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  • Interaction of ACE genotype and salt intake on hypertension among Chinese Kazakhs: results from a population-based cross-sectional study

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Epidemiology
Research
Interaction of ACE genotype and salt intake on hypertension among Chinese Kazakhs: results from a population-based cross-sectional study
  1. Yuyan Wang1,
  2. Biao Zhang1,
  3. Lei Hou1,
  4. Wei Han1,
  5. Fang Xue1,
  6. Yanhong Wang1,
  7. Yong Tang2,
  8. Shaohua Liang2,
  9. Weizhi Wang2,
  10. Kuliqian Asaiti3,
  11. Zixing Wang1,
  12. Yaoda Hu1,
  13. Lei Wang1,
  14. Changchun Qiu1,
  15. Mingtao Zhang2,
  16. Jingmei Jiang1
  1. 1 Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
  2. 2 The People’s Hospital in Altay Region, Xinjiang, China
  3. 3 Hong Dun Town Hospital, Altay Region, Xinjiang, China
  1. Correspondence to Dr Jingmei Jiang; jingmeijiang{at}ibms.pumc.edu.cn

Abstract

Objectives To explore the effect of interaction between ACE genotype and salt intake on hypertension among Chinese Kazakhs, and to compare applications of interactions between logistic model and generalised partially linear tree-based regression (GPLTR) model.

Design Population-based cross-sectional study.

Setting Hong Dun, North Xinjiang, China.

Participants Non-consanguineous Chinese Kazakh participants (n=916, 342 men and 574 women) aged ≥30 years.

Main outcome measures Association between ACE genotype and hypertension, association between salt intake and hypertension, and interaction of ACE genotype and salt intake on hypertension in two models.

Results Associations between salt intake and hypertension were different in ACE genotype of II and ID+DD. Under the logistic models, main and interaction effects were not observed for men, but effects were present in opposite directions for women (main effect of ACE: OR=0.20, p=0.003; interaction effect: OR=1.07, p=0.027). Under the GPLTR model, Bayesian information criterion trees included both salt intake and ACE genotype as split variables. Individuals with a salt intake ≥19.5 g/day and ID+DD genotypes had a 3.99-fold (p=0.004) higher risk of hypertension compared with the II genotype for men, whereas salt intake <20.1 g/day and ID+DD genotypes had an OR=0.55 (p=0.014) compared with the II genotype for women.

Conclusions An interaction of ACE genotype and salt intake on hypertension was observed among Chinese Kazakhs but in different ways according to sex. The GPLTR model appears to be more suitable for an exploration of interactions in complex diseases.

  • Hypertension
  • Interaction
  • ACE genotype
  • Salt intake
  • Logistic model
  • GPLTR model

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014246

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    Footnotes

    • Contributors YW and BZ abstracted data, performed data analysis and interpreted results with substantial contributions from the other co-authors, and drafted the manuscript, which was critically revised by all co-authors. JJ and LH conceived the study and assisted in data analysis, design of figures and tables. WH, FX and YW assisted in data analysis and interpretation, added important background knowledge and improved the manuscript by repeated readings and rephrasing as well as critical discussions of the intellectual content. MZ, YT, SL, WW, KA and CQ contributed to the data collection, quality control, general editing purposes and comments regarding medical terminology and critical review of the manuscript. ZW, YH and LW mainly performed statistical analyses, designed tables and figures and reviewed the manuscript. All authors have read and approved the final version of this manuscript for submission.

    • Funding This work was supported by National Natural Science Foundation of China (81273181).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Committee of Institute of the Basic Medical Sciences Chinese Academy of Medical Sciences.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data available.