1.Synthesis and characterization of matrix metalloproteinase-responsive BDNF controlled-release materials
Jun-Ru HEI ; Cui WANG ; Meng-Wen SONG ; Sheng-Qiang XIE ; Bing-Xian WANG ; Xiao-Juan LAN ; Han-Bo ZHANG ; Gang CHENG ; Zhi-Qiang LIU ; Xi-Qin YANG ; Jian-Ning ZHANG
Medical Journal of Chinese People's Liberation Army 2024;49(11):1319-1326
Objective To develop a matrix metalloproteinase(MMP)-responsive hyaluronic acid(HA)-based controlled-release material for brain-derived neurotrophic factor(BDNF)to provide a novel therapeutic strategy for intervention and repair of traumatic brain injury(TBI).Methods HA was modified with amination,followed by condensation with Suflo-SMCC carboxyl group to form amide,and then linked with glutathione(GSH)to synthesize HA-GSH.The recombinant glutathione S-transferase(GST)-tissue inhibitor of metalloproteinase(TIMP)-BDNF(GST-TIMP-BDNF)expression plasmid was constructed using molecular cloning technique with double enzyme digestion by Bam H Ⅰ and Eco R Ⅰ.The recombinant GST-TIMP-BDNF protein was expressed in the Escherichia coli prokaryotic expression system,and purified by ion exchange chromatography,confirmed by Western blotting.MMP diluents were supplemented with PBS,MMP inhibitor marimastat,and varing concentrations(0.4,0.6,0.8 mg/ml)of GST-TIMP-BDNF or GST-BDNF.MMP-2 activity was analyzed using an MMP activity detection kit to evaluate the inhibitory effect of the recombinant protein on MMP.Primary rat neurons were extracted and cultured to establish an iron death model induced by RSL3.The effect of recombinant protein GST-TIMP-BDNF on neuronal injury was detected by immunofluorescence staining.Results MRI hydrogen spectrum identification confirmed the successful synthesis of HA-GSH.Western blotting results showed the successful expression of the recombinant protein GST-TIMP-BDNF containing the GST tag using the E.coli prokaryotic expression system.MMP activity detection results indicated that the recombinant protein GST-TIMP-BDNF had a superior inhibitory effect on MMP-2 activity compared to GST-BDNF(P<0.05).Immunofluorescence staining results showed a significant increase in fluorescence intensity in rat neurons treated with GST-TIMP-BDNF after RSL3 induction(P<0.05).Conclusion A MMP-responsive HA-based BDNF controlled-release material has been successfully developed,exhibiting a protective effect on neuron damage.
2.Application of Dual-Layer Detector Spectral CT in the EGFR and ALK Gene Mutations of Lung Adenocarcinoma
Bingyin ZHU ; Xiaorui RU ; Heng ZHANG ; Gang HUANG ; Yaqiong MA
Chinese Journal of Medical Imaging 2024;32(5):454-460
Purpose The clinical and dual-layer detector spectral CT(DLCT)features of epidermal growth factor receptor(EGFR)mutation and anaplastic lymphoma kinase(ALK)rearrangement of lung adenocarcinoma were studied by DLCT multi-parameter imaging to explore a non-invasive prediction method for clinical diagnosis of lung adenocarcinoma gene expression.Materials and Methods A total of 98 cases of lung adenocarcinoma diagnosed by pathology in Gansu Provincial Hospital were prospectively collected from August 2020 to March 2022.Clinical parameters(gender,age,lesion morphology,number,mediastinal lymph node metastasis,EGFR and ALK mutations status)and DLCT parameters including slope of the spectrum curve of the arteriovenous phase(λHUA,λHUv),the standard iodine concentration of the arteriovenous phase(NICA,NICv),the 40 keV single-energy CT value of the arteriovenous phase(CTA 40 keV,CTv 40 keV),the active atomic number of the arteriovenous phases were collected,respectively.According to the expression of EGFR and ALK,all patients were divided into three groups:EGFR mutant group[EGFR(+)],ALK rearrangement group[ALK(+)],EGFR/ALK both negative group[EGFR/ALK(-)].Clinical and DLCT parameters of each group were analyzed.Results There were statistical difference in