Chen-Jung Wu

Increased risk of cognitive impairment in patients with components of metabolic syndrome.

AbstractThe number of old adults with cognitive impairment or dementia is anticipated to increase rapidly due to the aging population, especially the number of patients with multiple chronic conditions or metabolic perturbation. Metabolic syndrome (Mets) is among the most hazardous risk factors for cardiovascular disease and is linked to a chronic inflammatory disease. We investigated the National Health and Nutrition Examination Survey (NHANES) database for the years 1999 to 2002 to explore the connection between Mets and cognitive decline.A total of 2252 NHANES (1999–2002)-registered individuals who were stroke-free and aged ≧60 years were enrolled in this study. This study surveyed the effects of the existence of diverse characteristics of Mets on the individuals’ cognitive performances as measured with the digit symbol substitution test (DSST).The individuals with more features of Mets achieved lower DSST scores than those with fewer constituents of Mets (P < 0.001 for the trend) after adjustments for covariates. The &bgr; coefficients for the DSST scores of the participants with 1, 2, 3, and ≥4 features of Mets were −1.545, −3.866, −4.763, and −5.263, respectively. Cognitive decline was correlated with each of the constituents of Mets, which included high plasma glucose, elevated blood pressure, abdominal obesity, and decreased high-density lipoprotein cholesterol (P < 0.05 for the above factors), with the exception of high triglyceride levels (P > 0.05).Mets was positively associated with cognitive decline in individuals aged ≧60 years. The characteristics of Mets that were most strongly associated with cognitive decline were high plasma glucose and elevated blood pressure.

Examining the gender difference in the association between metabolic syndrome and the mean leukocyte telomere length

The mechanism of cellular aging likely involves decreased telomere length and is associated with age-related diseases such as cardiovascular disease. Metabolic syndrome (MetS) is an important risk factor for CVD. The purpose of this study was to investigate the association between LTL and MetS. We evaluated 7370 participants in the National Health and Nutrition Examination Survey (1999–2002). The association between LTL and individual MetS components and the number of MetS components was analyzed by multivariable regression models, adjusting for gender, race/ethnicity, albumin, C-reactive protein, alanine transaminase, uric acid and medical condition. An increase in the number of MetS components was strongly associated with shorter telomere length, especially in female participants (p for trend < 0.05). In addition, triglycerides were negatively associated with LTL in female participants (p < 0.001). Waist circumstance was associated with decreased LTL (p < 0.05) in both males and females. In summary, our study indicated that an increment of MetS component is strongly associated with shorter LTL, especially in the female population.

Examining the association between anthropometric parameters and telomere length and mortality risk

A shorter telomere length is associated with several systemic disorders. Telomere length may be an informative biomarker for the maintenance of the overall health status and mortality. There are a limited number of empirical studies concerning the effect of anthropometric parameters on telomere length. The data are derived from the National Health and Nutrition Examination Survey from 1999 to 2002. The primary outcomes of this study were to examine the potential relationships between the anthropometric indices and the telomere length, while secondary outcomes of this study was to investigate the association between different anthropometric indices and mortality risk. A significant positive correlation was noted between the mean telomere length and the thigh circumference (TC) and calf circumference (CC) in all designed models. Participants in the highest TC and CC quartiles tended to have a longer telomere length and lowered the hazards for all-cause mortality to 43% and 57%, respectively. Notably, the anthropometric indices involving the CC with higher values seemed to be surrogate markers for the reduction of the risk of all-cause, cardiovascular and malignancy-related mortality (all P < 0.05). The CCmay be a valuable tool to guide public health policy and a clinical prognostic indicator for the risk of mortality.

The association of uric acid with the risk of metabolic syndrome, arterial hypertension or diabetes in young subjects- An observational study

