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Background Pulse wave velocity (PWV) is a marker of arterial stiffness, which represents sub-clinical atherosclerosis. Pulsatile stress and high-sensitivity C-reactive protein (hs-CRP) are associated with arteriosclerosis. However, there is no prospective data confirming whether changes in pulsatile stress and inflammatory markers affect the progression of arterial stiffness. The aim of this study was to investigate the relationships over time between the effects of changes in pulsatile stress and hs-CRP, and arterial stiffness progression during a 2-year follow-up. Methods We performed a longitudinal study involving 3978 participants. All participants underwent a physical examination in 2010–2011 and 2012–2013, during which we measured participants' hs-CRP levels, brachial–ankle pulse wave velocity (baPWV), and pulsatile stress. Results Baseline hs-CRP was correlated with baPWV (r = 0.18, P = 0.000); however the correlation was weaker than that with systolic blood pressure (r = 0.65), pulsatile stress (r = 0.57), and rate-pressure product (r = 0.58). Multiple linear regression analysis demonstrated that changes in pulsatile stress, mean arterial pressure, and low-density lipoprotein-C (LDL-C) were positively correlated with changes in baPWV, with correlation coefficients of 0.27, 0.25, and 0.07, respectively, but not with changes in hs-CRP. Moreover, each 100-aU increase in pulsatile stress, 1 mmHg increase in mean blood pressure, and 1 mmol/L increase in LDL-C was associated with a 3 cm/s, 4.78 cm/s, and 17.37 cm/s increase in baPWV, respectively. Conclusions Pulsatile stress increases are associated with arterial stiffness progression, but that changes in hs-CRP had no effect on arterial stiffness progression. Hs-CRP may simply be a marker of inflammation in arterial stiffness and has no association with arterial stiffness progression.

We aimed to investigate whether liver steatosis severity affects the risk of developing diabetes in a large cohort study.We prospectively examined the association in 41,650 Chinese adults with negative hepatitis-B surface antigen who were free of alcohol consumption, diabetes, and liver cirrhosis at baseline. Cox proportional models were used to estimate the risk of diabetes after a mean of 3.6 years of follow-up. Nonalcoholic fatty liver disease (NAFLD) was assessed with hepatic ultrasonography. Elevated alanine transaminase (ALT) was defined as ALT concentrations19 and30 U/L in females and males, respectively. Diabetes was defined as a fasting glucoseLiver steatosis severity was significantly associated with higher risks of developing diabetes (adjusted hazard ratio [HR] for severe vs. without NAFLD = 2.66, 95% confidence interval [CI]: 2.17-3.25, P-trend.001) and impaired fasting glucose (fasting glucose between 5.6 and 6.9 mmol/L, adjusted HR = 1.36, 95% CI: 1.16-1.59, P-trend.001), as well as a faster increase rate of fasting glucose concentrations ( P-trend.001), during 3.6 years of follow-up. Elevated ALT was also associated with incident diabetes (HR = 1.12, 95% CI: 1.02-1.22), adjusting for NAFLD and other covariates.We observed a dose-response relationship between liver steatosis severity and increased diabetes risk, and ALT may predict incident diabetes independently of NAFLD.ALT = alanine transaminase; BP = blood pressure; CI = confidence interval; HCV = hepatitis C virus; HR = hazard ratio; IFG = impaired fasting glucose; NAFLD = nonalcoholic fatty liver disease; ULN = upper limit of normal.

