Healthy Chinese Women Research Articles

Untargeted metabolomics reveals plasma metabolites predictive of ectopic fat in pancreas and liver as assessed by magnetic resonance imaging: the TOFI_Asia study

BackgroundExcess visceral obesity and ectopic organ fat is associated with increased risk of cardiometabolic disease. However, circulating markers for early detection of ectopic fat, particularly pancreas and liver, are lacking.MethodsLipid storage in pancreas, liver, abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from 68 healthy or pre-diabetic Caucasian and Chinese women enroled in the TOFI_Asia study was assessed by magnetic resonance imaging/spectroscopy (MRI/S). Plasma metabolites were measured with untargeted liquid chromatography–mass spectroscopy (LC–MS). Multivariate partial least squares (PLS) regression identified metabolites predictive of VAT/SAT and ectopic fat; univariate linear regression adjusting for potential covariates identified individual metabolites associated with VAT/SAT and ectopic fat; linear regression adjusted for ethnicity identified clinical and anthropometric correlates for each fat depot.ResultsPLS identified 56, 64 and 31 metabolites which jointly predicted pancreatic fat (R2Y = 0.81, Q2 = 0.69), liver fat (RY2 = 0.8, Q2 = 0.66) and VAT/SAT ((R2Y = 0.7, Q2 = 0.62)) respectively. Among the PLS-identified metabolites, none of them remained significantly associated with pancreatic fat after adjusting for all covariates. Dihydrosphingomyelin (dhSM(d36:0)), 3 phosphatidylethanolamines, 5 diacylglycerols (DG) and 40 triacylglycerols (TG) were associated with liver fat independent of covariates. Three DGs and 12 TGs were associated with VAT/SAT independent of covariates. Notably, comparison with clinical correlates showed better predictivity of ectopic fat by these PLS-identified plasma metabolite markers.ConclusionsUntargeted metabolomics identified candidate markers of visceral and ectopic fat that improved fat level prediction over clinical markers. Several plasma metabolites were associated with level of liver fat and VAT/SAT ratio independent of age, total and visceral adiposity, whereas pancreatic fat deposition was only associated with increased sulfolithocholic acid independent of adiposity-related parameters, but not age.

Comparative metagenomic analysis of the vaginal microbiome in healthy women

The composition of these vaginal microbiome has a significant impact on women's health. However, few studies have characterized the vaginal microbiome of healthy Chinese women using metagenomic sequencing. Here, we carried out a comparative metagenomic analysis to survey taxonomic, functional levels, and microbial communities' genome content in healthy women's vaginal microbiome. Overall, we observed a total of 111 species, including all dominant vaginal Lactobacillus species, such as L. iners, L. crispatus, L. gasseri, and L. jensenii. Unlike microbial taxa, several pathways were ubiquitous and prevalent across individuals, including adenosine ribonucleotides de novo biosynthesis and pyruvate fermentation to acetate and lactate II. Notably, our diversity analysis confirmed a significant difference in healthy women from different ethnic groups. Moreover, we binned vaginal assemblies into 62 high-quality genomes, including 9 L. iners, 7 A. vaginae, 5 L. jensenii, and 5 L. crispatus. We identified the pan and core genomes of L. iners and A. vaginae and revealed the genetic diversity. Primary differences between strains were the hypothetical genes and mobile element-like genes. Our results provide a framework for understanding the implications of the female reproductive tract's composition and functional potential and highlight the importance of genome-resolved metagenomic analysis to further understand the human vaginal microbiome.

Characterisation of protein-truncating and missense variants in PALB2 in 15 768 women from Malaysia and Singapore

BackgroundRare protein-truncating variants (PTVs) in partner and localiser of BRCA2 (PALB2) confer increased risk to breast cancer, but relatively few studies have reported the prevalence in South-East Asian populations. Here,...

Study on Reference Range of Zinc, Copper and Copper/Zinc Ratio in Childbearing Women of China.

