The Relationship Between The Expression Levels Of Stress-related Factors And Metabolic Syndrome

Objectives To explore the relationship among the protein expression levels of serum heat shock protein70(HSP70) and tumor necrosis factor-a (TNF-a) in the Ningxia Hui and Han, metabolic syndrome (MS) and its related indicators; To explore the relationship among the occupational psychological stress, metabolic syndrome, HSP70and TNF-a, and analysis the risk factors of metabolic syndrome in the Ningxia Hui and Han ethnic, providing a scientific basis for the prevention of metabolic syndrome.Methods According to a1:1matched case-control study and the inclusion and exclusion criterias, selected600unrelated MS patients from20to60years old from November2011to October2012in the Ningxia Medical University Hospital (General Hospital) and teaching hospital (Wuzhong City People’s Hospital)as a case group. Matched by gender, age, ethnicity, selected600unrelated healthy population who have a regular health examination in the same location and in the same period as a control group. There was150Hui and150Han in the case group,150men and150women, mean age (50.38±6.82) years old;150Hui and150Han in the control group,150men and150women, mean age (50.38±6.78) years old. We used the self-designed questionnaire to survey the general, lifestyles, family histories and medical histories, did the physical measurements, collected10ml fasting venous blood samples for laboratory biochemical blood tests.Using a double antibody sandwich enzyme-linked immunosorbent assay (ELISA) to test the protein expression levels of the serum HSP70and TNF-α. We used the Occupational Stress Inventory (OSI) to investigate the subjects’occupational stress factors and stress levels. Results The expression levels of HSP70and TNF-a were significant differences in the MS group and the control group, and they were all significantly higher in the case group than in the control group (t=2.543,2.529, all P<0.05). The expression levels of HSP70was significantly higher in Hui than in Han ethnic(t=3.139,P<0.01), the expression levels of TNF-a in Hui and Han was statistically higher in Han than in Hui(t=16.193,P<0.01). The expression levels of HSP70in the abdominal obesity MS group, non-abdominal obesity MS group and control group, the difference were statistically significant (t=4.805,P<0.01), and it was higher in the abdominal obesity MS group than in the control group (P＜0.01), the difference between the non-abdominal obesity MS group and control group and abdominal obesity MS and non-abdominal obesity MS group were not significantly significant (all P>0.05); the expression levels of TNF-a in abdominal obesity MS group, non-abdominal obesity MS group and control group, the difference was not significant (t=2.752,P>0.05). With the interquartile range, the subjects were divided into low, medium, and high expression level groups, and we compared the objects’general clinical data, the results showed that with the increase of HSP70, WC, WHR, BMI, SBP, UA showed an upward trend (F=3.506,4.231,3.083,6.769,9.723, all P<0.05or P<0.01), with the increase of TNF-a, WHR, SBP, FPG, TG showed an upward then downward trend (F=5.797,4.404,3.129,4.392, all P<0.05or P<0.01). The components of MS(abdominal obesity, HDL-C and blood pressure) were all statistically significant among the different levels of HSP70(Χ2=6.218,8.375,8.599, all P<0.05), with the increase of HSP70, the abnormal rate of abdominal obesity, HDL-C, and blood pressure was increased and then decreased, but there were no significant differences among different HSP70levels in fasting blood glucose and high TG (all P＞0.05); with the increase of TNF-α, the abnormal rate of blood glucose was increased and then decreased(Χ2=6.887,P<0.05), but the abnormal rate of abdominal obesity, TG, HDL-C, and blood pressure were not significantly differences among the different levels of TNF-a (all P>0.05). With the increase of HSP70levels, the risk of MS was increased, the difference was statistical significance, the high expressed HSP70group suffering from MS was1.310-fold than the low expressed group(95%CIwas1.113to1.538); and so did TNF-a, the risk of suffering from MS was1.196-fold(95CIwas1.004to1.425). The Occupational psychological stress test results showed that the total score of stress factors, workload, interpersonal relationships, family/work balance, cognitive load, and other sources in the MS group were all higher than in the control group (t=6.676,10.269,6.569,2.028,8.714,2.838, all P<0.05), but the scores of management role, work responsibilities and organizational climate were not significantly differences in case group and control group (all P>0.05); the stress factors score, workload, interpersonal relationships, family/work balance, management roles, work responsibilities, cognitive load, organizational climate, and other sources Hui and Han population, they were all not significant differences (all P>0.05); the expression levels of HSP70in the three stress levels, there were significant differences in the MS group and control group(F=213.188,130.811,327.056, all P>0.01), with the increase of stress levels, the expression levels of HSP70showed an upward first then downward; the expression levels of HSP70in the three stress levels, there were significant differences in Hui and Han(F=158.175,168.454, all P<0.01), with the increase of stress levels, the expression levels of HSP70showed an upward first then downward. The expression levels of TNF-a were significant differences in the MS group and control group(F=27.671,28.586,55.363, all P<0.01), with the increase of stress levels, the expression levels of TNF-a was increased then decreased; The expression levels of TNF-a were significant differences in Hui and Han, and with the increase of stress levels, the expression levels of TNF-a was increased then decreased(F=43.831,46.599,P<0.01). Using Multiple linear regression analysis and Multivariate conditional logistic analysis, it showed that FPG, SBP, and TNF-a were all positively correlated with occupational stress factors (all P<0.01), HDL-C and HSP70were all negatively correlated with occupational stress factors (all P<0.01); risk factors of MS were BMI,WHR,LDL-C,ALT,UA, HSP70, family history of hypertension, family history of diabetes, and the levels of stress factors in Ningxia, protective factors of MS was education level.Conclusions1. HSP70was related to the incidence of MS in Ningxia,the expression levels of HSP70were significantly higher in MS than in the control group, it was significantly higher in Hui than in Han ethnic; TNF-a was related to the incidence of MS in Ningxia,the expression levels of TNF-a were significantly higher in MS than in the control group, it was significantly higher in Han than in Hui ethnic.2. The expression levels of HSP70protein was associated with abdominal obesity, low HDL-C, and hypertension, but may be irrelevant with high TG and fasting glucose; with the increase of HSP70, WC, WHR, BMI, SBP, and UA showed an upward trend, and the risk of MS was a significant increase. The expression levels of TNF-a was associated with fasting glucose, but may be irrelevant with abdominal obesity, high TG, low HDL-C, high blood pressure in Ningxia; the expression levels of TNF-a between WHR, SBP, FPG, TG were statistically differences, and with the increase of TNF-a levels, the risk of MS was also significantly increased.3. Compared with the control group,MS group experienced more stress factors, mainly from the workload, interpersonal relationships, family/work balance, cognitive load, and other sources; there was no significant difference in the levels of the occupational psychological stress in Hui and Han.4. The expression levels of HSP70was associated with the occupational psychological stress levels, and with the increase of the stress levels, the expression levels of HSP70in MS group and control group showed the upward then downward trend, so was Hui and Han. The expression levels of TNF-a was associated with the occupational psychological stress levels, and with the increase of the stress levels, the expression levels of TNF-a in MS group and control group showed an upward then downward trend, so was Hui and Han.5. MS was related to the occupational stress factors, FPG and SBP were positively correlated with occupational stress factors, HDL-C was negatively correlated with occupational stress factors. The risk factors of MS in Ningxia population were body mass index, waist-to-hip ratio, low-density lipoprotein cholesterol, alanine aminotransferase, serum uric acid, HSP70levels, family history of diabetes, family history of hypertension, and the levels of stress factors.