This study aims to investigate the correlation between the trajectory of systolic blood pressure (SBP) and new renal damage in a nonhypertensive population.This prospective cohort study included a total of 14 382 nonhypertensive individuals, employees of Kailuan Group of Companies, who took part in five healthy examinations in 2006-2007, 2008-2009, 2010-2011, 2012-2013, and 2014-2015, and had complete data. These individuals were divided into four groups according to the different trajectories of SBP: low-low, low-stable, middle-high, and high-high groups. The correlation between the trajectory of SBP and new renal damage in a nonhypertensive population was analyzed using a multivariate Cox's proportional hazard regression model.(a) A total of 14 382 individuals had complete data and the average age of these individuals was 44.6±10.8 years. Among these, 10 888 (75.7%) individuals were men and 3494 (24.3%) individuals were women. (b) These individuals were divided into four groups according to different trajectories of blood pressure: low-low group, accounting for 13.15% (blood pressure was106 mmHg); low-stable group, accounting for 53.91% (blood pressure was between 115 and 116 mmHg); middle-high group, accounting for 28.77% (blood pressure was between 125 and 131 mmHg); and high-high group, accounting for 4.6% (blood pressure was between 126 and 151 mmHg). (c) With the increase in the trajectory of SBP, the detection rate of renal damage increased gradually. From the low-low group to the high-high group, the detection rates of estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m were 2.3, 2.4, 3.6, and 4.3%, respectively; the positive rates of urinary protein were 1.7, 2.9, 3.8, and 5.5%, respectively; and the detection rates of eGFR less than 60 ml/min/1.73 m or positive urinary protein were 4, 5.2, 7.3, and 9.3%, respectively (P0.05). (d) After adjustment for other confounding factors, multivariate Cox's proportional hazard regression analysis showed that compared with the low-low group, the risk of eGFR less than 60 ml/min/1.73 m increased by nearly 1.5 times in the high-high group and in the low-stable, middle-high, and high-high groups, the risks of positive urinary protein, eGFR less than 60 ml/min/1.73 m, or positive urinary protein increased by 1.48-2.34 and 1.20-1.70 times, respectively.In a nonhypertensive population, the high trajectory of SBP is a risk factor for kidney damage.

Background With the marked increase in the prevalence of diabetes mellitus, it was the purpose of our study to assess a potential association of time-cumulated exposure to systolic (CumSBP) and of diastolic blood pressure (CumDBP) with onset of impaired glucose tolerance and diabetes mellitus. Methods The prospective investigation included participants of the longitudinal Kailuan Study with three baseline examinations in 2006–2007, 2008–2009 and 2010–2011, re-examination in 2012–2013, and no diabetes mellitus at baseline. Cumulative blood pressure (BP) was calculated as cumBP = [(BP1 + BP2)/2 × time1–2] + [(BP2 + BP3)/2 × time2–3]. Based on cumSBP, the study population was stratified into four groups (cumSBP

Preliminary experiments indicated that target cells were resistant to glucocorticoid (GC) after pathological stress. This study was designed to investigate the alterations in plasma corticosterone level and GC receptor (GR) of liver cytosols, to assess the relative inflammatory cytokines contribution to GC resistant, and to observe the action of alpha-melanocyte-stimulating hormone (alpha-MSH) on the potential implications of glucocorticord regulatory effects in burned rats. Male Wistar rats (weight range, 180-200g) received a 35% total body surface area immersion scald and were randomly divided to receive either tumor necrosis factor alpha (TNFalpha), interleukin-1beta (IL-1beta), polyclonal antibody (pAb), alpha-MSH, Ac-D-Lys-L-Pro-D-Val (KPV peptide), or saline (control). The binding capacity (Rt) of the steroid-binding sites was measured by radioligand binding assay, using [3H]dexamethasone as the ligand. We examined plasma levels of IL-1beta, TNFalpha, IL-10, and corticosterone following scald challenge in rats. The Rt of GR (208.45+/-30.78fmol/mg of protein) in hepatic cytosol in rats, 12h later the scald was significantly lower than that (306.71+/-27.96fmol/mg of protein) of the control group (P0.01). The injections of anti-rat TNFalpha (257.80+/-12.82fmol/mg of protein), IL-1beta antibody (254.46+/-21.21fmol/mg of protein), alpha-melanocyte-stimulating hormone (278.32+/-7.76fmol/mg of protein) and KPV peptide (263.46+/-17.46fmol/mg of protein) might prevent the Rt of GR from decreasing in hepatic cytosols of rats with scald, respectively (all of P0.05) in vivo. Scald-induced robust increases in plasma IL-1beta (214.08+/-27.25pg/ml), TNFalpha (111.18+/-23.97pg/ml), IL-10 (177.50+/-15.79pg/ml) and corticosterone (2680+/-443.23ng/ml) levels after 12h. The administration of TNFalpha, IL-1beta pAb, alpha-MSH and KPV might attenuate these increases. These studies suggest that pro-inflammatory cytokines are involved in downregulation of GRs and thus alpha-MSH and KPV might increase the level of GR in rats with immersion scald.