Background: Copper and zinc are both essential elements in humans, that play various biological roles in body functions. Population-based reference values have not yet been established in China especially in childbearing women. The aim of this study is to establish a reference value of Zn, Cu and Cu/Zn ratios in childbearing women aged 18–44 from a representative population in China. Method: A total of 191 healthy childbearing women aged 18–44 years old were enrolled from the China Adult Chronic Disease and Nutrition Surveillance (2015) in this study with a series strict inclusion criteria. Basic biological indicators (weight, height, waist, blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein, total cholesterol, triglyceride, fast glycose, HbA1c, blood pressure, uric acid) and elements levels in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Cu, Zn and Cu/Zn ratio. Results: The reference range of Zn, Cu and Cu/Zn ratio in plasma were 70.46–177.53 µg/dL, 74.30–170.68 µg/dL and 0.54–1.68, respectively. The reference range of Zn, Cu and Cu/Zn ratios in whole blood were 402.49–738.05, 74.63–124.52 and 0.13–0.25 µg/dL, respectively. Conclusion: The reference range of Zn, Cu and Cu/Zn ratios in plasma and whole blood of healthy Chinese childbearing women could be used as an indicator to evaluate the status of element deficiency and overload.

Chinese Female Adults Need More Iodine Intake Based on ‘Overflow Theory’

Background: In China, there is a dearth of data on the iodine balance study for adults. Especially, due to the special physiological cycle, the research of female iodine balance is insufficient or lasts for a short time. In the present study, we spent more than two months to explore the basal iodine requirement based on healthy Chinese female adults and a new ‘iodine overflow’ theory was proposed for the study of iodine balance. Methods: A total of 36 Chinese healthy female adults (age 20.67 ± 1.10 years) were recruited for this study, which included 40 days low iodine depletion period and 6 stages of 30 days supplementation study. Uniform diets with different iodine content were provided, in which non-iodized salt and pure water were provided in all the meals and the content of iodine in the diet was regulated by accurately weighing dairy products with measured iodine content. The total iodine intake from food was collected using weighing and duplicate portion method and the total iodine excretion through 24-hour urine and staged faeces were completely gathered and monitored. The iodine content in diet, urine and feces were measured by ICP-MS. The iodine intake and excretion were calculated and a mixed effects models model was set up between incremental iodine intake and incremental iodine excretion based on the ‘iodine overflow’ theory. Findings: At the start of experiment, the 24h UIC was 233.31±122.47μg/L, which meant an iodine overnutrition for the majority of subjects. The iodine intake and excretion were 13.64μg/day and 48.58μg/day at the end of 1st stage. The incremental iodine intakes (Δ iodine intake) was 21.05, 39.64, 60.85, 88.16, 120.25μg/day and the incremental iodine excretion (Δ iodine excretion) was 25.75, 37.03, 54.67, 77.59, 105.43μg/day for the supplementation stages. According to the ‘iodine overflow’ hypothesis, the zero iodine balance (Δ iodine intake = Δ iodine excretion) derived from a mixed effect model indicated a mean iodine intake of 52.24μg/d(1.00μg/d•kg). The RNI for iodine to healthy Chinese female adult was 73.1μg/d(1.39μg/d•kg). Interpretation: Our findings indicate that basal iodine requirement may be much less than the current iodine intake recommendation. A daily iodine intake of 52.24μg/d may meet the basal iodine requirement for healthy Chinese female and Chinese women may need more than 20% iodine intake than men based on the ‘iodine overflow’ hypothesis. The ‘iodine overflow’ theory could provide a new idea for iodine balance research and the further studies should be needed for the iodine intake recommendation. Trial Registration: The trial was registered at the Chinese Clinical Trial Registry (No:ChiCTR1800016184). Funding: National Natural Science Foundation of China and Sanming Project of Medicine in Shenzhen. Declaration of Interest: The authors declare that they have no conflict of interest. Ethical Approval: This study was approved by the Ethical Committee of the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention.

