Gender Differences in Plasma Phospholipid Fatty Acids and their Correlation with Blood Pressure in Community Elderly Hypertensive Patients

doi:10.12114/j.issn.1007-9572.2019.00.238

Abstract

Abstract: Background　Hypertension is one of the risk factors affecting the life quality of the elderly and it is closely related to blood lipid metabolism with gender differences.The blood fatty acid spectrum is an important indicator which reflects the level of blood lipid metabolism, but its correlation with the occurrence and development of hypertension is still controversial.Objective　To investigate the gender differences in plasma phospholipid fatty acids and their correlation with blood pressure in community elderly hypertensive patients of Ningxia.Methods　A total of 2 231 community residents of Ningxia who were examined in Ningxia International Travel Health Care Center in March 2016 were selected through cluster sampling method. According to the inclusion and exclusion criteria of this study, we screened 282 hypertension patients,149 males and 133 females. And their demographic information was collected. Physical examination was conducted to obtain the biochemical indicators and plasma phospholipid fatty acid spectrum.And then Spearman rank correlation analysis was used to analyze the relationship between plasma phospholipid fatty acid content and systolic blood pressure, diastolic blood pressure and pulse pressure difference. Multiple linear regression analysis was adopted to analyze the influencing factors of systolic blood pressure, diastolic blood pressure and pulse pressure difference. Results　The age, education level, marital status, monthly income, smoking, serum creatinine, blood urea（UA）, alanine aminotransferase（ALT）, aspartate aminotransferase（AST）of males were significantly higher than those of the females, while the total cholesterol, high-density lipoprotein cholesterol（HDL-C）and low-density lipoprotein cholesterol（LDL-C）of males were significantly lower than those of the females（P<0.05）．The plasma phospholipid fatty acid C13：0, C22：1, and C24：1, monounsaturated fatty acid（ MUFA）, C18：3n-3, C18：3n-6 and C20：2n-6 of females were higher than those of the males（P<0.05）．Correlation analysis showed that in male patients, plasma phospholipid fatty acids C12：0 and C20：4n-6 were negatively correlated with diastolic blood pressure（P<0.05）, while C21：0, C18：1, C20：5n-3, C18：2n-6, and C20：2n-6 were positively correlated with diastolic blood pressure（P<0.05）, C20：4n-6 were positively correlated with pulse pressure difference and there was negative correlation between C24：0, C18：1, C18: 3n-3, C20：5n-3 and C20：2n-6 and pulse pressure difference（P<0.05）．In female patients, plasma phospholipid fatty acid C10：0 was negatively correlated with systolic blood pressure, while C21：0, C22：0, C18：1T, C18：3n-3, and C18：2TT were positively correlated with systolic blood pressure（P<0.05）, and C22：0 and C14：1 were positively correlated with diastolic blood pressure（P<0.05）, C18：1T and C18：3n-6 were positively correlated with pulse differential pressure（P<0.05）．In hypertensive patients, the plasma phospholipid fatty acids C22：0 and C18：1T were positively correlated with systolic blood pressure, while C23：0 was negatively correlated with systolic blood pressure（P<0.05）, and C12：0 and C20：4n-6 were negatively correlated with diastolic blood pressure, and C15：0, C18：0, C21：0, C22：0, C18：1, C20：5n-3, C18：2n-6, and C20：2n-6 were positively correlated with diastolic blood pressure（P<0.05）, and C18：1T and C20：4n-6 were positively correlated with pulse pressure difference, while C20：5n-3 was negatively correlated with pulse pressure difference（P<0.05）．Multiple linear regression analysis showed that plasma phosphatic fatty acids C21：0〔β=3 312.095, 95%CI（969.916, 5 654.275）, P=0.007〕, C20：5n-3〔β=184.205, 95% CI （16.822, 351.588）, P=0.032〕, and C20：2n-6〔β=-12 371.615, 95%CI（-20 122.194, -4 621.037）, P=0.003〕were the influencing factors of male diastolic blood pressure.C18：3n-6〔β=492.867, 95%CI （77.420, 908.315）, P=0.021〕was the influencing factor of female pulse pressure difference, and C18：1T〔β=113.848, 95% CI （43.906, 183.790）, P=0.002〕and C20：4n-6〔β=31.488, 95% CI （2.431, 60.546）, P=0.034〕were the influencing factors of pulse pressure difference in elderly hypertension patients. Conclusion　The plasma phospholipid fatty acid C13：0, C22：1, and C24：1, MUFA, C18：3n-3, C18：3n-6 and C20：2n-6 of females are higher than those of the males in elderly community hypertensive patients of Ningxia. There are positively correlated between C21:0, C20:5n-3, C20:2n-6 with male diastolic blood pressure, C18:3n-6 with pulse differential pressure, C18:1T, C20:4n-6 with pulse differential pressure.Therefore, we should pay attention to the diet habit and rationally control the intake of fatty acids.

