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Vergatti A, Abate V, Giaquinto A, Altavilla N, D'Elia L, Evangelista M, De Filippo G, Piccinocchi G, Gennari L, Merlotti D, Galletti F, Strazzullo P, Rendina D. Role of active and environmental tobacco smoke on susceptibility to osteoporosis in women undergoing dual-X-ray absorptiometry. J Endocrinol Invest 2024; 47:937-946. [PMID: 37819412 DOI: 10.1007/s40618-023-02211-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE Current smoking is a risk factor for osteoporosis (Op), but few data are available regarding the passive smoke impact on Op susceptibility. This cross-sectional study aimed to evaluate the association between the smoking habits and Op in community-dwelling women undergoing dual-energy X-ray absorptiometry (DXA). METHODS On 01/06/2018, general practitioners from "COMEGEN" Medical Cooperative, Naples, Italy, selected the medical records from the last 10 years of women who had a measurement of bone mineral density performed and simultaneously completed a questionnaire about their smoking behaviour and their cohabiters'. The binary logistic regression analysis was used to estimate the role of passive smoke on the risk of Op, adjusting for age and body mass index (BMI). RESULTS Among 10,616 subjects, 3942 were currently smokers [CS; mean age 69.4 ± 10.4 years; BMI 27.0 ± 4.9 kg/m2], 873 were passive smokers (PS; mean age 67.8 ± 11.6 years; BMI 27.0 ± 4.9 kg/m2) and 5781 were never smokers (NS; mean age 67.8 ± 11.6 years; body mass index (BMI) 27.0 ± 4.9 kg/m2). Of all, 8562 women (mean age 70.3 ± 10.2 yrs; BMI 27.0 ± 4.9 kg/m2) received the Op diagnosis. PS showed an increased Op risk compared to NS [odds ratio (OR) 1.38 (1.14-1.67)] and comparable to CS [OR 1.02 (0.84-1.24)]. CONCLUSION The study results demonstrate an association between passive smoke and Op in community-dwelling women already presenting with susceptibility to Op according to Italian essential assistance levels, suggesting that passive and active smoke are equivalent Op risk factors in women.
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Affiliation(s)
- A Vergatti
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - V Abate
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - A Giaquinto
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - N Altavilla
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - L D'Elia
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - M Evangelista
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - G De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Service d'Endocrinologie et Diabétologie, Paris, France
| | | | - L Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - D Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - F Galletti
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
- Tobacco Treatment Center, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - P Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - D Rendina
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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Kang S, Han K, Jung J, Eun Y, Kim IY, Koh EM, Lee S, Cha HS, Kim H, Lee J. Women with Metabolic Syndrome and Unhealthy Lifestyle Factors Are at a Higher Risk for Hyperuricemia. J Clin Med 2023; 12:7159. [PMID: 38002772 PMCID: PMC10671870 DOI: 10.3390/jcm12227159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Hyperuricemia (HUA) has become a significant medical concern due to its complications and links to metabolic syndrome (MetS) and cardiovascular disease (CVD), which result in increased mortality. The pathogenic processes associated with unhealthy behaviors, MetS, and HUA can be cooperative and potentially synergistic in the activation of risk factors. Recent research has shown sex-based differences in the relationship between HUA and its associated risk factors. This study aimed to investigate these differences, particularly in the context of MetS and CVD risk factors and unhealthy lifestyles. We also aimed to evaluate the joint effects of these factors based on sex. We conducted a cross-sectional study using nationally representative survey data from the Korean National Health and Nutritional Examination Survey 2016-2018. We performed multivariable logistic regression analysis, calculating adjusted odds ratios (ORs) with their 95% confidence intervals (CIs). We also conducted subgroup analyses based on sex and the presence of MetS with or without unhealthy lifestyle factors (tobacco use, alcohol intake). We found sex-based differences in the relationships between HUA and MetS, CVD risk factors, and lifestyle behaviors. Our major finding was a significant association between MetS and HUA in both men and women, regardless of alcohol consumption and smoking status, and this association was stronger in women. We also observed a synergistic effect of MetS and lifestyle factors on the risk of HUA, particularly in women, in whom the risk of HUA increased up to four times compared to the reference group. A sex-based clinical strategy for HUA is necessary to reduce related complications and their socio-economic burden.