Transcriptomic analysis of endometrial receptivity for a genomic diagnostics model of Chinese women

To define the transcriptomic signature with respect to human endometrial receptivity in Chinese women by next-generation sequencing and to develop a more refined and customized bioinformatic predictive method for endometrial dating in Chinese women. Randomized. A tertiary hospital-based reproductive medicine center. Ninety healthy, fertile Chinese women. Human endometrial biopsies. Gene expression of endometrial biopsies. Ninety endometrial samples from healthy Chinese women during their menstrual cycles-including prereceptive (luteinizing hormone [LH] + 3 days/LH + 5 days), receptive (LH + 7 days), and post-receptive (LH + 9 days) phases-were subjected to transcriptomic analysis using messenger RNA (mRNA)-enriched RNA-Seq. Feature genes were obtained and used to train the predictor for endometrial dating, with 63 samples for the training set and 27 samples for the validation set. Differentially expressed genes (DEGs) were identified by comparing samples from different phases of the menstrual cycle. Based on the transcriptomic feature genes, we constructed a bioinformatic predictor for endometrial dating. The accuracy on assessment of the endometrium on days LH + 3, LH + 5, LH + 7, and LH + 9 was 100% in the training set and 85.19% in the validation set. Our transcriptomic profiling method can be used to monitor the window of implantation with regard to the endometrium in the Chinese population. This method potentially provides an evaluation of endometrial status, and can be used to predict a personal window of implantation by reproductive medicine clinicians.

Metabolic profiling in early pregnancy and associated factors of folate supplementation: A cross-sectional study

Pregnancy generally alters the balance of maternal metabolism, but the molecular profiles in early pregnancy and associated factors of folate supplementation in pregnant women remains incompletely understood. Untargeted metabonomics based on high-performance liquid chromatography-high-resolution mass spectrometry integrated with multivariate metabolic pathway analysis were applied to characterize metabolite profiles and associated factors of folate supplements in early pregnancy. The metabolic baseline of early pregnancy was determined by metabolic analysis of 510 serum samples from 131 non-pregnant and 379 pregnant healthy Chinese women. The pathophysiology of adaptive reactions and metabolic challenges induced by folate supplementation in early pregnancy was further compared between pregnant women with (n=168) and without (n=184) folate supplements. Compared with non-pregnant participants, 106 metabolites, majority of which are related to amino acids and lysophosphatidylcholine/phosphatidylcholine, and 13 metabolic pathways were significantly changed in early pregnancy. The supplementation of folate in early pregnancy induced marked changes in N-acyl ethanolamine 22:0, N-acyl taurine 18:2, glycerophosphoserine 44:1 and 8,11,14-eicosatrienoate, proline, and aminoimidazole ribotide levels. During early pregnancy, the metabolism of amino acids significantly changes to meet the physiological requirements of pregnant women. Folate intake may change glucose and lipid metabolism. These findings provide a comprehensive landscape for understanding the basic characteristics and gestational metabolic networks of early pregnancy and folate supplementation. This study provides a basis for further research into the relationship between metabolic markers and pregnancy diseases. This study protocol was registered on www.ClinicalTrials.gov, NCT03651934, on August 29, 2018 (prior to recruitment).

IL-17A polymorphism (rs2275913) and levels are associated with preeclampsia pathogenesis in Chinese patients

BackgroundPreeclampsia (PE) is a pregnancy-related condition that affects both the infant and the mother. Although the role of various inflammatory molecules in PE has been demonstrated, the importance of pro-inflammatory molecules such as IL-17A, IL-23 is not well understood. In the present investigation, a potential association of common genetic variants in the IL-17A and IL-23A genes with PE was investigated.Methods115 PE clinically diagnosed patients who registered to the International Peace Maternity and Child Health Hospital were enrolled in this research. One hundred two pregnant women and 147 healthy Chinese women were also included. ELISA was used to measure IL-17A and IL-23 serum levels in all enrolled subjects. Common genetic polymorphisms in IL-17A (rs 2,275,913, rs1974226, and rs1974226), IL-23A (rs11171806), and IL-12B (rs3212227) were genotyped using the PCR-RFLP or TaqMan probe-based method.ResultsElevated serum IL-17A levels were found in PE patients compared to pregnant (P < 0.0001) and healthy women (P < 0.0001). However, IL-23 levels were comparable across various clinical groups. In addition, heterozygous (GA) and minor allele (A) for IL-17A (rs2275913) and IL-23A (rs11171806) were more prevalent in PE patients compared to pregnant women indicating an important role in the predisposition to PE growth. Interestingly, IL-17A (r 2,275,913) mutants were associated with elevated IL-17A levels relative to wild type (GG).ConclusionsIL-17A (rs2275913) variants are associated with higher serum levels of cytokine, and predisposed PE development.

