BsmI-ApaI-TaqI TAC (BAt) Haplotype of Vitamin D Receptor Gene Is Associated with Increased Risk of Major Depressive Disorder

Heritability of major depressive disorder (MDD) is between 36 and 44%, suggesting that up to nearly half of the phenotypic variability is attributable to genes. A number of genetic polymorphisms have been shown to predispose certain individuals to depression. Of particular interest are the polymorphisms of the vitamin D receptor (VDR) gene. Although the VDR gene has been well characterized and a vast number of polymorphisms have been identified, the association between BsmI (rs1544410), ApaI (rs7975232) and TaqI (rs731236) single-nucleotide polymorphisms (SNPs), together with their haplotypes, and MDD risk have yet to be established. We conducted a matched case-control study with a total of 600 participants comprising 300 major depressive disorder (MDD) cases and 300 controls matched by age, gender and ethnicity in a 1:1 ratio, in four public hospitals in Kuala Lumpur and Selangor. Three adjacent SNPs of the VDR gene-BsmI (rs1544410), ApaI (rs7975232) and TaqI (rs731236)-were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Odds ratios and 95% confidence intervals (CIs) were obtained from conditional logistic regression using Stata 16. Linkage disequilibrium and haplotype association with MDD were analyzed using the online SNPStats program. None of the genotypes of the three SNPs was significantly associated with risk of developing MDD after adjusting for confounding factors. However, the TAC (BAt) haplotype was associated with increased odds of MDD (adjusted OR = 2.17, 95% CI = 1.30-3.61, p = 0.003) using CCT (baT) as reference haplotype. The findings suggest that the BsmI-ApaI-TaqI TAC (BAt) haplotype of the VDR gene increases susceptibility to MDD.

Association of Caspase-8 Genotypes With the Risk for Nasopharyngeal Carcinoma in Taiwan

BACKGROUND/AIM

Accumulating evidence shows that caspase-8 (Cas-8) rs3834129 genotypes determine susceptibility to various cancers, but their association with nasopharyngeal carcinoma (NPC) has not been examined. We aimed at investigating the association of Cas-8 rs3834129 with NPC risk.

MATERIALS AND METHODS

Cas-8 rs3834129 genotypes and their associations with NPC risk were investigated among 176 NPC patients and 352 non-cancer subjects by the PCR-RFLP method. Additionally, the interaction of Cas-8 rs3834129 genotypes with smoking was examined.

RESULTS

The II, ID and DD frequencies were 56.8, 36.9 and 6.3% among NPC patients and 54.8, 38.1 and 7.1% among control subjects (p_trend=0.8830). Allelic frequency distribution analysis also indicated that the D allele is not a risk factor for NPC (p=0.6183). There was no interaction between Cas-8 rs3834129 and smoking and NPC risk (p=0.8305).

CONCLUSION

Cas-8 rs3834129 genotypes play a minor role in the risk for NPC.

Risk factors and outcomes of bloodstream infections caused by Acinetobacter baumannii: a case-control study

The risk factors and outcomes of patients with bloodstream infections (BSIs) caused by Acinetobacter baumannii are major concerns in clinical therapy. Multicenter case-control studies were performed to compare the clinical characteristics of 47 A. baumannii BSI patients and 124 matched controls with nonbloodstream A. baumannii infections and the clinical and molecular characteristics of BSI survivors and nonsurvivors. Additionally, the mortality of BSIs was assessed. The clinical characteristics, including neutropenia, ICU admission prior to positive culture, primary infection in the central nervous system, and carbapenem use prior to positive culture, were independently associated with BSI caused by A. baumannii. The mortality of the BSI patients was significantly higher than that of the controls. A high Pitt bacteremia score was found to be an independent predictor of mortality in the BSI patients. The healthcare-associated factors, disease severity level, or antibiotic usage increased the risks of A. baumannii BSI and related mortality.

Offspring sex and risk of epithelial ovarian cancer: a multinational pooled analysis of 12 case-control studies