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Affiliation(s)
- Seonyoung Kang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06355, Republic of Korea; (S.K.); (S.L.); (H.-S.C.)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea;
| | - Jinhyoung Jung
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Yeonghee Eun
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - In Young Kim
- Department of Medicine, National Police Hospital, Seoul 05715, Republic of Korea;
| | - Eun-Mi Koh
- Korean Health Insurance Review and Assessment Service, Seoul 06653, Republic of Korea;
| | - Seulkee Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06355, Republic of Korea; (S.K.); (S.L.); (H.-S.C.)
| | - Hoon-Suk Cha
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06355, Republic of Korea; (S.K.); (S.L.); (H.-S.C.)
| | - Hyungjin Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06355, Republic of Korea; (S.K.); (S.L.); (H.-S.C.)
- Department of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Jaejoon Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06355, Republic of Korea; (S.K.); (S.L.); (H.-S.C.)
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Efendi D, Kurniasari MD, Tsai HT, Wanda D, Nurhaeni N, Efendi F. Path analysis of COVID-19 vaccine adherence among adolescents across Indonesia, in the Maluku-Papua Islands (Eastern Indonesia), and on Java Island. J Pediatr Nurs 2023; 73:e43-e53. [PMID: 37479557 DOI: 10.1016/j.pedn.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND COVID-19 incidence in Indonesia was high among adolescents, but vaccine acceptance remains low. The unequal geographical distribution of the health workforce and health facilities in Indonesia, including a lower number of health workers and facilities in Maluku-Papua, resulted in a low rate of vaccine acceptance. Knowledge, attitude, belief in the vaccine, comorbidity, congenital status are related to vaccine adherence, but mediation analysis of factors remains lacking. We aimed to analyze path analysis of knowledge, congenital, comorbidity, belief, and attitude to COVID-19 vaccine adherence among adolescents in Indonesia, Maluku-Papua Island, and Java Island. METHOD A nationwide cross-sectional study was undertaken among 7604 adolescents. A path analysis to investigate mediating effects between variables combined with bootstrapping was utilized to determine statistical significance. RESULT Knowledge, congenital status, comorbidity, belief, and attitude were significantly positively associated with COVID-19 vaccine adherence among adolescents in Maluku-Papua Island (p < 0.01; n = 4761), Java Island (p < 0.01; n = 1573), and Indonesia (p < 0.05; n = 7604). Congenital status, belief, and attitude negatively mediated the relationship between knowledge of and adherence to COVID-19 vaccine (p < 0.01) in Indonesia and among the subgroup on Maluku-Papua Island (p < 0.01), but a positive mediation (p = 0.04) in our subgroup analysis of Java Island. Comorbidity status, belief, and attitude negatively mediated relationship between knowledge and adherence to COVID-19 vaccine in Indonesia (p ≤0.01) and Maluku-Papua (p = 0.00), but no mediation role was found in Java Island (p = 0.58). CONCLUSION Comorbidity, congenital illness status, belief in and attitude to COVID-19 vaccine negatively mediated the relationship between knowledge of and adherence to COVID-19 vaccine among adolescents in Indonesia and our sub-group on Maluku-Papua Island but not on Java Island. PRACTICAL IMPLICATION Massive improvement in healthcare facility equality plays an important role in Indonesia gaining COVID-19 vaccine adherence.
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Affiliation(s)
- Defi Efendi
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia; Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok 16424, Indonesia; Nursing Department, Universitas Indonesia Hospital, Depok 16424, Indonesia.