Trimester-specific reference intervals of TAT, TM, tPAI-C and PIC for healthy Chinese pregnant women.

Pregnancy is a hypercoagulability state, the aim of this study was to observe the changes of thrombin-antithrombin complex (TAT), thrombomodulin (TM), tissue plasminogen activator-inhibitor complex (tPAI-C) and plasmin-α2-antiplasmin complex (PIC) during pregnancy and establish trimester-specific reference intervals for Chinese healthy pregnant women. In total 190 Chinese healthy pregnant women (first trimester 59 cases, second trimester 60 cases and third trimester 71 cases) were recruited in North China. TAT, TM, tPAI-C and PIC were processed on Sysmex HISCL 5000 automated chemiluminescence immune detection system. Trimester-specific reference intervals were established with the 2.5th and 97.5th percentile of the distribution. The reference intervals for TAT, TM, tPAI-C, PIC at trimester 1 were 0.40-3.65 ng/mL, 4.85-8.80 TU/mL, 1.75-6.40 ng/mL, 0.25-1.05 μg/mL, respectively. At trimester 2, the reference intervals were 1.65-8.61 ng/mL, 5.70-9.93 TU/mL, 2.91-7.71 ng/mL, 0.33-2.02 μg/mL, respectively. At trimester 3, the reference intervals were 3.16-12.68 ng/mL, 5.50-14.24 TU/mL, 2.70-10.69 ng/mL, 0.24-1.54 μg/mL, respectively. The changes of TAT, TM, tPAI-C, PIC during pregnancy are presented, and trimester-specific reference intervals for healthy pregnant women are described. The levels of TAT, TM, tPAI-C were increased gradually from trimester 1 to trimester 3, while the PIC level remains stable during all trimesters.

Relationship Between Serum Gamma-Glutamyl Transferase Level and Impaired Fasting Glucose Among Chinese Community-Dwelling Adults: A Follow-Up Observation of 6 Years.

Objective: We aimed to investigate the relationship between serum gamma-glutamyl transferase (GGT) and fasting blood glucose (FBG) levels, as well as the cumulative risk of impaired fasting glucose (IFG) regulation in the Chinese adult population after 6 years of follow-up. Methods: A total of 1360 apparently healthy Chinese men and women who completed a community-based health examination survey and did not have IFG in central China in 2010 and 2016 were included in this study. The patients were divided into four groups according to their baseline GGT (in quartiles). The relationship between GGT levels and FBG levels was examined using general linear regression models. The effect of the GGT level on the risk of IFG was analyzed using multivariate logistic regression. The first quartile group of GGT levels was set as the dummy variable in the model, and the odds ratios and 95% confidence intervals of the remaining quartile groups relative to the first quartile group were obtained. Results: After 6 years of follow-up, 16.4% (188/1148) of participants were diagnosed with IFG. The cumulative incidence of IFG in the four groups according to their baseline GGT levels (in quartiles) was 7.7%, 16.1%, 15.8%, and 26.8%, respectively. Based on the Cox multiple regression, the hazard ratio for IFG increased by 28.9% for each unit of increase in the baseline GGT level after adjusting for the confounding factors. The GGT levels of participants in the first quartile were used as the reference group. The relative risks of IFG in the second, third, and fourth quartiles of GGT were 1.70, 1.55, and 2.46, respectively (P = 0.005). Conclusions: GGT was positively associated with the risk of IFG and can be used as an indicator to assess whether a patient may develop prediabetes.

Microbiome in Healthy Women Between Two Districts With Different Air Quality Index.

