| Objective: 1)To investigate the correlation between occupational stress and coronary heart disease in Xinjiang Han and Uygur nationality.2)To obtain the 9p21 regional gene rs10757278,angiotensinogen(AGT)rs699 and aldosterone synthase gene(CYP11B2-344/T)rs179998 in the peripheral circulation of Han and Uygur coronary heart disease in Xinjiang region.3)To verify the relationship between gene polymorphism of 9p21 region,AGT,CYP11B2-344/T and coronary heart disease in the peripheral circulation of the population.4)Study the peripheral circulation of the Han and Uygur people in Xinjiang the mechanism of gene-gene,gene-environment interaction in the 9p21 region of the gene,AGT and CYP11B2-344/T in the ring is related to the occurrence of coronary heart disease.Methods: 1)Occupational stress was assessed among different occupational groups by using effort-reward imbalance scale(ERI).A total of 2,380 cases were included to investigate the factors related to occupational stress in these groups.To understand the prevalence of coronary heart disease in different occupational groups.2)To investigate the occupational stress in CHD patients and control groups of han and uygur people in xinjiang region,a case-control study was conducted,with the subjects of CHD patients as the case group and healthy people in the physical examination center as the control group.There were 310 cases in the case group and 536 cases in the control group.The relationship between occupational stress and severity of coronary artery stenosis on coronary angiography was analyzed.To analyze the relationship between occupational stress and coronary heart disease in different ethnic groups in xinjiang.3)To determine the relation between CHD and9p21 region of chromosome,as well as,genes AGT and cyp11b2-344 /T by KASP typing.By SPSS16.0 statistical software,to analysis the general epidemiological data,correlation analysis of alleles,genotypes and the relation with coronary heart disease.To analysis SNPs and CHD risk factors.To explore the relationship between genetic polymorphism locus and coronary heart disease in different ethnic groups in xinjiang.4)Using the generalized multifactor reduction method(GMDR)to construct the best model of gene-gene,gene-environment interaction,and use the Logistic regression to analyze the risk of gene-gene and gene-environment interaction,to analyze the interaction of related gene polymorphisms and environmental factors in the crowns.The value of disease in the pathogenesis of coronary heart disease is discussed.Results: 1)There was statistically significant difference in occupational stress among different occupations(P<0.01).The proportion of coal miners,railway workers and civil servants with high tension level is relatively high.2)Differences in occupational stress levels among different occupational characteristics were statistically significant(P<0.001);3)The differences in age,marital status and income were statistically significant(P<0.05);4)Among 2380 people,52 cases of coronary heart disease were detected,and the prevalence rate was 2.18%.Among them,the prevalence rate of coronary heart disease was 2.79%,0.52% for soldiers,2.83% for coal miners,0.92% for railway workers and 5.1% for civil servants.Chi square test showed that the prevalence rate of coronary heart disease was statistically significant among different occupational groups(P=0.001).5)To compare the living habits of the han and uygur populations between the case group and the control group showed differences in smoking,diet taste,sleep time,sleep quality and physical exercise between the case group and the control group for Han population(P<0.05).In uygur population,there were differences in smoking,diet taste,sleep quality and physical exercise between the case group and the control group(P < 0.05).6)A comparative analysis of clinical indicators between the han and uygur groups showed that the body mass index,waist circumference,waist-hip ratio,uric acid,fasting blood glucose,triglyceride and total cholesterol of the han group were all higher than those of the control group.In the uygur population,the body mass index,waist circumference,waist-hip ratio,creatinine,fasting blood glucose,triglycerides,high-density lipoprotein and total cholesterol in the case group were all higher than the control group(P<0.001),and low-density lipoprotein was lower than the control group(P<0.001).There was no significant difference in RBC distribution width and uric acid(P > 0.05).7)The comparison of occupational stress levels between the case group and the control group showed no significant difference(P>0.05).It suggested that coronary heart disease was independent of occupational stress level.There is no difference between the two nations.8)the Gensini scores of the han and uygur ethnic groups at different tension levels were compared between high and low intensity groups.The results showed that there was no difference in the Gensini scores at different