OBJECTIVE:It is well-established that metabolic syndrome (MetS) and its ingredients increase the risk of cardiovascular disease (CVD). However, evidence of the causal link at the genetic level is limited. The current study explored the causal relationship between MetS and its ingredients and six types of CVDs using two-sample Mendelian randomization (MR), which may be helpful for the early prevention and screening of CVDs. METHODS:Several appropriate single-nucleotide polymorphisms (SNPs) were selected as instrumental variables for MetS. The random-effects inverse variance weighting (IVW) method was used as the dominant method. The threshold value was set at P<1.39E-03. MR-Egger and weighted median methods were utilized as additional tests to the MR analysis. Finally, methods such as Cochran's Q test were used to evaluate heterogeneity and pleiotropy. RESULTS:Analysis of data from subjects of European ancestry revealed that genetically predicted MetS has a significant causal link with myocardial infarction (MI) and heart failure (HF). Significant causal effects were found between type 2 diabetes (T2D) and ischemic stroke (IS), MI, and coronary artery disease (CAD). Hypertension was causally associated with stroke, MI, CAD, and atrial fibrillation (AF). Meanwhile, a causal association was found between obesity and MI and CAD. High-density lipoprotein cholesterol (HDL-C) was causally associated with stroke and MI. Triglyceride was causally associated with MI and CAD. DISCUSSION:This study utilized 18 publicly available genome-wide association study (GWAS) summary statistics and three commonly used MR methods. Through various sensitivity validations, the reliability was verified. The results revealed 15 significant causal relationships between MetS and its components and six types of CVDs. CONCLUSIONS:The two-sample MR study reveals causal associations between MetS and its ingredients and six types of CVDs. Thus, early prevention and management of MetS and its ingredients remain a cornerstone of CVD prevention.

Objective: It is well established that melanocortin-4 receptor (MC4R) rs17782313 locus polymorphism is associated with increased obesity risk and that obesity is strongly associated with an enhanced risk of all metabolic syndrome (MS) components. Thus, in this study, we examined the association between the MC4R rs17782313 locus polymorphism and the risk of the remaining MS components, namely, diabetes, hypertension, low high-density lipoprotein (HDL), and hypertriglyceridemia. Methods: We performed an extensive literature screening across six scientific databases, namely, PubMed, Embase, Web of Science, Medline, ScienceDirect, CNKI, and WanFang employing a specific search strategy. Eligible studies were selected for inclusion in our meta-analysis, and odds ratio (OR) values and 95% confidence interval (CI) were computed through fixed- or random-effects models to examine correlation strength. In addition, we performed subgroup analyses involving adjustment factors (unadjusted body mass index [BMI], adjusted BMI), race (Caucasian, Asian), and source of controls (population, hospital). Results: Twenty-two eligible studies were selected from 846 articles, involving 28,018 patients and 98,994 normal participants. Based on this meta-analysis, the MC4R rs17782313 locus polymorphism was associated with an augmented risk of diabetes (allele contrast model T vs. C: OR = 1.05, 95% CI = 1.03-1.08; dominant model TT vs. TC + CC: OR = 1.07, 95% CI = 1.03-1.11) and hypertension (dominant model TT vs. TC + CC: OR = 1.16, 95% CI = 1.03-1.31) risk. However, based on this analysis, the MC4R rs17782313 locus polymorphism was not associated with low HDL and hypertriglyceridemia risk. Conclusions: Based on this analysis, the MC4R rs17782313 locus polymorphism is associated with enhanced risks of diabetes and hypertension, while the associations with low HDL and hypertriglyceridemia require further exploration.

Objective: The association of metabolic syndrome (MetS) and its components with chronic kidney disease (CKD) and renal function remains controversial in observational studies. To comprehensively investigate the association between MetS and its components with CKD and renal function, a Mendelian randomization (MR) study was performed. Methods: The inverse variance weighting (IVW) of random effects was used as the main estimation method, while MR-Egger and weighted median analysis results were used for auxiliary judgments. Cochran's Q test, MR-Egger intercept test, leave-one-out analysis, and funnel plots were used to assess heterogeneity and pleiotropy. Results: The MR analyses of genetically predicted MetS and its components' association with CKD risk and renal function showed the following causal associations: hypertension with CKD risk; MetS and obesity with increased blood urea nitrogen and decreased estimated glomerular filtration rate based on cystatin C; hypertension and diabetes with increased urine albumin-creatinine ratio and increased risk of microalbuminuria; and CKD with increased triglyceride. Conclusion: Based on genetic data, this study demonstrated an association between hypertension and CKD risk and a causal association between other MetS components and renal function. The early diagnosis and prevention of MetS and its components might be essential for CKD management.

OBJECTIVE To investigate the association between Lipocalin-2（LCN2） and non-alcoholic fatty liver disease（NAFLD）in Yanbian population and the interaction between LCN2 and fasting blood glucose（FBG） in NAFLD. METHODS A total of 2 192 adults over 20 years old who participated in physical examination for chronic diseases from June 2017 to December 2017 were selected as the study subjects. Height, body mass, blood lipid, blood glucose, kidney function, liver function and LCN2were determined, and the association between LCN2 and NAFLD and the interaction between LCN2and blood glucose in NAFLD were analyzed. RESULTS Age, body mass index, FBG, total cholesterol,triglyceride, low density lipoprotein, aspartate aminotransferase,alanine aminotransferase, gamma-glutamyl transpeptidase, serum uric acid, creatinine, urea nitrogen and LCN2 levels of NAFLD group were significantly higher than those of the control group（P＜0. 05）, while high density lipoprotein level was significantly lower than that of the control group（P＜0. 05）. Without adjustment, the risk of NAFLD in the high LCN2 group was 1. 755 times（95%CI: 1. 427 – 2. 158） that of the normal LCN2 group, and the risk disappeared after adjusting for age, gender and other influencing factors. After adjusting for age,gender and other influencing factors,the risk of NAFLD in the diabetes group was 2. 437 times（95%CI: 1. 638–3. 626） that of the normal group,and there was an interaction between LCN2 and FBG in NAFLD.CONCLUSION LCN2 is correlated with NAFLD,but it is not an independent influencing factor, and there is interaction between LCN2 and FBG in patients with NAFLD.