gender between the EGFR(+)group and EGFR/ALK(-)group(x2=11.010,P<0.05).There were statistical differences in lesion morphology among the three groups(x2=12.858,P<0.05).The value of CTv 40 keV in the EGFR(+)group was significantly higher than that in EGFR/ALK(-)group(t=1.997,P<0.05),and the NICv in the ALK(+)group was significantly lower than that in EGFR/ALK(-)group(t=2.155,P<0.05).The λHUv,NICv,CTv 40 keV of EGFR(+)group were significantly higher than those of ALK(+)group(t=2.613,3.149,3.218,all P<0.05).The sensitivity and specifiicity to identify EGFR(+)and EGFR/ALK(-)adenocarcinoma were 62.7%and 70.0%,the area under curve(AUC)was 0.634(95%CI 0.516-0.756)when the CTv 40 keV value was 141.070 Hu.The sensitivity and specificity to identify ALK(+)and EGFR/ALK(-)adenocarcinoma were 76.7%and 64.2%,the AUC was 0.706(95%CI 0.536-0.853)when NICv value was 0.287.The sensitivity to identify EGFR(+)and ALK(+)adenocarcinoma were 70.6%,64.7%,72.5%and the specificity was 76.5%,76.5%,82.4%,respectively,the AUC was 0.734(95%CI 0.606-0.829),0.751(95%CI 0.610-0.832),0.773(95%CI 0.649-0.861)when the values of λHUv,NICv and CTv 40 keV were 1.335,0.320 and 132.350,respectively.Delong test showed that the AUC of CTv 40 keV and λHUv was statistically different(Z=2.327,P<0.05),and the AUC of CTv 40 keV was 0.773.Conclusion The gender,lesion morphology and DLCT parameters(λHUv,CTv 40 keV,NICv)of lung adenocarcinoma have certain predictive value for EGFR and ALK genetic expression,which can help clinical judgment of lung adenocarcinoma gene mutation pattern.
3.Drug sensitivity and genomic characteristics of a strain of Listeria monocytogenes ST5 isolated from a neonate
Zeng-Bin LIU ; Li LIU ; Zhi-Rong LI ; Cai-Hong XU ; Hong-Bin WANG ; Ru-Gang YANG ; Tao FAN ; Jian-Hong ZHAO ; Jing-Rui ZHANG
Chinese Journal of Zoonoses 2024;40(7):644-651
This study aimed to determine the drug resistance phenotype and genetic characteristics of Listeria monocytogenes ST5 LK100 isolated from a neonate,which provided a basis for the diagnosis and treatment of L.monocyto-genes infection and to enhance the understanding of the genomic characteristics of this strain.A suspected L.monocytogenes strain was isolated from the gastric juice sample of an infected neonate,and identified with a VITEK2 Compact automatic mi-crobial identification instrument and 16S RNA sequencing.Five drug sensitivity tests were conducted on the identified strain with the E-test method.Additionally,the whole genome of the strain was sequenced using a third-generation sequencing plat-form.The antibiotic resistance elements of the strain were identified by BlastN with the CARD antibiotic resistance gene data-base.The multilocus sequence typing(MLST),serotyping,and virulence genes of the strain was determined by Pasteur da-tabase,the virulence gene distribution was analyzed using the virulence analysis website.The prophages of the strain were predicted and annotate by PHASTER online website.The strain(LK100)isolated from the neonate was identified as L.monocytogenes.This strain was sensitive to penicillin,ampicil-lin,meropenem,erythromycin,and trimethoprim-sulfame-thoxazole antibiotics.The MLST type and serotype was ST5 and 1/2b-3b,respectively.The total length of the chromoso-mal genome of LK100 was 3 032 582 bp with a GC content of 37.91%,and it contained a complete circular plasmid with a se-quence length of 52 822 bp.The strain LK100 carried complete InlA protein,LIPI-1 pathogenicity island,SSI-1 stress survival island,and an LGI2 genomic island.The intrinsic antibiotic resistance genes were mainly located on the chromosome.Five prophage sequences were predicted in the LK100 genome.This study identified a strain of ST5 L.monocytogenes LK100 from an infected neonate and characterized its genome and antibiotic sensitivity,laying the foundation for further research on ST5 L.monocytogenes.