While childbearing protects against risk of epithelial ovarian cancer (EOC), few studies have explored the impact on maternal EOC risk of sex of offspring, which may affect the maternal environment during pregnancy. We performed a pooled analysis among parous participants from 12 case-controls studies comprising 6872 EOC patients and 9101 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression for case-control associations and polytomous logistic regression for histotype-specific associations, all adjusted for potential confounders. In general, no associations were found between offspring sex and EOC risk. However, compared to bearing only female offspring, bearing one or more male offspring was associated with increased risk of mucinous EOC (OR = 1.45; 95% CI = 1.01-2.07), which appeared to be limited to women reporting menarche before age 13 compared to later menarche (OR = 1.71 vs 0.99; P-interaction = 0.02). Bearing increasing numbers of male offspring was associated with greater risks of mucinous tumors (OR = 1.31, 1.84, 2.31, for 1, 2 and 3 or more male offspring, respectively; trend-p = 0.005). Stratifying by hormonally-associated conditions suggested that compared to bearing all female offspring, bearing a male offspring was associated with lower risk of endometrioid cancer among women with a history of adult acne, hirsutism, or polycystic ovary syndrome (OR = 0.49, 95% CI = 0.28-0.83) but with higher risk among women without any of those conditions (OR = 1.64 95% CI = 1.14-2.34; P-interaction = 0.003). Offspring sex influences the childbearing-EOC risk relationship for specific histotypes and conditions. These findings support the differing etiologic origins of EOC histotypes and highlight the importance of EOC histotype-specific epidemiologic studies. These findings also suggest the need to better understand how pregnancy affects EOC risk.

Risk Factors Associated with Symptomatic Deep Vein Thrombosis Following Elective Spine Surgery: A Case-Control Study

BACKGROUND

Few studies provide insight into risk factors (RFs) associated with postoperative deep vein thrombosis (DVT) following elective spinal surgery. DVTs are detrimental in this population because of the risk of pulmonary embolization or surgical site hemorrhage with treatment.

OBJECTIVE

Elective spine surgery patients have a low incidence of DVT, thus a case-control study was selected to investigate RFs associated with postoperative, symptomatic DVT.

METHODS

Cases were matched to controls in a 1:2 ratio based on surgery type. Risk of having a prior DVT and choice of subcutaneous heparin dosing following surgery was analyzed in a multivariate regression model with other potentially confounding variables.

RESULTS

A total of 195 patients were included in this study. Independent of patient age, history of DVT was associated with postoperative symptomatic DVT (odds ratio [OR], 4.09; 95% confidence interval [CI], 1.22-13.78). Two versus 3 times daily postoperative heparin dosing (OR, 1.56; 95% CI, 0.32-7.56), surgery length (OR, 1.32; 95% CI, 0.98-1.79), and patient age (OR, 1.04; 95% CI, 1.0-1.08) were not statistically significant, independent RFs. Older age and longer length of surgery trended toward association with DVT without reaching significance. Length of stay was increased from 3-5 days (P < 0.001) in DVT patients compared with controls.

CONCLUSIONS

These results suggest that patients with a history of DVT undergoing elective spinal surgery are at higher risk of developing symptomatic DVT postoperatively resulting in significantly increased length of stay. Further studies on additional preoperative screening and medical optimization in elective spine surgery patients may help reduce the rate of symptomatic, postoperative DVT.

Long-term exposure to PM2.5 and its constituents and risk of Non-Hodgkin lymphoma in Denmark: A population-based case-control study

BACKGROUND

Particulate matter (PM) air pollution is a complex mixture and the various PM constituents likely affect health differently. The literature on the relationships among specific PM constituents and the risk of cancer is sparse. In this study, we aimed to evaluate the association of PM_2.5 and its constituents with the incidence of non-Hodgkin lymphoma (NHL) and the two main NHL subtypes.

METHODS

We undertook a nationwide register-based case-control study including 20,847 cases registered in the Danish Cancer Registry with NHL between 1989 and 2014. Among the entire Danish population, we selected 41,749 age and sex-matched controls randomly from the Civil Registration System. We assessed modelled outdoor PM concentrations at addresses of cases and controls with a state-of-the-art multi scale air pollution modelling system and used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables.

RESULTS

The 10-year time-weighted average concentrations of PM_2.5, primary carbonaceous particles (BC/OC), secondary inorganic aerosols (SIA), secondary organic aerosols (SOA) and sea salt were 17.4, 2.3, 7.8, 0.3, and 4.1 μg/m³, respectively among controls. The results showed higher risk for NHL in association with exposure to BC/OC (OR = 1.03; 95% CI: 1.00, 1.07, per interquartile range (IQR)) and SOA (OR = 1.54; 95% CI: 1.13, 2.09, per IQR). The results indicated a higher risk for follicular lymphoma in association with several PM components. Including PM_2.5 (OR = 1.16; 95% CI: 0.98-1.38), BC/OC (OR = 1.05; 95% CI: 0.97-1.14), SIA (OR = 1.44; 95% CI: 0.80-1.08), SOA (OR = 4.52; 95% CI: 0.86-23.83) per IQR.

CONCLUSION

This is the first study on PM constituents and the risk of NHL. The results indicated an association with primary carbonaceous and secondary organic PM. The results need replication in other settings before any firm conclusion can be reached.

