Vascular Function And Metabolic Syndrome And Left Ventricular Hypertrophy In Genetic Epidemiology Research

1. Elasticity Indices of Large and Small Arteries in Relation to the Metabolic Syndrome in ChineseBackground: The purpose of the present study was to investigate the elasticity of large and small arteries in relation to the components of the metabolic syndrome in a Chinese population.Methods: Arterial elasticity indices were derived from pulse wave analysis based on a modified Windkessel model in a total of 688 subjects, aged 33 to 65 years, who volunteered participating in our study.Results: The study population included 420 (61.0%) men and 433 (62.9%) hypertensive patients, of whom 197 (28.6%) took antihypertensive medication. Overall, the presence of the metabolic syndrome was 20.5%. In univariate analysis, both C1 and C2 were higher in men than women (P≤.008) and were inversely (P≤.05) correlated with age, systolic and diastolic blood pressure, pulse pressure, pulse rate and plasma glucose concentration, and positively (P < .0001) correlated with body height and body weight. In men, smokers, compared with non-smokers, had significantly lower C2 (P = .007), but they had similar C1 (P = .33). In adjusted analysis, patients with the metabolic syndrome, compared those without, had significantly (P < .01) lower C1 and C2. In continuous adjusted analysis, both C1 and C2 were significantly (P < .0001) associated with systolic and diastolic blood pressure, whereas in addition, C1 was also significantly associated with plasma glucose concentration (P = .007), and C2 with serum HDL cholesterol (P = .02).Conclusions: The metabolic syndrome is indeed a risk factor for reduced arterial elasticity.2. Left ventricular hypertrophy in relation to systolic blood pressure and the angiotensin converting enzyme I/D polymorphism in ChineseBackground: There is little population-based data on the prevalence and the environmental or genetic determinants of left ventricular hypertrophy (LVH) in China. The purpose of this paper is to study LVH in relation to systolic blood pressure and the angiotensin converting enzyme (ACE) insertion/deletion(I/D) polymorphism in Chinese.Methods: We recorded 12-lead ECG (CardioSoft, v4.2) in 1365 residents in the JingNing County, Zhejiang Province, China. LVH was defined according to the gender-specific Sokolow-Lyon and Cornell product ECG criteria.Results: Regardless of whether the Sokolow-Lyon or Cornell product ECG criteria was used, the prevalence of LVH (20.7% and 4.8%, respectively) significantly (p<0.0001) increased with male gender (odds ratio[OR] 2.33 and 7.15) and systolic blood pressure (per 10 mmHg increase, OR 1.46 and 1.33). If the Sokolow-Lyon criteria was used, the prevalence of LVH was also influenced by alcohol intake (OR 1.44, p=0.03) and body mass index (OR 0.83, p=0.0005). The association between the Sokolow-Lyon voltage amplitude and the ACE I/D polymorphism was dependent on antihypertensive therapy (p= 0.01). In 1262 untreated subjects, but not 103 patients on antihypertensive medication(p>0.12), the ACE DD compared with II subjects had significantly higher Sokolow-Lyon voltage amplitudes (29.8±0.6 vs. 28.0±0.5 mV, p=0.02) and higher risk of LVH (OR 1.74, 95% CI: 1.12-2.69, p=0.01). Conclusion: LVH is prevalent in Chinese, and is associated with systolic blood pressure and the ACE D allele. The genetic association might be modulated by antihypertensive therapy.