1
|
Shen FC, Chu CH, Chen JF, Kuo CS, Hsu CY, Lin CH, Sheen YJ, Su SC, Tien KJ, Lu CH, Lee CC, Yang YS, Tu ST, Chen PT, Chen CC, Chien MN, Li HY, Sheu WHH, Huang CN, Wang CY, Ou HY. Optimizing lipid control in Taiwanese diabetic patients: A collaborative consensus by the Diabetes Association of the Republic of China (Taiwan) and the Taiwanese Association of Diabetes Educators. J Diabetes Investig 2024. [PMID: 38676417 DOI: 10.1111/jdi.14222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
We present an in-depth analysis of dyslipidemia management strategies for patients with diabetes mellitus in Taiwan. It critically examines the disparity between established guideline recommendations and actual clinical practices, particularly in the context of evolving policies affecting statin prescriptions. The focus is on synthesizing the most recent findings concerning lipid management in patients with diabetes mellitus, with a special emphasis on establishing consensus regarding low-density lipoprotein cholesterol treatment targets. The article culminates in providing comprehensive, evidence-based recommendations tailored to the unique needs of those living with diabetes mellitus in Taiwan. It underscores the criticality of personalized care approaches, which incorporate multifaceted factors, and the integration of novel therapeutic options to enhance cardiovascular health outcomes.
Collapse
Affiliation(s)
- Feng-Chih Shen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Hsun Chu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jung-Fu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Sung Kuo
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Yao Hsu
- Department of Internal Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Ching-Han Lin
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Jing Sheen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Sheng-Chiang Su
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | | | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Chuan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Yi-Sun Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shih-Te Tu
- Division of Endocrinology and Metabolism, Department of Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Tsang Chen
- Yong De-Kang Internal Medicine Clinic, Tainan, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Nan Chien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Hung-Yuan Li
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wayne Huey-Herng Sheu
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Molecular and Genetic Medicine, National Health Research Institutes, Miaoli, Taiwan
| | - Chien-Ning Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Yuan Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Horng-Yih Ou
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
2
|
Lee YC, Chang CT, Chen RH, Wang TY, Chen CC. HbA1c and systolic blood pressure variation to predict all-cause mortality in patients with type 2 diabetes mellitus. Prim Care Diabetes 2024; 18:146-150. [PMID: 38309986 DOI: 10.1016/j.pcd.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/20/2024] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Glycated hemoglobin A1c (HbA1c) variation or blood pressure (BP) variation was known to be an independent predictor of all-cause mortality in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate the combined effect of HbA1c and systolic blood pressure (SBP) variation on all-cause mortality and if there was a gender difference in patients with T2DM. METHODS Patients with T2DM who had at least three HbA1c, SBP measurements within 12-24 months during 2001-2007 were included. Coefficient of variation (CV) was used to evaluate variation. The 75th percentile of HbA1c-CV and SBP-CV were set as a cutoff to define high and low variation. Hazard ratios (HRs) and 95% confidence intervals were estimated using Cox proportional hazard models. RESULTS A total of 2744 patients were included, of whom 769 died during the 11.7 observation years. The associated risk of all-cause mortality was 1.22 [1.01- 1.48], P = 0.044, for low HbA1c-CV & high SBP-CV; 1.28 [1.04-1.57], P = 0.020, for high HbA1c-CV & low SBP-CV; and 1.68 [1.31-2.17], P < 0.001, for high HbA1c-CV & high SBP-CV. The associated risk remained unchanged in either males or females older than 50 years old, although there is only numerically higher for high HbA1c-CV & low SBP-CV in females older than 50 years old. CONCLUSIONS Both HbA1c and SBP variation were significant predictors of all-cause mortality in patients with T2DM. The combined effect was higher than either alone and no gender difference in patients older than 50 years old.
Collapse
Affiliation(s)
- Yun-Chi Lee
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; Department of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Chwen-Tzuei Chang
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
| | - Rong-Hsing Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
| | - Tzu-Yuan Wang
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
| |
Collapse
|
3
|
Hsu CY, Yeh CY, Yen TY, Chen CC, Chen JF, Chu CH, Huang CN, Lin CL, Lin SY, Liu FH, Ou HY, Wang CY. The expert consensus on care and education for patients with diabetic kidney disease in Taiwan. Prim Care Diabetes 2024:S1751-9918(24)00037-8. [PMID: 38423826 DOI: 10.1016/j.pcd.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
Increasing prevalence of type 2 DM (T2DM) and diabetic kidney disease (DKD) has posed a great impact in Taiwan. However, guidelines focusing on multidisciplinary patient care and patient education remain scarce. By literature review and expert discussion, we propose a consensus on care and education for patients with DKD, including general principles, specifics for different stages of chronic kidney disease (CKD), and special populations. (i.e. young ages, patients with atherosclerotic cardiovascular disease or heart failure, patients after acute kidney injury, and kidney transplant recipients). Generally, we suggest performing multidisciplinary patient care and education in alignment with the government-led Diabetes Shared Care Network to improve the patients' outcomes for all patients with DKD. Also, close monitoring of renal function with early intervention, control of comorbidities in early stages of CKD, and nutrition adjustment in advanced CKD should be emphasized.
Collapse
Affiliation(s)
- Chih-Yao Hsu
- Endocrinology and Metabolism Division, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
| | | | - Tsung-Yi Yen
- Family Medicine Department, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Ching-Chu Chen
- Endocrinology and Metabolism Division, China Medical University Hospital, Taichung, Taiwan
| | - Jung-Fu Chen
- Endocrinology and Metabolism Division, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
| | - Chih-Hsun Chu
- Endocrinology and Metabolism Division, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chien-Ning Huang
- Endocrinology and Metabolism Division, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ching-Ling Lin
- Endocrinology and Metabolism Division, Cathay General Hospital, Taipei, Taiwan
| | - Shih-Yi Lin
- Endocrinology and Metabolism Division, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Feng-Hsuan Liu
- Endocrinology and Metabolism Division, Chang Gung Memorial Hospital, Taipei Branch, Taipei, Taiwan
| | - Horng-Yih Ou
- Endocrinology and Metabolism Division, National Cheng Kung University Hospital, Tainan, Taiwan.
| | - Chih-Yuan Wang
- Endocrinology and Metabolism Division, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
4
|
Kuo CS, Kuo NR, Yeh YK, Lee YJ, Chuang LM, Chen HF, Chen CC, Lee CC, Hsu CC, Li HY, Ou HY, Hwu CM. Residual risk of cardiovascular complications in statin-using patients with type 2 diabetes: the Taiwan Diabetes Registry Study. Lipids Health Dis 2024; 23:24. [PMID: 38263010 PMCID: PMC10804647 DOI: 10.1186/s12944-023-02001-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/31/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The residual risks of atherosclerotic cardiovascular disease in statin-treated patients with diabetes remain unclear. This study was conducted to identify factors associated with these residual risks in patients with no prior vascular event. METHODS Data on 683 statin-using patients with type 2 diabetes mellitus (T2DM) from the Taiwan Diabetes Registry were used in this study. Patients aged < 25 or > 65 years at the time of diabetes diagnosis and those with diabetes durations ≥ 20 years were excluded. The United Kingdom Prospective Diabetes Study risk engine (version 2.01; https://www.dtu.ox.ac.uk/riskengine/ ) was used to calculate 10-year residual nonfatal and fatal coronary heart disease (CHD) and stroke risks. Associations of these risks with physical and biochemical variables, including medication use and comorbidity, were examined. RESULTS The 10-year risks of nonfatal CHD in oral anti-diabetic drug (OAD), insulin and OAD plus insulin groups were 11.8%, 16.0%, and 16.8%, respectively. The 10-year risks of nonfatal stroke in OAD, insulin and OAD plus insulin groups were 3.0%, 3.4%, and 4.3%, respectively. In the multivariate model, chronic kidney disease (CKD), neuropathy, insulin use, calcium-channel blocker (CCB) use, higher body mass indices (BMI), low-density lipoprotein (LDL), fasting glucose, log-triglyceride (TG), and log-alanine transaminase (ALT) levels were associated with an increased CHD risk. The residual risk of stroke was associated with CKD, neuropathy, CCB use, and lower LDL cholesterol levels, higher BMI and diastolic blood pressure. CONCLUSION This study indicated that insulin was probably a residual risk factor of CHD but not stroke, and that there was a possible presence of obesity paradox in patients with T2DM on statin therapy. In addition to lowering TG and normalizing fasting glucose levels, lower LDL cholesterol level is better for reduction of risk of CHD on statin therapy. On the other hand, lower LDL cholesterol level could potentially be related to higher risk of stroke among populations receiving statin therapy. These findings suggest potential therapeutic targets for residual cardiovascular risk reduction in patients with T2DM on statin therapy.