4.Effects of Down-Regulation of PAK1 on Differentiation and Apop-tosis of MPN Cells with MPLW515L Gene Mutation and Survival of 6133/MPL Mice
Qi-Gang ZHANG ; Shu-Jin WANG ; Xiang-Ru YU ; Li-Wei ZHANG ; Kai-Lin XU ; Chun-Ling FU
Journal of Experimental Hematology 2024;32(5):1472-1478
Objective:To investigate the effects of down-regulation of p21 activated kinase 1(PAK1)on the proliferation,differentiation,and apoptosis of myeloproliferative neoplasm(MPN)cells(6133/MPL)with thrombopoietin receptor MPL mutation at codon 515(MPLW515L)and survival of 6133/MPL mice.Methods:Interference with the protein level of PAK1 in 6133/MPL cells was assessed using lentivirus-mediated shRNA transfection technology.CCK-8 assay was used to detect the effect of down-regulation of PAK1 on the proliferation viability of 6133/MPL cells,and colony-forming ability was measured by cell counting.Flow cytometry was used to detect the PAK1 kinase activity on the ability of polyploid DNA formation and cell apoptosis in 6133/MPL cells.The expression of cyclin D1,cyclin D3 and apoptosis-related protein Bax was detected by Western blot.The infiltration of tumor cells in spleen and bone marrow of 6133/MPL mice were detected by HE staining.Results:Down-regulation of PAK1 inhibited the proliferation and reduced the ability of cell colony formation of 6133/MPL cells.After knocking down PAK1,the content of polyploid DNA in 6133/MPL cells increased from 31.8 to 57.5%and 48.0%,and the proportion of apoptosis increased approximately to 10.8%.Down-regulation of PAK1 led to a reduction of infiltration of tumor cells in liver and bone marrow of 6133/MPL mice,thereby prolonging survival time.Conclusion:Down-regulation of PAK1 can significantly inhibit the growth of 6133/MPL cells,promote the formation of polyploid DNA,induce 6133/MPL cell apoptosis,and prolong the survival time of 6133/MPL mice.
5.Research Progress in Immune Checkpoint Inhibitors Combination Therapy Applied to Non-small Cell Lung Cancer after EGFR Mutation-targeted Therapy Resistance.
Jiamo LI ; Xingyu YAO ; Longjue QIU ; Ru ZHANG ; Gang WANG
Chinese Journal of Lung Cancer 2023;26(5):392-399
With the development of precision medicine for lung cancer, targeted therapy has greatly improved the survival and prognosis of patients with advanced non-small cell lung cancer (NSCLC), but the occurrence of acquired drug resistance ultimately leads to patients with no targeted drugs available and no standard treatment options for this group of patients afterwards. The emergence of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC. However, due to the unique features of NSCLC with epidermal growth factor receptor (EGFR) mutation, such as immunosuppressive tumor microenvironment (TME), single ICIs treatment has limited clinical benefits in NSCLC patients with EGFR mutation, and the combination of ICIs with chemotherapy and/or targeted therapies is the trend. This review further discusses potential subpopulations with EGFR mutations that may benefit from ICIs treatment, and analyzes how decisions can be made in the era of combined immunotherapy to maximize the efficacy of ICIs treatment in EGFR mutation targeted therapy for NSCLC patients with drug resistance, with the aim of achieving individualized treatment.
Humans
;
Carcinoma, Non-Small-Cell Lung/genetics*
;
Immune Checkpoint Inhibitors
;
Lung Neoplasms/genetics*
;
Mutation
;
ErbB Receptors/genetics*
;
Tumor Microenvironment
6.Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population.
Meng Fan LIU ; Rui Xia MA ; Xian Bao CAO ; Hua ZHANG ; Shui Hong ZHOU ; Wei Hong JIANG ; Yan JIANG ; Jing Wu SUN ; Qin Tai YANG ; Xue Zhong LI ; Ya Nan SUN ; Li SHI ; Min WANG ; Xi Cheng SONG ; Fu Quan CHEN ; Xiao Shu ZHANG ; Hong Quan WEI ; Shao Qing YU ; Dong Dong ZHU ; Luo BA ; Zhi Wei CAO ; Xu Ping XIAO ; Xin WEI ; Zhi Hong LIN ; Feng Hong CHEN ; Chun Guang SHAN ; Guang Ke WANG ; Jing YE ; Shen Hong QU ; Chang Qing ZHAO ; Zhen Lin WANG ; Hua Bin LI ; Feng LIU ; Xiao Bo CUI ; Sheng Nan YE ; Zheng LIU ; Yu XU ; Xiao CAI ; Wei HANG ; Ru Xin ZHANG ; Yu Lin ZHAO ; Guo Dong YU ; Guang Gang SHI ; Mei Ping LU ; Yang SHEN ; Yu Tong ZHAO ; Jia Hong PEI ; Shao Bing XIE ; Long Gang YU ; Ye Hai LIU ; Shao wei GU ; Yu Cheng YANG ; Lei CHENG ; Jian Feng LIU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(6):579-588
Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
Female
;
Humans
;
Adolescent
;
SARS-CoV-2
;
Smell
;
COVID-19/complications*
;
Cross-Sectional Studies
;
COVID-19 Vaccines
;
Incidence
;
Olfaction Disorders/etiology*
;
Taste Disorders/etiology*
;
Prognosis
7.Construction of a Mouse Model for Myeloproliferative Neoplasms and an Evaluation System.
