西乌珠穆沁旗居民慢性病危险因素监测分析

目的:了解西乌珠穆沁旗居民慢性病的危险因素,为防治慢性病提供科学依据。方法:用按比例多阶段随机抽样的方法抽取在西乌珠穆沁旗居住满5年的18岁以上居民3 528人作为调查对象,进行问卷调查及体格检查。结果:西乌珠穆沁旗居民中高血压、糖尿病和冠心病人群中危险因素是吸烟、饮酒、体育锻炼、体质指数,而脑卒中的人群危险因素是吸烟、饮酒。蒙古族人群吸烟率、饮酒率高于其他民族人群。调查人群的超重率和肥胖率分别为29.4%和16.8%,吸烟率为22.2%,饮酒率为15.9%,其中男性的吸烟率、饮酒率、锻炼率、超重率和肥胖率均高于女性。不同年龄组吸烟、饮酒、体育锻炼、体质指数差异均有统计学意义(P<0.05),多因素分析显示,性别、吸烟、饮酒、超重、肥胖、遗传等因素是西乌珠穆沁旗居民慢性病的患病危险因素。结论:影响西乌珠穆沁旗居民健康的危险因素较多,应积极采取预防控制措施,提高居民的生活质量。     

深圳地区高层管理人员脂肪肝危险因素分析

目的探讨深圳市高层管理人员脂肪肝危险因素。方法对深圳市企事业单位高层管理人员1515例体检者进行身高、体重、腰围、臀围、腹部B超、血脂等检测,并按腰臀比值、体质指数、高脂血症进行分层分析各组危险因素与脂肪肝的相关性。结果受检者脂肪肝患病率为21.19%（男性：28.09%,女性：8.84%）,中心性肥胖组（按WHR分型）和外周肥胖组（按BMI分型）的脂肪肝的检出率明显高于正常体型和正常体重组（P〈0.01）。中心性肥胖的脂肪肝患病率明显高于外周肥胖（P〈0.01）。中心性肥胖与外周肥胖都与脂肪肝的患病率呈正相关（P〈0.01）。结论深圳地区高层管理人员脂肪肝患病率较高,肥胖、高脂血症是导致脂肪肝的独立危险因素,中心性肥胖比外周型肥胖危险性更大。腰臀比值与体质指数都可作为脂肪肝的危险预测因素,腰臀比值比体质指数特异性更高,两者结合进行可明显提高脂肪肝风险预测的特异性和敏感性。     

海淀区居民慢性病相关危险因素的关联规则

目的：挖掘海淀区居民慢性病相关危险因素之间的关联模式。方法：将调查的3 219人的慢性病相关危险 因素信息作为数据集,用SPSS 18.0对慢性病相关危险因素在人群中的构成比进行统计描述与logistic回归分析,用SPSS Modeler14.1软件中的Apriori算法对数据集进行关联规则挖掘。结果：男性人群中有5条关联规则满足条件,这些关联 规则显示：过量饮酒、水果蔬菜摄入不足及身体活动不足与吸烟存在特定关联;水果蔬菜摄入不足、吸烟与身体活 动不足存在特定关联。女性人群中有1条关联规则满足条件,即水果蔬菜摄入不足与身体活动不足存在特定关联。 结论：海淀区居民慢性病相关危险因素如吸烟、过量饮酒、水果蔬菜摄入不足、身体活动不足之间存在关联。这些 慢性病相关危险因素关联模式能够帮助我们有针对性地优选慢性病干预模式,对有这些特定行为模式的人群提出靶 向性的干预措施。     

社区人群高血压与超重、肥胖的关系探讨

目的：了解永丰社区高血压患者与超重和肥胖的关系。方法：对永丰社区2125名30岁以上自然人群进行了整群抽样调查。结果：男女间高血压患病差异无显著性，在体质指数及腰臀比超常状态下男、女间差异有显著性意义。调查人群的高血压患者中男性肥胖率高于女性。结论：体质指数和腰臀比超常均增加人群患高血压的危险性。肥胖对男性的影响高于对女性的影响。当腰臀比异常时，体质指数对男女高血压患病产生显著性影响。     

