genes in neurotransmitter systems were associated with alcohol use disorders in a Tibetan population.

Studies of linkage and association in various ethnic populations have revealed many predisposing genes of multiple neurotransmitter systems for alcohol use disorders (AUD). However, evidence often is contradictory regarding the contribution of most candidate genes to the susceptibility of AUD. We, therefore, performed a case-control study to investigate the possible associations of genes selected from multiple neurotransmitter systems with AUD in a homogeneous Tibetan community population in China. AUD cases (N = 281) with an alcohol use disorder identification test (AUDIT) score ≥10, as well as healthy controls (N = 277) with an AUDIT score ≤5, were recruited. All participants were genotyped for 366 single nucleotide polymorphisms (SNPs) of 34 genes selected from those involved in neurotransmitter systems. Association analyses were performed using PLINK version 1.07 software. Allelic analyses before adjustment for multiple tests showed that 15 polymorphisms within seven genes were associated with AUD (p<0.05). After adjustment for the number of SNPs genotyped within each gene, only the association of a single marker (rs10044881) in HTR4 remained statistically significant. Haplotype analysis for two SNPs in HTR4 (rs17777298 and rs10044881) showed that the haplotype AG was significantly associated with the protective effect for AUD. In conclusion, the present study discovered that the HTR4 gene may play a marked role in the pathogenesis of AUD. In addition, this Tibetan population sample marginally replicated previous evidence regarding the associations of six genes in AUD

Lipid Profile and Its Association with Risk Factors for Coronary Heart Disease in the Highlanders of Lhasa, Tibet

Sherpa, Lhamo Y., Deji, Hein Stigum, Virasakdi Chongsuvivatwong, Ouzhu Luobu, Dag S. Thelle, Per Nafstad, and Espen Bjertness. Lipid profile and its association with risk factors for coronary heart disease in highlanders of Lhasa, Tibet. High Alt. Med. Biol. 12:57–63, 2011.—The aim of this study was to determine the prevalence of abnormal lipid levels and its association with selected coronary heart disease (CHD) risk factors in the Tibetan population living at 3660 meters above sea level in Lhasa, Tibet. Three hundred seventy one randomly selected male and female, aged 30 to 70 yr took part in the study. Based on the National Cholesterol Education Programme (NCED) adult treatment panel ATP-III 2004 criteria, the age-adjusted prevalence of hypertriglyceridemia was 12.0%; high triglycerides (TG), 33.4%; high low-density lipoprotein cholesterol (LDL-C), 4.8%; and low high-density lipoprotein cholesterol (HDL-C); 24.3%. After adjusting for age, sex, smoking, alcohol, physical activity, diet, hemoglobin (Hb) concentration, and systolic and diastolic blood pressure (BP), an increase in waist-to-hip ratio (WHR) by 0.1 unit was associated with a statistically significant increase in TG, total cholesterol (TC) and LDL-C by 0.25 mmol/L, 0.24 mmol/L, and 0.18 mmol/L, respectively. Female gender increased HDL-C by 0.18 mmol/L when compared with males. Age-adjusted prevalences of Framingham CHD risk score for males and females were 16.3% and 0.6%, respectively. This study demonstrated a high prevalence of hypertriglyceridemia in males, a higher prevalence of low HDL-C in females, and a high hypercholesterolemia prevalence in both genders. However, further longitudinal studies assessing CHD risk factors in high altitude natives are required

Estimated haplotype frequencies in the case-control subjects.

<p>Note: <i>p</i>, unadjusted <i>p</i> values,* <i>p</i><0.05;</p><p><i>p′</i>, adjusted <i>p</i> values, ** <i>p′</i><0.05.</p

Allelic frequencies of the markers with unadjusted <i>P</i><0.05.

<p>Note: Chr, Chromosome; A, Allele; OR, odds ratio;</p><p><i>p</i>, unadjusted <i>p</i> values,* <i>p</i><0.05;</p><p><i>p′</i>, adjusted <i>p</i> values, ** <i>p′</i><0.05.</p

Selection of candidate genes and SNPs.

<p>Selection of candidate genes and SNPs.</p