Background
Harmful substances in solid fuel and tobacco smoke are believed to enter the bloodstream via inhalation and to be metabolized in the liver, leading to chronic liver damage. However, little is known about the independent and joint effects of solid fuel use and smoking on risks of chronic liver disease (CLD) mortality.
Methods
During 2004–08, ∼0.5 million adults aged 30–79 years were recruited from 10 areas across China. During a 10-year median follow-up, 2461 CLD deaths were recorded. Multivariable Cox regression yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the individual associations of self-reported long-term cooking fuel and tobacco use with major CLD death.
Results
Overall, 49% reported solid fuel use and 26% smoked regularly. Long-term solid fuel use for cooking and current smoking were associated with higher risks of CLD deaths, with adjusted HRs of 1.26 (95% CI, 1.02–1.56) and 1.28 (1.13–1.44), respectively. Compared with never-smoking clean fuel users, the HRs were 1.41 (1.10–1.82) in never-smoking solid fuel users, 1.55 (1.17–2.06) in regular-smoking clean fuel users and 1.71 (1.32–2.20) in regular-smoking solid fuels users. Individuals who had switched from solid to clean fuels (1.07, 0.90–1.29; for median 14 years) and ex-regular smokers who stopped for non-medical reasons (1.16, 0.95–1.43; for median 10 years) had no evidence of excess risk of CLD deaths compared with clean fuel users and never-regular smokers, respectively.
Conclusions
Among Chinese adults, long-term solid fuel use for cooking and smoking were each independently associated with higher risks of CLD deaths. Individuals who had stopped using solid fuels or smoking had lower risks.
Despite their opposing actions on food intake, POMC and NPY/AgRP neurons in the arcuate nucleus of the hypothalamus (ARH) are derived from the same progenitors that give rise to ARH neurons. However, the mechanism whereby common neuronal precursors subsequently adopt either the anorexigenic (POMC) or the orexigenic (NPY/AgRP) identity remains elusive. We hypothesize that POMC and NPY/AgRP cell fates are specified and maintained by distinct intrinsic factors. In search of them, we profiled the transcriptomes of developing POMC and NPY/AgRP neurons in mice. Moreover, cell-type-specific transcriptomic analyses revealed transcription regulators that are selectively enriched in either population, but whose developmental functions are unknown in these neurons. Among them, we found the expression of the PR domain-containing factor 12 (Prdm12) was enriched in POMC neurons but absent in NPY/AgRP neurons. To study the role of Prdm12 in vivo, we developed and characterized a floxed Prdm12 allele. Selective ablation of Prdm12 in embryonic POMC neurons led to significantly reduced Pomc expression as well as early-onset obesity in mice of either sex that recapitulates symptoms of human POMC deficiency. Interestingly, however, specific deletion of Prdm12 in adult POMC neurons showed that it is no longer required for Pomc expression or energy balance. Collectively, these findings establish a critical role for Prdm12 in the anorexigenic neuron identity and suggest that it acts developmentally to program body weight homeostasis. Finally, the combination of cell-type-specific genomic and genetic analyses provides a means to dissect cellular and functional diversity in the hypothalamus whose neurodevelopment remains poorly studied.
This study suggests an association between pCNVs and fetal IMV. pCNVs may be involved in the pathological process of fetal IMV and postnatal NDs. Identifying specific genomic alterations may provide an insight into pathogenetic mechanism and aid better diagnosis and prognosis of neurodevelopmental outcomes in fetal IMV.
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