Impact on survival of urgent dialysis initiation in patients with end-stage renal disease: a case-control study

BACKGROUND

Outcomes of patients with end-stage renal disease at urgent dialysis initiation are varied, but evidence of their long-term prognosis is limited. We aimed to characterize patients undergoing urgent dialysis initiation and analyse its effect on survival outcome.

METHODS

We retrospectively identified 208 patients who began haemodialysis from 1 January 2012 to 31 December 2018 at our hospital. In this observational case-control study, the case group comprised patients starting urgent dialysis, and the control group comprised patients starting planned dialysis. We analysed laboratory data, sex, age, smoking history, comorbidities and presence of vascular access and nephrology care that potentially affected the outcome. Data were analysed with Kaplan-Meier curves of early and late period (3 years after dialysis initiation) survival and log-rank tests and with Cox regression analysis.

RESULTS

Median age (range) at dialysis initiation was 73 (28-90) years, with 50 (24%) patients in the urgent initiation group. Five (10%) patients in this group had vascular access at dialysis initiation, whereas 21 (42%) had not received adequate pre-dialysis nephrology care. The estimated median overall survival rates of the urgent group and planned initiation group were 42 months and not reached, respectively (P = 0.0011). Multivariable analysis found urgent dialysis initiation to be an independent risk factor for survival (HR 2.36; 95% CI 1.36-4.00; P = 0.02). Survival was not significantly different between the groups for patients who continued chronic dialysis for > 3 years from dialysis initiation (P = 0.1339).

CONCLUSION

The prognosis of patients starting dialysis in an urgent condition was poor compared with those who started planned dialysis.

Evaluation of relationship between KEAP1 gene and genetic susceptibility of deep vein thrombosis after orthopedic surgery in Han Chinese population

Deep vein thrombosis (DVT) is the blood clot formed in a vein deep in body, mostly occurred in the lower leg or thigh. Early studies indicate that DVT is a complex disorder affected by both environmental and genetic factors. Previous biological evidence have indicated that KEAP1 gene may play an important role in the pathogenesis of DVT. In the present study, we aimed to investigate the genetic association between genetic polymorphisms of KEAP1 gene and the risk of DVT in Han Chinese population. A total of 2558 study subjects comprised of 660 DVT following orthopedics surgery cases and 1898 controls were recruited as discovery sample. In addition, we have also recruited another independent sample sets including 704 DVT following orthopedics surgery cases and 1056 controls for replication. Ten tag SNPs located on KEAP1 gene were selected for genotyping. Single marker based association analyses were conducted at both allelic and genotypic levels. SNPs that passed the Bonferroni correction in the discovery stage were genotyped in the replication dataset. Bioinformatics tools including PolymiRTS, GTEx, STRING and Gene Ontology database were utilized to investigate the functional consequences of the significant SNPs. SNP rs3177696 was identified to be significantly associated with risk of DVT in the study subjects. The G allele of SNP rs3177696 was significantly related to decreased risk of DVT. Functional consequences of SNP rs3177696 were obtained based on bioinformatics analyses. The G allele of SNP rs3177696 was related to the increased gene expression level of KEAP1. In summary, we have identified KEAP1 gene to be a potential susceptible locus for DVT in Han Chinese population. Further bioinformatics analyses have provided supportive evidence for the functional consequence of the significant SNP.

Associations between serum concentration of flavonoids and breast cancer risk among Chinese women

PURPOSE

In vitro and in vivo studies suggested that flavonols, flavones, flavanones and flavan-3-ols have preventive effects on breast carcinogenesis. Epidemiological evidence about the associations between these flavonoid biomarkers and breast cancer risk is limited. This study aimed to investigate the association between serum concentration of these flavonoids and breast cancer risk among Chinese women.

METHODS

This hospital-based case-control study recruited 792 breast cancer cases and 813 age frequency-matched (5-year interval) controls who provided eligible blood samples in Guangdong Province, China. Ultra-high-performance liquid chromatography-tandem mass spectrometry was used to measure flavonoids. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence internal (CI).

RESULTS

Higher concentrations of serum flavonols, isorhamnetin, kaempferol, flavanones and naringenin were significantly associated with lower breast cancer risk, with adjusted ORs (95% CIs) for the highest versus the lowest group of 0.66 (0.49-0.89) for flavonols, 0.52 (0.38-0.70) for isorhamnetin, 0.60 (0.45-0.80) for kaempferol, 0.65 (0.49-0.87) for flavanones and 0.45 (0.34-0.60) for naringenin, respectively. Significant positive associations were observed between serum flavan-3-ols, epigallocatechin, epigallocatechin-3-gallate and breast cancer risk. No significant associations were observed for serum quercetin, flavones, apigenin, luteolin, hesperetin, catechin, epicatechin and epicatechin-3-gallate with overall breast cancer risk.

