Comparative Study On Suscepibility And Its Influencing Factors To Metabolic Syndrome In Korean-Chinese And Han-Chinese Population Of Yanbian Rural Area

Objective:To analyze the relationship between adult metabolic syndrome (MS) and its components and insulin resistance (IR) in Korean-Chinese and Han-Chinese populations residing in the rural area of Yanbian.Methods:Using a simple random and cluster sampling method,7836residents living in selected rural areas of Yanbian were examined from August2009to August2011. We excluded:(1) subjects who suffered from serious abnormal metabolic disorders or other organic diseases;(2) ethnic groups other than Korean and Han. All subjects knew the informed consent. The relevant data for this study were collected in the selected communities and health center by the family visit and health examination, including the general information, past history and family history of cardio cerebral vascular diseases, etc. Physical examination included anthropometric indices and blood pressure. In addition, insulin, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), blood glucose and other indexes were measured after12hour fasting. Fasting insulin (FIns) was detected by radioimmunoassay; human IR was estimated by the homeostasis model assessment method (Homeostasis model assessment, HOMA); and blood lipids and blood glucose were measured by automatic biochemical analyzer. Normal distribution measurement data were examined by t-test and the non-normal distribution measurement data were examined by rank sum test, the numeration data were compared with the Chi-square test; the correlation between MS and its components and IR was analyzed by a simple correlation analysis and partial correlation analysis; the MS and its components influencing factors were analyzed by the multi-regression analysis; MS and its components as the dependent variable and IR as independent variable were analyzed by the Logistic regression analysis; the variables were selected by BACKWARD, selected variables were significant level as α=0.05and deleted variables were significant level as α=0.10. Results:Of7,836subjects,3150were Korean-Chinese and4686were Han-Chinese. For Korean-Chinese, males comprise40.9%and were slightly younger than females (53.26±9.83vs.54.18±10.41years). For Han Chinese, males comprised39.5%and were slightly older than females (49.70±10.17vs.47.84±9.77). For Korean-Chinese, the age distribution of subjects forfive10-year age categories was6.8%for30-39,31.1%for40-49,35.4%for50-59,19%for60-69and7.6%for70and older. For Han-Chinese, the age distribution was12.3%,34.3%,33.1%,14.9%and5.4%, respectively.①On average, levels of height, weight, hip circumference, and body mass index (BMI) were higher in Han-Chinese. On the other hand, levels of waist circumference (WC), the serum total cholesterol (TC), triglyceride (TG) were higher in Korean-Chinese than those in Han-Chinese.(P<0.01).②The prevalence of MS was higher in Korean-Chinese compared with Han Chinese (29.9%vs19.4%;χ2=57.350, p<0.01). The differences in prevalence for the two ethnic groups were significant for both sexes:37%in male Korean-Chinese and26.2%in male Han-Chinese χ2=21.405, P<0.01);25.0%in female Korean-Chinese and15.1%in female Han-Chinese (χ2=35.742, P<0.01). The prevalence of MS was increased along with the age for two ethnic groups (P<0.01).③The prevalence of central obesity, dyslipidemia, hypertension was higher in Korean-Chinese than in Han-Chinese (P<0.01), while the prevalence of overall obesity was higher in Han-Chinese than that in Korean-Chinese (P<0.01).④The prevalence of IR was higher in Korean-Chinese than in Han-Chinese (27.6%vs22.2%; χ2=15.156, P<0.01) and this persisted in both sexes. For Han nationality, the risk was higher for overall obesity, central obesity, hypertriglyceridemia, low high-density lipoproteincholesterol, hypertension, hyperglycemia and MS in group with IR than that in non-IR group (P<0.01); for Korean-Chinese nationality, the risk was higher for all of them without low high-density lipoproteincholesterol in group with IR than that in non-IR group (P<0.01).⑥The partial correlate analysis showed that there was a significant positive correlation between IR and overall obesity, central obesity, hypertriglyceridemia, low high-density lipoproteincholesterol, hypertension, hyperglycemia and MS, the partial correlate coefficient was0.161,0.137,0.125,0.120,0.074,0.422and0.196(P<0.01).