1.Dipsacus asper Treats Alzheimer's Disease in Caenorhabditis elegans by Regulating PPARα/TFEB Pathway
Mengmeng WANG ; Jianping ZHAO ; Limin WU ; Shuang CHU ; Yanli HUANG ; Zhenghao CUI ; Yiran SUN ; Pan WANG ; Hui WANG ; Zhenqiang ZHANG ; Zhishen XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):104-114
ObjectiveTo investigate the anti-Alzheimer's disease (AD) effect of Dipsacus asper(DA) in the Caenorhabditis elegans model, and decipher the underlying mechanism via the peroxisome proliferator-activated receptor α (PPARα)/transcription factor EB (TFEB) pathway. MethodsFirst, transgenic AD C. elegans individuals were assigned into the blank control, model, positive control (WY14643, 20 µmol·L-1), and low-, medium-, and high-dose (100, 200, and 400 mg·L-1, respectively) DA groups. The amyloid β-42 (Aβ42) formation in the muscle cells, the paralysis time, and the deposition of amyloid β-protein (Aβ) in the head were detected. The lysosomal autophagy in the BV2 cell model was examined by Rluc-LC3wt/G120A. The expression levels of lysosomal autophagy-related proteins LC3Ⅱ, LC3I, LAMP2, and TFEB were detected by Western blot. Real-time quantitative polymerase chain reaction (Real-time PCR) was employed to determine the mRNA levels of autophagy-related genes beclin1 and Atg5 and lysosome-related genes LAMP2 and CLN2 downstream of PPARα/TFEB. A reporter gene assay was used to detect the transcriptional activities of PPARα and TFEB. Immunofluorescence was used to detect the fluorescence intensity of PPARα, and the active components of the ethanol extract of DA were identified by UPLC-MS. RCSB PDB, Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and Autodock were used to analyze the binding between the active components and PPARα-ligand-binding domain (LBD). ResultsCompared with the model group, the positive control group and 200 and 400 mg·L-1 DA groups showed prolonged paralysis time (P<0.05), and all the treatment groups showed decreased Aβ deposition in the head (P<0.01). DA within the concentration range of 50-500 mg·L-1 did not affect the viability of BV2 cells. In addition, DA enhanced the autophagy flux (P<0.05), up-regulated the mRNA levels of beclin1, Atg5, LAMP2, and CLN2 (P<0.05, P<0.01), promoted the nuclear translocation of TFEB (P<0.05), increased LAMP2 expression and autophagy flux (P<0.05, P<0.01), and enhanced the transcriptional activities of PPARα and TFEB (P<0.01). The positive control group and 200 and 400 mg·L-1 DA groups showed enhanced fluorescence intensity of PPARα in the BV2 nucleus (P<0.01). UPLC-MS detected nine known compounds of DA, from which 8 active components of DA were screened out. The docking results suggested that a variety of components in DA could bind to PPARα-LBD and form stable hydrogen bonds. ConclusionDA may reduce the pathological changes in AD by regulating the PPARα-TFEB pathway.
3.Risk assessment of human Spirometra mansoni infections and cross-sectional study on knowledge, attitude and practice towards sparganosis in endemic areas of Henan Province
Yalan ZHANG ; Tiantian JIANG ; Xiaohui MA ; Yan DENG ; Weiqi CHEN ; Yankun ZHU ; Zhenqiang TANG ; Xi-meng LIN ; Hongwei ZHANG
Chinese Journal of Schistosomiasis Control 2025;37(2):190-195
Objective To assess the risk of human Spirometra mansoni infections and investigate the knowledge, attitude and practice (KAP) towards sparganosis mansoni among residents in Henan Province, so as to provide insights into formulation of the sparganosis mansoni control measures. Methods Qinling Village in Fugou County of Zhoukou City, Bali Village in Yancheng District of Luohe City, Duzhai Village in Puyang County of Puyang City and Doushan Village in Luoshan County of Xinyang City were sampled as survey sites in Henan Province from July to August 2023, and more than 40 frogs were sampled from ponds or streams in each survey site for detection of Sparganum mansoni infections. At least 150 residents were sampled using a cluster sampling method from each survey site, and the sero-prevalence of anti-S. mansoni IgG antibody was estimated. In addition, a questionnaire survey was conducted on the KAP towards sparganosis mansoni among participants, and the proportion of eligible KAP, rate of correct KAP and KAP scores were calculated. Results A total 229 frogs were collected from 4 survey sites in 2023, and the overall prevalence of