| The metabolic syndrome (MetS) is a complex syndromewhich is composed ofadipose,protein and carbohydrate metabolic abnormalities. The syndrome including of central obesity, raised triglycerides, low high density lipoprotein, elevated blood pressure or raised glucose. It is mainly caused by genetic factors,lifestyle and diet.MetS increases the risk of developing type 2 diabetes, cardiovascular disease, cancer gout, nonalcoholic fatty liver disease, polycystic ovary syndrome, sleepapnea and dementia.Aims:To investigate the prevalence and risk factors of MetS, to evaluate the association between single nucleotide polymorphisms (SNPs) in the apolipoprotein APOA1-APOC3-APOA4-APOA5 gene cluster and MetS risk and to analysis theinteractions of environmental factors and APOA1-APOC3-APOA4-APOA5 gene cluster polymorphisms with MetS.Methods:Study in prevalence and risk factors forMetS was conducted using data from a large cross-sectional surveyrepresentative of the population of Jilin Province situated in northeastern China. The survey was designed to evaluate the prevalence and risk factors associated with chronic disease.Survey participations were randomly chosen from a multistage stratified cluster sampling of residents aged from 18 to 79 years in all nine administrativeareas of the province. Data were collected through face-to-face questionnaire interviews with additional anthropometry and laboratory examinations. The survey data wereweighted to reflect the sex, age and residence location distribution of Jilin Province using population data for the province from the sixth Chinese National Population Census,2010. Complete data for all the variables making up metabolic syndrome available for 16831 survey participants.Risk factors forMetS were examined by using univariate and multivariate logistic regression analysis based on the weighted sample data.We further identifieda sub-sample of 1813 survey subjects who met the criteria for MetSpatients and 2037 controls to this case-control study was used to evaluatethe association between SNPs in the apolipoprotein APOA1-APOC3-APOA4-APOA5gene cluster and MetS risk. Subjectswith cancer and other metabolic diseases were excluded from the controls.Genomic DNA was extracted from peripheral blood lymphocytes,SNP genotyping was determined by MALDI-TOF-MS.Associations between SNPs and MetS were examined by the method of case-control study design.Theinteractions of environmental factors and APOA1-APOC3-APOA4-APOA5 gene cluster gene polymorphism with MetS was conducted on the multivariate logistic regression analysis.RusultsThe overall adjusted prevalence of MetS was 32.86% in Jilin province. The prevalence of MetS in men was 36.64%, which was significantly higher than that in women 29.66%. MetS was more common urban areas(33.86%) than that in the rural areas(31.80%). This difference was statistically significant. The rate of central obesity, elevated blood pressure,elevated of TG, low high density lipoprotein and elevated glucose were 50.81%,52.18%,41.18%,31.06%and 30.22% respectively. Women had significantly lower risk of having the MetS(P<0.05). The risk of having MetSsignificantly increased with age(OR=8.621,95%CI= 6.594-11.272). Mental labor(OR=1.098,95%CI=1.008-1.195),,currentsmoking(OR=1.259,95%CI=1.108-1.429), excess salt intake(OR=1.252,95%CI= 1.149-1.363),fruit and dairy intake less than 2 times a week were positively associated with having MetS(P<0.05). People with family history of diabetes(OR=1.630,95%CI= 1.484-1.791), cardiovascular or cerebral diseases(<OR=1.297,95%CI=1.211-1.389) had more risk in catching MetS.Subjects carrying T allele of APOA1 rs5072 had an increased risk of MetS(ORT/C=1.617,95%CI=1.478-1.770). In the