Shu-Jin WANG ; Xiang-Ru YU ; Qi-Gang ZHANG ; Yan-Jie LI ; Chun-Ling FU ; Kai-Lin XU
Journal of Experimental Hematology 2023;31(4):1113-1118
OBJECTIVE:
To construct a myeloproliferative neoplasms (MPN) transplanted mouse model with JAK2-V617F, MPLW515L or CALR-Type I gene mutation, and establish a systematic evaluation system to verify the success of model construction.
METHODS:
The bone marrow c-kit+ cells of the mice were obtained by the following steps: The mice were killed by cervical dislocation, the femur, tibia and ilium were separated, and the bone marrow cells were collected. The c-kit+ cells were sorted after incubation with CD117 magnetic beads. The method of constructing mouse primary mutant cells is as follows: A gene mutation vector with a GFP tag was constructed by the retroviral system, and the retroviral vector was packaged into the Platinum-E cells to obtain the virus supernatant, and then used it to infect the c-kit+ cells of mice. The MPN mouse model was constructed as follows: the mouse primary c-kit+ cells containing the mutant genes were collected after infection, and then transplanted them via the tail vein into the female recipient mice of the same species which were irradiated with a lethal dose of gamma rays (8.0 Gy). The MPN mouse model was evaluated as follows: After transplantation, the peripheral blood of the mice was regularly collected from the tail vein to perform the complete blood count test, and the size of spleen and the degree of bone marrow fibrosis were estimated.
RESULTS:
The mouse c-kit+ cells with the mutant genes were successfully obtained from the bone marrow. MPN mouse model was successfully constructed: The peripheral blood cells of the MPN-transplanted mice carried exogenous implanted GFP-positive cells, and the white blood cells (WBC), platelet (PLT) and hematocrit (HCT) were all increased; the body weight loss, and the water and food intake were reduced in the transplanted mice; further pathological analysis showed that the transplanted mice displayed splenomegaly and bone marrow fibrosis. These results suggested that the MPN mouse model was successfully constructed. According to the common and different characteristics of the three MPN mouse model, a preliminary evaluation system for judging the success of MPN mouse model construction was summarized, which mainly included the following indicators, for example, the proportion of GFP-positive cells in the peripheral blood of mice; WBC, PLT and HCT; the degree of spleen enlargement and the bone marrow fibrosis.
CONCLUSION
The MPN mouse model with JAK2-V617F, MPLW515L or CALR-Type I gene mutation is successfully established by retroviral system, which can provide an important experimental animal model for the research of MPN pathogenesis and drug-targeted therapy.
Female
;
Mice
;
Animals
;
Primary Myelofibrosis
;
Myeloproliferative Disorders/genetics*
;
Bone Marrow/pathology*
;
Mutation
;
Disease Models, Animal
;
Neoplasms
;
Janus Kinase 2/genetics*
9.CXCR4 antagonist AMD3100 reduced oxaliplatin resistance in colorectal cancer cells
Gang HAN ; Yu CAO ; Yun ZHANG ; Yan-Yan ZHANG ; Xu ZHANG ; Ning-Ning LIU ; Ru JIA ; Hang-Jun GONG
Chinese Journal of Current Advances in General Surgery 2023;26(12):939-942
Objective:colorectal cancer is one of the common malignant tumors in the gas-trointestinal tract.Oxaliplatin is the first-line drug for the treatment of advanced colorectal cancer,but drug resistance often occurs.The mechanism of CXCR4 in oxaliplatin resistance of colon cancer is not clear.This study intends to explore the mechanism of CXCR4 mediated oxaliplatin resistance and the potential therapeutic value of CXCR4 inhibitor AMD3100.Methods:oxaliplatin resistant strains HCT116 were constructed.The expression of CXCR4 and the phosphorylation level of PI3K-Akt signal pathway were detected by Q-PCR and Western blot.The phosphorylation level of PI3K-Akt signal pathway was detected by Q-PCR and Western blot.The effect of AMD3100 an-tagonizing CXCR4 or combined application of Akt inhibitor LY294002 on oxaliplatin resistance of drug-resistant cells was detected by CCK8.Results:CCK-8 was used to detect the proliferation activity of Oxaliplatin in HCT116 drug resistant group compared with control cells in the absence of drugs and at different concentrations.The results showed that there was no significant change in the activity of the resistant strains,while the control cells showed a significant decrease.Q-PCR and Western blot showed that the expression of CXCR4 and the phosphorylation level of PI3K-Akt increased significantly in the drug-resistant group(P<0.05).After administration of CXCR4 inhibitor AMD3100,CXCR4 expression and PI3K-Akt phosphorylation decreased significantly(P<0.05).AMD3100 enhanced the sensitivity of drug-resistant cell lines to oxaliplatin.The combination of AMD3100 and Akt inhibitor LY294002 can further enhance the sensitivity of drug-resistant cell lines to oxaliplatin.Conclusion:CXCR4 mediated activation of PI3K-Akt signaling pathway plays an important role in the resistance of colon cancer to oxaliplatin.AMD3100 may become a potential therapeutic drug against chemoresistance of colon cancer.