Key words: Hypertension, Aged, Plasma phospholipid fatty acid, Gender, Root cause analysis, Urea

摘要： 背景　高血压是影响老年人群生命质量的危险因素之一，高血压的发生与血脂代谢密切相关，且存在着性别差异，而血液脂肪酸谱是反映血脂代谢水平的重要指标，但其与高血压的发生与发展尚存争议。目的　探讨宁夏社区老年高血压患者血浆磷脂脂肪酸的性别差异及其与血压的相关性分析。方法　2016年3月在宁夏国际旅行卫生保健中心进行体检的宁夏社区居民2 231例，根据纳入、排除标准筛选出高血压患者282例，其中男149例，女133例。收集其一般资料，并进行体格检查、生化指标检查及血浆磷脂脂肪酸谱测定。采用Spearman秩相关分析血浆磷脂脂肪酸含量与收缩压、舒张压、脉压的关系，采用多元线性回归分析收缩压、舒张压、脉压的影响因素。结果　男性患者年龄、文化程度、已婚率、月收入、吸烟率、血肌酐、尿酸（UA）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）水平高于女性，总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平低于女性（P<0.05）。女性患者血浆磷脂脂肪酸C13：0、C22：1、C24：1、单不饱和脂肪酸（MUFA）、C18：3n-3、C18：3n-6、C20：2n-6含量均高于男性（P<0.05）。相关性分析结果显示，男性患者血浆磷脂脂肪酸C12：0、C20：4n-6与舒张压均呈负相关，C21：0、C18：1、C20：5n-3、C18：2n-6、C20：2n-6与舒张压均呈正相关（P<0.05）；C20：4n-6与脉压呈正相关，C24：0、C18：1、C18：3n-3、C20：5n-3、C20：2n-6与脉压均呈负相关（P<0.05）。女性患者血浆磷脂脂肪酸C10：0与收缩压呈负相关，C21：0、C22：0、C18：1T、C18：3n-3、C18：2TT与收缩压均呈正相关（P<0.05）；C22：0、C14：1与舒张压均呈正相关（P<0.05）；C18：1T、C18：3n-6与脉压均呈正相关（P<0.05）。患者血浆磷脂脂肪酸C22：0、C18：1T与收缩压均呈正相关，C23：0与收缩压呈负相关（P<0.05）；C12：0、C20：4n-6与舒张压均呈负相关，C15：0、C18：0、C21：0、C22：0、C18：1、C20：5n-3、C18：2n-6、C20：2n-6与舒张压均呈正相关（P<0.05）；C18：1T、C20：4n-6与脉压均呈正相关，C20：5n-3与脉压呈负相关（P<0.05）。多元线性回归分析结果显示，血浆磷脂脂肪酸C21：0〔β=3 312.095，95%CI（969.916，5 654.275），P=0.007〕、C20：5n-3〔β=184.205，95%CI（16.822，351.588），P=0.032〕、C20：2n-6〔β=-12 371.615，95%CI（-20 122.194，-4 621.037），P=0.003〕是男性舒张压的影响因素，C18：3n-6〔β=492.867，95%CI（77.420，908.315），P=0.021〕是女性脉压的影响因素，C18：1T〔β=113.848，95%CI（43.906，183.790），P=0.002〕、C20：4n-6〔β=31.488，95%CI（2.431，60.546），P=0.034〕是老年高血压患者脉压的影响因素。结论　宁夏社区女性老年高血压患者血浆磷脂脂肪酸C13：0、C22：1、C24：1、MUFA、C18：3n-3、C18：3n-6、C20：2n-6含量均高于男性，且C21：0、C20：5n-3、C20：2n-6与男性舒张压，C18：3n-6与女性脉压，C18：1T、C20：4n-6与脉压均呈正相关。因此，应该注意饮食，合理控制脂肪酸的摄入。

关键词: 高血压, 老年人, 血浆磷脂脂肪酸, 性别, 影响因素分析, 尿素

WU Jiajia,ZHANG Yahui,TAO Yao, et al. Gender Differences in Plasma Phospholipid Fatty Acids and their Correlation with Blood Pressure in Community Elderly Hypertensive Patients 　[J]. Chinese General Practice, 2019, 22(35): 4298-4305. DOI: 10.12114/j.issn.1007-9572.2019.00.238.