人体测量学指标预测心血管疾病危险因素的研究进展

心血管疾病（CVD）的危险因素主要包括高血压、吸烟、血脂异常、糖尿病、超重/肥胖、身体活动不足和不合理膳食等方面。在临床实践中,人体测量学指标可应用于预测CVD的危险因素和评估诊治疗效。这些指标包括体质指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）等。每种测量学指标所针对的侧重点各不相同。BMI多用于评价全身性肥胖,WC侧重于评价腹部肥胖,WHR对CVD危险因素的预测能力较弱,WHtR校正了身高因素、人群间差异度小,预测CVD危险因素更具优越性。     

遗传和环境对于男性开始吸烟影响的双生子研究

目的：分析遗传和环境因素分别对于男性吸烟行为和开始吸烟年龄的影响。方法：回顾性调查1 006对18岁及以上成年双生子的吸烟状况及开始吸烟年龄,在分析同卵和异卵双生子同吸烟率的基础上分别计算吸烟行为和开始吸烟年龄的遗传度。结果：与西方文化不同,该双生子人群中男性吸烟比例达66.8%,相比之下女性仅有0.2%。同卵双生子中, 88.7%(566/638对)的双生子对中两个成员都是吸烟者或者具有吸烟经历或均不吸烟,而异卵双生子此比例仅为63.6%(234/368对)。该双生子样本吸烟行为的遗传度为69.0%±4.1%。双生子平均开始吸烟年龄（20.4±5.3）岁,同卵双生子开始吸烟年龄相关系数0.393,而异卵双生子达0.860。结论：中等程度的遗传度显示遗传因素对于男性双生子选择是否吸烟具有一定的影响,但是什么时候开始吸烟,更多取决于个人环境的影响。     

江阴市居民慢性病及相关行为危险因素调查

目的：掌握江阴市居民的慢性病基本情况及相关行为危险因素的流行率和分布特征。方法：采用分层随机整群抽样方法抽取5个镇（街道）18周岁及以上居民5 000人进行问卷调查和体格检查。结果：高血压、高脂血症、糖尿病、冠心病是影响我市居民健康的主要慢性病,患病率分别为22.1%、7.4%、4.3%、2.6%。主动锻炼过少、超重和肥胖、吸烟、饮酒、常食腌制食品、蔬菜摄入过少等是江阴市居民慢性病主要行为危险因素,发生率分别为81.15%、46.49%、26.72%、27.22%、17.11%、13.65%。结论 ：江阴市居民慢性病患病率处于较高水平,且慢性病发病呈年轻化、多元化趋势。超重和肥胖、吸烟、饮酒等慢性病行为危险因素普遍存在,且具有不同的人群分布特征。必须采取有针对性的干预措施,降低慢性病行为危险因素流行率,达到预防和控制慢性病的发生和发展。     

云南省三县（区）居民慢性病流行病学调查

目的 探讨云南省三县（区）居民慢性病流行病学特征及其影响因素，为云南省慢性病预防控制提供科学依据。方法 运用多阶段随机抽样方法，抽取3个县（区）、12个乡镇（街道）、36个村（居委）1217位居民进行问卷调查和体格测量。结果 三县（区）居民慢性病患病率为42．56％，其中男性为41．43％，女性为43．57％；慢性病患病率随年龄增加而增高：不同职业、文化程度慢性病患病率有显著性差异，汉族患病率明显高于少数民族；城市居民慢性病惠病率为48，81％，农村为42．10％；体质指数、腰臀围比、精神状况、劳动强度与饮酒是居民惠慢性病的相关影响因素。结论 三县（区）人群慢性病患病率整体水平较高，超重、精神状况欠佳、轻劳动强度、饮酒频度增加是构成慢性病患病增加主要危险因素，应高度关注高危人群及主要危险因素，制定有效可行的策略及措施，遏制慢性病的流行。     

丹东市乡村居民慢性病行为危险因素分析

目的：了解慢性病在丹东市乡村居民的惠病情况、易感人群的分布和主要危险因素。方法采用随机分层抽样对20岁以上常住人口共2682人进行居民健康状况及行为危险因素的调查。结果：慢性病中高血压、高血脂、冠心病的患病率分别为11．11％、18、63％、7．13％；吸烟、饮酒、成食、超重、失眠的比例分别为27．54％、22．72％、17．86％、28．61％、12、65％。多因素Logistic分析显示年龄、吸烟、饮酒、成食和超重、失眠等是慢性病的主要危险因素，并且随着饮酒年限和吸烟年限的增多，其患慢性病的危险性也呈显的上升。超重伴有高血压、高血脂的冠心病、脑卒中、糖尿病的患病率均比同龄健康成倍增高。结论：高血压、高血脂、冠心病等是丹东地区乡村居民的主要慢性病。加强健康教育、开展控烟与防治高血压是主要的干预措施。     