overdominant model, those with genotypes TC had a hogherrisk ofMetS (ORtC/TT+CC=1.617, 95%CI=1.478-1.770). The best model for APOC3rs5128 was the overdominant model, subjects carrying genotypes GC had an increased risk of MetS(0RGC/GG+CC,95%CI= 1.089-1.407). rs2854117 had no association with MetS(P>0.05). The best model for APOA4rs5128 was overdominant model, subjects carrying genotypes GA had an increased risk of MetS(ORGA/GG+AA,95%CI=1.025-1.331). Subjects carrying G allele of APOA5rs662799 also had an increased risk of MetS(ORG/A=1.450,95%CI= 1.312-1.602), In the codominant model, subjects with genotypes GG or GA had a higherrisk of MetS{ORGG/AA=1.232,95%CI=1.746-2.852, ORGA/AA=1.392,95%CI= 1.217-1.592). Carriers of the C allele of APOA5rs651821 had an increased risk of MetS(ORC/T=1.443,95%CI=1.306-1.594), In the codominant model,individuals with genotypes CC or TC had an increased risk of MetS(ORCC/TT=22.253,95%CI= 1.746-2.883, ORTC/TT=1.375,95%CI=1.203-1.572). Those carryingthe T allele of APOA5rs2075291 also had an increased risk of MetS(ORT/G=1.424,95%CI= 1.170-1.732), In the dominant model, carriers of the genotypes GT+TT had a higherrisk in catching MetS(ORGT+TT/GG=2.253,95%CI=1.168-1.760).Among the components of MetS, APOA1rs5072 T allele, APOC3rs5128 C allele, APOA4 rs5104 A allele, APOA5 rs662799 G allele, rs651821 C allele and rs2854117 T allele were associated with elevated TG levels (P<0.05). rs5072genotypes TC+TT, rs5128 genotypes GC+CC, rs2854117 genotypes GA+AA, rs5104 genotypes GA+GG, rs662799 genotypes AA or GA, rs651821 genotypes CC or TC and rs2075291 genotypes GT+TTwere also associatedwith elevated TG levels (P<0.05). rs662799 G allele, rs651821 C allele and rs2075291 T allele associated with low levels of HDL-C(P<0.05). rs5072genotypes TC+TT, rs662799 genotypes AA or GA, rs651821 genotypes CC or TC and rs2075291 genotypes GT+TT associated with low levels of HDL-C(P<0.05). rs2854117 A allele rs662799 G allele, rs651821 C allele and rs2075291 T allele associated with elevated blood pressure (P<0.05). rs5128genotypes GC, rs5104 genotypes GA, rs662799 genotypes AA or GA, rs651821 genotypes CC or TC and rs2075291 genotypes GT+TT also associated with elevated blood pressure(P<0.05). rs662799 G allele, rs651821 C allele and rs2075291 T allele were related with central obesity(P<0.05). rs5072genotypes TC, rs5128 genotypes GC, rs662799 genotypes AA or GA, rs651821 genotypes CC or TC and rs2075291 genotypes GT+TT were also associatedwith central obesity(P<0.05). rs662799 G allele, rs651821 C allele and rs2075291 T allele were related with elevated glucose(P<0.05). rs5128genotypes GC, rs5104 genotypes GA s662799 genotypes AA or GA, rs651821 genotypes CC or TC and rs2075291 genotypes GT+TT were related with elevated glucose(P<0.05). APOA5 rs662799 had interactions with tabacco use and alcohol consumption(PGE<0.05).Conclusions:The overall adjusted prevalence of MetS was 32.86% in Jilin province. The prevalence of MetS in men was 36.64%, in women was 29.66%. The prevalence of MetS was 33.86% in the urban areas, and 31.80% in the rural areas. The risk factors of MetS including being male, increasingage, mental labor, family history of diabetes, cardiovascular or cerebral diseases,current smoking, excess salt intake, fruit and dairy intake less than 2 times a week, and drinking.APOAlrs5072, APOC3rs5128, APOA5 rs651821, rs662799 and rs2075291 were associated with MetS. APOA1-APOC3-APOA4-APOA5 gene cluster may also have associations with MetS. SNPs in APOA1-APOC3-APOA4-APOA5 gene cluster gene were associated with components that make upMetSAPOA5 rs662799 hadinteractions with the environmental factors of MetS. |
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