⑦It was accompanied IR that9.3%of patients with non-abnormal metabolism,20.0%of patients with one kind of abnormal metabolism,26.5%with two kinds of abnormal metabolism,38.1%with three kinds of abnormal metabolism,52.8%with four kinds of abnormal metabolism and100%with all kinds of abnormal metabolism in Korean-Chinese, and that in Han-Chinese was12.8%,18.1%,26.9%,33.9%,47.9%and76.0%, respectively. The distribution of frequency for MS and its components with IR differed between the two ethnic groups, and that increased along with the increase of metabolic disorder numbers.⑧Our multivariate analysis showed that MS, hyperglycemia, central obesity, low high-density lipoproteincholesterol, overall obesity, hypertriglyceridemia, hypertension were all closely related with IR, the value of OR is2.687,13.312,1.818,1.513,1.355,1.307and1.215, respectively.Conclusion:1) The prevalence of MS and its components and IR was higher in Korean-Chinese than that in Han-Chinese.2) The risk was higher for overall obesity, central obesity, hyperlipidemia, hyperlipoproteinemia, hypertension, hyperglycemia and MS in group with IR than that in non-IR group.3) The distribution of frequency for MS and its components with IR differed between the two ethnic groups, and that increased along with the increase of metabolic disorder numbers.4) MS, hyperglycemia, central obesity, low high-density lipoproteincholesterol, overall obesity, hypertriglyceridemia, hypertension was closely related with IR. Objective:To study the relationship between adipocytokines and metabolic syndrome (MS), and the predictive value of adipocytokines on diagnosis of MS, we chose three adipocytokine biomarkers as adiponectin, leptin and tumor necrosis factor-a (TNF-a).Methods:We studied the role of adiponectin, leptin, and TNF-a in3150Korean Chinese and4686Han Chinese who participated in a population based epidemiologic survey. The level of adiponectin was measured by an enzyme-linked immunosorbent assay kit (ELISA), and levels of leptin and TNF-a were measured using radioimmunology assay kits. The MS definition of "Chinese guidelines on prevention and treatment of dyslipdemia in adults" was used. Normal distribution measurement data was examined by analysis of covariance. We first examine how the three biomarkers relate to MS, its components, and IR using correlation analyses. We then performed multivariate regression analysis and path analysis restricting to factors that were significant in the correlation analyses.Results:1) The level of adiponctin was higher in Han-Chinese than that in Korean-Chinese (Fmale=41.716, P<0.011; Ffemale=182.975, P<0.01) for both sexes, the levels of leptin and TNF-a were higher in Korean-Chinese than those in Han-Chinese for male (Flepin=41.716, P<0.01; FTNF-a=182.975, P<0.01), and the level of leptin was higher in Korean than that in Han for female (F=8.645, P<0.01).2) Levels of these2biomarkers, leptin and TNF-a, were higher in individuals of MS, IR, central obesity, overall obesity, hypertriglyceride and hypertension than that in control group (P<0.01). Levels of adiponctin were lowered in all groups except for those with hypertension and hyperglycemia than that in control group (P<0.01).3) The partial correlate analysis showed a significant positive correlation between leptin and the level of WC(0.404), BMI(0.520), TG (0.124), SBP (0.135), DBP (0.159), insulin (0.052) and IR (0.127) and0.104(P<0.01) after adjustment for sex, race, age. There was a significant positive correlation between TNF-α and the level of WC (0.900), BMI (0.686), TG(0.226), SBP(0.230), DBP(0.269), FBG(0.132), FIns(0.218) and IR(0.198)(P<0.01). There was a significant negative correlation between adiponectin and the level of WC (-0.237), BMI (-0.279), TG (-0.086), SBP (-0.039), DBP (-0.063), insulin (-0.089) and IR (-0.079).4) The multivariate regression analysis showed that:①the influencing factors of adiponectin were nationality, sex, SBP, IR, WC and BMI, the r-values were0.240,0.080,0.029,-0.037,-0.066and-0.231;②that of leptin were nationality, sex, IR, WC and BMI, the r-values were-0.080,-0.092,0.030,0.037and0.495;③that of TNF-a were IR, WC and BMI, the r-values were0.039、0.842and0.077.5) We performed pathway analysis to show that IR, TNF-a, adiponectin, leptin, WC, BMI and nationality (Korean-Chinese) explained31.2%of the variability in MS, and the direct path coefficients were0.553、0.401、-0.35、0.275、0.254、0.238and-0.193.Conclusion:1) Significant differences in levels of adiponectin, leptin and TNF-a were observed between Korean-Chinese and Han nationality.2) The