吴佳佳,张亚辉,陶瑶等. 社区老年高血压患者血浆磷脂脂肪酸的性别差异及其与血压的相关性研究[J]. 中国全科医学, 2019, 22(35): 4298-4305. DOI: 10.12114/j.issn.1007-9572.2019.00.238.

References

［1］World Health Organization.A global report on aging and health［R］．Geneva：WHO，2016.
［2］田野，陈娟，王海鹏，等．1991—2009年我国成人高血压流行趋势分析［J］．中国预防医学杂志，2014，15（2）：138-142．DOI：10.16506/j.1009-6639.2014.02.016.
TIAN Y，CHEN J，WANG H P，et al．Analysis on dynamic trend of hypertension in Chinese adults in 1991—2009［J］．Chinese Preventive Medicine，2014，15（2）：138-142．DOI：10.16506/j.1009-6639.2014.02.016.
［3］杨波.膳食n-3脂肪酸在中国人群中的降血压作用及机制研究［D］．杭州：浙江大学，2016.
YANG B.The anti-hypertensive actions exerted by dietary omega-3 polyunsaturated fatty acid in Chinese and its mechanism［D］．Hangzhou：Zhejiang University，2016.
［4］YANG B，DING F，YAN J，et al．Exploratory serum fatty acid patterns associated with blood pressure in community-dwelling middle-aged and elderly Chinese［J］．Lipids Health Dis，2016，15（1）：58．DOI：10.1186/s12944-016-0226-3.
［5］SKOP-LEWANDOWSKA A，KOLARZYK E，ZAJAC J，et al．The structure of fats and fatty acid consumption in elderly people with cardiovascular system diseases［J］．Adv Clin Exp Med，2016，25（1）：69-75．DOI：10.17219/acem/33842.
［6］HEIDARI Z，FEIZI A，AZADBAKHT L，et al．Usual energy and macronutrient intakes in a large sample of Iranian middle-aged and elderly populations［J］．Nutr Diet，2019，76（2）：174-183．DOI：10.1111/1747-0080.12431.
［7］ROWAN C G，TURNER J R，SHAH A，et al．Antihypertensive treatment and blood pressure control relative to hypertension treatment guidelines［J］．Pharmacoepidemiol Drug Saf，2014，23（12）：1294-1302．DOI：10.1002/pds.3694.
［8］Issue information-declaration of helsinki［J］．J Bone Miner Res，2019，34（3）：BMi-BMii．DOI：10.1002/jbmr.3492.
［9］PAN F，HE P Y，LIU C Y，et al．Variation of the korotkoff stethoscope sounds during blood pressure measurement：analysis using a convolutional neural network［J］．IEEE J Biomed Health Inform，2017，21（6）：1593-1598．DOI：10.1109/JBHI.2017.2703115.
［10］基层高血压管理专家委员会.国家基层高血压防治管理指南［J］．中国循环杂志，2017，32（11）：1041-1048．DOI：10.3969/j.issn.1000-3614.2017.11.001.
［11］LI Y C，YANG L，WANG L M，et al．Burden of hypertension in China：a nationally representative survey of 174，621 adults［J］．Int J Cardiol，2017，227（1）：516-523．DOI：10.1016/j.ijcard.2016.10.110.
［12］JACKSON K H，HARRIS W S.Blood fatty acid profiles：new biomarkers for cardiometabolic disease risk［J］．Curr Atheroscler Rep，2018，20（5）：22．DOI：10.1007/s11883-018-0722-1.
［13］闫贻忠，木拉提，牛强，等．新疆农村地区维吾尔族高血压患者血清游离脂肪酸与胰岛素抵抗的关系［J］．中华高血压杂志，2015，23（9）：863-867．DOI：10.16439/j.cnki.1673-7245.2015.09.019.
YAN Y Z，MU L T，NIU Q，et al．The relationship between serum free fatty acid and insulin resistance in Uygur hypertensive patients from a rural area of Xinjiang［J］．Chinese Journal of Hypertension，2015，23（9）：863-867．DOI：10.16439/j.cnki.1673-7245.2015.09.019.