CONCLUSIONS

This study suggested that serum flavonols and flavanones were inversely associated with breast cancer risk and serum flavan-3-ols were positively associated with breast cancer risk. Serum flavones were not associated with overall breast cancer risk. These findings warrant further confirmation in prospective studies.

Association of Gut Microbiota-Dependent Metabolite Trimethylamine N-Oxide with First Ischemic Stroke

AIM

We aimed to investigate the relationship of trimethylamine N-oxide (TMAO) concentrations with ischemic stroke in a large-scale case-control study conducted among the hospital-based general population.

METHODS

We recruited 953 case-control sex- and age-matched pairs, and cases were confined to first acute ischemic stroke in this study. Fasting plasma TMAO was measured using high-performance liquid chromatography-tandem mass spectroscopy. Conditional logistic regression analysis was conducted to calculate odds ratios (OR) for the association of plasma TMAO with ischemic stroke.

RESULTS

We found that plasma TMAO concentrations in patients with ischemic stroke were significantly higher than that in the control group (median: 2.85 µmol/L vs. 2.33 µmol/L, P＜0.001). In multivariable conditional logistic regression models, higher plasma TMAO concentrations were associated with increased odds of ischemic stroke [fully adjusted OR for highest vs. lowest TMAO quartile: 1.81; 95% confidence interval (CI): 1.27, 2.59; P for trend ＜0.001]. The multivariable-adjusted OR for ischemic stroke per 1 µmol/L increment of plasma TMAO was 1.05 (95% CI: 1.02, 1.08). Additionally, the positive association also persisted in subgroups stratified by age, sex, body mass index, smoking status, alcohol habits, history of diabetes, and history of hypertension.

CONCLUSIONS

This study suggested a positive association between plasma TMAO and ischemic stroke. Further studies are required to explore the role of plasma TMAO concentrations in predicting stroke risk.

The Effect of Common Variants in SLC44A2 on the Contribution to the Risk of Deep Cein Thrombosis after Orthopedic Surgery

Aim: Deep vein thrombosis (DVT) is a common complication of orthopedic surgery. Multiple lines of evidence indicate that genetic factors play an important role in the development of DVT following orthopedic surgery (DVTFOS). Recent evidence suggested that the solute carrier family 44 member 2 (SLC44A) gene may contribute to the risk of DVT. In this study, we aimed to investigate the associations of SLC44A2 and DVTFOS in Chinese Han individuals.

Methods: In the study, 2,655 subjects, including 689 DVTFOS patients and 1,966 controls, were recruited. Eighteen SNPs were genotyped in the study. Genetic association analyses were performed at both the single marker and haplotype levels. Bioinformatics analyses were conducted to predict the functional consequences of significant SNPs.

Results: SNP rs2288904 of SLC44A2 was identified as being significantly associated with DVTFOS (P = 0.0003, OR [95%CI]= 1.28[1.12–1.46]). Allelic analyses showed that the G allele of this SNP significantly elevated the risks of DVTFOS, which was replicated in the genotypic association analyses. Moreover, a two-SNP haplotype, including rs2288904, was found to be strongly correlated with the risk of DVTFOS (P = 4.15 × 10⁻¹¹). Widespread effects in the expression quantitative trait loci were identified for rs2288904 in multiple tissues.

Conclusion: In summary, our results provide further supportive evidence of the association of SLC44A2 with the risk of DVTFOS, which also provide clues for understanding the important roles of the SLC44A2 gene in the pathogenesis of DVTFOS and in the development of preventive strategies.

Long-term excess body fat in adulthood and the risk of pre- and postmenopausal breast cancer in Chinese women

PURPOSE

This study aimed to investigate the association between long-term excess body fat and breast cancer risk by studying adult weight gain together with the subsequent weight fluctuations.

METHODS

Weight gain measure in three different time periods in adulthood of 1500 participants was collected in a case-control study of Western China. Logistic regression models were used to estimate odds ratios and 95% CIs.

RESULTS

The increased risk of postmenopausal BC was associated with adult weight gain at 5 years and at 10 years before enrollment (OR 1.24, 95% CI 1.03-1.49 per 5 kg increase; OR 1.40, 95% CI 1.14-1.70 per 5 kg increase) but was not associated with adult weight gain at enrollment (OR 0.97, 95% CI 0.81-1.16 per 5 kg increase). Only a positive association was observed in premenopausal women who had gained > 5.0 kg at 10 years before enrollment (OR 1.61, 95% CI 1.10-2.35). Women who had gained > 5.0 kg at 10 years before enrollment and continued to gain during the subsequent 5 years had the highest postmenopausal BC risk (OR 3.34, 95% CI 1.58-7.08).

