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A Tale of Three Gorges in Yangtze River: The Impact of Lifestyle Changes on Atherogenesis in Mainland China
S84
Abstracts
ABSTRACTS
results suggest that hyperinsulinaemia is common in westernised Asians. Exercise ECGs may be a helpful clinical test to identify impending CHD in this group at an early stage of the disease. doi:10.1016/j.hlc.2007.06.214 210 Obstructive Sleep Apnoea Impairs Heart Rate Variability in Patients with the Metabolic Syndrome B. Weatherhead 1,2,3,∗ , C. Neil 1,2,3 , M. Barnes 1,2,3 , R. Pierce 1,2,3 , A. Collins 1,2,3 , A. Stewart 1,2,3 , G. Jerums 1,2,3 , D. Hare 1,2,3 1 Austin Health, Victoria, Australia; 2 University of Melbourne,
Australia; 3 Institute for Breathing and Sleep, Heidelberg, Victoria, Australia Introduction: Patients with metabolic syndrome (MetS) are at greater risk of obstructive sleep apnoea (OSA). It is not known whether impaired autonomic regulation, assessed by heart rate variability (HRV), in these patients is related to their sleep disordered breathing. Methods: Ninety-nine subjects with MetS (modified WHO criteria) underwent a 20-min supine ECG recording for HRV analysis, prior to overnight polysomnography (AHI, SaO2 nadir). R-R interval data were excluded if there was significant ectopy or artefact. Anthropometric indices, biochemical markers and 24-h ambulatory BP were also obtained. Relationships to OSA were examined using logistic regression, data for age, waist-to-hip ratio (WHR), daytime systolic BP, HF and SDNN being dichotomised by median split. Results: Satisfactory R-R interval data were acquired in 85 of the subjects (57 males, 28 females; mean age 58 years; mean BMI 34.9 kg m−2 , S.D. 5.9). The majority of patients (66%) exhibited at least moderate OSA (AHI > 20). An AHI > 20 was associated with a lower (<29.7) SDNN (P = 0.04). The 76 patients with nocturnal desaturation (SaO2 nadir ≤90%) demonstrated lower HF (OR 3.8, P = 0.03), independent of anthropometric measures, compared to the 9 patients without sleep hypoxaemia. Age, average daytime BP and HRV frequency domain variables were not related to severity of OSA as assessed by AHI. Conclusion: In patients with MetS, significant OSA is associated with impaired autonomic regulation. Those with sleep hypoxaemia have significant reductions in cardiovagal modulation. These impairments could be related to the increased incidence of cardiovascular events in patients with OSA. doi:10.1016/j.hlc.2007.06.215
Heart, Lung and Circulation 2007;16:S1–S201
211 A Tale of Three Gorges in Yangtze River: The Impact of Lifestyle Changes on Atherogenesis in Mainland China Y.J. Hu 1,∗ , P. Chook 2 , A.N. Wei 1 , L. Li 3 , K.S. Woo 1,2 1 Chongqing University of Medical Science, Chongqing, China; 2 The Chinese University of Hong Kong, Hong Kong; 3 Wu Shan
Center for Disease Control and Prevention, Chongqing, China Background: Westernization of Chinese adults is associated with subclinical atherosclerosis (CATHAY study). Near 1 million farmers have been resettled upland since 1996 in the 3-Gorges reservoir dam project, with obligatory job and lifestyle changes. Methods: To evaluate the impact of such changes on atherogenesis, 95 ex-farmers in Wu Shan (WS) (28.4% male, age: 49.7 ± 9 years) resettled for 3 years, and 87 age and gender-matched farmers in Da Chang (DC) (27.6% male, age: 48.8 ± 10 year) about to be resettled were studied. Carotid intima-media thickness (IMT, surrogate atherosclerosis marker) was measured by high-resolution ultrasound. Results: WS resettled ex-farmers had slightly higher body mass index (BMI) (p = 0.1), significantly higher waist–hip ratio (WHR), total plasma cholesterol (TC), triglyceride (TG) and prevalence of metabolic syndrome (ATPIII, MS) compared with DC farmers, but there was no significant differences in their blood pressures and HDLcholesterol. Carotid IMT was significantly higher in WS (0.71 ± 0.16 mm) than in DC (0.64 ± 0.11 mm) and correlated with MS (R2 = 0.68, p < 0.01). Da Chang
Wu Shan
p-Value
WHR
0.84 ± 0.06
0.89 ± 0.07
<0.0001
TC (mmol/l)
4.2 ± 0.9
5.1 ± 1.0
<0.0001
TG (mmol/l)
1.0 ± 0.7
2.2 ± 3.0
0.001
MS (%)
4.6
IMT (mm)
0.64 ± 0.11
20 0.71 ± 0.16
0.001 0.001
Conclusion: Sedentary lifestyle changes in Yangtze river 3-Gorges territories are associated with accelerated atherogenic process, with great implications in atherosclerosis prevention in China, now in fast modernization process. doi:10.1016/j.hlc.2007.06.216