BACKGROUND A growing number of studies are available to shed some light on the association between uric acid (UA) and cardiovascular diseases. However, there have been few studies to support a causal link between UA, metabolic syndrome (MetS), diabetes mellitus (DM) and hypertension (HTN) in young subjects. METHODS From the Health Examination Registration System of Taiwanese military service during the period 2013-2015, there were 46,561 eligible participants who were 20years old or older in our study. Different analytical steps of analysis were performed to examine the association between UA and cardiometabolic risk using logistic regression, receiver operating characteristic (ROC) curve analysis and Cox regression. RESULTS For total population, serum UA had significant associations with the presence of MetS (OR=2.08, 95% CI=1.51-2.87), DM (OR=2.59, 95% CI=1.09-6.19) and HTN (OR=1.49, 95% CI=1.07-2.07) in the cross-sectional analysis. According to the cut-off values of UA calculating by the ROC curve analysis in each sex/age subgroup, the association between UA and incident adverse outcomes were analyzed in a longitudinal study. In male, higher UA significantly increased the risks for developing MetS in 30-40years (HR=1.12, 95% CI=1.01-1.25), DM in <30years (HR=2.75, 95% CI=1.38-5.45) and HTN in all subgroups (HR=1.17, 95% CI=1.01-1.37; HR=1.65, 95% CI=1.08-2.53; HR=1.72, 95% CI=1.22-2.43). In females, a higher UA was significantly associated with an increased risk of incident MetS in >40years (HR=2.99, 95% CI=1.34-6.64), HTN in >40years (HR=2.58, 95% CI=1.02-6.55), and no increased risk of DM. CONCLUSIONS Our study concluded that serum UA is an important predictor for the risk of incident MetS, DM, and HTN in adults, especially in male population.

Secondhand Smoke is Associated with Hearing Threshold Shifts in Obese Adults.

Hearing loss resulted from multiple intrinsic and extrinsic factors. Secondhand smoke (SHS) and obesity had been reported to be related to hearing loss. This study explored the possible associations of SHS and obesity with the hearing threshold. The relations between SHS and the hearing threshold in subjects from three different body mass index classes were analyzed. Our study included data from 1,961 subjects aged 20–69 years that were obtained from the National Health and Nutrition Examination Survey for the years 1999–2004. After adjusting for potential confounding factors, the subjects with the higher tertiles of serum cotinine levels tended to have higher hearing thresholds than those with the lowest tertile of serum cotinine levels (for both trends, p < 0.05). Notably, the obese subjects with the higher tertiles of serum cotinine levels had significantly higher hearing thresholds for high frequencies and low frequencies than those with the lowest tertile of serum cotinine levels (for both trends, p < 0.05). Our study showed a significant positive association between SHS exposure and hearing thresholds in the adult population, especially in obese individuals. Based on our findings, avoiding exposure to SHS, especially in obese adults, may decrease the risk of hearing loss.

Does the additional component of calf-circumference refine metabolic syndrome in Correlating with Cardiovascular Risk?

Context Calf circumference (CC) was a useful anthropometric tool, but there was limited study on the effect of CC on metabolic syndrome (MetS) for cardiovascular risk. Objective The objective of our study was to determine whether adding CC as a component of MetS refined correlating MetS with cardiovascular, all-cause, and cancer mortality risks. Design, Setting, Patients, and Interventions From the National Health and Nutrition Examination Survey data set for 1999 through 2002, we analyzed four types of MetS: (1) increased waist circumference and two or more of four MetS components (WaistMetS); (2) decreased CC and two or more of four MetS components (CalfMetS); (3) increased waist-to-calf ratio and two or more of four MetS components (WCRMetS); and (4) decreased CC and three or more of five MetS components (CC+MetS). Primary Outcome Measure The cause-specific hazard ratios were measured as categorized by the four types of MetS. Results For cardiovascular mortality, the adjusted hazard ratios for WaistMetS, CalfMetS, WCRMetS, and CC+MetS were 1.867, 1.871, 1.949, and 2.306, respectively (all P < 0.001). Notably, CalfMetS showed the strongest positive correlation with serum C-reactive protein levels, and WCRMetS had the strongest positive relationship with homeostasis model assessment of insulin resistance. Conclusions Adding CC to the components of MetS correlated with higher cardiovascular and all-cause mortality risk than the traditional definition of MetS.

Examining the Associations among Fibrocystic Breast Change, Total Lean Mass, and Percent Body Fat

Fibrocystic breast change (FBC) is extremely common and occurrs in 90% of women during their lives. The association between body composition and risk of breast cancer is well established. We hypothesized that the effect might exist during the development of FBC. Our aim was to examine the relationships of total lean mass (TLM) and percent body fat (PBF) with FBC in a general female population. In total, 8477 female subjects aged 20 years or older were enrolled in the study at the Tri-Service General Hospital in Taiwan from 2011 to 2016. Comprehensive examinations including biochemical data, measurements of body composition and breast ultrasound were performed. PBF was positively associated with the presence of FBC (OR = 1.039, 95%CI: 1.018–1.060), and TLM showed the opposite result (OR = 0.893, 95%CI: 0.861–0.926). Condition of metabolic syndrome (MetS), diabetes (DM) and fatty liver modified the association between PBF and FBC (P < 0.001, P = 0.032 and P = 0.007, respectively). Female subjects diagnosed with MetS, DM, and fatty liver had higher risk of developing FBC than control subjects (OR = 1.110, 95%CI: 1.052–1.171; OR = 1.144, 95%CI: 1.024–1.278; OR = 1.049, 95%CI: 1.019, 1.080). Those with higher PBF (for highest quartile versus lowest, OR = 2.451, 95%CI: 1.523–3.944) or lower TLM (for highest quartile versus lowest, OR = 0.279, 95%CI: 0.171–0.455) had increased risk of developing FBC. In conclusion, increased PBF and reduced TLM were likely to predict the risk of the presence of FBC in a general female population.