As effectors, glucocorticoid and mineralocorticoid receptors play an important role in pathologic stress. This study was designed to observe the changes in glucocorticoid receptor of liver cytosols and mineralocorticoid receptor of kidney cytosols after pathologic stress in rats.Controlled laboratory study.Medical university.Male Wistar rats (weight range, 180-200 g).Rats received a low-degree or heavy-degree immersion scald that covered 10% or 35% total body surface area and were randomly divided to receive either tumor necrosis factor-alpha, interleukin-1beta polyclonal neutralizing antibody, alpha-melanocyte-stimulating hormone, KPV peptide (Ac-D-Lys-L-Pro-D-Val), or saline (control). The binding capacity and the apparent dissociation constant of the steroid-binding sites of normal, low-degree, and heavy-degree scalded rats were measured by radioligand-binding assay, with [3H]dexamethasone and aldosterone as the ligand, respectively.The binding capacity of glucocorticoid receptor in hepatic cytosols in rats 12 hrs after heavy-degree scald (208.45 +/- 30.78 fmol/mg of protein) was lower than that of the control group (306.71 +/- 27.96 fmol/mg of protein; p.01). The binding capacity of glucocorticoid receptor in hepatic cytosols in rats 12 hrs after low-degree scald (296.64 +/- 16.06 fmol/mg of protein) was not significantly different compared with the control group (p.05). There were two types of mineralocorticoid receptor in kidney cytosols in rats, and their binding capacity and apparent dissociation constant were not identical. The binding capacity of mineralocorticoid receptor in rats 12 hrs after heavy-degree scald (binding capacity 1, 22.40 +/- 5.40 fmol/mg of protein; binding capacity 2, 196.30 +/- 32.50 fmol/mg of protein) was lower than that of the control group (binding capacity 1, 41.60 +/- 7.20 fmol/mg of protein; binding capacity 2, 317.60 +/- 70.00 fmol/mg of protein; p.01). The binding capacity of mineralocorticoid receptor in kidney cytosols in rats 12 hrs after low-degree scald (binding capacity 1, 41.40 +/- 5.00 fmol/mg of protein; binding capacity 2, 314.80 +/- 45.70 fmol/mg of protein) was not significantly different compared with the control group (p.05). The injections of anti-rat tumor necrosis factor-alpha, interleukin-1beta polyclonal neutralizing antibody, alpha-melanocyte-stimulating hormone, and KPV peptide (Ac-D-Lys-L-Pro-D-Val) might prevent a reduction in the binding capacity of glucocorticoid receptor in hepatic cytosols and mineralocorticoid receptor in kidney cytosols in rats with heavy-degree scald in vivo.These studies suggest that the glucocorticoid receptor of hepatic cytosols and the mineralocorticoid receptor of renal cytosols decreased in rats with heavy-degree immersion scald and that the injections of anti-rat tumor necrosis factor-alpha, interleukin-1beta polyclonal neutralizing antibody, alpha-melanocyte-stimulating hormone, and KPV peptide might increase the level of glucocorticoid receptor and mineralocorticoid receptor in vivo.

To explore the impact of ideal health behaviors and health factors on the detection rate of the carotid plaques.Subjects with previous stroke, TIA, myocardial infarction were excluded from the study. A total of 5852 employees (active and retired employers from Tangshan Kailuan company) aged 40 years and over were included through stratified random sampling. Information was obtained from the unified questionnaire, measurements of blood biochemistry and carotid artery ultrasonography.(1) The carotid artery plaque detection rates were 67.0%, 52.3%, 50.5%, 44.3%, 37.2%, 31.9%, 26.1% and 4.2% in the groups with 0, 1, 2, 3, 4, 5, 6 and 7 components of ideal cardiovascular health behaviors and health factors, respectively. (2) The carotid artery plaques total burden score [TBS: M (Q1, Q3)] were 7(7,7), 7(5,7), 7(5,7), 5(3,5), 5(3,5), 5(3,5), 3(3,3), 3(3,3) in the groups with 0, 1, 2, 3, 4, 5, 6 and 7 components of ideal cardiovascular health behaviors and health factors, respectively. (3) Multiple logistic regression analysis showed that 3, 4, 5 and greater than 5 components of ideal cardiovascular health behaviors and health factors were protective factors against carotid plaques compared to less than 2 components of ideal cardiovascular health behaviors and factors (all P0.05), the OR (95%CI) values were 0.78 (0.62 - 0.98), 0.53(0.62 - 0.98), 0.52 (0.39 - 0.71) and 0.40 (0.25 - 0.64), respectively.Increasing ideal cardiovascular health behaviors and factors are negatively linked with the detection rate and TBS of the carotid plaques.