10.Epidemiological characteristics and trends of cardiometabolic risk factors in residents aged 18-64 years in 15 provinces of China.
Ying Ying JIAO ; Liu Sen WANG ; Hong Ru JIANG ; Xiao Fang JIA ; Zhi Hong WANG ; Hui Jun WANG ; Bing ZHANG ; Gang Qiang DING
Chinese Journal of Epidemiology 2022;43(8):1254-1261
Objective: To investigate the epidemiological characteristics and trends of cardiometabolic risk factors in residents aged 18-64 years in 15 provinces (autonomous regions,municipalities) of China, and to analyze the impact of demographic characteristics on cardiometabolic risk factors. Methods: 19 827 adults aged 18-64 from the "China Health and Nutrition Survey" in 2009, 2015 and 2018 were selected as subjects. Using the data of demographic and economic factors, blood biochemical measurements and physical measurements, the trend of detection rates of metabolic risk factors in different years was analyzed by Joinpoint regression model. The association between risk factors and demographic characteristics was analyzed by multinomial logit model. Results: Among all the risk factors, overweight and central obesity had the highest detection rates (36.41% and 39.93%, respectively). In addition, among the three years, the clustering of risk factors was highest in 2015 and decreased slightly in 2018. Joinpoint regression model analysis showed that the detection rates of most metabolic risk factors expressing an overall upward trend from 2009 to 2018 but there was no significantly statistical difference in annual percentage change (APC). Among the risk factors under APC>0, the APC of obesity and diabetes was the largest (APC=5.37%, t=3.26, P=0.190; APC=5.52%, t=7.70, P=0.082), while among the risk factors with APC<0, high hs-CRP appeared as the largest (APC=-6.95%, t=-4.17, P=0.150). Multinomial logit model showed that male had higher risk of developing all metabolic risk factors than female except LDL-C, TC and hs-CRP. The risk of other risk factors except HDL-C in adults aged 45-64 years was higher than that in the younger age group aged 18-44 years, and was more significant in hypertension and elevated HbA1c, which were 4.67 (95%CI:4.07-5.37) times and 3.73 (95%CI:2.91-4.77) times of the younger age group, respectively. Residents living in the eastern areas had the highest risk of obesity, borderline high LDL-C, hypertension, elevated blood glucose and diabetes, and the lowest risk of elevated TG and high hs-CRP. People from the western region had the lowest risk of central obesity, elevated blood pressure and hypertension. Conclusions: In the three years, the detection rate and clustering of most risk factors were the highest in 2015, and there was little change in 2018. Gender, age and geographical distribution were the main influencing factors of cadiometabolic risk factors. It is suggested to adopt targeted prevention strategies and intervention measures to reduce the risk of cardiovascular disease.
Adolescent
;
Adult
;
C-Reactive Protein
;
Cardiometabolic Risk Factors
;
China/epidemiology*
;
Cholesterol, LDL
;
Diabetes Mellitus/epidemiology*
;
Female
;
Humans
;
Hypertension/epidemiology*
;
Male
;
Middle Aged
;
Obesity/epidemiology*
;
Obesity, Abdominal
;
Prevalence
;
Risk Factors
;
Young Adult

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