Collapse
Affiliation(s)
- Chin-Sung Kuo
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Nai-Rong Kuo
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yun-Kai Yeh
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yau-Jiunn Lee
- Department of Internal Medicine, Lee's Endocrinology Clinic, Pingtung, Taiwan
| | - Lee-Ming Chuang
- Division of Endocrinology & Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Hua-Fen Chen
- Section of Endocrinology and Metabolism, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Chuan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan
| | - Hung-Yuan Li
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Horng-Yih Ou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
- College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chii-Min Hwu
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
5
|
Chen CC, Lin CH, Lin MC. Maternal autoimmune disease and risk of offspring autism spectrum disorder - a nationwide population-based cohort study. Front Psychiatry 2023; 14:1254453. [PMID: 38025447 PMCID: PMC10654781 DOI: 10.3389/fpsyt.2023.1254453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders which cause long term social and behavior impairment, and its prevalence is on the rise. Studies about the association between maternal autoimmune diseases and offspring ASD have controversial results. The aim of this study was to investigate whether maternal autoimmune diseases increase the risk of ASD in offspring from a population-based perspective. Methods The data sources were Taiwan's National Health Insurance Research Database (NHIRD) and Taiwan's Maternal and Child Health Database (MCHD), which were integrated and used to identify newborns whose mothers were diagnosed with autoimmune disease. Newborns were matched by maternal age, neonatal gender, and date of birth with controls whose mothers were without autoimmune disease using a ratio of 1:4 between 2004 and 2019. Data on diagnoses of autoimmune disease and autism spectrum disorders were retrieved from NHIRD. Patients who had at least 3 outpatient visits or at least 1 admission with a diagnosis of autoimmune disease and autism spectrum disorders were defined as incidence cases. The risks of ASD in offspring were compared between mothers with or without autoimmune disorders. Results We identified 20,865 newborns whose mothers had been diagnosed with autoimmune disease before pregnancy and matched them at a ratio of 1:4 with a total of 83,460 newborn whose mothers were without autoimmune disease, by maternal age, neonatal gender, and date of birth. They were randomly selected as the control group. The cumulative incidence rates of autism spectrum disorders (ASD) were significantly higher among the offspring of mothers with autoimmune diseases. After adjusting for cofactors, the risk of ASD remained significantly higher in children whose mother had autoimmune diseases. Regarding to specific maternal autoimmune disease, Sjögren's syndrome and rheumatoid arthritis were both associated with elevated risks of ASD in offspring. Conclusion Mother with autoimmune disease might be associated with increasing the risk of autism spectrum disorder in offspring.
Collapse
Affiliation(s)
- Ching-Chu Chen
- Children’s Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Chih Lin
- Children’s Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Department of Food and Nutrition, Providence University, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| |
Collapse
|
6
|
Marshall DC, Shim A, Chen CC, Lin H, Yu F, Argiriadi P, Choi IJ, Chhabra AM, Simone CB. A Dosimetric Assessment of Sexual Organ Sparing Proton Radiotherapy in Female Pelvic Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e695. [PMID: 37786040 DOI: 10.1016/j.ijrobp.2023.06.2174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Optimizing treatment techniques for female patients undergoing curative treatment for pelvic cancers requires incorporating the goals of maximizing cure while maintaining quality of life. Optimizing treatment to maintain sexual quality of life has received little attention in female patients despite the presence of and toxicity risks to functional anatomic organs and their associated neurovasculature, including the bulboclitoris, vagina, and ovaries. Recent dosimetric data without employing sexual organ sparing suggest that mean VMAT dose to the bulboclitoris in low rectal cancer is around 3300 cGy, and in anal cancer, mean dose is around 2000 cGy to the external genitalia and 4500-5000 cGy to the bulboclitoris, all of which would be expected to result in clinically significant toxicity. Therefore, investigation of the avoidance of these important organs is needed and we hypothesize that proton techniques may achieve greater sparing than photon techniques. MATERIALS/METHODS In this study, we dosimetrically compare proton- vs. photon-based techniques in sparing functional sexual organs. The cohort consisted of four consecutive female pelvic cancer cases that had received 5000 cGy or greater. All cases were re-planned with VMAT and protons while optimizing dose to functional sexual organs and maintaining target coverage. Sexual organ structures assessed include the genitalia, vagina, ovaries, bulboclitoris and internal pudendal arteries. Given the small number of patients included in this demonstration study, statistical tests were not performed. RESULTS MRI was required to appropriately delineate soft tissue. In all cases, dosimetric sparing of sexual organs was improved with proton therapy without compromising target coverage. Mean doses were marginally decreased for structures within the PTV, while structures such as the bulboclitoris were spared substantially. Mean dose to the external genitalia was low with sparing using both VMAT (Median [IQR] (cGy): 852 [811, 1090]) and Proton techniques (Median [IQR] (cGy): 39.4 [11.9, 78.5]). Similarly, mean dose with sparing to the external genitalia was lower than would be expected without sparing, using both VMAT and Proton techniques (Median (IQR) Dmean (cGy) VMAT 3100 [2890, 3580] vs. Proton 1530 [1100, 2090]), with protons demonstrating greater sparing. In one case of a sacral chordoma, ovaries were substantially spared to below ablative thresholds (Dmean (cGy) VMAT 3598.8 and 3548.0 vs Proton 34.1 and 103.3). CONCLUSION Magnetic resonance imaging at simulation combined with proton radiotherapy for female sexual organ sparing may provide a technically feasible route to more equitable sexual outcomes for female patients. These results will guide future studies to optimize proton treatment techniques for female sexual organ sparing for future trials.
Collapse
Affiliation(s)
- D C Marshall
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Shim
- New York Proton Center, New York, NY
| | - C C Chen
- New York Proton Center, New York, NY
| | - H Lin
- New York Proton Center, New York, NY
| | - F Yu
- New York Proton Center, New York, NY
| | - P Argiriadi
- Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY
| | - I J Choi
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A M Chhabra
- New York Proton Center, New York, NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - C B Simone
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| |
Collapse
|
7
|
Wang CY, Huang KC, Lu CW, Chu CH, Huang CN, Chen HS, Lee IT, Chen JF, Chen CC, Chen CS, Hsieh CH, Tien KJ, Chien HY, Huang YY, Hsu JP, Shane GT, Chang AC, Wu YC, Sheu WHH. A Randomized Controlled Trial of R-Form Verapamil Added to Ongoing Metformin Therapy in Patients with Type 2 Diabetes. J Clin Endocrinol Metab 2022; 107:e4063-e4071. [PMID: 35917580 PMCID: PMC9516171 DOI: 10.1210/clinem/dgac436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT There is a medical need for effective insulin-independent antidiabetic drugs that can promote pancreatic β-cell function and have a low risk of hypoglycemia in type 2 diabetes mellitus (T2DM) patients. R-form verapamil (R-Vera), which is able to enhance the survival of β-cells and has higher cardiovascular safety margin compared with racemic verapamil, was developed as a novel approach for T2DM treatment. OBJECTIVE This randomized, double-blind, placebo-controlled clinical trial was designed to evaluate the efficacy and safety of 3 dosages of R-Vera added to ongoing metformin therapy in T2DM patients who had inadequate glycemic control on metformin alone. METHODS Participants were randomly assigned in an equal ratio to receive R-Vera 450, 300, or 150 mg per day, or matching placebo, in combination with metformin. The primary endpoint was change in hemoglobin A1c (HbA1c) after 12 weeks of treatment. RESULTS A total of 184 eligible participants were randomized to receive either R-Vera or placebo plus metformin. At week 12, significant reductions in HbA1c were observed for R-Vera 300 mg/day (-0.36, P = 0.0373) and 450 mg/day (-0.45, P = 0.0098) compared with placebo. The reduction in HbA1c correlated with decreasing fasting plasma glucose levels and improved HOMA2-β score. Treatment with R-Vera was well tolerated with no hypoglycemic episodes occurring during the trial. CONCLUSION Addition of R-Vera twice daily to ongoing metformin therapy significantly improved glycemic control in T2DM patients. The favorable efficacy and safety profile of R-Vera 300 mg/day can be considered as the appropriate dose for clinical practice.
