Abstract:Aim To investigate the association between triglyceride-glucose (TyG) index, a substitute marker of insulin resistance, and the risk of stroke. Methods The data were obtained from the baseline survey of Tianjin region in the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei in 2017—2018.Data were collected by questionnaire, physical examination and laboratory examination. The case group and control group were matched 1∶1 according to the same gender and age ±2 years. Conditional Logistic regression model was used to analyze the association between TyG index and risk of stroke. Results A total of 536 patients were included in the analysis. The TyG index in the case group was higher than that in the control group (P＜0.000 1). Multivariate conditional Logistic regression analysis showed that compared with individuals with TyG index＜8.38, the OR(95%CI) for stroke in the 8.38≤TyG index＜8.7,8.67≤TyG index＜9.10, TyG index≥9.10 were 1.13(0.1,2.10), 1.47(0.8,2.74), 2.24(1.6,4.72). Conclusion TyG index was an independent risk factor for stroke. With the increase of TyG index, the risk of stroke increased gradually.

Abstract:Aim To investigate the predictive value of remnant cholesterol in the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in coronary heart disease patients with high-normal blood pressure. Methods A total of 421 patients with high-normal blood pressure who underwent coronary angiography in the Department of Cardiology, General Hospital of Northern Theater Command from 2004 to 2014 were retrospectively analyzed. In this study, 97 patients with high-normal blood pressure who developed MACCE in this cohort were selected as the case group, and 97 patients with high-normal blood pressure who did not develop MACCE in the same cohort were selected as the control group by random number table for a case-control study. Results The number of patients with high-salt diet, the number of diabetic patients, the value of left ventricular end-diastolic diameter (LVEDD) and Gensini score in the case group were higher than those in the control group (which were 2.6,6.8,1.14 and 1.67 times of the control group respectively), the differences were statistically significant (P＜0.05). In lipid-related indicators, the levels of remnant cholesterol, triglyceride and total cholesterol in the case group were higher than those in the control group (which were 1.1,1.38 and 1.07 times of the control group respectively), the differences were statistically significant (P＜0.05). Logistic regression analysis showed that diabetes mellitus (OR＝14.4,5%CI:5.13～42.89, P＜0.01), high salt diet (OR＝6.6,5%CI:3.00～13.90, P＜0.01) and remnant cholesterol levels (OR＝10.7,5%CI:2.89～35.05, P＜0.01) were associated with MACCE in patients with high-normal blood pressure. The predictive value of remnant cholesterol for MACCE was evaluated by receiver operating characteristic (ROC) curve. The results showed that the area under ROC curve for remnant cholesterol to predict MACCE was 0.644 (95%CI:0.567～0.721). The optimal cut-off value was 0.52 mmol/L, and the sensitivity and specificity were 72.2% and 50.5%, respectively. Conclusion Diabetes mellitus, remnant cholesterol level and high-salt diet were independent risk factors for MACCE in patients with high-normal blood pressure, and remnant cholesterol level ＞0.52 mmol/L could predict the occurrence of MACCE in patients with high-normal blood pressure.

Abstract:Aim To investigate the relationship between serum ferritin and coronary heart disease (CHD). Methods 256 CHD patients and 256 healthy controls were recruited in our case-control study. Basic information was obtained by using questionnaire and measured for blood pressure, weight, height, waist circumference, hip circumference. Venous blood was collected for detecting serum lipid, fasting plasma glucose and ferritin. All data were analyzed with SPSS 20.0. Multivariate Logistic regression model was used to assess association of serum ferritin with coronary heart disease. Results There was no significant difference for gender and age between patients and controls (P＞0.05). The patients’ body mass index (BMI), ratio of waist to hip circumference, triglyceride, C-reaction protein, serum ferritin, systolic blood pressure, and diastolic blood pressure were significantly higher than that of the controls(P＜0.05). Data from univariate analysis showed that BMI, waist circumference, systolic blood pressure, triglyceride, smoking ,drinking and serum ferritin were risk factors of CHD. The highest group of serum ferritin had a 12.30-fold risk of CHD (95%CI:7.33～20.64) than the lowest group without adjustment for confounding factors. In multivariate Logistic regression model, after adjustment for traditional CHD risk factors, serum ferritin was still associated with CHD. The highest group of serum ferritin had a 13.75-fold risk of CHD (95%CI:8.02～23.56) in model 1, and 7.09-fold risk of CHD(95%CI:3.68～13.64) compared with the lowest group. Conclusion The study confirmed that high serum ferritin was associated with the increased risk of CHD.