南京市某社区老年人群高血压患病率及危险因素分析

目的:了解南京市近年来老年人群的高血压患病率及危险因素,为有效预防和控制老年高血压提供科学依据。方法:采用2007年南京市某社区老年人健康体检数据库,对老年人高血压患病情况及危险因素进行统计分析。结果:2007年该社区老年人群高血压患病率为37.1%,男性远高于女性,老年男性(≥80岁)高血压患病率有下降趋势;年龄增大,体质指数、腰臀比及血脂代谢异常者的高血压患病率急剧上升。结论:社区老年人群高血压患病率较高,严重危害老年人的身心健康,应予重视;年龄、体质指数、腰臀比及甘油三酯是老年人群高血压的危险因素;开展积极有效的老年人高血压防制措施十分必要。     

青少年双生子血尿酸的遗传度研究

目的用双生子研究方法对青少年血尿酸的遗传度进行估计。方法取青岛双生子库募集青少年双生子,测量身高、体质量和血尿酸。相同性别和血型的双生子采用16个多态标记进行卵型鉴定。通过校正年龄、性别和体质指数(BMI)来构建结构方程模型估计遗传度。结果共收集521对双生子数据,其中同卵双生子274对,异卵双生子247对。经平方根转换后,男性血尿酸水平略高于女性(t=5.584,P<0.001),通过校正年龄、性别和BMI后双生子血尿酸的组内相关系数同卵双生子为0.80,异卵双生子为0.46。运用性别限制模型进行拟合,最佳模型为AE模型,加性遗传因素和特殊环境因素共同作用血尿酸的水平。血尿酸的遗传度为77.5%(95%CI为0.731～0.811),特殊环境因素占22.5%(95%CI为0.189～0.269)。结论遗传因素是影响本研究样本双生子血尿酸水平的主要因素。     

中国双胎及双胎合并出生缺陷的流行病学调查

目的：调查我国围产儿双胎与双胎合并出生缺陷尤其是合并神经管缺陷的发生率及其流行病学情况。方法：于1986年10月1日－1987年9月30日,对全国原29个省,市、自治区共945所城乡医院 住院分娩围产儿,进行了双胎出生率的调查及统一标准的出生缺陷前瞻性的监测,结果：全年共生围产儿1243284名,其中双胎12715对,双胎发生率为10．23％,双胎中出生缺陷发生率为36．81‰,其中神经管缺陷最为高发,为5．27‰,双胎的发生无南北地域及城乡的差异,多发生在生育期高峰年龄（20－29）岁,初产多见,1年中10,11月份出生的发生率高,双胎合并出生缺陷亦无明显南北地域及城乡差异,多发生在20－39岁,无产次及季节的差异;双胎合并神经管缺陷多见于北方诸省及农村人口,其发生与年龄及产次无明显关系;但与季节密切相关,11月份高发。结论：双胎合并出生缺陷,尤其是合并神经管缺陷的发生率均明显高于全国总围产儿合并出生缺陷及神经管缺陷的发生率,因此对双胎妊娠应注意作产前监测。     

Metabolic studies in unaffected co-twins of non-insulin-dependent diabetics

Forty-eight out of 53 non-insulin-dependent diabetic identical twin pairs were concordant for diabetes. In the five discordant pairs the diabetic twin had only recently been diagnosed. Oral glucose tolerance tests were carried out on the unaffected twins of the five pairs and on matched controls. Fasting concentrations of blood glucose (5.5 +/- 0.6 v 3.7 +/- 0.3 mmol/l; 99.1 +/- 10.8 v 66.6 +/- 5.4 mg/100 ml), haemoglobin A1 (mean 9.1%, range 8.8-9.2% v mean 7.9%, range 7.4-8.4%), lactate, alanine, and glycerol (0.090 +/- 0.017 v 0.045 +/- 0.008 mmol/l); and the lactate: pyruvate ratio were significantly higher in the twins than controls. After glucose challenge blood glucose, lactate, alanine, and glycerol concentrations and lactate: pyruvate ratio were increased in the twins. Insulin response was severely impaired, being almost absent in four of the five twins. The non-diabetic members of the discordant non-insulin-dependent diabetic pairs showed noticeable metabolic abnormalities which would later presumably deteriorate to frank diabetes. These findings, taken with the high concordance rate for non-insulin-dependent diabetic twins, suggest that non-insulin-dependent diabetes is predominantly, possibly entirely, inherited.     