| | - Maria Dyah Kurniasari
- Nursing Department, Faculty of Medicine and Health Science, Universitas Kristen Satya Wacana, Diponegoro Street, No. 52-60, Salatiga 50711, Indonesia
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan, ROC; Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, 250. Wuxing Street, Taipei 11031, Taiwan, ROC
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia
| | - Nani Nurhaeni
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga-Jl. Dr. Ir. H. Soekarno, Mulyorejo, Kec. Mulyorejo, Kota Surabaya 60115, Indonesia
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Kurniasari MD, Karwur FF, Rayanti RE, Shih YW, Yuliana S, Miao NF, Chou KR, Shen CJ, Tsai HT. Immersion in Water Between 20-30 oC Mediated Inflammations Marker to Reduced Pain Among Indonesian With Gout Arthritis: A Community-Based Randomized Controlled Trial. Biol Res Nurs 2023; 25:267-281. [PMID: 36207143 DOI: 10.1177/10998004221132843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Gout is triggered by high urate levels and causes inflammation, pain, and an impaired quality of life. Immersion in water at 20-30°C reduces inflammation and pain in arthritis. Yet, relationships of immersion in water at 20-30°C with urate levels and the nucleotide-binding domain (NOD)-like receptor protein 1 (NLRP1) inflammasome have never been clarified. OBJECTIVES We aimed to investigate the effects of immersion in water at 20-30°C on urate levels, the NLRP1 inflammasome, pain, and quality of life among acute gout patients. METHODS A community-based randomized control trial design was used with 2 parallel-intervention groups: immersion in water at 20-30°C (20 min/day for 4 weeks) group and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were assigned using block randomization. We analyze the results (coef. β) and 95% confidence intervals (CIs) using a generalized estimating equation model. We analyzed mediating effects using a path analysis. RESULTS Significant pain alleviation (β = -2.06 [95% CI = -2.67∼-1.45]; β = -2.42 [95% CI = -2.97∼-1.87]) and improved quality of life (β = 5.34 [95% CI = 3.12-7.57]; β = 9.93 [95% CI = 7.02-12.83]) were detected at 2 and 4 weeks of follow-up compared to the pre-test and control group. Urate levels (β = -0.34 [95% CI = -0.52∼-0.16]) were reduced at the 2-week follow-up, but there was no significant change in the NLRP1 inflammasome compared to the pre-test and control group after immersion in water at 20-30°C. Both the NLRP1 inflammasome (β = -0.48 [95% CI = -0.63∼-0.34]); water 0.01) and urate levels (β = -0.11 [95% CI = -0.24∼-0.03]; p < 0.01) had partial indirect (mediating) effects on the link between immersion in water at 20-30°C and pain at the 4-week follow-up. CONCLUSIONS Immersion in water at 20-30°C significantly decreased pain and increased the quality of life. Immersion in water at 20-30°C mediated NLRP1 and urate levels to decrease pain, although it had no significant effect on the NLRP1 inflammasome concentration after 4 weeks of follow-up and reduced urate levels only at 2 weeks after immersion in water at 20-30°C.
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Affiliation(s)
- Maria Dyah Kurniasari
- Faculty of Medicine and Health Science, 106208Universitas Kristen Satya Wacana, Salatiga, Indonesia
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Ferry Fredy Karwur
- Faculty of Medicine and Health Science, 106208Universitas Kristen Satya Wacana, Salatiga, Indonesia
| | - Rosiana Eva Rayanti
- Faculty of Medicine and Health Science, 106208Universitas Kristen Satya Wacana, Salatiga, Indonesia
| | - Ya Wen Shih
- School of Nursing, 38028National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Sri Yuliana
- Department of Nursing, Yahya Health Science Institute of Bima, West Nusa Tenggara, Indonesia
| | - Nae Fang Miao
- Post-Baccalaureate Program in Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Kuei Ru Chou
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Chia Jung Shen
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
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Jang YS, Nerobkova N, Yun I, Kim H, Park EC. Association between smoking behavior and serum uric acid among the adults: Findings from a national cross-sectional study. PLoS One 2023; 18:e0285080. [PMID: 37130102 PMCID: PMC10153749 DOI: 10.1371/journal.pone.0285080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Gout incidence is increasing worldwide; appropriate management of serum uric acid levels and a healthy lifestyle may help its prevention. The popularity of electronic cigarettes and the resultant emergence of dual smokers is increasing. Despite many studies on the effects of various health behaviors on serum uric acid levels, the association between smoking and serum uric acid levels remains controversial. This study aimed to investigate the association between smoking and serum uric acid levels. METHODS In this study, total sample of 27,013 participants (11,924 men and 15,089 women) were analyzed. This study used data from the Korea National Health and Nutrition Examination Survey (2016-2020) and grouped adults into dual smokers, single smokers, ex-smokers, and non-smokers. Multiple logistic regression analyses were performed to investigate the association between smoking behavior and serum uric acid levels. RESULTS Compared to male non-smokers, male dual smokers had significantly higher serum uric acid level (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.08-1.88). In female, serum uric acid level was higher among single smokers than non-smokers (OR, 1.68; 95% CI, 1.25-2.25). Higher serum uric acid levels were more likely to be present in male dual smokers with a > 20 pack-year smoking habit (OR, 1.84; 95% CI, 1.06-3.18). CONCLUSION Dual smoking may contribute to high serum uric acid levels in adults. Thus, serum uric acid levels should be properly managed through smoking cessation.