Collapse
Affiliation(s)
| | | | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100229, Taiwan
| | - Chih-Hsun Chu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Chien-Ning Huang
- Institute of Medicine, Chung Shan Medical University & Hospital, Taichung 402306, Taiwan
| | - Harn-Shen Chen
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Jung-Fu Chen
- Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan
| | - Chung-Sen Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei City Hospital Zhongxiao Branch, Taipei 115006, Taiwan
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114202, Taiwan
| | - Kai-Jen Tien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan 710402, Taiwan
| | - Hung-Yu Chien
- Department of Endocrinology and Metabolism, Taipei City Hospital Renai Branch, Taipei 106243, Taiwan
| | - Yu-Yao Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Jui-Pao Hsu
- Center Laboratories Inc., Taipei 115603, Taiwan
| | | | | | - Yen-Chieh Wu
- Lumosa Therapeutics Co., Ltd., Taipei 115603, Taiwan
| | - Wayne Huey-Herng Sheu
- Correspondence: Wayne Huey-Herng Sheu, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 112201, Taiwan.
| |
Collapse
|
8
|
Abstract
Enhanced recovery after surgery (ERAS) and minimally invasive surgery are two important development directions of modern surgery in the 21st century. They provide new clinical treatment methods and theoretical basis for the rapid recovery of surgical patients and more rational utilization of medical resources. They are two hot topics in clinical research and academic exchange of surgery-related subjects, and promote the rapid development and clinical application of surgery. ERAS covers a range of preoperative, intraoperative, and postoperative optimization measures, of which minimally invasive surgery is an important part of intraoperative optimization. The quality of surgery, especially minimally invasive surgery, plays a key role in postoperative recovery, which is the most important one of all ERAS measures. With good surgical quality and no postoperative complications, patients will recover quickly. Therefore, minimally invasive surgery plays a central role in the ERAS concept. The combination of ERAS with minimally invasive surgery is not only safe and feasible, but is also better than these two clinical therapies alone for postoperative recovery, and improves short-term and long-term outcome and accelerates the recovery of patients. For surgical diseases treated with minimally invasive surgery as far as possible, using the ERAS management for patients will result in reduced traumatic stress, better surgical tolerance, less postoperative pain, smaller incision, earlier ambulation, better organ function, and less morbidity of complications. In short, ERAS and minimally invasive surgery complement and promote each other. As two outstanding achievements of modern medicine, they are clinical treatments that provide sufficient theoretical basis for rapid recovery of patients and open a new chapter for the development of modern surgery.
Collapse
Affiliation(s)
- C C Chen
- Department of Colorectal Surgery, Gastrointestinal Surgery Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| |
Collapse
|
9
|
Hu HY, Cheng FS, Yen YF, Lin SY, Weng SH, Chou YC, Chu DC, Chen CC. Mask reuse during the COVID-19 pandemic: a national survey in Taiwan. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The use of masks is an effective measure to prevent severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection; however, mask reuse is not recommended. Studies examining the factors associated with mask reuse during the coronavirus disease (COVID-19) pandemic are limited. This nationwide survey aimed to determine the prevalence and factors associated with mask reuse among Taiwanese citizens during the pandemic.
Methods
From May 18 through May 31, 2020, a computer-assisted telephone interview system was used to randomly select Taiwanese citizens who were interviewed for COVID-19 preventive behaviors and knowledge on the usage of masks. Multivariate logistic regression was used to identify factors associated with mask reuse during the COVID-19 pandemic. Moreover, generalized estimating equations (GEE) were used to analyze the rate of mask reuse among participants before and during the pandemic.
Results
For a total of 1,075 participants, the overall mean age was 57.4 years, and 82.2% of participants reported mask reuse during the COVID-19 pandemic. After controlling for other covariates, participants who had a greater knowledge on mask usage or had a high supply of masks were less likely to reuse masks during the pandemic. GEE analysis showed that compared with the participants' mask wearing behaviors before the COVID-19 pandemic, they were more likely to reuse masks during the pandemic.
Conclusions
The rate of mask reuse among the general population during the pandemic was significantly higher than that before the pandemic. Individuals were less likely to reuse masks if they had adequate knowledge on mask usage or had a high supply of masks. Since mask reuse is associated with a higher risk of COVID-19 due to the possibility of wearing SAS-CoV-2-contaminated masks, it is imperative to educate people on the correct usage of masks. Further, the government should provide sufficient masks to the general population to decrease the reuse of masks.
Key messages
Mask reuse increased during the COVID-19 pandemic due to the shortage in supply. It is imperative to educate people about the correct usage of masks.
Collapse
Affiliation(s)
- HY Hu
- Taipei City Hospital, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
| | - FS Cheng
- Taipei City Hospital, Taipei, Taiwan
| | - YF Yen
- Taipei City Hospital, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
| | - SY Lin
- Taipei City Hospital, Taipei, Taiwan
| | - SH Weng
- Taipei City Hospital, Taipei, Taiwan
| | - YC Chou
- Taipei City Hospital, Taipei, Taiwan
| | - DC Chu
- Taipei City Hospital, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
| | - CC Chen
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
10
|
Lin CC, Chen CC, Li CI, Liu CS, Lin WY, Lin CH, Yang SY, Li TC. Derivation and validation of a clinical prediction model for risks of venous thromboembolism in diabetic and general populations. Medicine (Baltimore) 2021; 100:e27367. [PMID: 34596150 PMCID: PMC8483831 DOI: 10.1097/md.0000000000027367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 09/09/2021] [Indexed: 01/05/2023] Open
Abstract
Most studies on the prediction of venous thromboembolism (VTE) focused on hospitalized, surgery, and cancer patients or women receiving hormonal contraceptives or menopausal hormone therapy. No study considered diabetic and general populations to establish a VTE prediction model, especially in Asia. We developed a predictive model for VTE among type 2 diabetic patients and the general population.This study considered 2 nationwide retrospective cohort studies consisting of 52,427 diabetic participants and 508,664 participants from the general population aged 30 to 85 years during 2001 to 2004 in Taiwan. All participants were followed up until VTE event, death, or December 2011. The outcome event was VTE, including deep venous thrombosis and pulmonary embolism. Candidate predictors consisted of socio-demographic factors, diabetes-related factors and biomarkers, comorbidities, and medicine use. Our study followed the procedures proposed by the Framingham Heart Study to develop prediction models by using a Cox regression model. The predictive accuracy and performance characteristics were assessed using the area under curve of receiver operating characteristics curve and calibration of a risk score were performed by Hosmer-Lemeshow goodness-of-fit test.The common factors for persons with type 2 diabetes and general population included age, hospitalization status 1 year before the baseline, hypertension, chronic kidney disease, chronic obstructive pulmonary disease, and anti-diabetes medications; the specific factors for persons with type 2 diabetes consisted of body mass index, glycosylated hemoglobin A1C, and creatinine; and the factors for general population included gender, peripheral vascular disease, cancer, hypertension medication, cardiovascular medication, and non-steroidal anti-inflammatory drug. The area under curve of 3-, 5-, and 8-year VTE prediction models were 0.74, 0.71, and 0.69 in the diabetic population and 0.77, 0.76, and 0.75 in the general population, respectively.The new clinical prediction models can help identify a high risk of VTE and provide medical intervention in diabetic and general populations.