［14］胡志坚，江永青，谷翔，等．中心肥胖型高血压患者血清游离脂肪酸与载脂蛋白的变化［J］．实验与检验医学，2016，34（1）：15-17．DOI：10.3969/j.issn.1674-1129.2016.01.005.
HU Z J，JIANG Y Q，GU X，et al．Study on the level variety of serum free fatty acid and apolipoprotein in central obese hypertensive patients［J］．Experimental and Laboratory Medicine，2016，34（1）：15-17．DOI：10.3969/j.issn.1674-1129.2016.01.005.
［15］何伟林，陈纪春，李莹，等．我国队列人群1998—2015年血清总胆固醇水平的变化趋势［J］．中国循环杂志，2018，33（5）：452-456．DOI：10.3969/j.issn.1000-3614.2018.05.008.
HE W L，CHEN J C，LI Y，et al．Trends in serum total cholesterol during 1998 to 2015 among the population-based cohorts of China［J］．Chinese Circulation Journal，2018，33（5）：452-456．DOI：10.3969/j.issn.1000-3614.2018.05.008.
［16］傅雪芹，敖学容.原发性高血压患者发病危险因素的性别差异［J］．中国老年学杂志，2014，34（2）：373-374．DOI：10.3969/j.issn.1005-9202.2014.02.043.
［17］王学屏，陈瑞鹏，邢朝云，等．农村老年人日常饮食营养调查［J］．中国老年学杂志，2016，36（16）：4077-4078．DOI：10.3969/j.issn.1005-9202.2016.16.097.
［18］陈炎，陈亚蓓，陶荣芳.《2016年中国成人血脂异常防治指南》内容介绍［J］．中国实用内科杂志，2017，37（S1）：38-42．DOI：10.19538/j.nk2017SI0113.
CHEN Y，CHEN Y B，TAO R F.Interpretation of “guideline for prevention and treatment of dyslipidemia in chinese adults in 2016”［J］．Chinese Journal of Practical Internal Medicine，2017，37（S1）：38-42．DOI：10.19538/j.nk2017SI0113.
［19］KASKA L，MIKA A，STEPNOWSKI P，et al．The relationship between specific fatty acids of serum lipids and serum high sensitivity C-reactive protein levels in morbidly obese women［J］．Cell Physiol Biochem，2014，34（4）：1101-1108．DOI：10.1159/000366324.
［20］李小霞，刘婉露，刘莎，等．宁夏农村居民血清脂联素和hs-CRP水平与高血压前期关系研究［J］．中华疾病控制杂志，2017，21（10）：983-987．DOI：10.16462/j.cnki.zhjbkz.2017.10.004.
LI X X，LIU W L，LIU S，et al．Association of serum adiponectin and hypersensitive C-reactive with pre-hypertension of rural residents in Ningxia［J］．Chinese Journal of Disease Control & Prevention，2017，21（10）：983-987．DOI：10.16462/j.cnki.zhjbkz.2017.10.004.
［21］丁芳，王峰磊，杨波，等．高血压患者血清脂肪酸与血压的相关性研究［J］．浙江预防医学，2015，27（6）：551-555．DOI：10.19485/j.cnki.issn1007-0931.2015.06.004.
DING F，WANG F L，YANG B，et al．A study on the relationship between serum fatty acids and blood pressure among hypertension patients［J］．Zhejiang Journal of Preventive Medicine，2015，27（6）：551-555．DOI：10.19485/j.cnki.issn1007-0931.2015.06.004.
［22］李青青.血浆磷脂脂肪酸与人体组成及代谢综合征的关联性研究［D］．杭州：浙江大学，2015.
LI Q Q.Association of plasma phospholipid fatty acid with body composition and metabolic syndrome［D］．Hangzhou：Zhejiang University，2015.
［23］郑燕伟，刘杰，陶敏芳，等．女性绝经状态与血脂代谢的关系研究［J］．中国妇幼健康研究，2017，28（9）：1112-1114．DOI：10.3969/j.issn.1673-5293.2017.09.024.
ZHENG Y W，LIU J，TAO M F，et al．Association between female menopausal status and blood lipid metabolism［J］．Chinese Journal of Woman and Child Health Research，2017，28（9）：1112-1114．DOI：10.3969/j.issn.1673-5293.2017.09.024.
［24］徐新献，周婧，姚武位，等．高龄老年高血压患者脉压特征的分析［J］．重庆医学，2016，45（20）：2837-2839．DOI：10.3969/j.issn.1671-8348.2016.20.033.