双生子中脂蛋白脂酶基因S447X突变与血脂、血压的关联和连锁分析

目的:在以一般人群为基础的中国成人双生子中探讨脂蛋白脂酶(LPL)基因S447X突变是否和血脂、血压有关联和连锁.方法:基于双生子登记系统,对双生子进行问卷、体检、生化指标测定以及S447X突变的检测.按性别分层,分别进行S447X突变与甘油三酯(TG)、高密度脂蛋白(HDL)、收缩压(SBP)、舒张压(DBP)及其异常之间的单因素和控制混杂因素后的多因素关联分析.用基于Halesman-Elston回归的非参数同胞对连锁分析方法,在异卵双生子(DZ)中进行该突变位点和血脂、血压的连锁分析.结果:在962对成人双生子中,S447X突变等位基因的频率为8.6%;TG、HDL、SBP和DBP的遗传度分别为57%、68%、46%和44%;单因素和多因素关联分析显示,在女性双生子中,S447X突变和TG下降12.9%显著相关,也和SBP下降2.7 mm Hg(1 mm Hg=0.133 kPa)、DBP下降1.8 mm Hg显著相关.而且,S447X突变和高TG异常、低HDL异常及高血压的发生风险降低也呈显著相关,OR值分别为0.38(95%CI:0.20～0.76)和0.49(95%CI:0.29～0.81)和0.47(95%CI:0.25～0.86).结论:在女性双生子中,S447X突变和血脂改善及血压降低相关,但在男性双生子中没有发现这种关联.也没有发现S447X突变位点和血脂及血压性状位点的连锁关系.因此,S447X突变和血脂及血压的关系可能是由于该突变和其它调节血脂和/或血压的功能性突变存在连锁不平衡所致.     

成年双生子血压水平与DNA甲基化相关性研究

目的：在成年双生子人群中探索与血压指标（收缩压、舒张压、平均动脉压、脉压）存在相关性的DNA甲基化位点。方法：研究人群来自中国双生子登记系统,共476名双生子,问卷调查包括一般人口学特征、生活方式及疾病状况等信息,体格检查包括血压、身高、体重等信息,使用Infinium HumanMethylation450 BeadChip芯片对外周全血进行全基因组DNA甲基化检测。在调整潜在混杂因素的基础上,通过构建混合效应模型在全基因组范围寻找与血压指标存在相关性的DNA甲基化位点,显著性水平为错误发现阳性位点率<0.05。结果：经过数据质量控制最终纳入465名双生子（122对同卵双生子,104对异卵双生子,13对双生子的其中之一）,年龄(44.8±13.2)岁,男性多于女性,同卵略多于异卵,目前吸烟和目前规律饮酒者所占比例均大于30%。所有双生子个体均行全基因组DNA甲基化与血压指标相关分析,经多重校正后未发现显著的甲基化位点,但位于10号染色体的cg07761116在3个血压指标（收缩压、舒张压、平均动脉压）相关分析中的P值相对较小, 提示其可能是一个与血压相关的位点。还有7个位点在两个血压指标相关分析中的P值较小,所在基因与神经发育、蛋白质稳态、炎症反应等功能相关。结论：没有明确证据支持与血压水平存在相关性的甲基化位点,可能由于样本量不足等原因,可以为后续开展类似的双生子研究提供参考,后续研究可以关注10号染色体上的cg07761116及其他P值较小的位点。     

THE STUDY OF DENTAL CARIES AMONG 280 TWIN PAIRS

The twin study was intent a to estimate the relative influence of hereditary factors and environmental factors in causing caries. The subjects selected from the city Beijing, China, are 280 same-sexed twin pairs. 186 pairs are monozygotic (MZ) twins; the other 94 pairs are dizygotic (DZ) twins. The total sample involved in the present study was significantly great in size and different statistical methods of analysis were adopted. The conclusion reached is such that non-genetic factors rather than genetic factors have more influence in causing caries.     