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Affiliation(s)
- Yun Seo Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Nataliya Nerobkova
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Il Yun
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Non-comorbid Respiratory Factor and Work of Breathing in Pediatric COVID-19 Patient: How is Their Synergistic Correlation with the Level of Care? NURSE MEDIA JOURNAL OF NURSING 2022. [DOI: 10.14710/nmjn.v12i3.45340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Work of breathing (WOB) and non-comorbidities factors in the respiratory system are the two probable findings in pediatric COVID-19 patients. However, the association of those factors with level of care was not well reported.Purpose: This study aimed to identify the relation between potential predictors including comorbidity, low nutritional fulfillment, infectious disease, shock, cough, O2 saturation reduction, abnormal blood gas analysis and sore throat with the level of care among pediatric COVID-19 patients. We also analyzed the synergistic correlation of non-comorbidities factors in the respiratory system and work of breathing to predict level of care in pediatric COVID-19 patients.Methods: A cross-sectional study was conducted in the six referral hospitals from July to September 2020 in four provinces in Indonesia. An observation checklist was used to collect data from the medical records of pediatric patients with COVID-19, including medical diagnosis, demographic, and clinical manifestation. This study included 423 participants aged from 0 to 18. The multivariate logistic regression was performed to test the adjusted odds ratios (AORs) with the 95% confidence intervals (CIs) of the association between WOB, non-comorbid respiratory, and level of care. Moreover, dummy variables (2x2) were made to analyze synergistic correlation of non-comorbid respiratory disease and WOB. The AOR with the 95% CIs was applied in the association between the complication of non-comorbid respiratory diseases and high work of breathing with level of care among pediatric patients with COVID-19.Results: Results showed that age, presence of comorbidity, nutritional fulfillment, infectious disease, shock, work of breathing, O2 saturation reduction, abnormal blood gas analysis, sore throat, and convulsive meningeal consciousness were significantly associated with the level of care (p<0.05). Pediatric patients with non-comorbid respiratory and increased work of breathing had a 15.59 times higher risk of requiring PICU care level (p<0.01). Meanwhile, pediatric patients who experienced both non-comorbid respiratory and increased work of breathing had a 5.76 times risk of requiring an intermediate level of care (p<0.05), and 9.32 times higher risk of requiring a PICU level of care (p<.05).Conclusion: It was found that both non-comorbid respiratory and increased WOB had a significant relationship with the level of care for pediatric patients with COVID-19. Nurse should take into account those clinical findings to increase the awareness in monitoring clinical deterioration in pediatric COVID-19 patients.
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Wu ZD, Yang XK, He YS, Ni J, Wang J, Yin KJ, Huang JX, Chen Y, Feng YT, Wang P, Pan HF. Environmental factors and risk of gout. ENVIRONMENTAL RESEARCH 2022; 212:113377. [PMID: 35500858 DOI: 10.1016/j.envres.2022.113377] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/30/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Gout is a chronic disease with inflammatory arthritis caused by monosodium urate (MSU) crystals deposition, an elevated serum urate level (hyperuricaemia) is the critical factor leading to MSU crystals deposition and promoting the progression of gout. The onset and development of gout is generally the result of multiple factors, such as diet, heredity and environmental factors. Although genetics and diet are thought to play as major factors, a growing body of research evidence has highlighted that environmental factors also play a significant role in the onset and exacerbation of gout. Recent studies have shown that air pollutants such as particulate matter, sulfur dioxide (SO2) and carbon monoxide (CO) may increase the risk of hospitalizations for gout, and that the changes in temperature and humidity may affect uric acid (UA) levels. There is also seasonal trend in gout. It has been demonstrated that environmental factors may induce or accelerate the production and release of pro-inflammatory mediators, causing an unbalance oxidative stress and systemic inflammation, and then participating in the overall process or a certain link of gout. Moreover, several environmental factors have shown the ability to induce the production urate and regulate the innate immune pathways, involving in the pathogenesis of gout. Nevertheless, the role of environmental factors in the etiology of gout remains unclear. In this review, we summarized the recent literatures and aimed to discuss the relationship between environmental factors (such as microclimate, season, ambient/indoor air pollution and extreme weather) and gout. We further discussed the inflammatory mechanisms of environmental factors and gout and the comprehensive effects of environmental factors on gout. We also made a prospect of the management and treatment of gout, with special consideration to environmental factors associated with gout.