S. mansoni infection was 4.37% (10/229) in frogs, with 7.75% (10/129) prevalence in wild frogs and 0 in farm-bred frogs. A questionnaire survey was performed among 649 residents sampled from 4 survey sites, and 649 serum samples were collected. The seroprevalence of anti-S.mansoni IgG antibody was 0.15% (1/649) and the overall proportion of eligible KAP was 23.73% (154/649) among participants. There were age- (χ2 = 30.905, P = 0.000), educational level- (χ2 = 41.011, P = 0.000), and occupation-specific proportions of eligible KAP among participants (χ2 = 10.721, P = 0.005), and the proportion of eligible KAP decreased with age (χ2 trend = 22.717, P = 0.000) and increased with education levels (χ2 trend = 40.025, P = 0.000). The rates of correct KAP towards sparganosis mansoni were 40.81% (2 119/5 192), 96.66% (1 882/1 947) and 63.81% (3 727/5 841) (χ2 = 1 913.731, P = 0.000) among residents, respectively. The rates of correct KAP towards sparganosis mansoni varied significantly among survey sites (χ2 = 136.872, 42.347 and 255.157; all P values= 0.000, with the highest rate of correct knowledge (51.94%, 748/1 440) and practices (75.86%, 1 229/1 620) in Yancheng District of Luohe City and the highest rate of correct attitudes in Puyang County of Puyang City (99.11%, 446/450) (all P values< 0.05). Conclusions There is still a high transmission risk of sparganosis mansoni in Henan Province, and the KAP towards sparganosis mansoni is required to be improved among residents.
4.Salvianolic Acid F Regulates Bax/Caspase-3/GSDME Signaling Pathway to Inhibit Pyroptosis of HK-2 Cells
Xiancong SHI ; Zhishen XIE ; Liang ZHAO ; Jiajun WANG ; Yafei DUAN ; Pan WANG ; Zhenqiang ZHANG ; Xiaowei ZHANG ; Jiangyan XU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(9):56-64
ObjectiveTo investigate the mechanism of salvianolic acid F (Sal F) in repairing the high glucose-induced injury in human kidney-2 (HK-2) cells via the B-cell lymphoma-2 (Bcl-2)-associated X protein (Bax)/cysteinyl aspartate-specific proteinase 3 (Caspase-3)/gasdermin-E (GSDME) pathway. MethodThe cell counting kit-8 (CCK-8) was used to measure the relative viability of HK-2 cells exposed to high glucose and different concentrations (2.5, 5, 10, 20 μmol·L-1) of Sal F and the relative viability of HK-2 cells treated with Sal F for different time periods. The levels of lactate dehydrogenase (LDH) and interleukin-1β (IL-1β) in the supernatant of the cell culture were measured by the LDH assay kit and enzyme-linked immunosorbent assay (ELISA) kit, respectively. Flow cytometry combined with Annexin V-FITC/propidium iodide (PI) and Hoechst 33342/PI staining was employed to reveal the proportion of PI-positive HK-2 cells exposed to high glucose. Western blotting was employed to determine the protein levels of Bax, Bcl-2, cytochrome C, cysteinyl aspartate-specific proteinase (Caspase)-9, Caspase-3, and GSDME in the HK-2 cells exposed to high glucose and treated with Sal F. The 2,7-dichlorodihydrofluorescein diacetate fluorescence probe (DCFH-DA) and mitochondrial membrane potential assay kit (JC-1) were used to determine the production of reactive oxygen species (ROS) and the mitochondrial membrane potential in the HK-2 cells exposed to high glucose and treated with Sal F. ResultCompared with the blank group, the model group showed decreased cell viability (P<0.01), elevated levels LDH and IL-1β, increased proportion of PI-positive cells (P<0.01), up-regulated protein levels of Bax, cytochrome C, Caspase-9, Caspase-3, and GSDME (P<0.01), down-regulated protein level of Bcl-2 (P<0.01), decreased mitochondrial membrane potential, and excessive ROS accumulation. Compared with the model group, Sal F repaired the high glucose-induced injury in HK-2 cells (P<0.05), lowered the levels of LDH and IL-1β (P<0.05, P<0.01), and decreased the proportion of PI-positive cells (P<0.01). In addition, Sal F down-regulated the protein levels of Bax, cytochrome C, Caspase-9, Caspase-3, and GSDME and up-regulated the protein level of Bcl-2 (P<0.05, P<0.01), increased the mitochondrial membrane potential, and decreased the accumulation of ROS in HK-2 cells. ConclusionSal F can reduce the production of ROS, restore the balance of mitochondrial membrane potential, and inhibit pyroptosis via the Bax/Caspase-3/GSDME signaling pathway to repair the high glucose-induced injury in HK-2 cells.