Collapse
Affiliation(s)
- Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Chu Chen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| |
Collapse
|
11
|
Cheng CF, Hsieh AR, Liang WM, Chen CC, Chen CH, Wu JY, Lin TH, Liao CC, Huang SM, Huang YC, Ban B, Lin YJ, Tsai FJ. Genome-Wide and Candidate Gene Association Analyses Identify a 14-SNP Combination for Hypertension in Patients With Type 2 Diabetes. Am J Hypertens 2021; 34:651-661. [PMID: 33276381 DOI: 10.1093/ajh/hpaa203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/19/2020] [Accepted: 12/02/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND High blood pressure is common and comorbid with type 2 diabetes (T2D). Almost 50% of patients with T2D have high blood pressure. Patients with both conditions of hypertension (HTN) and T2D are at risk for cardiovascular diseases and mortality. The study aim was to investigate genetic risk factors for HTN in T2D patients. METHODS This study included 999 T2D (cohort 1) patients for the first genome scan stage and 922 T2D (cohort 2) patients for the replication stage. Here, we investigated the genetic susceptibility and cumulative weighted genetic risk score for HTN in T2D patients of Han Chinese descent in Taiwan. RESULTS Thirty novel genetic single nucleotide polymorphisms (SNPs) were associated with HTN in T2D after adjusting for age and body mass index (P value <1 × 10-4). Eight blood pressure-related and/or HTN-related genetic SNPs were associated with HTN in T2D after adjusting for age and body mass index (P value <0.05). Linkage disequilibrium and cumulative weighted genetic risk score analyses showed that 14 of the 38 SNPs were associated with risk of HTN in a dose-dependent manner in T2D (Cochran-Armitage trend test: P value <0.0001). The 14-SNP cumulative weighted genetic risk score was also associated with increased regression tendency of systolic blood pressure in T2D (SBP = 122.05 + 0.8 × weighted genetic risk score; P value = 0.0001). CONCLUSIONS A cumulative weighted genetic risk score composed of 14 SNPs is important for HTN, increased tendency of systolic blood pressure, and may contribute to HTN risk in T2D in Taiwan.
Collapse
Affiliation(s)
- Chi-Fung Cheng
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ai-Ru Hsieh
- Department of Statistics, Tamkang University, New Taipei City, Taiwan
| | - Wen-Miin Liang
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Hsiun Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Jer-Yuarn Wu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chuen Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Bo Ban
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong, China
| | - Ying-Ju Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
| |
Collapse
|
12
|
Guo JD, Hlavacek P, Poretta T, Wygant G, Lane D, Gorritz M, Wang X, Chen CC, Wade RL, Pan X, Rajpura J, Stwalley B, Rosenblatt L. Inpatient and outpatient treatment patterns of cancer-associated thrombosis in the United States. J Thromb Thrombolysis 2021; 50:386-394. [PMID: 31955338 PMCID: PMC7366581 DOI: 10.1007/s11239-019-02032-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Low molecular weight heparins (LMWHs) and direct oral anticoagulants (DOACs) are among the recommended treatment options for cancer-associated thrombosis (CAT) in the 2019 National Comprehensive Care Network guidelines. Little is known about the current utilization of DOACs in CAT patients, particularly on the inpatient to outpatient therapy transition. This study assessed real-world treatment patterns of CAT in hospital/ED in adult cancer patients (≥ 18 years) diagnosed with CAT during a hospital visit in IQVIA's Hospital Charge Data Master database between July 1, 2015 and April 30, 2018, and followed their outpatient medical and pharmacy claims to evaluate the initial inpatient/ED and outpatient anticoagulants received within 3 months post-discharge. Results showed that LMWH and unfractionated heparin (UFH) were the most common initial inpatient/ED CAT treatments (35.2% and 27.4%, respectively), followed by DOACs (9.6%); 20.8% of patients received no anticoagulants. Most DOAC patients remained on DOACs from inpatient/ED to outpatient settings (71.4%), while 24.1%, 43.5%, and 0.1% of patients treated with LMWH, warfarin, or UFH respectively, remained on the same therapy after discharge. In addition, DOACs were the most common initial post-discharge outpatient therapy. Outpatient treatment persistence and adherence appeared higher in patients using DOACs or warfarin versus LMWH or UFH. This study shows that DOACs are used as an inpatient/ED treatment option for CAT, and are associated with less post-discharge treatment switching and higher persistence and adherence. Further research generating real-world evidence on the role of DOACs to help inform the complex CAT clinical treatment decisions is warranted.
Collapse
Affiliation(s)
- J D Guo
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA.
| | | | - T Poretta
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - G Wygant
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - D Lane
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - M Gorritz
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - X Wang
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - C C Chen
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - R L Wade
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - X Pan
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - J Rajpura
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - B Stwalley
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - L Rosenblatt
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| |
Collapse
|
13
|
Lin YT, Huang WL, Wu HP, Chang MP, Chen CC. Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes. J Clin Med 2021; 10:jcm10071401. [PMID: 33915706 PMCID: PMC8037774 DOI: 10.3390/jcm10071401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 12/28/2022] Open
Abstract
Heart failure (HF) is a common presentation in patients with type 2 diabetes mellitus (T2DM). Previous studies revealed that the HbA1c level is significantly associated with HF. However, little is known about the association between HbA1c variability and HF. We aimed to evaluate the association of mean and variability of HbA1c with HF in patients with T2DM. Using Diabetes Share Care Program data, patients with T2DM who had mean HbA1c (HbA1c-Mean), and HbA1c variability (tertiles of HbA1c-SD and HbA1c-adjSD) within 12–24 months during 2001–2008 were included. The cutoffs of HbA1c-Mean were set at <7%, 7–7.9%, and ≥8%. Hazard ratios (HRs) for HF during 2008–2018 were estimated using Cox proportional hazard models. A total of 3824 patients were included, of whom 315 patients developed HF during the observation period of 11.72 years. The associated risk of HF increased with tertiles of HbA1c variability and cutoffs of HbA1c-Mean. In mutually adjusted models, HbA1c-Mean showed a consistent dose-response association with HF, while the association of HbA1c variability with HF disappeared. Among patients with HbA1c-Mean <7%, the associated risk of HF in patients with HbA1c variability in tertile 3 was comparable to patients with HbA1c-Mean ≥8%. In conclusion, mean HbA1c was an independent predictor of HF and not explained by HbA1c variability. In addition to absolute HbA1c level, targeting on stability of HbA1c in patients with good glycemic control was also important for the development of HF in patients with T2DM.
Collapse
Affiliation(s)
- You-Ting Lin
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (Y.-T.L.); (W.-L.H.)
- Department of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Wei-Lun Huang
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (Y.-T.L.); (W.-L.H.)
- Department of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Hung-Pin Wu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan;
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Man-Ping Chang
- Department of Nursing, National Taichung University of Science and Technology, Taichung 40354, Taiwan;
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (Y.-T.L.); (W.-L.H.)
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Correspondence: ; Tel.: +886-4-2206-2121 (ext. 4676)
| |
Collapse
|
14
|
Cheng CF, Lin YJ, Lin MC, Liang WM, Chen CC, Chen CH, Wu JY, Lin TH, Liao CC, Huang SM, Hsieh AR, Tsai FJ. Genetic risk score constructed from common genetic variants is associated with cardiovascular disease risk in type 2 diabetes mellitus. J Gene Med 2020; 23:e3305. [PMID: 33350037 DOI: 10.1002/jgm.3305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/21/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) experience a two-fold increased risk of cardiovascular diseases. Genome-wide association studies (GWAS) have identified T2DM susceptibility genetic variants. Interestingly, the genetic variants associated with cardiovascular disease risk in T2DM Han Chinese remain to be elucidated. The present study aimed to investigate the genetic variants associated with cardiovascular disease risk in T2DM. METHODS We performed bootstrapping, GWAS and an investigation of genetic variants associated with cardiovascular disease risk in a discovery T2DM cohort and in a replication cohort. The discovery cohort included 326 cardiovascular disease patients and 1209 noncardiovascular disease patients. The replication cohort included 68 cardiovascular disease patients and 317 noncardiovascular disease patients. The main outcome measures were genetic variants for genetic risk score (GRS) in cardiovascular disease risk in T2DM. RESULTS In total, 35 genetic variants were associated with cardiovascular disease risk. A GRS was generated by combining risk alleles from these variants weighted by their estimated effect sizes (log odds ratio [OR]). T2DM patients with weighted GRS ≥ 12.63 had an approximately 15-fold increase in cardiovascular disease risk (odds ratio = 15.67, 95% confidence interval [CI] = 10.33-24.00) compared to patients with weighted GRS < 10.39. With the addition of weighted GRS, receiver-operating characteristic curves showed that area under the curve with conventional risk factors was improved from 0.719 (95% CI = 0.689-0.750) to 0.888 (95% CI = 0.866-0.910). CONCLUSIONS These 35 genetic variants are associated with cardiovascular disease risk in T2DM, alone and cumulatively. T2DM patients with higher levels of weighted genetic risk score have higher cardiovascular disease risks.
