The Optimal Ethnic-Specific Waist-Circumference Cut-Off Points of Metabolic Syndrome among Low-Income Rural Uyghur Adults in Far Western China and Implications in Preventive Public Health

Background: Metabolic syndrome is pandemic; however, the cut-off values for waist circumference (WC) vary widely depending on the ethnic groups studied and the criteria applied for WC measurement. Previous studies for defining optimal WC cut-off points included high-income and urban settings, and did not cover low-income, rural settings, especially for ethnic minorities. This study aimed at defining optimal ethnic-specific WC cut-off points in a low-income, rural population comprising the largest inhabitant minority group residing in far Western China. Methods: Questionnaire-based surveys, physical examinations, and blood testing of 3542 individuals were conducted in 2010, using a stratified cluster random sampling method in rural Uyghur residents (≥18 years old) from 12 villages in Xinjiang, China, approximately 4407 km away from the capital city, Beijing. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Optimal, ethnic-specific WC cut-off values for diagnosing metabolic syndrome were determined using receiver operator characteristic (ROC) curve analysis. Results: As WC increased, there was a significant, increasing trend of detection and risk in rural Uyghur adults, regardless of the presence of ≥1 or ≥2 components of metabolic syndrome by IDF criteria. The optimal ethnic-specific WC cut-off point to predict the presence of metabolic syndrome was 85 cm for men and 82 cm for women. With these cut-off points, the prevalence rates of metabolic syndrome among men, women, and overall population in Uyghur adults were 19.5%, 23.0%, and 21.3%, respectively. Conclusions: We report a high prevalence of metabolic syndrome, especially in women, among rural Uyghurs in Western China. A WC cut-off of 85 cm in men and 82 cm in women was the best predictor of metabolic syndrome in this population. Because of the cost-effectiveness in measuring WC, we recommend that these WC cut-off points be integrated into local preventive policies for public health as the primary screening criteria for metabolic syndrome and related diseases among low-income, rural minorities

An Evaluation on the Effect of Health Education and of Low-Dose Statin in Dyslipidemia among Low-Income Rural Uyghur Adults in Far Western China: A Comprehensive Intervention Study

Objective: To evaluate the effect of comprehensive intervention by health education and medical intervention to dyslipidemia Uyghur patients in low-income rural areas in Xinjiang, China. Method: A multistaged (prefecture-county-township-village) stratified cluster random sampling method was used to select participants in southern Xinjiang. Twelve villages in Jiangbazi Township in Jiashi County were chosen. These villages were randomly divided into six intervention groups and six control groups, and local Uyghur aged 18 years or older residing in the village for at least 6 months were interviewed for a baseline prevalence study and to select participants for two years of comprehensive intervention including low dose simvastatin and the effects of the interventions were observed. Results: A total of 655 participants (347 participants in the intervention groups, 308 participants in the control groups) were randomly selected from 12 villages in Jiangbazi Township, follow-up rate is 87.0%. Compared to baseline mean levels of TG and LDL-C were reduced by 1.39 mmol/L (p < 0.01) and 2.12 mmol/L (p < 0.01) respectively and levels of HDL-C increased by1.22 mmol/L (p < 0.01) in the intervention group. Lipids were controlled in 38.61% of the intervention groups vs. 3.57% of the control groups (p < 0.01). Compared with baseline lipid levels, TG, TC, LDL-C and HDL-C was significantly improved, compared with it was in control groups. Conclusions: Blood lipid levels of Uygur patients with dyslipidemia can be effectively improved through health education combined with low-dose statin administration. This suggests that national strategies in public health be developed to improve the treatments to low-income rural minorities with dyslipidemia

Nomogram Based on Cytokines for Cardiovascular Diseases in Xinjiang Kazakhs

Background. This study involved the development of a predictive 5-year morbidity nomogram for cardiovascular diseases (CVD) in Xinjiang Kazakhs based on cytokine levels. Methods. The nomogram was based on a baseline survey of the town of Nalati in the Kazakh Autonomous Prefecture of Xinjiang from 2009 to 2013. By 2016, we had monitored 1508 people for a median time of 5.17 years and identified CVD events in the study population by collecting case information from local hospitals. The study population was divided into the training (n=1005) and validation cohorts (n=503) in a 2 : 1 ratio. The area under the receiver operating characteristic curve (AUC) was used to verify the predictive accuracy of the nomogram. The result was assessed in a validation cohort. Results. At the end of the study, the incidence of CVD in Xinjiang Kazakhs was found to be 11.28%. We developed a new nomogram to predict the 5-year incidence of CVD based on age, interleukin-6 (IL-6), and adiponectin (APN) levels, diastolic blood pressure, and dyslipidemia. The AUC for the predictive accuracy of the nomogram was 0.836 (95% confidence interval: 0.802–0.869), which was higher than that for IL-6 and APN. These results were supported by validation studies. Conclusions. The nomogram model can more directly assess the risk of CVD in Kazakhs and can be used for CVD risk assessment