5.Modified Tongqiao Huoxuetang Down-regulates PI3K/Akt Pathway to Treat Basilar Artery Dolichoectasia
Feixiang LIU ; Daopei ZHANG ; Zhaoxin WU ; Huailiang ZHANG ; Yunke ZHANG ; Jinxin MIAO ; Zhenqiang ZHANG ; Ruiqin SUN ; Lixiang WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):87-94
ObjectiveTo establish a mouse model of basilar artery dolichoectasia (BAD) and explore the mechanism of modified Tongqiao Huoxuetang (JTQHX) in regulating BAD via phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) pathway. MethodSixty C57/BL6 female mice were randomized into sham operation (injected with 10 U·mL-1 inactivate elastase), model, atorvastatin calcium tablets (2.6 mg·kg·d-1), and low- and high-dose (crude drug 3.4, 17 g·kg-1·d-1, respectively) JTQHX groups. The mouse model of BAD was established by injection with 10 U·mL-1 elastase. After 14 days of modeling, the sham operation group and model group were administrated with equal volumes of pure water by gavage, and other groups with corresponding drugs for 2 months. The levels of interleukin-6 (IL-6) and calpain (LpA) in the serum were measured by enzyme-linked immunosorbent assay (ELISA). Verhoeff 's Van Gieson (EVG) staining was employed to observe the pathological changes of blood vessels. Terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) was employed to examine the apoptosis rate of vascular smooth muscle cells (VSMCs). Image Pro Plus was used to observe and calculate the curvature index, elongation length, percentage increase in vessel diameter, and curvature angle of the basilar artery vessels in mice. Western blot was employed to determine the expression levels of PI3K and Akt in the vascular tissue. ResultCompared with the sham operation group, the model group showed lowered IL-6 level (P<0.01), no significant change in LpA level, increased apoptosis of VSMCs (P<0.01), and increased curvature index, elongation length, percentage increase in vessel diameter, and curvature angle (P<0.01). Furthermore, the modeling up-regulated the protein levels of PI3K and Akt in blood vessels (P<0.01) and aggravated the destruction of the inner elastic layer, atrophy of the muscular layer, and hyaline changes in the connective tissue of the medial membrane of the basilar artery wall. Compared with the model group, 2 months of treatment with JTQHX elevated the IL-6 level (P<0.01), reduced the apoptosis of VSMCs (P<0.01), decreased the curvature index, elongation length, percentage increase in vessel diameter, and curvature angle (P<0.05, P<0.01), and down-regulated the protein levels of PI3K and Akt in blood vessels (P<0.01). In addition, the treatment alleviated the destruction of the inner elastic layer, atrophy of the muscular layer, and hyaline changes in the connective tissue of the medial membrane of the basilar artery wall. ConclusionJTQHX inhibits the elongation, expansion, and curvature of basilar artery vessels and alleviates the pathological changes by reducing the apoptosis of VSMCs and down-regulating the expression of PI3K/Akt pathway.