Abstracts
ABSTRACTS
results suggest that hyperinsulinaemia is common in westernised Asians. Exercise ECGs may be a helpful clinical test to identify impending CHD in this group at an early stage of the disease. doi:10.1016/j.hlc.2007.06.214 210 Obstructive Sleep Apnoea Impairs Heart Rate Variability in Patients with the Metabolic Syndrome B. Weatherhead 1,2,3,∗ , C. Neil 1,2,3 , M. Barnes 1,2,3 , R. Pierce 1,2,3 , A. Collins 1,2,3 , A. Stewart 1,2,3 , G. Jerums 1,2,3 , D. Hare 1,2,3 1 Austin Health, Victoria, Australia; 2 University of Melbourne,
Australia; 3 Institute for Breathing and Sleep, Heidelberg, Victoria, Australia Introduction: Patients with metabolic syndrome (MetS) are at greater risk of obstructive sleep apnoea (OSA). It is not known whether impaired autonomic regulation, assessed by heart rate variability (HRV), in these patients is related to their sleep disordered breathing. Methods: Ninety-nine subjects with MetS (modified WHO criteria) underwent a 20-min supine ECG recording for HRV analysis, prior to overnight polysomnography (AHI, SaO2 nadir). R-R interval data were excluded if there was significant ectopy or artefact. Anthropometric indices, biochemical markers and 24-h ambulatory BP were also obtained. Relationships to OSA were examined using logistic regression, data for age, waist-to-hip ratio (WHR), daytime systolic BP, HF and SDNN being dichotomised by median split. Results: Satisfactory R-R interval data were acquired in 85 of the subjects (57 males, 28 females; mean age 58 years; mean BMI 34.9 kg m−2 , S.D. 5.9). The majority of patients (66%) exhibited at least moderate OSA (AHI > 20). An AHI > 20 was associated with a lower (<29.7) SDNN (P = 0.04). The 76 patients with nocturnal desaturation (SaO2 nadir ≤90%) demonstrated lower HF (OR 3.8, P = 0.03), independent of anthropometric measures, compared to the 9 patients without sleep hypoxaemia. Age, average daytime BP and HRV frequency domain variables were not related to severity of OSA as assessed by AHI. Conclusion: In patients with MetS, significant OSA is associated with impaired autonomic regulation. Those with sleep hypoxaemia have significant reductions in cardiovagal modulation. These impairments could be related to the increased incidence of cardiovascular events in patients with OSA. doi:10.1016/j.hlc.2007.06.215
Heart, Lung and Circulation 2007;16:S1–S201
211 A Tale of Three Gorges in Yangtze River: The Impact of Lifestyle Changes on Atherogenesis in Mainland China Y.J. Hu 1,∗ , P. Chook 2 , A.N. Wei 1 , L. Li 3 , K.S. Woo 1,2 1 Chongqing University of Medical Science, Chongqing, China; 2 The Chinese University of Hong Kong, Hong Kong; 3 Wu Shan
Center for Disease Control and Prevention, Chongqing, China Background: Westernization of Chinese adults is associated with subclinical atherosclerosis (CATHAY study). Near 1 million farmers have been resettled upland since 1996 in the 3-Gorges reservoir dam project, with obligatory job and lifestyle changes. Methods: To evaluate the impact of such changes on atherogenesis, 95 ex-farmers in Wu Shan (WS) (28.4% male, age: 49.7 ± 9 years) resettled for 3 years, and 87 age and gender-matched farmers in Da Chang (DC) (27.6% male, age: 48.8 ± 10 year) about to be resettled were studied. Carotid intima-media thickness (IMT, surrogate atherosclerosis marker) was measured by high-resolution ultrasound. Results: WS resettled ex-farmers had slightly higher body mass index (BMI) (p = 0.1), significantly higher waist–hip ratio (WHR), total plasma cholesterol (TC), triglyceride (TG) and prevalence of metabolic syndrome (ATPIII, MS) compared with DC farmers, but there was no significant differences in their blood pressures and HDLcholesterol. Carotid IMT was significantly higher in WS (0.71 ± 0.16 mm) than in DC (0.64 ± 0.11 mm) and correlated with MS (R2 = 0.68, p < 0.01). Da Chang
Wu Shan
p-Value
WHR
0.84 ± 0.06
0.89 ± 0.07
<0.0001
TC (mmol/l)
4.2 ± 0.9
5.1 ± 1.0
<0.0001
TG (mmol/l)
1.0 ± 0.7
2.2 ± 3.0
0.001
MS (%)
4.6
IMT (mm)
0.64 ± 0.11
20 0.71 ± 0.16
0.001 0.001
Conclusion: Sedentary lifestyle changes in Yangtze river 3-Gorges territories are associated with accelerated atherogenic process, with great implications in atherosclerosis prevention in China, now in fast modernization process. doi:10.1016/j.hlc.2007.06.216