Interactions of six SNPs in APOA1 gene and types of obesity on low HDL-C disease in Xinjiang pastoral area of China

Abstract Background This study aims to investigate association between six single nucleotide polymorphisms(SNPs) in APOA1 gene and types of obesity with the risk of low level HDL-C in the pastoral area of northwest China. Methods A total of 1267 individuals including 424 patients with low HDL-C disease and 843 health subjects were analyzed based on matched for age, sex. SNPShot technique was used to detect the genotypes of rs670, rs5069, rs5072, rs7116797, rs2070665 and rs1799837 in APOA1 gene. The relationship between above six SNPs and types of obesity with low HDL-C disease was analyzed by binary logistic regression. Results Carriers with rs670 G allele were more likely to get low HDL-C disease (OR = 1.46, OR95%CI: 1.118–1.915; P = 0.005); The genotypic and allelic frequencies of rs5069, rs5072, rs7116797, rs2070665, rs1799837 revealed no significant differences between cases and controls (P < 0.05); with reference to normal weight, Waist circumference (WC), Waist-to-hip ratio (WHR) individuals, respectively, general obesity measured by BMI had 2.686 times (OR95%CI: 1.695–4.256; P < 0.01), abdominal obesity measured by WC had 1.925 times (OR95%CI: 1.273–2.910; P = 0.002) and abdominal obesity measured by WHR had 1.640 times (OR95%CI: 1.114–2.416; P = 0.012) risk to get low HDL-C disease; APOA1 rs670 interacted with obesity (no matter general obesity or abdominal obesity) on low HDL-C disease. Conclusions APOA1 gene may be associated with low HDL-C disease in the pastoral area of northwest China; obesity was the risk factor for low HDL-C disease; the low HDL-C disease is influenced by APOA1, obesity, and their interactions

Risk of coronary heart disease in the rural population in Xinjiang: A nested case-control study in China.

BACKGROUND AND AIM:Coronary heart disease (CHD) is a chronic complex disease caused by a combination of factors such as lifestyle behaviors and environmental and genetic factors. We conducted this study to evaluate the risk factors affecting the development of CHD in Xinjiang, and to obtain valuable information for formulating appropriate local public health policies. METHOD:We conducted a nested case-control study with 277 confirmed CHD cases and 554 matched controls. The association of the risk factors with the risk of CHD was assessed using the multivariate Cox proportional hazard model. Multiplicative interactions were evaluated by entering interaction terms in the Cox proportional hazard model. The additive interactions among the risk factors were assessed by the index of additive interaction. RESULTS:The risk of CHD increased with frequent high-fat food consumption, dyslipidemia, obesity, and family history of CHD after adjustment for drinking, smoking status, hypertension, diabetes, family history of hypertension, and family history of diabetes. We noted consistent interactions between family history of CHD and frequent high-fat food consumption, family history of CHD and obesity, frequent high-fat food consumption and obesity, frequent high-fat food consumption and dyslipidemia, and obesity and dyslipidemia. The risk of CHD events increased with the presence of the aforementioned interactions. CONCLUSIONS:Frequent high-fat food consumption, family history of CHD, dyslipidemia and obesity were independent risk factors for CHD, and their interactions are important for public health interventions in patients with CHD in Xinjiang

Association between Six CETP Polymorphisms and Metabolic Syndrome in Uyghur Adults from Xinjiang, China