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Affiliation(s)
- Zheng-Dong Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Xiao-Ke Yang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yi-Sheng He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Jing Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Jie Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Kang-Jia Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Ji-Xiang Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Yue Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Ya-Ting Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Peng Wang
- Teaching Center of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China.
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Kurniasari MD, Monsen KA, Weng SF, Yang CY, Tsai HT. Cold Water Immersion Directly and Mediated by Alleviated Pain to Promote Quality of Life in Indonesian with Gout Arthritis: A Community-based Randomized Controlled Trial. Biol Res Nurs 2022; 24:245-258. [DOI: 10.1177/10998004211063547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Gout arthritis is an autoinflammatory arthritis that generates chronic long-term pain. Pain impacts physical activities, joint mobility, stress, anxiety, depression, and quality of life. Cold-water immersion therapy reduces inflammation and pain associated with gout arthritis. However, cold-water immersion therapy has not been conducted among people worldwide with gout arthritis. Objective: To investigate the cold-water immersion intervention on pain, joint mobility, physical activity, stress, anxiety, depression, and quality of life among acute gout patients. Methods: A community-based randomized control trial design with two parallel-intervention groups: a cold-water immersion group (20–30°C 20 minutes/day for 4 weeks) and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were recruited using a multi-stage sampling method and were randomly assigned using block randomization. A generalized estimating equation model was used to analyze the results (coef. β) and produce 95% confidence intervals (CIs). A path analysis was used to analyze mediating effects. Results: Significant pain alleviation ( β = −2.06; −2.42), improved joint mobility ( β = 1.20, 1.44), physical activity ( β = 2.05, .59), stress ( β = −1.25; −1.35), anxiety ( β = −.62; −1.37), and quality of life ( β = 5.34; 9.93) were detected after cold-water immersion at the second-week, and were maintained to the fourth-week time point, compared to pre-intervention and the control group. Depression ( β = −1.80) had decreased by the fourth week compared to the pre-test and control group. Cold-water immersion directly mediated alleviation of pain ( β = −.46, p ≤ .001) and to promote the quality of life ( β = .16, p = .01). Conclusions: Cold-water immersion decreased pain, stress, anxiety, and depression, and increased joint mobility, physical activity, and quality of life. It mediated alleviation of pain to increase the quality of life.
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Affiliation(s)
- Maria Dyah Kurniasari
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
- Faculty of Medicine and Health Science, Universitas Kristen Satya Wacana, Salatiga, Indonesia
| | - Karen A. Monsen
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Shuen Fu Weng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Chyn Yng Yang
- Integrated Medical Examination Center, Taipei Medical University Hospital, Taipei, Taiwan, ROC
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
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Dyah Kurniasari M, Karwur FF, Rayanti RE, Huruta AD, Lin YH, Weng SF, Tsai HT. Increased Systolic Blood Pressure Mediates the Relationship Between Urate and Gout Risk in Indonesia: A Novel Application of a Partial Least Squares-Structural Equation Model. Biol Res Nurs 2021; 24:40-47. [PMID: 34340595 DOI: 10.1177/10998004211029044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout. OBJECTIVE We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model. METHOD A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting. RESULT We found that a 1 mg/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48-7.09) and an AOR of 4.44 (95% CI: 3.07-6.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (β = 0.05; 95% CI Bias Corrected [0.02-0.08], p < 0.001). CONCLUSION Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.
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Affiliation(s)
- Maria Dyah Kurniasari
- School of Nursing, College of Nursing, Taipei Medical University, Republic of China.,Faculty of Medicine and Health Sciences, Department of Nursing, Universitas Kristen Satya Wacana, Salatiga City, Indonesia
| | - Ferry Fredy Karwur
- Faculty of Medicine and Health Sciences, Department of Nutrition, Universitas Kristen Satya Wacana, Salatiga City, Indonesia
| | - Rosiana Eva Rayanti
- Faculty of Medicine and Health Sciences, Department of Nursing, Universitas Kristen Satya Wacana, Salatiga City, Indonesia
| | - Andrian Dolfriandra Huruta
- Faculty of Economics and Business, Universitas Kristen Satya Wacana, Salatiga, Indonesia.,PhD Program in Business, Chung Yuan Christian University, Zhongli District, Taoyuan, Republic of China
| | - Yu Huei Lin
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Republic of China
| | - Shuen Fu Weng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Republic of China.,Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Republic of China
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Republic of China.,Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Republic of China
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