tension levels,and the difference was not statistically significant(P>0.05).9)occupational stress level between different ethnic groups compared with coronary vascular lesion counts,the han nationality patients,high occupational stress group single lesion,double branch lesions and three disease accounted for 49.20%,36.40% and 36.40% respectively,uygur ethnic groups in patients with single lesion,double branch lesions and three lesions accounted for 54.40%,22.80% and 22.80%,respectively,different levels of occupational stress and coronary vascular lesions counts of comparison,there was no statistically significant difference(P>0.05).10)Logistic regression analysis about risk factors of coronary artery disease for Han and Uighur people,the result showed age(relative to people under age 40,50 years of age OR older with increased risk of coronary heart disease,OR=9.174,95% CI:4.547-18.507,P<0.001),smoking(OR=22.560,95% CI:11.231-45.317,P<0.001),the sleep time(relative to sleep at 6 hours following the crowd,in more than 8 hours sleep time people hae an increased risk of coronary heart disease,OR=7.99,History of hypertension(OR=5.755,95% CI: 1.836-18.037,P=0.003),history of diabetes(OR=51.533,95% CI:11.974-221.787,P<0.001),family history of coronary heart disease(OR=3.746,95% CI:1.984-7.072,P<0.001)low-density lipoprotein(OR=3.320,95% CI:1.705-6.467),P < 0.001)were independent risk factor for coronary heart disease in han population.Results showed smoking(OR=4.551,95% CI:1.227-16.878,P=0.023),drinking(OR=4.617,95% CI:1.067-19.982,P=0.040),history of hypertension(OR=48.395,95% CI: 2.539-922.345,P=0.010),history of diabetes(OR=33.291,95% CI:4.785-231.596,P < 0.001),low-density lipoprotein(OR=11.837,95% CI:1.904-73.594,P=0.008)were independent risk factors for coronary heart disease in uygur population.The risk factors of coronary heart disease were different between han and uygur.11)All genotypes and alleles at the rs10757278,rs699 and rs179998 sites were compared between different occupational stress groups,and the differences were not statistically significant(P>0.05);12)At the rs10757278 site,rs10757278 was significantly associated with coronary heart disease in the han and uygur populations.The distribution frequency of GG at the polymorphic locus of the han group was higher than that of the control group,and the difference was statistically significant(P=0.005).The distribution frequency of GG at the polymorphic locus was higher in the Uigur group than in the control group,and the difference was statistically significant(P=0.007).Furthermore,there was no significant difference between the two groups(P>0.05).The case group of G allele was higher than the control group,and the difference was statistically significant.Compared with G allele,A allele could reduce the risk of CHD by 0.676 times(P=0.002,95% CI: 0.527~0.867).13)At the rs699 site,there was a significant correlation between rs699 and coronary heart disease in the Uighur population.In the case group,the polymorphic locus GG was higher than that in the control group(P=0.043),and the risk of coronary heart disease was increased by 2.103 times in the individuals with GG type compared with those with GA+AA type(P=0.002,95% CI: 1.306~3.385).Comparing the uygur case group and the han case group,the polymorphic locus GG of the han case group was higher than that of the uygur,with statistically significant differences(P=0.001),and the risk of coronary heart disease was reduced by 0.469 times in the individuals with GG type compared with those with GA+AA type(P=0.002,95% CI: 0.291~0.758).The G allele in the uygur case group was higher than that in the uygur control group.Relative to the G allele,the A allele could reduce the risk of CHD by 0.635 times(P=0.012,95% CI: 0.452~0.909).Compared with the case group of han nationality,the G allele of uygur nationality was higher than that of han nationality.Relative to the G allele,the A allele could increase the risk of CHD by 2.122 times(P=0.000,95% CI: 1.449~3.018).14)At the rs179998 locus,the polymorphic loci AA of the Uighur case group was higher than that of the han,with statistically significant differences(P=0.001),and the risk of coronary heart disease was reduced by 0.387 times(P=0.002,95% CI: 0.236~0.634)in the han case group compared with the AG+GG individuals.The A allele in the han group was higher than that in the Uigur group.Relative to the G allele,the A allele reduced the risk of CHD by 0.442 times(P=0.000,95% CI: 0.313~0.626).15)GMDR analysis of gene-gene interaction showed that rs10757278-rs699 in the 9p21 region has the main effect,the cross consistency coefficient is 10/10,the symbol test P is 0.001,and the cross validation consistency of the interactive model of rs10757278,agt-rs699 and cyb11b2-rs179998 in the 9p21 region is the largest(10/10).The interaction model was statistically significant(P<0.05)for han population;rs10757278-rs699-rs179998 in the region of 9p21 has the main effect,the cross