［25］窦娟，徐新献，何灵妍，等．年龄、性别与老年高血压患者脉压的关系［J］．现代医药卫生，2017，33（23）：3610-3612．DOI：10.3969/j.issn.1009-5519.2017.23.026.
［26］王海燕，朱志远，任燕妮，等．老年高血压患者动态脉压与颈动脉硬化的关系［J］．山东医药，2016，56（10）：62-63．DOI：10.3969/j.issn.1002-266X.2016.10.027.
［27］谢上才，江力勤.反式脂肪酸对心血管的危害及机制的研究进展［J］．心脑血管病防治，2016，16（2）：134-135，139．DOI：10.3969/j.issn.1009-816x.2016.02.19.
［28］于化泓.反式脂肪酸对人脐静脉内皮细胞功能影响及其诱导凋亡通路的研究［D］．南昌：南昌大学，2018.
［29］TSUKAMOTO I，SUGAWARA S.Low levels of linoleic acid and α-linolenic acid and high levels of arachidonic acid in plasma phospholipids are associated with hypertension［J］．Biomed Rep，2018，8（1）：69-76．DOI：10.3892/br.2017.1015.
［30］ZHENG Z J，FOLSOM A R，MA J，et al．Plasma fatty acid composition and 6-year incidence of hypertension in middle-aged adults：the atherosclerosis risk in communities （ARIC） study［J］．Am J Epidemiol，1999，150（5）：492-500.
［31］GANGEMI S，PESCARA L，D'URBANO E，et al．Aging is characterized by a profound reduction in anti-inflammatory lipoxin A4 levels［J］．Exp Gerontol，2005，40（7）：612-614．DOI：10.1016/j.exger.2005.04.004.
［32］解晓媛，丁彦春.前列腺素E2和高血压靶器官损害相关性的研究进展［J］．中华高血压杂志，2016，24（3）：216-219．DOI：10.16439/j.cnki.1673-7245.2016.03.007.
［33］DAS U N.Arachidonic acid in health and disease with focus on hypertension and diabetes mellitus：a review［J］．J Adv Res，2018，10（11）：43-55．DOI：10.1016/j.jare.2018.01.002.
［34］DAS U N.Ageing：is there a role for arachidonic acid and other bioactive lipids?A review［J］．J Adv Res，2018，10（11）：67-79．DOI：10.1016/j.jare.2018.02.004.
［35］YAMASHITA K，HIGA M，KUNISHITA R，et al．Dihomo-gamma-linolenic acid levels and obesity in patients with type 2 diabetes［J］．Diabetol Int，2015，6（3）：206-211．DOI：10.1007/s13340-014-0187-6.
［36］罗富健，黄建凤.低舒张压与心血管疾病关系的研究进展［J］．心血管病学进展，2016，37（5）：486-490．DOI：10.16806/j.cnki.issn.1004-3934.2016.05.009.
LUO F J，HUANG J F.Research progress of relationship between low diastolic blood pressure and cardiovascular disease［J］．Advances in Cardiovascular Diseases，2016，37（5）：486-490．DOI：10.16806/j.cnki.issn.1004-3934.2016.05.009.
［37］朱鹏立.老年低舒张压的单纯收缩期高血压治疗探讨［J］．中华高血压杂志，2018，26（2）：110-113．DOI：10.16439/j.cnki.1673-7245.2018.02.005.
［38］汪志明，余超，陆姝欢，等．DHA/EPA在心血管疾病防治中的重要作用［J］．中国食品添加剂，2014，15（9）：164-170．DOI：10.3969/j.issn.1006-2513.2014.09.018.
WANG Z M，YU C，LU S H，et al．Protective effect of docosahexaenoic acid and eicosapntemacnioc acid on cardiovascular disease［J］．China Food Additives，2014，15（9）：164-170．DOI：10.3969/j.issn.1006-2513.2014.09.018.

[1]	QIN Fengyin, ZHANG Qishan, LAI Jinjia, HUANG Yimin, HAN Guoyin, SUN Xinglan, WANG Fen, TAN Yibing. Current Status and Influencing Factors of the Intention to Screen for High-risk Stroke among Community Residents in Guangdong [J]. Chinese General Practice, 2023, 26(34): 4283-4289.