Association of β3 Adrenergic Receptor and Peroxisome Proliferator-activated Receptor Gamma 2 Polymorphisms With Insulin Sensitivity： A Twin Study

Objective To study the effect of β3 adrenergic receptor(β3AR) Trp64Arg and peroxisome proliferator activated receptor gamma 2(PPARγ2) Pro12Ala polymorphisms on insulin resistance. Methods One hundred and eight dizygotic twin pairs were enrolled in this study. Microsatellite polymorphism was used to diagnose zygosity of twins. Insulin sensitivity was estimated with logarithm transformed homeostasis model assessment(HOMA). PCR-RFLP analysis was performed to detect the variants. As a supplement to the sib-pair method,identity by state(IBS) was used to analyze the association of polymorphisms with insulin sensitivity. Results The genotype frequencies of Trp64Trg,Trp64Arg,and Arg64Arg were 72.3%,23.8%,and 3.9%,respectively,while the genotype frequencies of Pro12Pro,Pro12Ala,and Ala12Ala were 89.9%,9.6%,and 0.5%,respectively. For β3AR Trp64Arg the interclass co-twin correlations of Waist-to-hip ratio(WHR),blood glucose(GLU),and insulin(INS),homeostasis model assessment insulin resistance index(HOMA-IR) of the twin pairs sharing 2 alleles of IBS were greater than those sharing 0-1 allele of IBS,and HOMA-IR had statistic significance. For PPARγ2 Pro12Ala most traits of twin pairs sharing 2 alleles of IBS had greater correlations and statistic significance in body mass index(BMI),WHR,percent of body fat(PBF) and GLU,but there were low correlations of either insulin or HOMA-IR of twin pairs sharing 1 or 2 alleles of IBS. The combined effects of the two variations showed less squared significant twin-pair differences of INS and HOMA-IR among twins sharing 4 alleles of IBS. Conclusions β3AR Trp64Arg and PPARγ2 Pro12Ala polymorphisms might be associated with insulin resistance and obesity,and there might be slight synergistic effects between this two gene loci,and further studies are necessary to confirm this finding.     

Fetal echocardiographic screening in twins for congenital heart diseases

Background Congenital heart disease (CHD) is the most common congenital disorder at birth. Yagel and colleagues’s method of heart examination has been proved valuable in finding CHD prenatally in single pregnancies. The aim of this study was to analyze the frequency of CHD in twin pregnancies and the sensitivity of the method. Methods A total of 1103 pregnant women with twins were enrolled in this study, including 127 cases with high-risk for CHD. Five transverse ultrasound measurements were used for fetal heart examination, including the upper abdomen view, four-chamber view, five-chamber view, pulmonary artery bifurcation view, and three-vessel view. In the fetuses who were diagnosed with CHD and whose parents requested termination of the pregnancy, autopsy of the fetal heart was performed after an abortion, and a blood sample was collected from the heart for chromosome evaluation. In the other fetuses, a close follow-up was conducted by echocardiography within one year after birth. Results Antenatally, CHD was found in 12 twins, of which 4 were from the high-risk group (3.15%), and 8 from the low-risk group (0.82%). In 2 pairs of the twins, the two fetuses had a same kind of CHD (one pair had tetralogy of Fallot (TOF), another pair had rhabdomyoma). Another pair had different types of anomaly (one fetus had TOF, and the other duodenal atresia with a normal heart). Termination of pregnancy was performed in these three pairs and the autopsy of the fetal heart confirmed the ultrasound findings. In the other 9 pairs, CHD was detected in one fetus, and a normal heart in the others. In the cases who received chromosome evaluation, 2 had abnormal chromosomes. During the follow-up after birth, heart examinations confirmed the prenatal diagnosis in 7 of the 9. The diagnosis of CHD was missed antenatally in 2 pairs of twins. In both the cases, one fetus was normal, and the other was confirmed as having CHD after birth (small ventricle septum defect in one, and persistent open ductus arteriosus in the other). Thus, the total frequency of CHD was 16 (7.3/1000), which was similar to that in single pregnancies. The sensitivity of fetal echocardiography was 87.5% and the specificity was 100%. Conclusions The frequency of CHD is the same in twin as in single pregnancies. Systemic ultrasound scanning with five transverse views is effective in diagnosing fetal CHD in twin pregnancies.     

芜湖市198对双生儿的调查分析

通过对芜湖市中、小学和幼儿园的58 887名学生的普查,发现198对双生子,双生子发生率为3.4‰,其中同卵双生占60.77％,异卵双生占39.23％。本文就双生子的胎次和父母育龄的分布;双生子的智力、体征;双生与遗传等方面进行了研究。