Abstract:Aim To explore risk factors of resistant hypertension(RH)via the method of case-control. Methods 247 cases of hospitalized patients with hypertension taking three different antihypertensive drugs including diuretics was observed. RH was selected according to the 24 h dynamic blood pressure monitoring. 247 patients were divided into two groups: 112 cases in RH group, 135 cases in non RH group. General data, fasting blood glucose(FBG）, 2 hours postprandial blood glucose(2hPBG）, triglyceride(TG）, total cholesterol(TC）, high density lipoprotein cholesterol(HDLC）, low density lipoprotein cholesterol(LDLC）, serum creatinine(SCr）, blood uric acid(BUA)and blood urea nitrogen(BUN)were recorded. Left ventricular end-diastolic interventricular septal thickness(IVST)was measured by color ultrasound. Description analysis, chi-square test, t test and Logistic regression statistical analysis method were used to analyze the data. Results Body mass index(BMI）, SCr, TG, TC, HDLC, estimated glomerular filtration rate(eGFR)and IVST had significant difference between RH group and non RH group(P<0.05, P<0.01）. After correction of gender, age, BMI and disease duration, Logistic regression analysis and ROC curve analysis showed that IVST, mean arterial pressure(MAP)and eGFR had good predictability on blood pressure control, IVST was the strongest, the area under curve(AUC)of IVST, MAP, and eGFR was 0.663, 0.600 and 0.418 respectively. Conclusions IVST, MAP and eGFR are risk factors for resistant hypertension. Understanding the risk factors in patients with RH can help to reduce damage of target organ and improve the life quality of patients.

Abstract:AimTo investigate the risk factors of leukoaraiosis (LA) in hospitalized patients.MethodsBetween January 2010 to June 2010 in our hospital 509 patients diagnosed by brain magnetic resonance imaging (MRI) as leukoaraiosis were the case group, and 509 cases with no-leukoaraiosis were the control group during the corresponding period.The risk factors of the two groups were inquired according to case-control study design.A database was used and statistical analysis was undergone by SPSS 12.0.ResultsThe unconditional multiple Logistic regression analysis showed that：female ［OR and 95% CI:7.857 (5.139-12.011)］，old age，drink，hypertension in diastolic pressure，cerebral infarction ［OR and 95% CI: 5.591 (3.660-8.541)］，metabolic syndrome were independent risk factors of leukoaraiosis, significantly increasing the risk of leukoaraiosis (all p<0.05).But in these patients, the risk of leukoaraiosis ［OR and 95% CI: 0.699 (0.599-0.815)］ was decreased in patients with increased total cholesterol.ConclusionThe causes of hospitalized patients with leukoaraiosis are various, as a result, early intervention should be aimed at different risk factors to prevent the occurrence of leukoaraiosis.

Abstract:Aim To investigate the association of activated coagulation factor Ⅶ (FⅦa) and its gene MspI polymorphism for cerebral infarction with hypertension in Chinese. Methods This study was performed with the method of candidate gene and case-control study. FⅦ genotypes were identified with polymerase chain reaction amplified genomic deoxyribonulieic acid (DNA) and MspI restriction fragment length polymorphism analysis,and plasma FⅦa levels were detected with recombinant tissue factor method in 149 hypertensive patients, 132 hypertensive patients with ischemic stroke (stroke group) and and 148 normotensive sex- and age- matched control subjects. Results Plasma FⅦa levels were significantly higher in patients with ischemic stroke than those of patients with hypertension (2.78±0.59 v.s 2.53±0.62 μg/L, p<0.05). FⅦa is a risk factor for ischemic stroke with hypertension on Logistic regression analysis.(Or=1.134, p<0.05). The allelic frequencies were in Hardy-Weinberg equilibrium. The results suggested that the distribution of genotype and allelic frequencies in every group had no significant difference, also no difference in subgroups of ischemic stroke (p>0.05). FⅦa levels were significantly higher in Arg homozygotes than in Gln allele carriers (2.72±0.60 v.s 1.98±0.59 μg/L, p<0.05)and associated with FⅦ gene polymorphism. Conclusions Plasma FⅦa levels may be an important risk factor of cerebral infarction with hypertension and the levels are influenced by MspI polymorphism of the FⅦ gene.