Collapse
Affiliation(s)
- Chi-Fung Cheng
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan.,Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ying-Ju Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Mei-Chen Lin
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Wen-Miin Liang
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Hsiun Chen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Institute of Biomedical Sciences, Taipei, Taiwan
| | - Jer-Yuarn Wu
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Institute of Biomedical Sciences, Taipei, Taiwan
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ai-Ru Hsieh
- Department of Statistics, Tamkang University, New Taipei, Taiwan
| | - Fuu-Jen Tsai
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
| |
Collapse
|
15
|
Chen CC, Li TC, Huang CY, Chang MP. Validation of the Chinese version of the insulin treatment appraisal scale. Diabetes Res Clin Pract 2020; 170:108485. [PMID: 33035596 DOI: 10.1016/j.diabres.2020.108485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/26/2020] [Accepted: 09/25/2020] [Indexed: 11/25/2022]
Abstract
AIMS To test the reliability and validity of the Chinese version of the Insulin Treatment Appraisal Scale (ITAS) questionnaire in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 200 patients with T2DM were consecutively recruited from the outpatient clinic in Taiwan. The World Health Organization guideline was followed to translate the questionnaire. The internal consistency was assessed by Cronbach's α coefficient and item-total correlations. The construct validity was evaluated by using confirmatory factor analysis, convergent validity, and discriminate validity. RESULTS The Cronbach's α coefficient for estimates of internal consistency of the total scale was 0.72, and ranged from 0.76 to 0.77 for the subscales. A value of ≥0.40 was considered being substantial. The item-total correlation values were 14 out of 20 items having substantial correlations (4 out of 4 items on the positive appraisal scale and 10 out of 16 items on the negative appraisal scale). The confirmatory factor analysis confirmed both positive and negative factors with total explained variance 33.9% (12.2% for positive subscale and 21.7% for negative subscale). The success rate, calculated from the item-total correlation values, was 70% for the convergent validity (100% for positive subscale and 63% for negative subscale) and 90% for discriminate validity (100% for positive subscale and 88% for negative subscale), respectively. Both the ceiling effect and floor effect were 0%. CONCLUSIONS The Chinese version of the ITAS questionnaire is a valid and reliable instrument for measuring the perceptions of insulin injection in patients with T2DM.
Collapse
Affiliation(s)
- Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; School of Chinese Medicine, China Medical University, Taichung 40447, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung 40402, Taiwan; Department of Healthcare Administration, College of Health Science, Asia University, Taichung 41354, Taiwan
| | - Chi-Yu Huang
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
| | - Man-Ping Chang
- Department of Nursing, National Taichung University of Science and Technology, Taichung 40354, Taiwan.
| |
Collapse
|
16
|
Chen JF, Peng YS, Chen CS, Tseng CH, Chen PC, Lee TI, Lu YC, Yang YS, Lin CL, Hung YJ, Chen ST, Lu CH, Yang CY, Chen CC, Lee CC, Hsiao PJ, Jiang JY, Tu ST. Use and effectiveness of dapagliflozin in patients with type 2 diabetes mellitus: a multicenter retrospective study in Taiwan. PeerJ 2020; 8:e9998. [PMID: 33240585 PMCID: PMC7678460 DOI: 10.7717/peerj.9998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/28/2020] [Indexed: 01/10/2023] Open
Abstract
Aims/Introduction To investigate the clinical outcomes of patients with type 2 diabetes mellitus (T2DM) who initiated dapagliflozin in real-world practice in Taiwan. Materials and Methods In this multicenter retrospective study, adult patients with T2DM who initiated dapagliflozin after May 1st 2016 either as add-on or switch therapy were included. Changes in clinical and laboratory parameters were evaluated at 3 and 6 months. Baseline factors associated with dapagliflozin response in glycated hemoglobin (HbA1c) were analyzed by univariate and multivariate logistic regression. Results A total of 1,960 patients were eligible. At 6 months, significant changes were observed: HbA1c by −0.73% (95% confidence interval [CI] −0.80, −0.67), body weight was -1.61 kg (95% CI −1.79, −1.42), and systolic/diastolic blood pressure by −3.6/−1.4 mmHg. Add-on dapagliflozin showed significantly greater HbA1c reduction (−0.82%) than switched therapy (−0.66%) (p = 0.002). The proportion of patients achieving HbA1c <7% target increased from 6% at baseline to 19% at Month 6. Almost 80% of patients experienced at least 1% reduction in HbA1c, and 65% of patients showed both weight loss and reduction in HbA1c. Around 37% of patients had at least 3% weight loss. Multivariate logistic regression analysis indicated patients with higher baseline HbA1c and those who initiated dapagliflozin as add-on therapy were associated with a greater reduction in HbA1c. Conclusions In this real-world study with the highest patient number of Chinese population to date, the use of dapagliflozin was associated with significant improvement in glycemic control, body weight, and blood pressure in patients with T2DM. Initiating dapagliflozin as add-on therapy showed better glycemic control than as switch therapy.
Collapse
Affiliation(s)
- Jung-Fu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yun-Shing Peng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chung-Sen Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei City Hospital Zhongxiao Branch, Taipei, Taiwan
| | - Chin-Hsiao Tseng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Chi Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ting-I Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yung-Chuan Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yi-Sun Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ching-Ling Lin
- Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan
| | - Szu-Ta Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chieh-Hsiang Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.,Lutheran Medical Foundation, Kaohsiung Christian Hospital, Kaohsiung, Taiwan
| | - Chwen-Yi Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chun-Chuan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Pi-Jung Hsiao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Ju-Ying Jiang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shih-Te Tu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| |
Collapse
|
17
|
Abstract
Background: Thionamides have been extensively used to treat patients with hyperthyroidism worldwide. Recent pharmacovigilance studies have revealed a safety signal between carbimazole or methimazole and pancreatitis. The associated risk remains unclear. Methods: We identified patients with newly diagnosed acute pancreatitis from 2000 to 2013 as the case group from the Taiwan Longitudinal Health Insurance Database 2000, which contains data from 1996 to 2013. Each patient with acute pancreatitis was matched for age, sex, comorbidities, and cancer with four controls through propensity score matching. A total of 52 patients without matched controls were excluded. Sensitivity analyses including the 52 excluded patients were performed using a matching ratio of 1:2. Odds ratios (ORs) along with 95% confidence intervals (CIs) for the association were estimated using multivariate logistic regression. Results: We included 9204 and 36,816 patients in the case and control groups, respectively. The proportions of patients who had used thionamides, carbimazole, methimazole, and propylthiouracil were similar in these two groups. In addition, the adjusted OR (CI) for the association of acute pancreatitis with thionamides was 1.03 (0.86-1.24), with carbimazole it was 0.90 (0.63-1.30), with methimazole it was 1.05 (0.84-1.31), and with propylthiouracil it was 1.00 (0.74-1.34). The sensitivity analysis results were unchanged. Conclusions: We were unable to demonstrate an association between acute pancreatitis and usage of thionamides.