Although the diversity and abundance of skin microbiome are mainly determined by intrinsic factors, including gender, age, anatomical site, and ethnicity, we question whether facial microbiome could be affected by long-term exposure to airborne pollution. Using 16S ribosomal RNA (rRNA) gene amplicon sequencing, we analyzed the facial bacterial microbiome of healthy and young Chinese women (25–35 years old) between two districts with different air quality indices (AQIs) in Zhejiang Province. The overall microbiome structure was obviously different between these two districts. It revealed an increase in both the abundance and diversity of facial bacterial microbiome in Hangzhou (HZ) with higher AQI compared with those in Yunhe (YH) with lower AQI. Linear discriminant analysis (LDA) and Lefse analysis identified a total of 45 genera showing significant overrepresentation in the HZ group. Furthermore, PICRUSt analysis showed that functional pathways associated with metabolism of saturated fatty acid were relatively more predominant in the HZ group, whereas those with DNA repair or mitochondrial DNA replication were more predominant in the YH group. Our present data can provide useful information for further researches on the composition and function of the skin microbiome related to air pollution factors as well as for the development of therapeutic agents targeting the microbes and their metabolites to resist damages of airborne pollutants.

Isolation and characterization of lactic acid bacteria from human milk

Human milk is the main source of nutrition for infants and the transmission of various microorganisms. The lactic acid bacteria (LAB) in breast milk allow for the establishment of the gut microflora of infants. In this study, we aimed to assess the probiotic potential of LAB strains isolated from breast milk of healthy Chinese women. Two strains, Lacticaseibacillus rhamnosus (formerly Lactobacillus rhamnosus) LHL6 and LHL7, were selected and identified through morphology observation, Gram staining, and 16S rDNA phylogenetic analysis. Using Limosilactobacillus fermentum (formerly Lactobacillus fermentum) CECT5716 as the standard reference strain, the screened strains were characterized for aspects of growth, production of lactic acid and H2O2, antibiotic susceptibility, survival under simulated gastrointestinal conditions, and tolerance to cadmium (Cd). In de Man, Rogosa, and Sharpe (MRS) broth, LHL6 and LHL7 showed longer lag phases than CECT5716 but higher specific growth rates. For the production of lactic acid and H2O2, LHL7 performed better than LHL6 and CECT5716, indicating better antimicrobial ability. Strain LHL7 generated 9.99 mg/L H2O2, considerably higher than 1.25 mg/L for LHL6 and 2.33 mg/L for CECT5716. According to European Food Safety Authority minimum inhibitory concentrations, all of the investigated strains were resistant to chloramphenicol, streptomycin, and kanamycin. However, unlike LHL6 and CECT5716, LHL7 was susceptible to ampicillin and resistant to tetracycline. Resistance to azithromycin, cephalexin, and penicillin G were similar for all 3 strains, whereas CECT5716 was resistant to a higher concentration of roxithromycin. All 3 strains were able to survive in a simulated gastric-like solution, but a low percentage survived in the presence of 0.4% bile salt and 7% pancreatin. Encapsulation with protectants may enhance the survival rate. All 3 strains were tolerant to 500 mg/L Cd in MRS broth and to 1,000 mg/L Cd on MRS agar medium. In summary, 2 novel strains of LAB were obtained that have similar characteristics to the reference strain CECT5716. This work identified potential probiotic candidates for application in the food and pharmaceutical industries and facilitated identification of further probiotics.

Angiotensin-Converting Enzyme Gene D/I Polymorphism in Relation to Endothelial Function and Endothelial-Released Factors in Chinese Women.