Association of Percentage Body Fat and Metabolic Health in Offspring of Patients with Cardiovascular Diseases

Family history was one of the major risk factors for developing adverse health outcomes such as metabolic syndrome (MetS), type 2 diabetes mellitus (DM) and hypertension (HTN). Our aim was to examine the relationship between different family histories and cardiometabolic events, including DM, stroke, myocardial infarction (MI), and HTN. Participants who attended the health examinations at the Tri-Service General Hospital from 2010 to 2016 were enrolled in the study and were categorized into four groups by representing different family history. A multivariable logistic regression model was used for the associations between various family history with the cardiometabolic events. Subjects with family history of DM were divided into quartiles by percentage body fat (PBF) to be analyzed for these adverse outcomes. In the cross-sectional analysis, subjects with family history of DM had significant association with MetS (OR = 1.34 [95%CI: 1.17–1.54]) and DM (OR = 3.03 [95%CI: 2.44–3.76]), and those with family history of HTN were positively associated with HTN (OR = 1.60 [95%CI: 1.41–1.81]). Notably, those with family history of DM in higher PBF quartiles had substantially increased association of cardiometabolic events (MetS: OR = 15.20 [95%CI: 9.87–23.39]; DM: OR = 3.35 [95%CI: 1.91–5.90]; HTN: 2.81 [95%CI: 1.84–4.29]). Individuals with family history of DM were positively associated with MetS and DM, and those with family history of HTN was associated with HTN. Family history assessment was requested especially in obese population for screening adverse health outcomes.

Exploring the Link between Serum Phosphate Levels and Low Muscle Strength, Dynapenia, and Sarcopenia

Emerging evidences addressed an association between phosphate and muscle function. Because little attention was focused on this issue, the objective of our study was to explore the relationship of phosphate with muscle strength, dynapenia, and sarcopenia. From the National Health and Nutrition Examination Survey, a total of 7421 participants aged 20 years or older were included in our study with comprehensive examinations included anthropometric parameters, strength of the quadriceps muscle, and appendicular lean masses. Within the normal range of serum phosphate, we used quartile-based analyses to determine the potential relationships of serum phosphate with dynapenia, and sarcopenia through multivariate regression models. After adjusting for the pertinent variables, an inverse association between the serum phosphate quartiles and muscle strength was observed and the linear association was stronger than other anthropometric parameters. Notably, the significant association between phosphate and muscle strength was existed in >65 years old age group, not in 20–65 years old. The higher quartiles of phosphate had higher likelihood for predicting the presence of dynapenia rather than sarcopenia in entire population. Our study highlighted that higher quartiles of phosphate had significant association with lower muscle strength and higher risks for predicting the presence of dynapenia.

Detrimental association between betel nut chewing and colorectal polyps in adult populations

Adverse systemic effect caused by betel nut had been reported for decades. Our aim was to determine whether betel nut had detrimental impact on the development of colorectal polyps in general population. Participants who attended health examinations at the Tri-Service General Hospital (TSGH) from 2010 to 2016 were included in the study. The habit of betel nut chewing was obtained from a self-reported questionnaire. Colorectal polyps were diagnosed by colonoscopies operated by experienced physicians. A logistic regression model was used for the association between betel nut chewing with the presence of colorectal polyps. After adjustment for pertinent information such as age, gender, biochemistry data and personal history, the odd ratios (ORs) of colorectal polyps among betel nut chewers was 1.49 (95%CI: 1.14–1.94). Besides, betel nut chewers in the higher percentage body fat (PBF) group had higher risk for developing colorectal polyps with ORs of 2.07 (95%CI:1.23–3.47). Subjects with habit of betel nut chewing were associated with an increased risk of colorectal polyps in Taiwanese general population. Screening for betel nut chewing history and encouraging cessation might offer improved quality of life. A further research for this association was warranted.