Ching-Chiang Lin

Hepatitis B virus infection among pregnant women in Taiwan: Comparison between women born in Taiwan and other southeast countries

BackgroundTaiwans national vaccination program has successfully decreased the prevalence of hepatitis B infection after twenty years of implementation and might be indirectly beneficial to the second generation. In this study, we compared the hepatitis B infection status of two groups: pregnant Taiwanese women and other Southeast Asian women, who because they had immigrated later in life to Taiwan by marriage to a Taiwanese man, had not been exposed to that vaccination program to evaluate the effect of hepatitis vaccination program on women of child-bearing age and further explored the potential impact of immigration on the hepatitis B public health policy in Taiwan.MethodsData was collected from 10,327 women born in Taiwan and 1,418 women born in other Southeast Asian countries, both groups receiving prenatal examinations at Fooyin University Hospital between 1996 and 2005. The results of serum hepatitis B s-Antigen (HBsAg) and hepatitis B e-Antigen (HBeAg) tests and other demographic data were obtained by medical chart review.ResultsThe pregnant women from Taiwan had a higher HBsAg positive rate (15.5%) but lower HBeAg(+)/HBsAg(+) ratio (32.1%) than the women from other countries (8.9% and 52.4%). For those born before July, 1984, the period of no national vaccination program, Taiwanese women had a higher HBsAg positive rate than other Southeast Asian women (15.7% vs. 8.4%), but for women born after that day and before June 1986, the period of vaccination for high risk newborns, the HBsAg positive rates found to be slightly lower for Taiwanese women than for other Southeast Asian women (11.4% vs. 12.3%) and the difference was more significant (3.1% vs. 28.6%) after June 1986, the period of vaccination for all newborns. While the HBeAg(+)/HBsAg(+) ratios decreased with age in both groups, they were consistently higher in women from other Southeast Asian countries than in women born in Taiwan after age 20.ConclusionIn Taiwan, the neonatal vaccination program that was implemented in 1984 has successfully reduced hepatitis B infection among pregnant women in present day, and is likely to indirectly prevent hepatitis B infection in the next generation. However, the increasing number of pregnant women from other Southeast Asian countries without a national neonatal vaccination program or with a program that was introduced later than the one in Taiwan will likely lessen the positive impact of this program and should be further assessed.

Rubella Seroepidemiology and Catch-up Immunization among Pregnant Women in Taiwan: Comparison between Women Born in Taiwan and Immigrants from Six Countries in Asia

Rubella vaccination in Taiwan started in 1986; mass vaccination was introduced into the national immunization program in 1992. In recent years, 17-31% of all marriages in Taiwan have been between Taiwanese men and foreign women. The aim of this study was to analyze rubella seroepidemiology and the rate of catch-up immunization in women. We recruited 10,089 pregnant women, including 1,920 immigrants, who had received prenatal examinations during 1999-2006. The rates of seronegativity among global, Taiwan-born, and non-Taiwan-born pregnant women were 14.0%, 11.9%, and 23.1%, respectively. The seronegativity of rubella antibodies decreased from 28.2% for Taiwan-born women born before September 1971 to 8.0% for those born thereafter. The rates of rubella catch-up immunization among global, Taiwan-born, and non-Taiwan-born pregnant women were 28.6%, 20.5%, and 42.2%, respectively. Our results suggest that substantial numbers of older Taiwan-born women and immigrant women remain susceptible to rubella infection.

The Divalent Elements Changes in Early Stages of Chronic Kidney Disease

As the glomerular filtration rate (GFR) decreases, it can cause imbalance in some divalent elements. These imbalances can cause increased oxidative stress in patients with renal impairment. The aim of present study was to investigate the changes of these divalent elements with CKD progression. One hundred and ninety-four patients with chronic kidney diseases (CKD) were divided into five stages, stage 1, 2, 3a, 3b, 4, and were recruited into this study. The divalent elements, calcium, magnesium, phosphorus, as well as iron, zinc, and copper were determined in clinical chemistry analyzer. Higher CKD stages were found to be associated with increased levels of phosphorus and copper; Ptrend values were 0.002 and 0.004, respectively. Also, higher CKD stages were associated with decreased levels of zinc; Ptrend value was 0.002, after adjustment for age, gender, smoke, education, diabetes, hypertension, and BMI. Decreased levels of zinc and elevated levels of phosphorus and copper might increase the oxidative stress and complications in CKD patients. Future randomized studies are needed to show whether adjusting dietary intake of phosphorus, copper, and zinc might affect the progression of CKD.

Changes in Trace Elements During Early Stages of Chronic Kidney Disease in Type 2 Diabetic Patients

Trace elements can influence glucose metabolism and be related to oxidative stress in type 2 diabetes mellitus. Moreover, trace elements play important roles in the nephrotic complications of these patients. Nevertheless, few investigations have been made into the changes in the levels of trace elements in diabetic patients at various stages of chronic kidney disease (CKD). The aims of this present study were to determine the levels of some important trace elements in diabetic patients during the early stages of CKD and to identify the relationship between these elements and CKD progression in type 2 diabetic patients. One hundred and forty-eight type 2 diabetic patients with chronic kidney diseases were recruited into this study. The subjects were grouped into four stages (1, 2, 3a, 3b) of CKD, according to their urine protein levels and estimated glomerular filtration rates (eGFRs). The levels of serum zinc and iron exhibited a statistically significant decreasing trend (P trend = 0.032 and 0.047, respectively) from stage 1 to stage 3b after adjustment for age, gender, smoking, alcohol consumption, education, hypertension, and body mass index. The other tested elements, including copper, magnesium, selenium, chromium, and manganese, did not display any significant trends upon proceeding from stage 1 to stage 3b. Thus, serum zinc and iron appear to be useful markers when evaluating the early progression of CKD in type 2 diabetic patients.

PP274-MON: Outstanding abstract: Chromium, Magnesium, Zinc and Oxidative Stress Biomarker in Type 1 Diabetic Patients at Pre-Puberty, Puberty, and Young Adulthood Stages

Results: Lymphocyte VC levels were significantly lower in patients with severe PD (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.80 0.97; P < 0.01). Plasma VC levels tended to be lower in this group, although the difference was not significant (OR, 0.98; 95%CI, 0.96 1.00; P = 0.09). PD severity was not significantly associated with serum VA (P = 0.61), serum b-carotene (P = 0.17), or serum VE (P = 0.15) levels. Conclusion: Lymphocyte VC level is a potentially useful biomarker of PD progression, but before it can be applied to clinical practice, prospective cohort studies on the relationship between changes in lymphocyte VC level and the progression of PD are required.