levels of leptin and TNF-a are higher in individuals with MS and its components, and IR, and the level of adiponctin is lower in group of MS and its components and IR than that in control group.3) Moreover some biomarkers (levels of WC, BMI, TG, SBP, DBP, FIns and IR) and overall obesity, central obesity, hypertriglyceridemia, hypertension, hyperglycemia, MS were negatively correlated with adiponctin, while other biomarkers (levels of WC, BMI, TG, SBP, DBP, FBG, FIns and IR) and overall obesity, central obesity, hypertriglyceridemia, hypertension, hyperglycemia, MS were positively correlated with leptin and TNF-a.4) The adiponectin was closely related with race, sex, SBP, IR, WCand BMI; leptin was closely related with race, sex, IR, WCand BMI; TNF-awas closely related with IR, WCand BMI.5)Taken together,31.2%of MS is occurred by IR, TNF-a, adiponectin, leptin, WC, BMI and nationality in Korean-Chinese and Han-Chinese. Objective:To investigate genetic association between metabolic syndrome (MS) and four SNPs (SNP+45, SNP+276T/G, SNP-11377, SNP-11391) in a candidate gene, ApMl, located on3q27in Korean-Chinese population of Yanbian rural area was studied.Methods:197cases with MS and147age and sex frequency match controls were studied. The diagnostic criteria of "Chinese guidelines on prevention and treatment of dyslipdemia in adults" was used for the definition of MS. DNA was extracted with the TIA Namp Genomic DNA Kit. Four SNPs, specifically SNP+45, SNP+276SNP-11377, and SNP-11391, were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Primers for the SNPs were designed using Oligo6.0software. Restriction end nuclease Sma I, EcoR I and BamI were used to determine the genotype of SNP+45, SNP+276, SNP-11377, SNP-11391.Result:The TT, TG and GG genotype frequencies at the SNP+45site were50.3%,43.1%,6.6%in individuals with MS and51.0%,41.5%,7.5%in controls, and no statistical difference between cases and controls was observed for genotype and allele frequencies. At the SNP+276site, the GG, TG and TT genotype frequencies in MS group were65.5%,26.5%and7.6%, and those in controls were48.3%,42.9%and8.8%, respectively. The MS cases were more likely to have a higher frequency of GG genotype than in controls (P<0.01). At the SNP-11377site, the CC, CG and GG genotype frequencies in the MS group were62.4%,31.5%and6.1%and those in controls were44.2%,49.0%and6.8%, respectively. The frequency of CC genotype in MS cases was higher than in controls, and this was significantly different at P<0.01. At the SNP-11391site, the AA, GA and GG genotype frequencies in MS cases were8.1%,28.9%and62.9%and those in controls were9.5%,44.9%and45.6%. The frequency of GG genotype in MS cases was higher than in controls (P<0.01).For MS group, the levels of WC, BMI, TG and SBP in GG genotype were significantly higher than that in non-GG genotype for SNP+276(P<0.01); the levels of weight, WC, BMI,TG, SBP and DBP in CC genotype were significantly higher than that in non-CC genotype for SNP-11377(P<0.01); the levels of TG, SBP, DBP and FBG in GG genotype were significantly higher than that in non-GG genotype for SNP-11391(P<0.01). For SNP+45, there was not statistically different between TT and non-TT group. We further examined the relation between four candidate SNPs and intermediate risk factors (such as IR, BMI, etc) first and then we examined the relation between the four candidate SNPs and MS using multivariate Logistic regression analysis. The results showed that:1) the SNP+45was closely related with central obesity and hypertension, the value of OR was1.773and2.150.2) SNP+276was closely related with dyslipidemia and MS, the OR value was2.009and2.031;3) SNP-11377was closely related with IR, dyslipidemia and MS, the OR value was1.095,2.606and2.097;4) SNP-11391was closely related with IR, central obesity, hypertension, MS and dyslipidemia, the OR value was1.710,1.723,1.906,2.028and2.128.Conclusion:1) There are SNPs of adiponectin gene+45sites,+276sites,11377sites,11391sites in Korean-Chinese population of Yanbian rural area.2) There are different susceptibility to MS and its components and IR in4different loci of Adiponectin genotype: SNP+45site TT genotype increased the susceptibility to central obesity and hypertension; SNP+276GG genotype increased the susceptibility to dyslipidemia and MS; SNP-11377CC genotype increased the susceptibility to dyslipidemia, IR and MS; SNP-11391GG genotype increased the susceptibility to IR, central obesity, hypertension, dyslipidemia and MS.