Collapse
Affiliation(s)
- Jia-Yin Guo
- Department of Medicine, China Medical University, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Ling Chang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medicine, School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Address correspondence to: Ching-Chu Chen, MD, Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung 40447, Taiwan
| |
Collapse
|
18
|
Chen HH, Hsieh MC, Ho CW, Chen CC, Hsu SP, Lin CL, Kao CH. Effects of dipeptidyl peptidase-4 inhibitor treatment doses on tuberculosis in patients with diabetes: a long-term nationwide population-based cohort study. Ann Palliat Med 2020; 9:2817-2825. [PMID: 32787376 DOI: 10.21037/apm-20-278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/01/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND To investigate the association of dipeptidyl peptidase-4 inhibitors (DPP4is) treatment doses and tuberculosis (TB) in patients with diabetes. METHODS We allocated participants into DPP4i users and non-users from the Longitudinal Health Insurance Database. A chi-square test and Wilcoxon's rank-sum test were used to analyze the baseline discrete variables and continuous variable, respectively. The incidence rate was calculated in 1,000 personyears. The hazard ratios (HRs) were adjusted using a multivariate Cox regression model. The effect of DDP4i dosage on TB was analyzed. The Kaplan-Meier method was used to assess the cumulative incidence curves with a log-rank test. RESULTS We identified 6,399 DPP4i users and 6,399 non-users. The incidence rate of TB in DPP4i users and non-users was 22.2 and 16.2 per 1,000 person-years, respectively. The HR of TB for DPP4i users relative to non-users was 1.04 (P=0.89). Most of the analysis of factors such as the incidence rate, gender and diabetic comorbidities in our study were non-significant. The risk of developing TB in patients with over 20 average defined daily doses (DDDs) per year was increased by 2.19 times (P=0.048). CONCLUSIONS In our long-term nationwide population-based cohort study, higher doses of DPP4i (20 average DDDs) could increase TB infection risk in patients with diabetes. To pay more attention to this kind of diabetic patients with DPP4i treatment will be more important for the public health issue of TB prevention.
Collapse
Affiliation(s)
- Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung; School of Medicine, Institute of Medicine and Public Health, Chung Shan Medical University, Taichung
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung; Graduate Institute of Integrative Medicine, China Medical University, Taichung; Division of Clinical Nutrition, China Medical University Hospital, Taichung
| | - Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung; School of Chinese Medicine, China Medical University, Taichung
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung; College of Medicine, China Medical University, Taichung
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung; Department of Bioinformatics and Medical Engineering, Asia University, Taichung; Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung. ;
| |
Collapse
|
19
|
Chen HH, Chen CC, Ho CW, Hsieh MC, Hsu SP, Lin CL, Kao CH. Dipeptidyl peptidase-4 inhibitor treatment could decrease Klebsiella pneumoniae pneumonia in patients with type 2 diabetes. Postgrad Med 2020; 132:714-719. [PMID: 32633173 DOI: 10.1080/00325481.2020.1793520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the effect of dipeptidyl peptidase-4 inhibitor (DPP4i) for Klebsiella pneumoniae (KP) pneumonia in patients with diabetes. PATIENTS AND METHODS Patients newly diagnosed with type 2 diabetes from 2009 to 2012 were recruited for this population-based and observational study. Diabetes complications severity index (DCSI) score and defined daily dose (DDD) were used for analysis. The multivariable Cox proportional hazards models were used to estimate the risk of KP pneumonia by DPP4i use, with adjustments for propensity score. The Kaplan-Meier method with the log-rank test was used to estimate the risk of KP pneumonia for DPP4i users. RESULTS 34774 patients were included. The incidence rate of KP pneumonia in DDP4i users was 1.51 per 1000 person-years and that for the comparison was 2.25 per 1000 person-years. DDP4i users also had a significantly lower cumulative incidence of KP pneumonia (log-rank test p-value = 0.03). DDP4i users had a significantly lower risk of developing KP pneumonia compared with nonusers (adjusted HR = 0.67, 95% CI = 0.48-0.95). CONCLUSIONS For public health issue with type2 diabetes and infection, DPP4i use decreased KP pneumonia. Male gender, patients with co-morbidities, patients with higher DSCI score and higher DDD of DPP4i were observed to decrease KP pneumonia infection in our analysis. The possible role of DPP4i causing immunological disturbances should be considered.
Collapse
Affiliation(s)
- Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan.,School of Medicine, Institute of Medicine and Public Health, Chung Shan Medical University , Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital , Taichung, Taiwan.,School of Chinese Medicine, China Medical University , Taichung, Taiwan
| | - Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan.,Graduate Institute of Integrative Medicine, China Medical University , Taichung, Taiwan.,Division of Clinical Nutrition, China Medical University Hospital , Taichung, Taiwan
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital , Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital , Taichung, Taiwan.,College of Medicine, China Medical University , Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, China Medical University , Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital , Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University , Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital , Taichung, Taiwan
| |
Collapse
|
20
|
Chang YC, Chao SH, Chen CC, Ser KH, Chong K, Lu CH, Hsieh ML, Huang YY, Lee YC, Hsu CC, Chuang LM, Lee WJ. The Effects of Bariatric Surgery on Renal, Neurological, and Ophthalmic Complications in Patients with Type 2 Diabetes: the Taiwan Diabesity Study. Obes Surg 2020; 31:117-126. [PMID: 32683637 PMCID: PMC7808993 DOI: 10.1007/s11695-020-04859-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/09/2020] [Accepted: 07/11/2020] [Indexed: 12/13/2022]
Abstract
Background Bariatric surgery has been shown to improve glycemic control in patients with type 2 diabetes. However, less is known whether it can also reduce diabetic renal, neurological, and ophthalmic complications. Methods This prospective multicenter cohort study compared renal, ophthalmic, and neurological complications between 49 patients with obesity/overweight receiving bariatric surgery and 338 patients receiving standard medical treatment after follow-up for 2 years. Patients received neurological examinations including toe tuning fork vibration test, ankle tendon reflex test, 10-g monofilament test, and ophthalmic examinations including visual acuity measurement and fundus examinations. Multiple regressions, propensity score weighting, and matching were employed to adjust for baseline differences. Results After 2 years of follow-up, patients with type 2 diabetes receiving bariatric surgery had greater reduction in BMI, HbA1c, and urine albumin–creatinine ratio, greater improvement in estimated glomerular filtration rate, and greater increase in tuning fork test score of right and left toes compared with the medical group. However, there is no improvement in 10 g-monofilament test, visual acuity, diabetic non-proliferative retinopathy, and proliferative retinopathy. Similar results were obtained using multiple regression adjustment, propensity-score weighting, or comparing age-, sex-, and BMI-matched subjects. Conclusions After 2-year follow-up, patients with obesity/overweight and type 2 diabetes receiving bariatric surgery have increased glomerular filtration rate, reduced albuminuria, and improved tuning folk vibration sensation. Electronic supplementary material The online version of this article (10.1007/s11695-020-04859-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yi-Cheng Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Medical Genomics and Proteomics, National Taiwan University, Taipei, Taiwan.,Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Seh-Huang Chao
- Division of General Surgery, Jen-Ai Hospital, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Kong-Han Ser
- Department of Surgery, Ten-Chen General Hospital, Taoyuan, Taiwan
| | - Keong Chong
- Department of Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
| | - Chieh-Hsiang Lu
- Division of Metabolism & Endocrinology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Meng-Lun Hsieh
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Medical Genomics and Proteomics, National Taiwan University, Taipei, Taiwan
| | - Yu-Yao Huang
- Division of Metabolism & Endocrinology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Chih Lee
- Department of International Business, Chien Hsin University of Science and Technology, Taoyuan, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. .,Graduate Institute of Molecular Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wei-Jei Lee
- Division of General Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan. .,Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
21
|
Ho CW, Chen HH, Hsieh MC, Chen CC, Hsu SP, Yip HT, Kao CH. Hashimoto's thyroiditis might increase polycystic ovary syndrome and associated comorbidities risks in Asia. Ann Transl Med 2020; 8:684. [PMID: 32617304 PMCID: PMC7327368 DOI: 10.21037/atm-19-4763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background To investigate whether increased the comorbidities such as coronary artery disease (CAD) and risks between Hashimoto’s thyroiditis (HT) and polycystic ovary syndrome (PCOS) in Taiwanese women. Methods Patients newly diagnosed as having HT during 2000–2012 were assigned to the case group. Cases and controls were matched for age and comorbidities at a 1:2 ratio using propensity score matching. Incidence was calculated in the unit of 1000 person-year. Univariate and multivariate Cox proportional hazard regression, multivariate Cox, logistic regression, and Kaplan-Meier analyses were performed. Results Among 3,996 participants, 2,664 constituted the control group and 1,332 constituted the case group. The PCOS risk in patients with HT increased by 2.37 times [95% confidence interval (CI): 1.22–4.62] compared with the controls. Hypertension (HTN) [adjusted odds ratio (OR): 1.31, 95% CI: 1.03–1.66] and hyperlipidemia (adjusted OR: 1.55, 95% CI: 1.2–1.9) were more common in HT patients without PCOS than in other patients. The adjusted OR for CAD in patients with HT was 1.51 (95% CI: 1.11–2.06), whereas that in patients with HT and PCOS was 5.92 (95% CI: 1.32–26.53). Conclusions In our study, the PCOS risk in patients with HT increased by 2.37 times, which is lower than the increase in HT risk in Asian patients with PCOS (4.56 times). The proportion of CAD increased significantly by 5.92 times in patients with HT and PCOS compared with patients with HT only.