[2]	FENG Xiaoyu, LI Wanling, LYU Siman, NI Cuiping, WANG Haocheng, LIU Yu. International Research Status and Hot Spot Analysis of InterRAI HC Based on Bibliometrics [J]. Chinese General Practice, 2023, 26(34): 4351-4358.
[3]	GU Hanxin, LIU Yang, LIU Yuanli. Falls Prevention Intervention for Community-dwelling Older Adults from the Perspective of Policy Tools: an International Comparative Study [J]. Chinese General Practice, 2023, 26(34): 4231-4238.
[4]	HAO Aihua, ZENG Weilin, LI Guanhai, XIA Yinghua, CHEN Liang. Current Situation of the Construction of Family Doctor Team: an Investigation Based on the Perspective of General Practitioners [J]. Chinese General Practice, 2023, 26(34): 4261-4268.
[5]	LI Dianjiang, PAN Enchun, SUN Zhongming, WEN Jinbo, WANG Miaomiao, WU Ming, SHEN Chong. The Current Status and Influencing Factors of Clinical Inertia in Type 2 Diabetes Patients in Community [J]. Chinese General Practice, 2023, 26(34): 4296-4301.
[6]	WANG Yue, CHEN Qing, LIU Lurong. Detection Rate of Depression and Its Influencing Factors in Chinese Elderly: a Meta-analysis [J]. Chinese General Practice, 2023, 26(34): 4329-4335.
[7]	YU Xinyan, ZHAO Jun, ZHAO Xiaoye, JIANG Qingru, CHEN Yatian, WANG Yan, ZHANG Haicheng. Application of Mobile Smart Healthcare in the Prevention and Control of Cardiovascular Diseases in Elderly Patients with Chronic Diseases in Primary Care [J]. Chinese General Practice, 2023, 26(33): 4167-4172.
[8]	WANG Lina, GAO Pengfei, CAO Fan, GE Ying, YAN Wei, HE Daikun. Analysis of the Prevalence and Influencing Factors of Non-alcoholic Fatty Liver Disease in Different Gender Groups [J]. Chinese General Practice, 2023, 26(33): 4143-4151.
[9]	XIN Gongkai, CONG Xin, YUAN Lei, CHENG Yuetong, NI Cuiping, ZHANG Weiwei, ZHANG Pingping, LIU Yu. Research Progress on Comprehensive Assessment Tools for the Elderly with Dementia [J]. Chinese General Practice, 2023, 26(33): 4103-4109.
[10]	ZHANG Jin, DING Zhiguo, QI Shuo, LI Ying, LI Weiqiang, ZHANG Yuanyuan, ZHOU Tong. Relationship between Serum Thyroid Hormone Levels and Prognosis during Hospitalization in Heart Failure Patients [J]. Chinese General Practice, 2023, 26(33): 4125-4129.
[11]	ZHOU Yuyu, GAO Chuan, CUI Puan, WANG Yaping, HE Zhong. Influencing Factors of Shared Decision Making between Doctors and Patients in Menopausal Hormone Therapy in Patients with Menopausal Syndrome [J]. Chinese General Practice, 2023, 26(33): 4181-4186.
[12]	LIANG Xuan, NA Feiyang, QIN Mengyao, YANG Hui, GUO Li, GUO Qi, REN Lei, CHEN De, LIU Donghai, ZHANG Rongfang. Clinical Characteristics and Influencing Factors of Bronchial Asthma Combined with Obstructive Sleep Apnea-hypopnea Syndrome in Children [J]. Chinese General Practice, 2023, 26(33): 4225-4230.
[13]	LI Qianqian, CHEN Xunrui, ZHANG Wenying, YUAN Haihua, ZHANG Yanjie, JIANG Bin, LIU Feng. Demand and Influencing Factors for Community Health Services during Chemotherapy of Patients with Advanced Cancer [J]. Chinese General Practice, 2023, 26(33): 4173-4180.
[14]	GAO Dekang, WEI Shaohua, MA Xiaoming, DU Peng, XING Chungen, CAO Chun. Risk Factors for Loss of Skeletal Muscle Mass and Its Correlation with Complications after Major Hepatectomy for Liver Cancer [J]. Chinese General Practice, 2023, 26(32): 4031-4037.
[15]	ZHANG Shuai, LI Qin, LI Dongfeng, XIAO Jinping, LI Yunpeng. A Prospective Cohort Study of Solid Fuels Use and Risk of Hypertension in Chinese Older Adults [J]. Chinese General Practice, 2023, 26(32): 4001-4006.