consistency coefficient is 10/10,the sign test P value is 0.055,and the interaction model is not statistically significant(P>0.05)for the uygur population;16)GMDR analysis of gene-environment interaction showed that the dominant benefit of uric acid in the han population.The maximum cross-validation consistency of uric acid factor composition(10/10),and higher Testing balance accuracy(0.8555),but no statistical significance(P>0.05).The interaction models composed of BMI-uric acid,rs1075727-waistline-uric acid,rs1075727-rs699-BMI-uric acid,rs1075727-rs699-rs179998-BMI-uric acid were not statistically significant(P>0.05).Among uygur people,BMI is the main benefit,and the cross-validation consistency of BMI factors is the largest(10/10).Testing balance accuracy is also higher,which is 0.838,with statistical significance(P<0.05).The interaction models composed of BMI-waist circumference,rs1075727-rs699-rs17998-BMI,rs1075727-rs699-rs179998-age-BMI was the best model.selected in this study is the best model;17)The logistic regression analysis of gene-environment interaction showed that BMI dominated factors,there was a statistically significant interaction into the Logistic regression as an analysis of the factors for Uighur population.BMI and waist into the equation,and the interaction between interaction can make the Uighur population the occurrence of coronary heart disease risk reduction(OR=0.998((P=0.001,95% CI(0.998 ~ 0.999)).Therefore,it can be considered that the interaction model consisting of BMI-waist,and rs10757278-rs699-rs179998-age-BMIselected in this study is the best model.the five-person interaction can reduce the risk of coronary heart disease in uygur population.OR=0.788((P<0.001,95%(0.746~0.833)).Conclusion: 1)In this study,2380 people of different professions in xinjiang were studied for cross-sectional survey.The proportion of coal miners,railway workers and civil servants with high stress level was higher among different occupational types.The prevelence rate of coronary heart disease was 2.2%.Among them,the detection rate of teachers’ coronary heart disease was 2.79%,that of soldiers was 0.52%,that of coal miners was 2.83%,that of railway workers was 0.92% and that of civil servants was 5.1%.The prevelence rate of coronary heart disease in different occupational groups was statistically significant(P<0.01).The prevelence of coronary heart disease was not statistically significant at different occupational stress levels.2)There was no difference in occupational stress level between han and uygur patients with coronary heart disease.There was no direct correlation between occupational stress and coronary heart disease;3)The degree of coronary artery lesions of different ethnic groups is different.Compared with the number of coronary artery lesions of the han and uygur patients,the majority of the han is single vessel lesions and double vessel lesions,while the majority of the uygur is single vessel lesions and three vessel lesions.Coronary artery disease of han nationality is more serious than that of uygur nationality.4)Age,smoking,sleep time,history of hypertension,diabetes,family history of coronary heart disease,low-density lipoprotein were risk factors for coronary heart disease in the han population.Smoking,drinking,history of hypertension,diabetes and low density lipoprotein were independent risk factors for coronary heart disease in uygur population.The risk factors of coronary heart disease were different among different nationalities.5)The mutations of 9p21 region-rs10757278,AGT-rs699 and CYB11B2-rs179998 were significantly associated with coronary heart disease and presented ethnic differences.The distribution frequency of GG genotypes in the han and uygur case groups at rs10757278 was higher than that in the control group,and the difference was statistically significant.The GG genotype was higher in the case group and Uigur group at the rs699 locus than in the control group.6)In gene-gene interaction,there is interaction between the two gene loci of rs10757278-rs699 in the han population,and the three gene loci of rs10757278,AGT-rs699 and CYB11B2-rs179998 in the 9p21 region.There was no interaction between the three genes in the Uighur population.The gene-gene interaction between han and uygur has ethnic differences.7)In gene-environment interaction,uric acid is the main benefit of the han population,and the interaction model composed of uric acid and BMI with three gene loci is not statistically significant and has no interaction effect.In uygur people,BMI is the main benefit,and there are interaction between BMI-waist circumference,rs10757278 in the 9p21 region,agt-rs699-rs179998-bmi and rs10757278-rs6998-rs179998-rs17998-age-BMI in the 9p21 region.The interaction of the five groups can reduce the risk of coronary heart disease in the Uighur population.The gene-environment interaction model of han and uygur is different. |
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