6.Mechanism of Yishen Tongluo Prescription in Inhibiting Endoplasmic Reticulum Stress and Improving Apoptosis of Renal Tubular Epithelial Cells Based on PERK/ATF4/CHOP
Xuan SU ; Liang ZHAO ; Mengmeng WANG ; Jing DING ; Zhenqiang ZHANG ; Xiaowei ZHANG ; Jiangyan XU ; Zhishen XIE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(2):26-36
ObjectiveTo investigate the effect of Yishen Tongluo prescription (YSTLP) on apoptosis of renal tubular epithelial cells and explore the mechanism based on endoplasmic reticulum stress pathway of protein kinase R-like endoplasmic reticulum kinase (PERK)/activating transcription factor 4 (ATF4)/transcription factor C/EBP homologous protein (CHOP). MethodThe db/db mice were randomly divided into model group, valsartan group (10 mg·kg-1), and low, middle, high-dose YSTLP groups (1, 2.5, 5 g·kg-1). Samples were collected after eight weeks of drug intervention. In addition, db/m mice in the same litter served as the control group. Human renal tubular epithelial cells (HK-2) were cultured in vitro and divided into the control group, advanced glycated end-product (AGE) group, and AGE + low, middle, and high-dose YSTLP groups (100, 200, 400 mg·L-1). TdT-mediated dUTP nick end labeling (TUNEL) staining was used to detect the apoptosis rate of HK-2 cells. Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay was conducted to detect the viability of HK-2 cells. Calcium fluorescence probe staining and luciferase reporter gene method were adopted to detect the luciferase activity of folded protein response element (UPRE) and endoplasmic reticulum stress. Immunohistochemical (IHC) analysis was carried out to measure the protein expressions of phosphorylated PKR (p-PERK), CHOP, and ATF4. Real-time polymerase chain reaction (Real-time PCR) was used to measure the mRNA expression levels of CHOP and X-box binding protein 1 (XBP1) in mouse kidney and HK-2 cells. Western blot was used to detect the protein expression level of p-PERK, PERK, CHOP, ATF4, B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), and cleaved Caspase-3 in mouse kidney and HK-2 cells. ResultIn the cellular assay, HK-2 cell viability was significantly reduced, and the apoptosis rate was elevated in the AGE group compared with the control group (P<0.01). The mRNA and protein expression levels of apoptosis-related factor Bcl-2 were significantly reduced (P<0.01), and those of Bax were significantly increased (P<0.01). The protein expression level of cleaved Caspase-3 was significantly increased (P<0.01). Compared with the AGE group, YSTLP administration treatment resulted in elevated cell viability and reduced apoptosis rate (P<0.01). The mRNA and protein expression levels of Bcl-2 were significantly elevated in a time- and dose-dependent manner (P<0.01), and those of Bax were significantly reduced in a time- and dose-dependent manner. The protein expression level of cleaved Caspase-3 was significantly reduced in a time- and dose-dependent manner (P<0.01). The intracellular Ca2+ imbalance and UPRE luciferase fluorescence intensity were increased in the AGE group compared with the control group (P<0.01). The mRNA levels of endoplasmic reticulum stress-related factors CHOP and XBP1 were significantly increased (P<0.01), and the protein expression levels of p-PERK, CHOP, and ATF4 were significantly increased (P<0.05). Compared with the AGE group, YSTLP effectively improved intracellular Ca2+ imbalance in HK-2 cells and decreased UPRE luciferase fluorescence intensity in a dose-dependent manner (P<0.01). It reduced the mRNA levels of endoplasmic reticulum stress-related factors CHOP and XBP1 (P<0.01) and the protein expression levels of intracellular p-PERK, CHOP, and ATF4 in a dose- and time-dependent manner (P<0.01). In animal experiments, the protein expression level of Bcl-2 was significantly reduced(P<0.01), and that of cleaved Caspase-3 and Bax was significantly increased in the model group compared with the control group (P<0.05). The protein expression level of Bcl-2 was dose-dependently elevated, and that of cleaved Caspase-3 and Bax was dose-dependently decreased in the YSTLP groups compared with the model group (P<0.01). Compared with the control group, the mRNA expression levels of CHOP and XBP1 were significantly elevated in the model group (P<0.05, P<0.01), and the protein expression levels of p-PERK, CHOP, and ATF4 were significantly increased (P<0.05). Compared with the model group, YSTLP significantly decreased the mRNA expression levels of CHOP and XBP1 (P<0.01) and the protein expression levels of p-PERK, CHOP, and ATF4 (P<0.01). ConclusionYSTLP can effectively inhibit endoplasmic reticulum stress and improve apoptosis of renal tubular epithelial cells, and its mechanism may be related to the regulation of the PERK/AFT4/CHOP pathway.