To compare the incidence of cardio-cerebral vascular events between pregnancy induced hypertension (PIH) women and non-PIH(NPIH) women.Ambispective cohort study method was used and 4630 pregnant women giving birth during October 1976 to December 2008 in our hospital and participated the healthy examination between July 2006 and October 2007 at Kailuan medical group were included and divided into PIH group (n = 694) and NPIH group (n = 3936) by the history of PIH. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.(1) The follow-up time was 2 to 34 (15.32 ± 7.94) years. (2) The childbearing age, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while gestational weeks and weight of newborn were significantly less in PIH group than in NPIH group (all P0.01). Levels of systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol and fasting blood glucose during healthy examination between July 2006 and October 2007 were significantly higher in PIH group than in NPIH group (P0.05 or P0.01). (3) There were 71 cardio-cerebral vascular events during the follow-up. In PIH group, the incidence rate of cardio-cerebral vascular events, myocardial infarction and cerebral infarction was 20.64%, 11.08% and 8.67%, respectively, while the corresponding incidence rate was 7.82%, 4.02% and 2.67% in NPIH group (all P0.01). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction and cerebral infarction in PIH group was 2.99 fold (95%CI: 1.80 - 4.95), 3.91 fold (95%CI: 1.71 - 8.91) and 3.96 fold (95%CI: 1.95 - 8.05) higher than in NPIH group.PIH is an independent risk factor for cardio-cerebral vascular events.

To observe the prevalence and distribution of ideal cardiovascular health behavior.Health examination data between 2008 to 2009 from the employees of Kailuan Group were analyzed.A total of 101 333 subjects took part in the health examination, subjects with previous myocardial infarction (n = 871), stroke (n = 2255), myocardial infarction and stroke (n = 162) and subjects with incomplete examination data (n = 9311) were excluded and 88 534 subjects were included for final analysis [mean age (50.6 ± 12.3) years, male 69 916]. (1) Body mass index (BMI), systolic and diastolic pressure, cholesterol (TC) and triglyceride were significantly higher in males than in females (all P0.05), women's income and the education lever were significantly higher than men (P0.05). (2) The distribution of ideal cardiovascular health behavior (smoking, BMI, physical exercise, salt intake) was 55.8%, 41.4%, 18.9% and 14.0% respectively among the population; the ideal cardiovascular factors (fasting blood glucose, TC, blood pressure) was 80.9%, 61.8% and 18.5%, respectively. (3) The subjects with distribution of seven, six, five, four ideal cardiovascular health behavior and factors was 0.1%, 1.9%, 9.1%, 20.3%, respectively. (4) Multiple logistic regression analysis showed that female, age55 and high education level were associated with the ideal cardiovascular health status with a RR value (95%CI) of 4.52 (4.32 - 4.72), 1.46 (1.39 - 1.53) and 2.23 (2.10 - 2.37), respectively.The prevalence of ideal cardiovascular health is extremely low in the study population, most persons were not in the ideal cardiovascular health behavior and factors and female, age55 and high education level are linked with ideal cardiovascular health status.

To evaluate the predictive value of baseline serum high sensitivity C-reactive protein for the first cardio-cerebral vascular event in the population with diabetes.In this prospective cohort study, a total of 101 510 employees of Kai Luan Group, who received healthy examination from July 2006 to October 2007, were screened and 7865 subjects with fasting plasma glucose ≥ 7.0 mmol/L or known diabetes mellitus and under insulin or hypoglycemic drugs therapy were followed up for 38 - 53 (48.02 ± 3.14) months.(1) Incidence rates of total cardio-cerebral vascular events, cerebral infarction and myocardial infarction increased in proportion to increased levels of baseline hsCRP (P0.01). After adjusting for age, gender, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and cigarette smoking, multivariate Cox's proportional hazards regression analysis indicated that the individuals in the highest quartile of hsCRP levels group (hsCRP ≥ 2.50 mg/L) had an increased risk of total cardio-cerebral vascular events (RR: 1.64, 95% CI: 1.20 - 2.24), cerebral infarction (RR: 1.52, 95% CI: 1.03 - 2.24), myocardial infarction (RR: 2.57, 95% CI: 1.34 - 4.91) compared with those in the lowest quartile group (hsCRP0.41 mg/L). (2) Higher baseline hsCRP levels were associated with aging, female gender, higher BMI, SBP, DBP, fasting blood glucose, TC, TG, LDL-C levels and lower HDL-C levels (all P0.05).Baseline hsCRP level is associated with increased first cardio-cerebral vascular event in the population with diabetes.