CONCLUSION

Adult weight gain at 5 years and 10 years before enrollment are more closely associated with postmenopausal BC risk than adult weight gain at enrollment in Western China. Controlling body weight as early as possible throughout adulthood to keep weight gain not more than 5.0 kg is particularly necessary for Chinese women.

A pseudolikelihood approach for assessing genetic association in case-control studies with unmeasured population structure

The case-control study design is one of the main tools for detecting associations between genetic markers and diseases. It is well known that population substructure can lead to spurious association between disease status and a genetic marker if the prevalence of disease and the marker allele frequency vary across subpopulations. In this paper, we propose a novel statistical method to estimate the association in case-control studies with unmeasured population substructure. The proposed method takes two steps. First, the information on genomic markers and disease status is used to infer the population substructure; second, the association between the disease and the test marker adjusting for the population substructure is modeled and estimated parametrically through polytomous logistic regression. The performance of the proposed method, relative to the existing methods, on bias, coverage probability and computational time, is assessed through simulations. The method is applied to an end-stage renal disease study in African Americans population.

Identification of rare and common variants in BNIP3L: a schizophrenia susceptibility gene

BACKGROUND

Schizophrenia is a chronic and severe mental disorder, and it has been predicted to be highly polygenic. Common SNPs located in or near BNIP3L were found to be genome-wide significantly associated with schizophrenia in recent genome-wide association studies. The purpose of our study is to investigate potential causal variants in BNIP3L gene.

RESULTS

We performed targeted sequencing for all exons and un-translated regions of BNIP3L gene among 1806 patients with schizophrenia and 998 healthy controls of Han Chinese origin. Three rare nonsynonymous mutations, BNIP3L (NM_004331): c.52A>G, c.167G>A and c.313A>T, were identified in schizophrenia cases, and two of them were newly reported. The frequencies of these rare nonsynonymous mutations were significantly different between schizophrenia cases and healthy controls. For the common variants, rs147389989 achieved significance in both allelic and genotypic distributions with schizophrenia. Rs1042992 and rs17310286 were significantly associated with schizophrenia in meta-analyses using PGC, CLOZUK, and our new datasets in this study.

CONCLUSIONS

Our findings provided further evidence that BNIP3L gene is a susceptibility gene of schizophrenia and revealed functional and potential causal mutations in BNIP3L. However, more functional validations are suggested to better understand the role of BNIP3L in the etiology of schizophrenia.

Association of Gremlin-2 gene polymorphisms with osteoporosis risk in Chinese postmenopausal women

The Gremlin-2 (GREM2) plays crucial roles in modulating bone homeostasis through the bone morphogenetic protein-2 pathway. However, GREM2 gene variants in osteoporosis were less frequent in a Chinese population. Therefore, the present study recruited 310 patients with osteoporosis and 339 healthy postmenopausal women to assess the correlation of GREM2 gene polymorphisms with the risk of osteoporosis. Polymerase chain reaction (PCR) and Sanger sequencing were utilized to genotype samples. The results showed that GREM2 gene rs4454537, not rs11588607, polymorphism was significantly associated with an increased risk of osteoporosis in postmenopausal women. Moreover, stratified analyses indicated a significant association between rs4454537 polymorphisms and body mass index of <25 kg/m². Additionally, the association between GREM2 rs4454537 polymorphism and clinical characteristics was assessed, which showed that this locus decreased the bone mineral density (BMD) in postmenopausal osteoporotic individuals. Furthermore, individuals with CC genotype appeared to have a higher GREM2 expression compared with those bearing the TT genotype of rs4454537 polymorphism. However, the genotype distribution of rs4454537 polymorphism showed no statistical difference between osteoporotic patients as a function of fracture status. In summary, GREM2 rs4454537 polymorphism decreases BMD and increases osteoporotic risk in postmenopausal women.

Dietary patterns and gastric cancer risk in a Korean population: a case-control study

PURPOSE

Dietary pattern analysis has been considered as an approach to capture the complex interactions of overall diet, which are often lost in studies of single dietary components (e.g., foods and nutrients). The aim of this study was to identify the major dietary patterns of Koreans via principal component analysis based on the food groups and to investigate the association between dietary patterns and gastric cancer (GC) risk.

METHODS

In this study, participants were recruited from the National Cancer Center, Korea. Among them, 415 cases were diagnosed with early GC, and 830 controls were age- and sex-matched at a ratio of 1:2. To determine the subjects' dietary patterns, 34 predefined food groups based on the 106-item semiquantitative food frequency questionnaire (SQFFQ) were used. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated across the tertiles of dietary pattern scores using logistic regression models.