Collapse
Affiliation(s)
- Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung
| | - Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung.,School of Medicine, Institute of Medicine and Public Health, Chung Shan, Medical University, Taichung
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung.,Graduate Institute of Integrative Medicine, China Medical University, Taichung.,Division of Clinical Nutrition, Department of Internal Medicine, China Medical University Hospital, Taichung
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung.,School of Chinese Medicine, China Medical University, Taichung
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung
| | - Hei-Tung Yip
- Management Office for Health Data, China Medical University Hospital, Taichung.,School of Medicine, College of Medicine China Medical University, Taichung
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung
| |
Collapse
|
22
|
Abstract
Background: To investigate the association between Graves' disease (GD) and polycystic ovary syndrome (PCOS) and its comorbidities.Methods: Logistic regression was performed to determine the association between the two conditions. Cumulative incidence curves were obtained using the Kaplan-Meier method and log-rank test. Hazard ratios were determined using the Cox proportional hazards regression model.Results: We included 5399 patients with GD as the study group and 10,798 patients without GD as the control group. The cumulative incidence curve of PCOS in patients with GD was significantly higher than that in patients without GD (p = .02). The adjusted hazard ratio for PCOS in patients with GD compared with patients without GD was 1.47 (95%CI = 1.09-1.98). The adjusted odds ratio of hyperlipidemia in patients with GD and PCOS was 2.18 (95%CI = 1.14-4.17) higher than that in patients with GD only.Conclusion: Our study demonstrated that women with GD could be at risk of developing PCOS; additionally, a higher incidence of comorbidities, including hyperlipidemia, was noted in women with GD and PCOS.
Collapse
Affiliation(s)
- Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, Institute of Medicine and Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrative Medicine, China Medical University, Taichung, Taiwan
- Division of Clinical Nutrition, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung, Taiwan
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hei-Tung Yip
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
23
|
Chen HH, Ho CW, Hsieh MC, Chen CC, Hsu SP, Lin CL, Kao CH. Gout can increase the risk of periodontal disease in Taiwan. Postgrad Med 2020; 132:521-525. [PMID: 32298158 DOI: 10.1080/00325481.2020.1757267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: To evaluate the risk of periodontal disease (PD) in gout patients. Methods: This retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2000. The gout cohort included 31,759 patients newly diagnosed with gout from 2000 to 2012, and the comparison (nongout) cohort included 63,517 patients. Univariate and multivariable adjusted hazard ratios (aHRs), with corresponding 95% confidence intervals (CIs), were estimated using the Cox proportional hazard model for determining the occurrence of PD in both cohorts. We also measured the cumulative incidence of PD in these two cohorts using the Kaplan-Meier method and assessed the curve difference using the log-rank test. Results: The mean follow-up time was more than 6 years for both cohorts. The overall incidence rate of PD was significantly higher in the gout cohort than in the comparison cohort (5.04 vs 4.16 per 10,000 person-years; aHR = 1.13, 95% CI = 1.10-1.16). Only patients using colchicine had a significantly lower risk of PD (aHR = 0.85, 95% CI = 0.79-0.91). Conclusion: In our study, patients with gout showed an increased risk of PD, and treatment with colchicine could decrease the risk. Abbreviations: PD: periodontal disease; LHID: Longitudinal Health Insurance Research Database; NHIRD, National Health Insurance Research Database; ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical Modification; CI: confidence interval; HR: hazard ratio.
Collapse
Affiliation(s)
- Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan.,School of Medicine, Institute of Medicine and Public Health, Chung Shan Medical University , Taichung, Taiwan
| | - Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan.,Graduate Institute of Integrative Medicine, China Medical University , Taichung, Taiwan.,Division of Clinical Nutrition, China Medical University Hospital , Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital , Taichung, Taiwan.,School of Chinese Medicine, China Medical University , Taichung, Taiwan
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital , Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital , Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University , Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University , Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital , Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University , Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital , Taichung, Taiwan
| |
Collapse
|
24
|
Tseng JY, Chen HH, Huang KC, Hsu SP, Chen CC. Effect of mean HbA1c on the association of HbA1c variability and all-cause mortality in patients with type 2 diabetes. Diabetes Obes Metab 2020; 22:680-687. [PMID: 31903705 DOI: 10.1111/dom.13951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/20/2019] [Accepted: 12/28/2019] [Indexed: 02/01/2023]
Abstract
AIM To evaluate the effect of mean HbA1c on the correlation between HbA1c variability and all-cause mortality, and the risks associated with different levels of HbA1c and glycaemic control status in patients with type 2 diabetes. MATERIALS AND METHODS Patients with type 2 diabetes and at least three HbA1c measurements within 12-24 months were included. HbA1c variability score, coefficient of variation (CV) and standard deviation (SD) were used to evaluate variability. A variability score of 50 was set as a cutoff to define low and high variability. RESULTS A total of 4216 patients were included, of whom 1196 died during the observation period (11.1 ± 3.2 years). All-cause mortality increased with HbA1c variability score and the quartiles of HbA1c CV and SD. The strength of this association was attenuated after adjustment for mean HbA1c, and the risks associated with HbA1c variability and glycaemic control status were similar. The highest associated risk was observed with an HbA1c variability score of >50 and mean HbA1c of ≥7.5%. Mortality risk was significantly higher with a mean HbA1c of ≤6.0% and >8.5% and of ≤6.0% and >8.0% for low and high HbA1c variability, respectively. CONCLUSIONS Mean HbA1c contributed to the correlation between HbA1c variability and all-cause mortality. The risks associated with HbA1c variability and glycaemic control status were similar. The relationship between mean HbA1c and mortality presented a J-shaped distribution for both low and high HbA1c variability.
Collapse
Affiliation(s)
- Juei-Yu Tseng
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medicine, China Medical University, Taichung, Taiwan
| | - Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Kuo-Chin Huang
- Integration of Traditional Chinese-Western Medicine, Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medicine, China Medical University, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| |
Collapse
|
25
|
Chen HH, Hsieh MC, Ho CW, Chen CC, Hsu SP, Chang SS, Lin CL, Kao CH. Increased the risk of heart failure and comorbidities in patients with gout treatment: a population-based cohort study. Ann Transl Med 2020; 8:462. [PMID: 32395506 PMCID: PMC7210207 DOI: 10.21037/atm.2020.03.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background To investigate the association between gout treatment and heart failure (HF). Methods Patients with gout between 2000 and 2010 constituted the gout cohort. The main outcome was a new diagnosis of HF. Multivariable Cox proportional hazard regression models were used to measure the effect of gout on the risk of developing HF. The Kaplan-Meier method was used to estimate the cumulative HF incidence curve for the gout and nongout cohorts. Results The cohort study included 50,166 patients with gout. The incidence of HF was 1.96 times higher in the gout cohort than the non-gout cohort (7.11 vs. 3.63 per 10,000 person-years). The adjusted HR of developing HF was a 1.06-fold increase (95% CI: 1.06–1.07) with age and a 1.08-fold increase for women compared with men (95% CI: 1.02–1.14). HF incidence was higher in patients with receiving any two or more types of anti-gout drug treatment. Conclusions Our study revealed that gout could increase the risk of HF. Gout treatment in Taiwan cannot improve HF and actually increase the risk for HF after combination therapy for gout. The public health burden of gout should be resolved in the future.