目的 探讨延边地区汉族、朝鲜族男性颈围与高血压、腹型肥胖的关系.方法 选择2017年6-9月在某社区参与慢性病健康体检的1276位成年男性为研究对象.检测颈围、腰围、身高、体重、收缩压、舒张压等,并进行统计分析.结果 随着颈围的增加,不同民族男性高血压和腹型肥胖的患病率呈显著增加(均趋势P值<0.05);颈围与体质指数、腰围、收缩压、舒张压、低密度脂蛋白胆固醇呈正相关,而与高密度脂蛋白胆固醇呈负相关(P<0.05);在调整混杂因素以后,朝鲜族男性颈围上三分位组高血压的患病危险升高,是下三分位组的3.201倍,而腹型肥胖的患病危险几乎不变.汉族男性颈围上三分位组高血压和腹型肥胖的患病危险均下降,分别是下三分位组的1.833倍和77.445倍.颈围在朝鲜族男性人群中诊断高血压和腹型肥胖的ROC曲线下面积分别为0.614和0.843,最佳切点是38.30 cm和39.30 cm;在汉族男性中,颈围诊断高血压和腹型肥胖的曲线下面积分别为0.605和0.883,最佳切点分别为41.45 cm和40.10 cm.结论 在延边地区朝鲜族和汉族男性中,颈围与高血压、腹型肥胖密切相关,颈围的增加可以预测高血压、腹型肥胖的发生,且对于朝鲜族男性腹型肥胖的预测价值高于汉族男性.

目的 探究视黄醇结合蛋白 4(retinol binding protein 4,RBP4)、内脂素与肾小球滤过率(glomerular filtra-tion rate,GFR)的相关性,分析影响过程中的可能中介变量并探讨其中介作用.方法 选择 2011 年延边地区某医院 18 岁以上健康体检人群共计 969 例.分析该人群RBP4、内脂素与GFR的相关性;采用多重线性回归分析GFR与各检测指标之间的关联,筛选可能的中介变量;构建方程模型进行路径分析,并使用自助法(Bootstrapping法)评估中介作用的显著性.结果 GFR异常组RBP4、内脂素水平均高于正常组,差异有统计学意义,且RBP4、内脂素与GFR相关.SBP、DBP、HDL、GGT为RBP4、内脂素与GFR影响过程可能的中介变量(P<0.05),路径分析及Bootsrapping法检验中介效应显示SBP、DBP、HDL、GGT在RBP4、内脂素对GFR的影响过程中均起到中介作用.结论 RBP4、内脂素与GFR有相关性,且SBP、DBP、HDL及GGT具有中介作用.

目的 探讨在中老年人群中视黄醇结合蛋白(RBP)4、内脏脂肪素(Visfatin)与非酒精性脂肪肝(NAFLD)的相关性.方法 选取2011 年延边大学附属医院进行健康体检的45 岁及以上年人中身高、体质量等一般指标和RBP4 和Vis-fatin等指标完整的407 人作为研究对象,分析RBP4、Visfatin与NAFLD的相关性.结果 NAFLD组的RBP4 和Visfatin水平均高于非NAFLD组(P＜0.05),且RBP4 和Visfatin均与体质量指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL)、空腹血糖(FBG)呈正相关,而与高密度脂蛋白胆固醇(HDL)呈负相关(P＜0.05);未调整时高RBP4 和高Visfatin组患NAFLD的危险分别是低 RBP4 组和低 Visfatin 组的 3.175 倍(95%CI:2.014～5.004)和 2.446 倍(95%CI:1.595～3.752),调整年龄、性别、BMI、血压、肝功、肾功等因素后高RBP4 仍然是NAFLD患病危险因子(OR=1.902,95%CI:1.044～3.466),而Visfatin患病危险消失.结论 在中老年人群中RBP4 和Visfatin与NAFLD密切相关,特别是RBP4 是独立的影响因素.

目的 探讨正常范围内的γ-谷氨酰转肽酶(GGT)和谷丙转氨酶(GPT)与代谢综合征(MS)的相关关系.方法 选取2017年6月-2019年10月在某医院体检科参与健康体检的20岁以上成年男女共3169名.分别分析GGT、GPT与各项指标的相关性及不同GGT、GPT水平的MS的患病风险.结果 随着GPT和GGT水平升高,高血压、高血脂、高血糖和超重及肥胖的患病危险均呈上升趋势,差异有统计学意义(P趋势<0.001).不作调整时,GPT、GGT的上四分位数组MS患病危险分别是下四分位数组的5.020倍(95％CI:3.466～7.271)和5.532倍(95％CI:3.757～8.146),调整年龄、性别、尿酸、总胆固醇、低密度脂蛋白后,上四分位数组MS患病危险是分别下四分位数组的3.693倍(95％CI:2.505～5.443)和4.737倍(95％CI:3.094～7.253),并且不同模型中随着GGT和GPT水平的增加患MS危险是上升的.结论 正常范围内的血清GGT和GPT水平与MS及其组分密切相关,可能是MS的重要预测指标.