RESULTS

The two dietary patterns derived in this study were named westernized and prudent. Those patterns explained 24.83% of the total variation in food intake. Higher scores on the prudent pattern was inversely associated with the risk of GC (OR [95% CI] for the highest vs. lowest tertiles: 0.58 [0.41-0.84], p for trend = 0.004).

CONCLUSION

Our findings suggest that adherence to the prudent dietary pattern represented by high loadings of vegetables and fruits, was associated with lower GC risk. Further studies with a prospective design and larger sample sizes are necessary.

CYP2B6 Polymorphisms Are Associated with Ischemic Stroke Risk in a Chinese Han Population

Genetic factors have been demonstrated to play an important role in the pathology of ischemic stroke (IS). This study was conducted to explore the association between CYP2B6 polymorphisms and IS risk in a Chinese Han population. Four single-nucleotide polymorphisms (SNPs) in CYP2B6 from 477 cases and 495 controls were genotyped using the Agena MassARRAY. The odds ratio (OR) and 95% confidence interval (CI) were calculated under genetic models and haplotype analysis to assess the association between SNPs and IS risk. We found that rs2099361 was associated with an increased IS risk (CC vs. AA: overall: OR = 1.85, 95% CI: 1.16-2.93, P = 0.010; age ≤ 60: OR = 1.94, 95% CI: 1.02-3.70, P = 0.045; male: OR = 2.17, 95% CI: 1.22-3.86, P = 0.009). The GT genotype of rs4803420 was associated with a reduced IS risk (OR = 0.74, 95% CI: 0.57-0.98, P = 0.036); the GG genotype was associated with an increased IS risk in women (OR = 2.31, 95% CI: 1.00-5.31, P = 0.049). The rs1038376 polymorphism was associated with reduced IS risk for age ≤ 60 years (AT vs. TT: OR = 0.63, 95% CI: 0.40-0.99, P = 0.046). Interestingly, there were significant differences in some clinical indicator levels between case and control groups, and genotypes of SNPs. Our results indicated that CYP2B6 polymorphisms (rs2099361, rs4803420, and rs1038376) were associated with the risk of IS. Further studies are still needed to validate our findings with larger sample sizes.

Incretin-based therapy and risk of cholangiocarcinoma: a nested case-control study in a population of subjects with type 2 diabetes

BACKGROUND AND AIMS

One cohort and several basic science studies have raised suspicion about an association between incretin therapies and cholangiocarcinoma. Our aim was to verify the occurrence of CC in relation to incretin-based medication use versus any antidiabetic treatment in an unselected population of diabetic patients.

METHODS

A population-based matched case-control study was conducted using administrative data from the Region of Piedmont (4,400,000 inhabitants), Italy. From a database of 312,323 patients treated with antidiabetic drugs, we identified 744 cases hospitalized for cholangiocarcinoma from 2010 to 2016 and 2976 controls matched for gender, age and initiation of antidiabetic therapy; cases and controls were compared for exposure to incretin-based medications. All analyses were adjusted for risk factors for CC, as ascertained by hospital discharge records. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by fitting a conditional logistic model.

RESULTS

The mean age of the sampled population (cases and controls, 75 years) was very high, with no gender prevalence. Five per cent was treated with incretin-based medications. After adjusting for possible confounders, we found no increased risk of cholangiocarcinoma associated with the use of either DPP4i (OR 0.98, 95% CI 0.75-1.29: p = 0.89) or GLP-1-RA (OR 1.09, 95% CI 0.63-1.89; p = 0.76) in the 24 months before hospital admission. Neither the duration of the therapy nor the dose modified the risk of cholangiocarcinoma.

CONCLUSIONS

Our findings suggest that, in an unselected population, the use of both classes of incretin-based medications is not associated with an increased risk of cholangiocarcinoma.

The ATM rs189037 G>A polymorphism is associated with the risk and prognosis of gastric cancer in Chinese individuals: A case-control study

