Study On Cardiovascular Disease Risk Factors And An Early Warning System And Intervention Strategy In Adolescents

The younger age of onset of cardiovascular diseases is a serious public health problem inthe world, particularly among children and adolescents. Cardiovascular disease is described asa chronic and multiple factorial process from adolescence to adulthood. Many cardiovascularrisk factors begin in adolescence and its harmful consequences could be tracked into adulthood.However, there is a relative lack of published early warning and intervention approach to ado-lescents in China. The objective of our study was to create an early warning system and inter-vention strategy for to reduce cardiovascular disease risk among Chinese adolescents and im-prove future quality of life.Part Ⅰ：Objective The purpose was to determine the prevalence of cardiovascular disease riskfactors among chinese adolescents and establish an early warning system for cardiovasculardisease incidence risk during adolescence. Methods The cross-sectional study was conductedwith6505adolescents (2965boys,3540girls), aged9-18years old. Height, weight, bloodpressure, lipids, leptin, adiponectin and other physiological indicators were examined andclustering of carvdiovascular disease risk factors was analyzed. Results According to our sur-vey data, some heart health risk factors were already present in9-18years old Chinese asoles-cents.10.07%were overweight and6.90%were obese using the WGOC standard.10.67%hadhypertension,14.23%had diabetes Mellitus,12.65%had hypertriglyceridemia,5.93%had hy-percholesterolemia,20.95%had high levels of LDL cholesterol,14.23%had low levels ofHDL cholesterol. Compared with previous reports, there has been a significant increase in theprevalence of obesity, hypertension, diabetes, dyslipidemia in asolescents. We set up an earlywarning system for assessing on cardiovascular disease incidence risk among Chinese asoles-cents based on epidemiological investigation and statistical analysis of the major modifiablepredisposing risk factors for cardiovascular disease. Conclusion Chinese adolescents are atvery high risk of cardiovascular disease. An early warning system of Chinese asolescents car-diovascular disease includes:⑴Obese(according to WGOC standard);⑵SBP≥130mmHg;⑶TG≥2.26mmol/l;⑷FPG≥5.6mmol/l;⑸HDL <0.91mmol/l. An asolescent’s score willget one point, if he has one item. The higher his score of early warning system, the greater heare at risk of cardiovascular disease.PartⅡ：Objective An intervention strategy was summarized to reduce cardiovascular risk factors among Chinese adolescents. Methods Mental health disorders was evaluated in1087adolescents aged9-18years old using the General Health Questionnaire(GHQ). The relation-ship between psychosocial factors and the risk of hypertension will be analyzed. We created anintervention strategy on the basis of the major modifiable predisposing cardiovascular risk fac-tors the result of meatal health survey. Intervention approaches including psychological healtheducation, food intake controlling, and physical exercise was conducted in50obese adoles-cents for four mouths. Results15.53%had hypertension in patients that had a diagnosablemental disorders problem was higher than1.46%had hypertension in control group. There wasa significant weight loss and reduction in body mass index (P<0.01) after the intervention ap-proach was conducted for four months. The rates of BMI change in intervention adolescentsprovided valuable data and evidence to reduce cardiovascular risk in adolescents. ConclusionIn general adolescents, psychological disorders may increase the risk of hypertension incidence.Anxiety and insomnia, depression emotion had very impartant effect on concurrence of hyper-tension in all pathogenic factors of psychological disorders. A scientific school-based interven-tion strategy was been summarized which included: health education, food intake controllingand physical exercise plan.Part Ⅲ：Objective The aim of our study was to analyze a possible association between adi-ponectin45T/G single nucleotide polymorphism and hypertension among Chinese adolescents.Methods The distribution of genotype and allele frequencies of adiponectin SNP45was ob-served using restriction analysis in31hypertension adolescents and in21non-hypertensioncontrol individuals. Results Compared with non-hypertension control group, hypertensiongroup showed a higher distribution of GG+GT genotype. Compared with the single nucleotidepolymorphism45of the adiponectin, the G allele frequently was more frequently found in hy-pertension group than in the non-hypertension control group. We found a significant associa-tion between adiponectin single nucleotide polymorphism45and the prevalence of hyperten-sion in adolescents. Conclusion Our present study provided evidence that SNP45T/G in theadiponectin gene may play a very important role in susceptibility to hypertension and the Gallele may be contribute to a genetic risk in hypertension among Chinese adolescents.Part Ⅳ：Objective To discuss the mechanism of serum leptin in a mice model of obesity.Methods Eighteen C57BL/6J male mice of4weeks old were divided into two groups: normalfood(12.7kcal%fat), high fat diet food(45kcal%fat). Mice were fed different food for8weeks. Body weight was measured and leptin levels were determined with an ultrasensitiveleptin ELISA kit. Hypothalamus was isolated from obese mice and control mice. Pomc mRNA quantification by RT-PCR analysis. Results After8weeks on the diet, the obese phenotype wasobserved in the mice fed a high-fat diet food. Comparing two groups, serum leptin levels ofobese mice were higher than control mice（p<0.01）. Although gene expression values showedpomc mRNA levels were a slightly higher in obese mice compared with control group, but thisresult was not statistically significant (p>0.05). Conclusion Analysis revealed that obesityupregulated the expression of serum leptin. In obese mice, the levels of pomc mRNA expres-sions was not significantly higher than in control mice，indicating leptin expression dysfunctionin hypothalamus.