| Background and ObjectivesThe lifestyle and genetic background of the Kazakhs in Xinjiang are different from that of the Han,and Kazakhs have a high hypertension prevalence.Citizens,farmers,and nomads are three typical groups of Kazakhs in Xinjiang,with different socioeconomic status and way of life.Few hypertension-related studies have been done to compare these three groups,and few hypertension-related family studies have been done among Kazakhs.The purpose of this study is to analyze the prevalence of hypertension and its related comorbidities,including obesity,dyslipidemia,and diabetes,among Kazakh citizens,farmers,and nomads in Xinjiang,as well as the influence factors of hypertension in these three groups,and to explore the familial aggregation of hypertension-related phenotypes,including obesity,blood pressure,blood lipids,and blood glucose.This study aims to provide target hypertension prevention strategies for these three groups among Kazakhs in Xinjiang.MethodsThis was a cross-sectional study.From 2012 to 2013,a random cluster sampling method was used to obtain 1.668 Kazakh adults aged>30 in Hongdun Town.Altay City,Xinjiang,including 193 citizens,838 farmers,and 637 nomads.303 families(1370 participants)had at least two family members,including 983 participants had at least one genetically related family members.Detailed questionnaires,standard anthropometric measurements and laboratory examinations were conducted to obtain information of participants.The relationship of family members was obtained by village staff,police stations,and the participants.The prevalence of hypertension and its related comorbidities and the influence factors of hypertension were studied in these three groups.Use random forest model to analyze the influence factors of hypertension.Use the SHAP(SHaply Additive exPlanation)value to analyze the influence degree and the influence direction of the factors on the risk of hypertension.Use participants with family members being included in this research to study familial aggregation of hypertension-related phenotypes.Calculate the correlations of hypertension-related phenotypes in different family relationship(including parentoffspring,siblings,and spouse pairs),and calculate the heritability,genetic correlations,and environmental correlations among hypertension-related phenotype by variance components model.Familial aggregation study was performed using S.A.G.E(Statistical Analysis for Genetic Epidemiology)and SOLAR(Sequential Oligogenic Linkage Analysis Routines)software.ResultsThe hypertension prevalence among citizens,farmers,and nomads was 31.6%,44.5%,and 50.7%,respectively.The hypertension prevalence among female citizens aged 30-59 was slightly lower than that of farmers and nomads,and the hypertension prevalence among male aged 30-59 were similar among these three groups.Hypertensive patients in these three groups had high obesity rates(citizens:85.2%,farmers:70.0%,nomads:64.1%),high dyslipidemia rates(citizens:75.4%,farmers:67.0%,nomads:67.8%),and low diabetes rate(citizens:8.2%,farmers:1.6%,nomads:3.7%).The comorbidities of hypertensive patients among citizens had the most serious situation,with higher obesity rate,higher diabetes rate,higher triglyceride(TG)abnormal rate,and higher high-density lipoprotein cholesterol(HDL-C)abnormal rate compared with farmers and nomads(P<0.016).We ranked the factors that contributed more to the risk of hypertension in descending order,according to the average value of the absolute value of SHAP value.The top five factors were waist circumference,age,TG,total cholesterol(TC),and body mass index(BMI)for citizens;age,low-density lipoprotein cholesterol(LDL-C),waist circumference,TG,and TC for farmers;age,waist circumference,LDL-C,BMI,and TC for nomads.Among these three groups,increased waist circumference,increased age.increased TG,increased TC,increased BMI,increased LDL-C,and increased fasting plasma glucose were associated with increased risk of hypertension.The prediction accuracy of the random forest model for citizens,farmers,nomads,was 0.82,0.75,and 0.78.respectively.Obesity,blood pressure,blood lipids,and blood glucose had familial correlations among Kazakh family relationship,and the correlations ranged from 0.08 to 0.28.The correlation of systolic blood pressure among parent-offspring,siblings,and spouse pairs was 0.24,0.27,and 0.28,respectively,and the correlation of diastolic blood pressure was 0.18,0.23,and 0.18,respectively.The heritability of obesity,blood pressure,blood lipids and blood glucose ranged from 0.26 to 0.43.Genetic correlations among obesity,blood lipids,blood glucose and blood pressure ranged from 0.27 to 0.52,and environmental correlations between obesity and blood pressure ranged from 0.17 to 0.22(P<0.05).ConclusionsCitizens,farmers,and nomads of Kazakhs in Xinjiang have high hypertension prevalence.For the prevention of hypertension,all three groups should pay attention to controlling obesity and blood lipid levels and improving dietary patterns.Compared with farmers and nomads,citizens need to pay more attention to controlling obesity and TG level and reducing alcohol consumption.Compared with citizens,farmers and nomads need to pay more attention to improving dietary patterns.The hypertension-related phenotypes of Kazakhs in Xinjiang were influenced by both genetic factors and environmental factors.Family study provided a way to explore the influence of genetic factors on phenotypes for economically underdeveloped areas. |
PDF Full Text Request