The ataxia telangiectasia mutated (ATM) gene is involved in repairing DNA lesions and maintaining genome stability, which is related to cancer invasion and metastasis. This gene influences the risk of cancers. Many studies have demonstrated that the ATM rs189037 G>A polymorphism is linked with the risks of different types of cancer. However, no study has probed the relationship between the ATM rs189037 G>A polymorphism and gastric cancer (GC) risk. Therefore, the aims of this study were to investigate the association of the ATM rs189037 G>A polymorphism with the risk and prognosis of GC in a case-control investigation of 345 GC patients and 467 controls in China. The rs189037 G>A polymorphism was genotyped using polymerase chain reaction-restriction fragment length polymorphism. This polymorphism was related to a significantly higher risk of GC [AA vs. GG: OR (95% CI): 1.80 (1.20-2.70), P = 0.04; GG vs. AA + GA: 1.46 (1.08-1.98); A vs. G: 1.34 (1.10-1.64), P = 0.004]. Subgroup analyses showed significant associations with female gender, smoking, alcohol consumption, age ≥60 years, and positive Helicobacter pylori status. This polymorphism was also correlated with TNM stage III + IV and tumor size >4 cm. GC patients carrying the AA genotype of the rs189037 polymorphism also had lower overall survival. In conclusion, the ATM rs189037 G>A polymorphism was related to increased susceptibility to and poorer prognosis in GC in this Chinese population.

Maternal and perinatal characteristics, congenital malformations and the risk of wilms tumor: the ESTELLE study

PURPOSE

Wilms tumor (WT), or nephroblastoma, is an embryonic tumor that constitutes the most common renal tumor in children. Little is known about the etiology of WT. The aim of this study was to investigate whether maternal or perinatal characteristics were associated with the risk of WT.

METHODS

The ESTELLE study is a national-based case-control study that included 117 cases of WT and 1,100 controls younger than 11 years old. The cases were children diagnosed in France in 2010-2011 and the controls were frequency matched with cases by age and gender. The mothers of case and control children responded to a telephone questionnaire addressing sociodemographic and perinatal characteristics, childhood environment, and lifestyle. Unconditional logistic regression models adjusted on potential cofounders were used to estimate the odds ratios (OR) and their confidence intervals (95% CI).

RESULTS

High birth weight and the presence of congenital malformation were associated with WT (OR 1.9 [95% CI 1.0-3.7] and OR 2.5 [95% CI 1.1-5.8], respectively). No association with breastfeeding or folic acid supplementation was observed.

CONCLUSIONS

Although potential recall bias cannot be excluded, our findings reinforce the hypothesis that high birth weight and the presence of congenital malformation may be associated with an increased risk of WT. Further investigations are needed to further elucidate the possible role of maternal characteristics in the etiology of WT.

Reduced serum BDNF levels are associated with the increased risk for developing MDD: a case-control study with or without antidepressant therapy

Objective

We do not have any consistent markers for major depressive disorder (MDD) though various biological factors are involved in the pathophysiology. We aimed to evaluate the serum brain-derived neurotrophic factor (BDNF) levels in MDD patients with or without antidepressant therapy compared to healthy controls (HCs).

Results

We assessed serum BDNF levels among three groups: drug-naïve MDD patients (n = 41), drug-treated MDD patients (n = 44), and age-and sex-matched HCs (n = 82). Serum BDNF levels were measured by enzyme-linked immunosorbent assay (ELISA) kit. Serum levels of BDNF were detected significantly lower in drug-naïve MDD patients compared to HCs. No significant alterations of serum BDNF levels between drug-treated patients and HCs were identified. Significant negative correlations between serum BDNF levels and Hamilton depression rating (Ham-D) scores were observed in both drug-naïve and drug-treated MDD patients. Receiver operating characteristic (ROC) analysis showed good diagnostic value for serum BDNF levels in drug-naïve MDD patients with the area under the curve at 0.821. The present study suggests that low serum BDNF levels may be involved in the pathophysiology of MDD. The reduced serum BDNF levels might be used as an early risk assessment marker for major depression.

Are infectious diseases risk factors for sarcoidosis or a result of reverse causation? Findings from a population-based nested case-control study

Findings from molecular studies suggesting that several infectious agents cause sarcoidosis are intriguing yet conflicting and likely biased due to their cross-sectional design. As done in other inflammatory diseases to overcome this issue, prospectively-collected register data could be used, but reverse causation is a threat when the onset of disease is difficult to establish. We investigated the association between infectious diseases and sarcoidosis to understand if they are etiologically related. We conducted a nested case-control study (2009-2013) using incident sarcoidosis cases from the Swedish National Patient Register (n = 4075) and matched general population controls (n = 40,688). Infectious disease was defined using inpatient/outpatient visits and/or antimicrobial dispensations starting 3 years before diagnosis/matching. Adjusted odds ratios (aOR) of sarcoidosis were estimated using conditional logistic regression and tested for robustness assuming the presence of reverse causation bias. The aOR of sarcoidosis associated with history of infectious disease was 1.19 (95% confidence interval [CI] 1.09, 1.29; 21% vs. 16% exposed cases and controls, respectively). Upper respiratory and ocular infections conferred the highest OR. Findings were similar when we altered the infection definition or varied the infection-sarcoidosis latency period (1-7 years). In bias analyses assuming one in 10 infections occurred because of preclinical sarcoidosis, the observed association was completely attenuated (aOR 1.02; 95% CI 0.90, 1.15). Our findings, likely induced by reverse causation due to preclinical sarcoidosis, do not support the hypothesis that common symptomatic infectious diseases are etiologically linked to sarcoidosis. Caution for reverse causation bias is required when the real disease onset is unknown.

