Association Of EMILIN1、SLC6A2 Polymorphisms And Occupational Stress With Hypertension

Objective: To investigate the basic situation of occupational stress levels, health status of Xinjiang grade three A hospitals’ medical staff, and to explore EMIL1N1 、SLC6A2 polymorphisms in the role of occupational stress caused by hypertension. To perfect occupational stress and health epidemiological data of Xinjiang grade three A hospitals’ medical staff, and to establish and improve the level of the physical and mental health of medical staff so as to provide a scientific basis for prevention and treatment of hypertension. Methods: 1. In this study, Xinjiang grade three A hospitals’ medical staff(internal medicine, surgery, medical technical) 2036 people as the research object by cluster sampling, were evaluated by job stress survey(JSS) and chronic non-communicable diseases and behavior risk factors questionnaire survey. 2. A case-control study was conducted 200 hypertention patients as case and 200 normals(with matched same-sex, age ± 3 years and same-ethnic) as controls, and gene polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results: 1. The questionnaires were distributed 2,036 and recovered 1,847 valid questionnaires, with recovery rate of 90.7%. Male group got higher scores than female group in each dimension of occupational stress( P<0.05). Each dimension of occupational stress in different work age groups on the distribution difference were statistically significant(P<0.05). Work age<10 year group got lower scores than work age 10-20 year group in each dimension of occupational stress; work age10-20 year group got higher scores than work age>20 year group in each dimension of occupational stress( P<0.05). Each dimension of occupational stress in different departments on the distribution difference were statistically significant(P<0.05). Surgical and obstetrics-gynecology group got higher sores than internal and pediatrics medicine group in each dimension of occupational stress, except intensity of job stress.(P<0.05).Surgical and obstetrics-gynecology group and internal medicine and pediatrics group got higher sores than medical technical group in each dimension of occupational stress(P<0.05). 2. In this study, the prevalence of chronic diseases of the top seven were followed by the neck, lumbar disease( 24.6%), chronic digestive system diseases(21.5%), hypertension(14.9%), hyperlipidemia(10.1%), respiratory diseases(8.0%),chronic urinary system diseases(5.2%), thyroid disease(4.1%). The prevalence rate of neck, lumbar disease and chronic digestive system diseases, hypertension,hyperlipidemia went higher with the increase of work age(P<0.05). The prevalence rate of neck, lumbar disease, chronic digestive system diseases, hypertension, hyperlipidemia in different levels of occupational stress groups on the distribution difference were statistically significant(P<0.05). 3. Case group of total cholesterol, fasting blood glucose were higher than the control group(P<0.05). Case group and control group in the genetic history of high blood pressure, passive smoking, salt taste, frequency of night shift, sleep quality, occupational stress level on the distribution difference were statistically significant( P<0.05). Case group got higher sores than control group in each dimension of occupational stress( P<0.05). 4. There was significant difference in frequencies of genotype and allele in rs2304682 between case and control groups(P<0.05). There was significant difference in frequencies allele in rs2397771 between case and control groups(P<0.05). After adjustment of genetic history of high blood pressure, passive smoking,salt taste, frequency of night shift, sleep quality, occupational stress level, compared to rs2304682 CC genetype, the GG genotype increased the risk of high blood pressure(OR=2.611, 95%CI: 1.190-5.727); compared to rs2304682 CC+CG genetype, the GG genotype increased the risk of high blood pressure(OR=2.432, 95%CI: 1.156-5.118).Compared to rs2397771 GG genetype, the GC genotype increased the risk of high blood pressure(OR=1.731, 95 % CI: 1.057-2.835); compared to rs2397771 GG genetype, the GC+ CC genotype increased the risk of high blood pressure(OR=1.703, 95 % CI:1.081-2.683). 5. Through multi-factor unconditioned Logistic detected gene-gene interactions and gene-enviroment interactions, rs2304682-rs2397771,rs2397771-occupational stress, rs2304682-occupational stress model were not statistically significant( P > 0.05). Through GMDR detected gene-gene interactions and gene-enviroment interactions, rs2304682-rs2397771 model were statistically significant(P<0.05); occupational stress- frequency of night shift model, rs2397771-occupational stress- frequency of night shift model were statistically significant(P<0.001). The interaction effect model of rs2397771-occupational stress- frequency of night shift was thebest gene-environment interaction model. Conclusion: 1. Male group get higher occupational stress level than female group. Each dimension of occupational stress in different work age groups on the distribution difference are statistically significant.Work age 10-20 year group is highest level of occupational stress, and work age<10 year group and work age 10-20 year group are lower. Each dimension of occupational stress in different departments on the distribution difference are statistically significant. The level of occupational stress is highest in Surgical and obstetrics-gynecology group, and middler in internal medicine and pediatrics group, least in medical technical group. 2. Work age and occupational stress are influence factors of chronic disease. 3. Genetic history of high blood pressure, passive smoking, salt taste, frequency of night shift, sleep quality,occupational stress level are risk factors of hypertension. 4. Gene polymorphism of rs2304682 and C allele of rs2397771 may associate with the susceptibility of hypertension.GG genotype of rs2304682, GC genotype and GC+CC genotype of rs2397771 may associate with the susceptibility of hypertension, after adjustment of genetic history of high blood pressure, passive smoking, salt taste, frequency of night shift, sleep quality and occupational stress level. 5. Through GMDR detected gene-gene interactions and gene-enviroment, rs2304682-rs2397771 is best gene-gene interaction model, occupational stress- frequency of night shift model, rs2397771-occupational stress- frequency of night shift model were statistically significant. The interaction effect model of rs2397771-occupational stress- frequency of night shift is the best gene-environment interaction model.