7.The protective effect of a traditional chinese medicine composition on ANIT induced liver injury in mice with cholestasis
Nian YANG ; Bole ZHANG ; Junxia ZHANG ; Zhenqiang ZHANG
Journal of Pharmaceutical Practice and Service 2024;42(12):508-511
Objective To explore the protective effect of a traditional chinese medicine composition on ANIT induced cholestasis liver injury in mice. Methods 8-week old SPF Kunming mice were randomly divided into 6 groups, 10 mice in each group which were the blank control group (normal saline gavage), the model control group (normal saline gavage), the low (gavage dose: 5.25 g/kg) group, the medium (gavage dose: 11.25 g/kg) group and the high (gavage dose: 20.25 g/kg) group of traditional chinese medicine composition, the positive control (Ursodeoxycholic acid, UDCA, 0.1 g/kg). Mice were administered with continuous gavage once a day, for 7 consecutive days. On the 5th day, the blank normal control group was given an equal amount of olive oil by gavage, all other groups were given ANIT (65 mg/kg) by gavage for modeling. After 48 hours of modeling, 30 minutes after the last administration of each group of mice, blood and liver tissue samples were collected for testing of various indicators. The corresponding kits were used to detect the content of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total bile acid (TBA), γ-glutamyl transpeptidase (γ-GT), total bilirubin (TBIL), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) and malondialdehyde (MDA) in peripheral blood of mice, respectively. HE staining was used to observe the pathological changes in the liver of mice. Results Compared with the model group, each dose group of traditional chinese medicine composition reduced the levels of ALT, AST, ALP, TBA, TBIL, γ-GT and MDA (P<0.05) significantly, markedly increased the levels of SOD and GSH-PX (P<0.05). Compared with the model group, the low-dose and high-dose groups of traditional chinese medicine composition showed a decrease in hepatic steatosis and a reduction in inflammatory. The moderate dose group showed a significant reduction in hepatic cell steatosis and a significant improvement in inflammatory infiltration, the liver cells were arranged in cords, and the structure of lobules of liver was intact. Conclusion Traditional chinese medicine composition could improve serum biochemical indicators of liver injury, reduce jaundice and eliminate oxidative free radicals, thereby exerting a protective effect against ANIT-induced cholestatic liver injury in mice.
8.Neuroprotective effect of ethanol extract of Corni Fructus on Aβ25-35- induced Alzheimer's disease mice by regulating LSD1/PSD95
Jige YANG ; Lixin LI ; Zhonghua LI ; Yunfang SU ; Zijuan ZHANG ; Junying SONG ; Huahui ZENG ; Zhenqiang ZHANG ; Jinlian MA
Journal of Beijing University of Traditional Chinese Medicine 2024;47(3):352-363
Objective This study investigated the protective effects of Corni Fructus ethanol extract on β-amyloid protein 25-35 (Aβ25-35)-induced Alzheimer's disease (AD) mice by regulating histone lysine-specific demethylase 1 (LSD1) / postsynaptic density protein 95 (PSD95) on synapses and neuroinflammation. Methods Specifically, according to the body weight, 40 C57BL/6N mice were randomized into four groups: the sham operation group, the model group, the low-dose (0.1mg/g) and the high-dose (0.3 mg/g) Corni Fructus ethanol extract groups. Aβ25-35 was injected into the hippocampus of mice in three groups except for the sham operation group to established AD model. All mice were orally administered with either Corni Fructus ethanol extract or vehicle by gavage for 7 days before molding and continued 5 days after surgery for a total of 60 days. Morris water maze, Y maze and open field tests were performed to evaluate the recognition memory and space exploration ability of mice. The expression of LSD1, PSD95, synaptophysin (SYN), interleukin-1β (IL-1β), tumor necrosis factor-α(TNF-α) and H3K9me2 level were measured by Western blotting. Chromatin immunoprecipitation (CHIP) combined with qPCR was used to detect H3K9me2 modification of PSD95 promoter region and mRNA levels of PSD95. The correlation between the expression of H3K9me2 and PSD95 and the expression of IBA1 in the hippocampus were detected by immunofluorescence assay.Results The result showed that Corni Fructus ethanol extract significantly reversed Aβ25-35-induced learning and memory impairment in AD mice. Compared with the model group, Corni Fructus ethanol extract demonstrated shorter escape latency, increased number and time of autonomous activities and the rate of autonomous alternation. Moreover, it increased the expression of LSD1 in hippocampus of AD mice(P<0.05), and reduced H3K9me2 modification level in the promoter region of PSD95 gene, and then promoted the mRNA transcription and protein expression of PSD95. Immunofluorescence staining indicated the reduction of H3K9me2 modification level in hippocampus was accompanied by the enhancement of PSD95 expression. Corni Fructus ethanol extract could also inhibit the activation of microglia and reduce the expression of proinflammatory factors IL-1β and TNF-α.Conclusion Corni Fructus ethanol extract may regulate PSD95 gene transcription by up-regulating the expression of LSD1 and reducing the H3K9me2 modification level in its promoter region, thereby increasing the expression of PSD95, a key protein in synaptic plasticity regulation, which alleviate neuroinflammatory response, improve learning and memory dysfunction in AD model mice, and thus play a protective role in Aβ25-35-induced nerve damage.