Many studies have investigated the relationship between angiotensin-converting enzyme (ACE) D/I polymorphism and cardiovascular disease or endothelial dysfunction; however, hardly any of these studies has taken aging or menopause into consideration. Furthermore, despite that many studies have examined the regulatory effects of endothelial-released factors (ERFs) on endothelial function, no study has evaluated the relationship between ERFs and endothelial function with respect to ACE D/I polymorphism and menopause status. To answer these questions, 391 healthy Chinese women over a wide range of ages (22–75 years) were enrolled and divided into pre-menopause group and post-menopause group. After ACE D/I genotype being identified, the women were then classified into either DI/II or DD genotype. Flow-mediated dilatation (FMD) of brachial endothelium and plasma levels of ERFs: nitric oxide (NO), endothelin-1 (ET-1), and angiotensin II (Ang II) were measured. The results showed that frequencies of ACE D/I genotypes were in accordance with the Hardy-Weinberg equilibrium, and the frequency of I allele was higher than D allele. In pre-menopause group, FMD was significantly higher in women of DI/II than DD (P = 0.032), and age-dependent in both genotypes (DD, P = 0.0472; DI/II, P < 0.0001). In post-menopause group, FMD was similar between women of DI/II and DD, and age-dependent only in women of DI/II (P < 0.0001). In pre-menopause group, Ang II level was significantly higher in women of DD than DI/II (P = 0.029), and FMD was significantly correlated with all ERFs in women of DD (NO, P = 0.032; ET-1, P = 0.017; Ang II, P = 0.002), but only with Ang II in women of DI/II (P = 0.026). In post-menopause group, no significant difference was observed in any ERF between women of DI/II and DD, and FMD was only significantly correlated with ET-1 in women of DD (P = 0.010). In summary, FMD in women of DI/II was superior to DD in pre-menopause and more age-dependent than DD in post-menopause, and FMD was closely associated with ERFs. In conclusion, Chinese women of DI/II seem to have lower risk than DD in pre-menopause, but similar risk as DD in post-menopause in developing cardiovascular disease.

Three-dimensional anthropometric analysis of eyelid aging among Chinese women

Eyelid morphology is highly susceptible to aging. Previous studies have described the process of eyelid aging in Caucasians; however, anthropometric data describing aging in Chinese eyelids are lacking. Therefore, this study aimed to quantitatively analyze the effect of aging on the eyelids of Chinese women through a three-dimensional (3D) anthropometry. In this prospective, cross-sectional study, 3D photos were captured from 188 healthy Chinese Han women, who were categorized into four age groups. Anthropometric landmarks were identified for the measurement of eyelid parameters, and a unified coordinate system was built into each subject. Linear and angular measurements were computed from the coordinates and were compared between the groups. An age-related decrease was observed in the ocular width, outer canthal width, palpebral fissure height, and multiple angular measurements. This indicated upper eyelid ptosis, which reduced the lateral and superior visual field. Lateral shift of the upper eyelid arc was not observed. The lower eyelid underwent slight elevation with increasing age. Aging rendered the periorbital region esthetically less pleasing, as shown by changes in the multiple proportion indices computed. Furthermore, an intergroup comparison indicated that eyelid aging was accelerated after the age of 40 years among Chinese women. This study used 3D photography to quantitatively analyze how eyelids in Chinese women changed with age. The anthropometric data collected could help with antiaging cosmetic surgery planning and postoperative assessment.

Age-related fatty infiltration of lumbar paraspinal muscles: a normative reference database study in 516 Chinese females.

Fatty infiltration, as a result of aging, is an essential biomarker of muscle degeneration. This research aimed to investigate the age-dependent change of fatty degeneration in the paraspinal muscles of healthy Chinese women. This study also explores the effect of body size on fatty infiltration of paraspinal muscles. Cross-sectional area of paraspinal muscles (CSAmuscle) and intermuscular adipose tissue (CSAIMAT) were measured at the L3 mid-vertebral level of 516 healthy females, who underwent abdomen quantitative computed tomography (QCT) scans. Subsequently, IMAT% [CSAIMAT / (CSAIMAT + CSAmuscle)] were calculated. The relationship between basic information and measurements was evaluated using Spearman correlations. Comparisons of QCT results among different BMI subgroups in different age groups were analyzed with the Kruskal-Wallis H test and LSD, post-hoc correction. Age-related changes were calculated after the adjustment of height and weight. The mean CSAIMAT of 20-29 years group (n=69) and 70-79 years group (n=25) were 3.00 cm2 and 11.06 cm2, respectively. While the mean CSAmuscle of 20-29 years group was 38.46 cm2 and 70-79 years group was 30.86 cm2. The mean IMAT% difference between 20-29 years group and 70-79 years group was -18.55%. Strong, positive non-linear associations were observed between ageing and CSAIMAT, along with IMAT% (r=0.656, P<0.01; r=0.714, P<0.01). However, CSAmuscle was shown to decrease with age in a weak, negative linear fashion (r=-0.265, P<0.01). Positive relationships between BMI and CSAIMAT, CSAmuscle, along with IMAT%, were found. Significant differences were observed between obesity and normal BMI subgroup for all variables in three age groups. CSAIMAT showed a larger age-related difference compared to CSAmuscle. Fatty infiltration in paraspinal muscles increased with age and BMI, while muscle loss may be associated with aging. The present study provided standardized reference data for the fatty degeneration of paraspinal muscles across the adult lifespan of Chinese females, which will play a critical role in future studies.