The epithelial cadherin -160C/A polymorphism is associated with decreased risk of colorectal cancer: a case-control study

The epithelial cadherin (CDH1) is an important determinant of tumor progression. Previous studies have indicated that the CDH1 -160C/A polymorphism was associated with the risk of colorectal cancer (CRC). However, they yielded conflicting results. Thus, we conducted this case-control study to evaluate the association between the CDH1 -160C/A polymorphism and susceptibility to CRC in a Chinese population. We recruited 351 cases and 411 controls in this case-control study. The genotype of the CDH1 -160C/A polymorphism was performed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS). This study found that the CDH1 -160C/A polymorphism was associated with decreased risk of CRC in this Chinese Han population. Subgroup analyses showed that the CDH1 -160C/A polymorphism decreased the risk of CRC among the males and non-drinkers. In addition, a significantly decreased risk was observed in CRC patients with tumor size ≤ 5 cm, and AA genotype showed a protective role in the CRC patients with no lymph node metastasis. In conclusion, this study shows that CDH1 -160C/A polymorphism is associated with decreased risk of CRC in a Chinese Han population.

Whole-transcriptome sequencing uncovers core regulatory modules and gene signatures of human fetal growth restriction

Background

Fetal growth restriction (FGR) contributes the primary cause of perinatal mortality and morbidity with impacts on the long-term health. To determine the core gene expression network and gene signatures, which in combination with ultrasound confirmation will more effectively differentiate constitutionally normal small for gestational age and pathological FGR groups, we performed RNA sequencing for protein-coding genes, lncRNAs, and small RNAs in a case–control study of umbilical cord blood.

Results

Five pairs of FGR case and control umbilical cord blood samples were used for RNA sequencing and weighted gene co-expression network analysis (WGCNA). Results showed that 339 mRNAs, 295 lncRNAs, and 13 miRNAs were significantly differentially expressed between FGR cases and controls. Bioinformatics analysis indicated that these differentially expressed molecules were mainly involved in metabolism, neural, cardiac, and immune systems, and identified 18 WGCNA modules for FGR. Further quantitative verification was performed using umbilical cord blood and maternal peripheral blood from 12 pairs of FGR cases and controls. The logistic regression and receiver operating characteristic curve indicated that RP11_552M6.1, LINC01291, and Asgr1 in umbilical cord blood, while Sfrp2, miR-432-5p, and miR-1306-3p in maternal peripheral blood had potential significance for FGR.

Conclusions

We comprehensively profiled the whole-transcriptome landscape of human umbilical cord blood with FGR, constructed the core WGCNA modules, and delineated the critical gene signatures of FGR. These findings provide key insight into intrauterine perturbations and candidate signatures for FGR.

Impact of Ulnar Styloid Fractures on the Treatment Effect of Distal Radius Fractures with Volar Plate Fixation: A Case Control Study

BACKGROUND

There is a controversy regarding whether ulnar styloid fractures affect the efficacy of treatment of distal radial fractures. The purpose of this study was to investigate whether ulnar styloid fractures impact wrist joint function in patients without distal radioulnar joint instability, after distal radial fracture fixation using a volar plate.

MATERIALS AND METHODS

Seventy-five patients with a distal radial fracture were treated using a volar plate between February 2010 and February 2016 (33 men and 42 women; mean age 40.9 ± 9.4 years). Forty-four patients had ulnar styloid fractures (Group A) and 31 patients did not (Group B). There were no differences between the two groups with regard to sex, age, course of the disease and fracture type (P > 0.05).

RESULTS

The mean follow-up time was 21 months. There were no differences between the groups in palmar tilt, radial inclination and radial length when the distal radial fractures had healed (P > 0.05). At the final follow-up visit, the two groups were similar in terms of wrist motion range, and grip and pinch strength (P > 0.05). The Gartland-Werley scores were 13 for excellent, 26 for good, 3 for fair and 2 for poor (excellence rate 89%) for Group A, and 10 for excellent, 17 for good, 2 for fair and 2 for poor (excellence rate 87%) for Group B. The difference between the two groups was not significant (Z = - 0.097, P = 0.922).

CONCLUSION

After open reduction and plate fixation of distal radial fractures, if stability of the distal radioulnar joint is achieved, untreated ulnar styloid fractures have no impact on wrist joint function.