| Objective:1) To investigate prevalences of AF(AF) in Uygur and Han elderly populations in Xinjiang region.2) To explore factors related to AF among Uygur and Han elderly people in Xinjiang.3)To investigate the relationship between KCNE1(rs1805127),KCNE4(rs12621643) and AF in Uygur and Han ethnicities in Xinjiang.4) To explore the association between Tag SNP of KCNE2, KCNE3gene and AF. Methods:Part1:Adopting the sampling method of stratified, random, cluster form. Residents aged more than60years old were investigated in south, north and east of Xinjiang Region. All subjects were asked for date of birth, medical history, medication details of AF and other information. physical check were performed by investigators. Each person was undergone12-lead ECG examination. Finally, the epidemical data were analyzed. Part2:A case-control study was done by our team, cases were selected partly from epidemiological survey, the first affiliated hospital of Xinjiang Medical University, the second People’s Hospital in Kashi city, People’s Hospital in Hotan city and other hospitals in Xinjiang. All subjects were elderly patients and aged more than60years old. Control group were chosen partly from the epidemiological investigation and health check, and all controls were randomly selected by the standard of ECG without AF. Questionnaire of risk factors on AF were performed for all subjects. And date of birth, smoking, drinking, family history of AF, history of hypertension, diabetes, coronary heart disease were collected. The related factors of AF were analyzed by multivariate Logistic regression. Part3:Adopting the case-control study method, AF cases were collected in the first affiliated hospital of Xinjiang Medical University, People’s Hospital in Hotan city and other hospitals in Xinjiang.and controls were selected in accordance with the ethnicity, gender and age of AF group by1:1ratio. All subjects were asked for the date of birth, gender, ethnicity, smoking, alcohol consumption, hypertension and other information, while the clinical data of physical check, ECG, echocardiography were collected. The final diagnosis of AF was made by senior physicians.5ml venous blood were collected. DNA was extracted from peripheral blood using DNA extraction kit. KCNE1(rs1805127) and KCNE4(rs12621643) were detected using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Finally, the polymorphisms were analyzed in Han and Uygur populations. Part4:The methods were same to Part3, the Tag SNP KCNE2(rs9984281). KCNE3(rs9516)、KCNE3(rs10898993)、KCNE3(rs3867279)、KCNE3(rs626930) were detected using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or Sequencing method. Finally, the polymorphisms were analyzed in Han and Uygur populations. Results:Part1:The AF prevalence among Uygur and Han elderly people totally was3.56%. The crude prevalence of AF among Uygur elderly people was2.91%, AF crude prevalence in Han elderly people was4.13%. Male and Female prevalences of AF among Uygur elderly people were3.19%and2.61%respectively, and5.01%and3.31%among Han elderly people accordingly. Prevalences of valvular, non-valvular and isolated AF were0.91%,1.98%, and0.65%in Uygur and Han elderly populations. The prevalence of valvular AF among Uygur elderly people was higher than that in Han nationality; the prevalences of non-valvular and isolated AF in Han population were higher than Uygur. The compliance of warfarin medication was poor in both of Uygur and Han nationality, The compliance of aspirin and3-blocker medication among Han elderly people was better than that in Uygurs. The prevalences of ischemic stroke were8.82%and0.98%between AF and non-AF elderly people in Uygur ethnicity, the prevalence of ischemic stroke in Han nationality were6.08%and0.70%between AF and non-AF elderly subjects. Part2:The risk factors for AF were age, obesity, OSAHS, hypertension, cholesterol, Hcy, hs-CRP and IL-6among Uygur elderly people; risk factors for AF among Han elderly people in Xinjiang were age, alcohol, hypertension, cholesterol, Hcy, hs-CRP and IL-6. Part3:1) In Uygur and Han populations, age and gender between AF and control groups were matched. The differences of KCNE1(rs1805127) genotype and allele frequencies between the two groups in Uygur population were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that KCNE1(rs1805127) was one of the independent risk factors for AF in Uygur population. The differences of the KCNE4SNP (rs12621643) genotype and allele frequencies were statistically significant between AF and control groups in Uygur and Han populations (P<0.05), Logistic regression analysis showed that KCNE4SNP (rs12621643) was the risk factor in Uygur and Han patients with AF (P<0.05). The differences of KCNE1(rs1805127) genotype and allele frequencies between AF and control groups in Han population were not statistically significant (P>0.05); Logistic regression results displayed KCNE1(rs1805127) had no association with AF in Han population (P>0.05);2) The PARc%of OSAHS, obesity, hypertension, cholesterol, Hcy, hs-CRP,IL-6, KCNE1(rs1805127) and KCNE4(rs12621643) were9.68%,12.06%,15.76%,6.91%,11.37%,17.78%,9.31%,11.27%and6.46%in Uygur nationality respectively. The PARc%of drinking AF, hypertension, cholesterol, Hcy, hs-CRP, IL-6and KCNE4(rsl2621643) were12.94%,14.48%,7.24%,8.49%,17.29%,9.49%and7.41%in Han ethnicity. The interaction between KCNE1(rs1805127) and KCNE4(rs12621643) had nothing to do with AF in Uygurs, the interaction between drinking and KCNE4(rs12621643) had no association with AF in Hans. Part4:The KCNE2(rs9984281), KCNE3SNP1(rs9516), SNP2(rs10898993), SNP3(rs3867279) and SNP4(rs626930) had nothing to do with AF in Uygur and Han populations. Conclusions:Part1:Prevalence of AF in Han elderly population was higher than that in Uygurs. The AF prevalence between male and female elderly populations showed no significant difference in Uygur nationality, the male AF prevalence in Han elderly people was higher than that in female population.Valvular AF should be paid more attention among Uygur elderly people for prevention and treatment of AF. The warfarin medications should be put emphasis on AF treatment among Uygur and Han elderly patients with AF; medication compliance in patients with AF should be strengthened in the future. AF patients with ischemic stroke among Uygur and Han elderly people were significantly higher than in non-AF. Part2:Elderly patients with AF were required to take hypertension and cholesterol under control well, and emphasis should be paid to the diagnosis and treatment of Hcy, hs-CRP and IL-6in both of the two ethnicities. Management of diet and exercise should be put more importance on preventing and treating AF among Uygur elderly people, Han elderly people should avoid drinking. Part3:The KCNE1(rs1805127) was an independent risk factor for AF in the Uygur population. KCNE1(rs1805127) did not associate with the incidence of AF in the Han population. The KCNE4SNP (rs12621643) was an independent risk factor for AF among Uygur and Han populations. Better management of controllable risk factors of AF according to the "risk gene" may has a certain effect on the prevention and treatment of AF. The interaction between KCNE1(rs1805127) and KCNE4(rs12621643) had no influence on AF in Uygur population. In Han nationality, the interaction between alcohol and KCNE4(rs12621643) had no effect on AF. Part4:The KCNE2(rs9984281), KCNE3SNP1(rs9516), SNP2(rs10898993), SNP3(rs3867279) and SNP4(rs626930) had nothing to do with the incidence of AF among Uygurs and Hans. |
PDF Full Text Request