Age-, Site-, and Sex-Specific Normative Centile Curves for HR-pQCT-Derived Microarchitectural and Bone Strength Parameters in a Chinese Mainland Population

High-resolution peripheral quantitative computed tomography (HR-pQCT) is an advanced 3D imaging technology that has the potential to contribute to fracture risk assessment and early diagnosis of osteoporosis. However, to date no studies have sought to establish normative reference ranges for HR-pQCT measures among individuals from the Chinese mainland, significantly restricting its use. In this study, we collected HR-pQCT scans from 863 healthy Chinese men and women aged 20 to 80 years using the latest-generation scanner (Scanco XtremeCT II, Scanco Medical AG, Brüttisellen, Switzerland). Parameters including volumetric bone mineral density, bone geometry, bone microarchitecture, and bone strength were evaluated. Age-, site-, and sex-specific centile curves were established using generalized additive models for location, scale, and shape with age as the only explanatory variable. Based on established models, age-related variations for different parameters were also quantified. For clinical purposes, the expected values of HR-pQCT parameters for a defined age and a defined percentile or Z-score were provided. We found that the majority of trabecular and bone strength parameters reached their peak at 20 years of age, regardless of sex and site, then declined steadily thereafter. However, most of the cortical bone loss was observed after the age of 50 years. Among the measures, cortical porosity changed most dramatically, and overall, changes were more notable at the radius than the tibia and among women compared with men. Establishing such normative HR-pQCT reference data will provide an important basis for clinical and research applications in mainland China aimed at elucidating microstructural bone damage driven by different disease states or nutritional status. © 2020 American Society for Bone and Mineral Research.

Development of Gestational Age-Specific Thyroid Function Test Reference Intervals in Four Analytic Platforms Through Multilevel Modeling.

Background: A population-based reference interval (RI) of thyroid hormones in pregnancy using a standardized methodology is crucial for clinicians to make accurate diagnoses and important for the comparison of test results obtained from different analytic platforms. Methods: We enrolled 600 healthy Chinese women to obtain longitudinal serum samples across gestation, after exclusion of subjects with antibodies to thyroid peroxidase, thyroglobulin or thyrotropin receptor. Gestational age-specific RIs were constructed by using polynomial regression equations with MLwiN. Results: Free thyroxine (fT4) levels rose to a peak at the 7th-8th gestational weeks and then declined gradually till 28th week, while thyrotropin (TSH) level decreased from early pregnancy to a nadir at the 9th week. The data support the recent notion by the American Thyroid Association to raise the TSH upper RI to 4.0 mIU/L. We also demonstrate that thyroid hormone reference ranges are not affected in a mildly iodine-deficient population and by including women with the presence of antibodies against thyroid peroxidase and thyroglobulin who are otherwise healthy. Conclusions: The study highlights a methodology in constructing gestational age-specific thyroid function test RIs on different analytic platforms to provide a better interpretation and comparison of results obtained across different platforms.