9.Study on the mechanism of astragaloside Ⅰ inhibiting podocyte pyroptosis in diabetic kidney disease
Yafei DUAN ; Xiancong SHI ; Liang ZHAO ; Mingzhen LYU ; Xinqi REN ; Yulei GU ; Jiangyan XU ; Zhenqiang ZHANG ; Jinxin MIAO ; Zhishen XIE ; Xiaowei ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2024;47(10):1408-1415
Objective To investigate the mechanism of astragaloside Ⅰ,the active constituent of milkvetch root,in inhibiting podocyte injury and improving diabetic kidney disease.Methods According to the body weight,60 male db/db mice were randomly divided into the model group,astragaloside Ⅰ low-dose group(10 mg/kg),astragaloside Ⅰ medium-dose group(20 mg/kg),astragaloside Ⅰ high-dose group(40 mg/kg),and valsartan group(10mg/kg),with 12 mice per group.Twelve db/db littermate control db/m mice were used as the control group.The drug was administered by gavage for 8 weeks.Transmission electron microscope was used to observe the ultrastructure of the kidney;immunohistochemistry and Western blotting were used to detect the expression of nephrotic protein(nephrin),a marker of renal podocytes;enzyme-linked immunosorbent assay was used to detect the contents of interleukin-1β(IL-1β)and interleukin-18(IL-18)in the serum of mice;Western blotting was used to detect the protein expressions of NOD-like receptor thermoprotein domain-related protein 3(NLRP3),cysteinyl aspartate specific proteinase 1(Caspase-1),and Gasdermin D(GSDMD)in kidney tissue.Results Compared with the control group,the glomeruli of the model group showed obvious podocyte loss and foot process fusion;the protein expression of nephrin was decreased(P<0.05);the contents of IL-1 β and IL-18 in serum were increased(P<0.05);the protein expressions of NLRP3,Cleaved-Caspase-1,and GSDMD-N were increased(P<0.05).Compared with the model group,the renal pathological damage in the astragaloside Ⅰ administration groups were alleviated;the protein expression of nephrin was increased(P<0.05);the contents of IL-1β and IL-18 in serum were decreased(P<0.05);the protein expressions of NLRP3,Cleaved-Caspase-1,and GSDMD-N were decreased(P<0.05).Conclusion Astragaloside Ⅰ may play a role in intervening diabetic kidney disease by inhibiting pyroptosis and improving podocyte injury.
10.Exploring the influencing factors of stroke and constructing a nomogram prediction model in Chinese middle-aged and older population
Jin LI ; Hou HOU ; Yaxin WANG ; Xin ZHANG ; Zhenqiang SONG ; Mingyan SUN
Chinese Journal of Arteriosclerosis 2024;32(10):865-871
Aim To explore the related influencing factors of stroke in middle-aged and elderly population in China,and to construct a nomogram prediction model to provide more personalized reference for the prevention and treat-ment of stroke.Methods This study included 13 063 participants from the China Health and Retirement Tracking Survey project.This project conducted a cross-sectional survey in 2011 using a multi-stage sampling method,targeting in-dividuals aged 45 and above from 150 counties and 450 communities(villages)in 28 provinces(autonomous regions and municipalities).Detailed data were collected on participants'socio-demographic characteristics,physical measurements,health status,healthcare utilization,household income,and expenditure.The study participants were followed up to as-sess stroke in 2013,2015,and 2018.Univariate and multivariate Cox regression analyses were employed to identify the factors associated with stroke incidence and to construct a nomogram predictive model.Results During the follow-up,774 participants developed to stroke.Multivariate Cox regression results showed that older age(HR=1.028,95%CI:1.019-1.038),being single(HR=1.295,95%CI:1.031-1.626),smoking(HR=1.264,95%CI:1.074-1.489),abnormal body mass index(HR=1.204,95%CI:1.020-1.420),hypertension(HR=2.200,95%CI:1.855-2.609)and diabetes(HR=1.483,95%CI:1.117~1.970)were the risk factors affecting the incidence of stroke,high levels of annual per capita expenditure(HR=0.783,95%CI:0.642-0.953)are antagonistic factors in the incidence of stroke.The nomogram constructed based on the above factors had good predictive performance,and its area under the curve(AUC)was about 0.700.Conclusion Old age,being single,smoking,abnormal body mass index,history of hypertension and diabetes are independent risk factors for stroke,the nomogram constructed based on these factors can help predict the incidence rate of stroke.

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