Objective: To explore the association between CETP gene polymorphisms and metabolic syndrome (MS), as well as the relationship between the CETP gene polymorphisms and each component of MS. Methods: A total of 571 individuals which were randomly selected from 5692 Uyghur adults were subdivided into two groups, including 280 patients with MS and 291 control subjects, using the group-matching method after matching for gender. We detected CETP polymorphisms (rs5882, rs1800775, rs3764261, rs12149545, rs711752, and rs708272) by using the Snapshot method. Results: (1) Significant differences were found involving the frequency distribution of genotypes and alleles of rs1800775, rs3764261, rs12149545, rs711752, and rs708272 between the control and MS groups (all p &lt; 0.05). (2) rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms were significantly related to the risk of MS (all p &lt; 0.05). (3) The rs1800775 polymorphism was associated with high fasting blood glucose levels and low high density lipoprotein cholesterol (HDL-C); rs3764261 and rs12149545 polymorphisms were associated with all components of MS except high blood pressure; rs711752 and rs708272 polymorphisms were associated with low HDL-C (all p &lt; 0.05). (4) Complete linkage disequilibrium (LD) was identified for two pairs of single nucleotide polymorphisms (SNPs) (rs3764261 and rs12149545 (D’ = 1.000, r2 = 0.931), rs711752 and rs708272 (D’ = 1.000, r2 = 0.996)). (5) The A-G-G-G-C (p = 0.013, odds ratio [OR] = 0.622, 95% confidence interval [95% CI] = 0.427–0.906) and A-T-A-A-T (p &lt; 0.001, OR = 0.519, 95% CI = 0.386–0.697) haplotypes were more frequent in the control group than in the case group. Conclusions: The rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms of CETP were associated with MS and its components among the Uyghur ethnic group. Complete LD was found between two pairs of SNPs (rs3764261 and rs12149545, rs711752, and rs708272). The A-G-G-G-C and A-T-A-A-T haplotypes might be protective factors for MS

Association between Eight Functional Polymorphisms and Haplotypes in the Cholesterol Ester Transfer Protein (CETP) Gene and Dyslipidemia in National Minority Adults in the Far West Region of China

We have investigated the relationship between the polymorphisms and haplotypes in the CETP gene, and dyslipidemia among the Xinjiang Kazak and Uyghur populations in China. A total of 712 patients with dyslipidemia and 764 control subjects of CETP gene polymorphism at rs12149545, rs3764261, rs1800775, rs711752, rs708272, rs289714, rs5882, and rs1801706 loci were studied by the Snapshot method, linkage disequilibrium analysis and haplotype construction. The results are as follows: (1) the minor allele of eight loci of frequencies in the two groups were different from other results of similar studies in other countries; (2) In the linear regression analysis, the HDL-C levels of rs708272 TT, rs1800775 AA, rs289714 CC and rs711752 AA genotypes were significantly higher than those of other genotypes, however, the rs3764261 GG and rs12149545 GG genotypes were significantly lower than those of other genotypes in the two ethnic groups. The HDL-C levels of the rs12149545 GG genotype were lower than those of other genotypes; (3) in the control group, the rs708272 CT genotype of TG levels were lower than in the CC genotype, the T genotype of LDL-C levels were lower than in the CC genotype, and the HDL-C levels were higher than in the CT genotype; the rs1800775 AC genotype of TG levels were higher than in the AA genotype, the rs711752 AG genotype of TG levels were lower than in the GG genotype, the AA genotype LDL-C levels were lower than in the GG genotype, and the HDL-C levels were higher than in the AG genotype; the rs1800775 AC genotype of TG levels were higher than in the AA genotype. In the dyslipidemia group, the rs708272 TT genotype of TC and LDL-C levels were higher than in the CT genotype and the rs3764261 TT genotype of TC levels were higher than in the GG genotype. The rs711752 AA genotype of TC and LDL-C levels were higher than in the AG genotype, and the rs12149545 AA genotype of TC and LDL-C levels were higher than in the GG genotype; (4) perfect Linkage Disequilibrium was observed for two sets of two SNPs: rs3764261 and rs12149545; rs711752 and rs708272. (5) Using SHEsis software analysis, the five A/T/A/A/T/C/A/G, A/T/A/A/T/T/G/A, G/G/A/G/C/C/G/G, G/G/C/G/C/C/A/G and G/G/C/G/C/T/G/G haplotypes were between dyslipidemia group and control group statistically significantly different (p &lt; 0.05 in each case). The polymorphism of CETP genes rs708272, rs3764261, rs1800775, rs711752, rs12149545 was closely related to the dyslipidemia in the Xinjiang Uyghur and Kazakh ethnic groups; and the rs708272 T, rs3764261 T, rs711752 A, and rs12149545 A alleles could reduce risk of dyslipidemia in the Uyghur and Kazakh populations, however, the rs1800775 C allele showed risk factors