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

BackgroundMany efforts have been focused on the alternative glycemic marker glycated albumin (GlyA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GlyA in healthy Chinese pregnant women and to assess the predictive value of serum GlyA in adverse pregnancy outcomes.MethodsTotally 421 healthy subjects including 137 in the first trimester, 152 in the second trimester, and 132 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GlyA. In addition, 67 pregnant women diagnosed with GDM were enrolled at 24–28 weeks of gestation. The diagnostic value of GlyA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24–28 weeks of gestation. The association between GlyA in the late pregnancy and the adverse pregnancy outcomes was analyzed with the data collected from January to June 2018 at our hospital.ResultsThe estimated RIs of GlyA in present study were 11.26–15.10%, 10.04–13.50%, and 9.76–13.09% in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GlyA and 0.705 for FPG. More importantly, the GlyA level in the third trimester was not more elevated in the patients with adverse pregnancy outcomes including large for gestational age (LGA), preterm delivery, hypertension and preeclampsia (PE). The exception was made with the GDM patients who suffered from postpartum hemorrhage and had significantly higher GlyA levels than the control group.ConclusionsOur results showed that the GlyA was continuously decreased as the gestational age went up. The GlyA testing has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

Age distribution of human papillomavirus infection and neutralizing antibodies in healthy Chinese women aged 18–45 years enrolled in a clinical trial

ObjectivesData from clinical trials of human papillomavirus (HPV) vaccines showed that women naïve (negative for both type-specific antibodies and DNA) to vaccine types would derive benefit from vaccination; therefore, an understanding of the proportion of naïve women in different age groups is important for developing HPV vaccination strategies. MethodsFrom November 2012 to April 2013, a total of 7372 healthy women aged 18–45 years were recruited in five provinces in China. Cervical specimens and serum samples were collected for each woman at entry. Cervical specimens were first tested by the HPV DNA enzyme immunoassay method; if positive, the specimens were then tested by reverse hybridization line probe assay and HPV-16 and HPV-18 specific polymerase chain reactions. Neutralizing antibodies against HPV-16 or HPV-18 were tested with a pseudovirion-based neutralization assay. ResultsThe overall prevalence of high-risk HPV DNA was 14.8% (1088/7367, 95% CI 14.0–15.6), and the seroprevalence of neutralizing antibodies against HPV-16 and HPV-18 was 12.6% (925/7367) and 4.9% (364/7367), respectively. In younger women (18–26 years) and middle-aged women (27–45 years), 83.8% (3116/3719) and 81.4% (2968/3648) were naïve to both HPV-16 and HPV-18 (both neutralizing antibodies and DNA were negative), respectively. In addition, 98.5% (3664/3719) and 98.0% (3575/3648) of the younger or middle-aged women were naïve to at least one HPV type (HPV-16 or HPV-18). DiscussionThis study revealed that the majority of Chinese women aged 18–26 years and 27–45 years were naïve to both HPV-16 and HPV-18 and would thus derive full benefit from bivalent HPV vaccination.

Community and individual iodine status assessment in premenopausal women in Shanxi, China: Repeated spot urine versus 24-hour urine.

Urinary iodine is an essential index of iodine nutrition evaluation. To establish the number of repeated spot urine collections necessary to reflect individual iodine status over 2 months and assess its feasibility to serve as an independent indicator of individual iodine status. We performed a longitudinal, 2-months study from May to June in 2015 of 23 apparently healthy Chinese women aged 18 to 44 (32±9) y. Spot urine samples were collected on any two days of the week, and 24-h urine samples were collected once every 6 days. 368 spot urine and 230 24-h urine samples were analysed. The median urinary iodine concentration (UIC) was 140.5 (75.2, 246.9) μg/L. The estimated 24-h urinary iodine excretion (24-h UIE) values from spot urine samples and measured 24-h UIE values from 24-h urine samples were 348±240 μg/24h and 330±216 μg/24h (p=0.003), respectively. Irrespective of the urinary iodine method, the intra- individual coefficient of variation (CV%) was lower than the inter-individual CV%. Bland-Altman analysis revealed differences between spot urine and 24-h urine. When the precision ranges with 95% confidence were ±15%, ±20%, ±25% or 30%, the number of an individual's spot urine samples required were 30, 16, 11 or 8, respectively. Repeated spot urine is not a feasible way to assess recent individual iodine intake. The development of a multi-indicator system could provide an acceptable individual evaluation index of iodine status.