Collapse
Affiliation(s)
- Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung.,School of Medicine, Institute of Medicine and Public Health, Chung Shan Medical University, Taichung
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung.,Graduate Institute of Integrative Medicine, China Medical University, Taichung.,Division of Clinical Nutrition, Department of Internal Medicine, China Medical University Hospital, Taichung
| | - Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung.,School of Chinese Medicine, China Medical University, Taichung
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung.,School of Medicine, College of Medicine, China Medical University, Taichung
| | - Cheng-Li Lin
- School of Medicine, College of Medicine, China Medical University, Taichung.,Management Office for Health Data, China Medical University Hospital, Taichung
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung
| |
Collapse
|
26
|
Guo JY, Chen HH, Yang YC, Wu PY, Chang MP, Chen CC. The association of dipeptidyl peptidase IV inhibitors and other risk factors with bullous pemphigoid in patients with type 2 diabetes mellitus: A retrospective cohort study. J Diabetes Complications 2020; 34:107515. [PMID: 31932172 DOI: 10.1016/j.jdiacomp.2019.107515] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/24/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bullous pemphigoid (BP) is an autoimmune blistering skin disorder with unknown etiology. Evidence revealed that dipeptidyl peptidase IV inhibitors (DPP4i) may increase the associated risk. This study aimed to evaluate the relationship of BP with the administration of DPP4i and other risk factors in patients with type 2 diabetes mellitus (T2DM). METHODS Using the Taiwan National Health Insurance Database (NHIRD) from 2009 to 2013, we identified patients with T2DM and the use of DPP4i 12 weeks or greater as a DPP4i cohort and patients with T2DM who never use DPP4i as a control cohort. They were frequency matched on gender and age within 5 years at a ratio of 1:2. The Cox proportional hazard regression model was used to estimate the hazard ratios (HRs) and confidence intervals (CIs) for the cohorts. RESULTS A total of 14,187 individuals taking DPP4i and 28,374 matched cohorts without taking DPP4i were included. The incidence rate of BP was higher in DPP4i cohort than in control cohort (1.41 vs. 0.59 per 1000 person-years; adjusted HR 2.14, 95% CI = 1.02-4.50). The cumulative event rate of BP in DPP4i cohort was higher than in control cohort (log-rank test, p = .01). Patients with dementia and taking spironolactone had a higher associated risk to develop BP; lower associated risk in patients taking metformin. CONCLUSIONS In patients with T2DM, subjects taking DPP4i, having dementia, and taking spironolactone were associated with an increased risk for the development of BP.
Collapse
Affiliation(s)
- Jia-Yin Guo
- Department of Medicine, China Medical University, Taichung 40402, Taiwan; Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
| | - Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung 40447, Taiwan; School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Yu-Cih Yang
- Management office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan; School of Medicine, China Medical University, Taichung 40447, Taiwan
| | - Po-Yuan Wu
- School of Medicine, China Medical University, Taichung 40447, Taiwan; Department of Dermatology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Man-Ping Chang
- Department of Nursing, School of Health, National Taichung University of Science and Technology, Taichung 40343, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
| |
Collapse
|
27
|
Liao LN, Li TC, Li CI, Liu CS, Lin WY, Lin CH, Yang CW, Chen CC, Chang CT, Yang YF, Liu YL, Kuo HL, Tsai FJ, Lin CC. Genetic risk score for risk prediction of diabetic nephropathy in Han Chinese type 2 diabetes patients. Sci Rep 2019; 9:19897. [PMID: 31882689 PMCID: PMC6934611 DOI: 10.1038/s41598-019-56400-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/10/2019] [Indexed: 11/09/2022] Open
Abstract
We evaluated whether genetic information could offer improvement on risk prediction of diabetic nephropathy (DN) while adding susceptibility variants into a risk prediction model with conventional risk factors in Han Chinese type 2 diabetes patients. A total of 995 (including 246 DN cases) and 519 (including 179 DN cases) type 2 diabetes patients were included in derivation and validation sets, respectively. A genetic risk score (GRS) was constructed with DN susceptibility variants based on findings of our previous genome-wide association study. In derivation set, areas under the receiver operating characteristics (AUROC) curve (95% CI) for model with clinical risk factors only, model with GRS only, and model with clinical risk factors and GRS were 0.75 (0.72-0.78), 0.64 (0.60-0.68), and 0.78 (0.75-0.81), respectively. In external validation sample, AUROC for model combining conventional risk factors and GRS was 0.70 (0.65-0.74). Additionally, the net reclassification improvement was 9.98% (P = 0.001) when the GRS was added to the prediction model of a set of clinical risk factors. This prediction model enabled us to confirm the importance of GRS combined with clinical factors in predicting the risk of DN and enhanced identification of high-risk individuals for appropriate management of DN for intervention.
Collapse
Affiliation(s)
- Li-Na Liao
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Healthcare Administration, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chuan-Wei Yang
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chiz-Tzung Chang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Fei Yang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yao-Lung Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Huey-Liang Kuo
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. .,Human Genetic Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. .,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. .,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
28
|
Huang YC, Chen CC, Wang TY, Nguyen HTT, Chen YH, Wu CM, Chang YW, Liao WL, Tsai FJ. C-Reactive Protein Gene Variants and Their Serum Levels in Early Adult-onset Type 2 Diabetes Mellitus. In Vivo 2019; 33:1685-1690. [PMID: 31471424 DOI: 10.21873/invivo.11656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/09/2019] [Accepted: 07/12/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND/AIM C-Reactive protein (CRP) is a common marker of inflammation. Elevated CRP levels have been associated with increased risk of development of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association of CRP gene polymorphisms with early-onset T2DM and the effect of genetic variants on CRP level. MATERIALS AND METHODS In total, 948 individuals with early-onset (n=271) or late-onset (n=677) T2DM were enrolled in the study. Five single-nucleotide polymorphisms (SNPs) in the CRP gene, namely rs3093077, rs2808630, rs1800947, rs11265263, and rs11265265, were selected for genotyping, and CRP levels were measured. RESULTS Genotypic, allelic, and haplotype frequencies of these five SNPs were not significantly different between patients with early- and those with late-onset. T2DM Higher serum CRP levels were independently associated with the C-allele of rs3093077 and T-allele of rs11265265 (p<0.001). Furthermore, the C-allele of rs3093077 was associated with higher CRP level in both early- (p=0.016) and late-onset (p<0.001) T2DM. CONCLUSION CRP gene variants may contribute to the risk of early-onset T2DM by affecting the serum CRP level.
Collapse
Affiliation(s)
- Yu-Chuen Huang
- School of Chinese Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ching-Chu Chen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Tzu-Yuan Wang
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Hung Tran The Nguyen
- International Master's Program of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Chia-Ming Wu
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ya-Wen Chang
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Wen-Ling Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, R.O.C. .,Center for Personalized Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Fuu-Jen Tsai
- Department of Medical Research, Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan, R.O.C. .,Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan, R.O.C
| |
Collapse
|
29
|
Hirose T, Chen CC, Ahn KJ, Kiljański J. Use of Insulin Glargine 100 U/mL for the Treatment of Type 2 Diabetes Mellitus in East Asians: A Review. Diabetes Ther 2019; 10:805-833. [PMID: 31020538 PMCID: PMC6531539 DOI: 10.1007/s13300-019-0613-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Indexed: 12/18/2022] Open
Abstract
Insulin glargine (IGlar) 100 U/mL (IGlar-100) is widely used in East Asian countries for the treatment of type 2 diabetes mellitus (T2DM) and is the gold standard of basal insulin treatment. In this review we summarize key information about clinical experience with IGlar-100 in East Asian patients with T2DM, including findings from clinical trials and postmarketing studies. We also provide recommendations and opinions on the optimal use of IGlar-100 in this population. The findings from the studies highlighted in our review indicate that IGlar-100 can be a suitable treatment option for East Asians with T2DM, from initial therapy in combination with oral antihyperglycemic medications through to different combinations and intensification models. FUNDING: Eli Lilly and Company.
Collapse
Affiliation(s)
- Takahisa Hirose
- Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- China Medical University School of Chinese Medicine, Taichung, Taiwan
| | - Kyu Jeung Ahn
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | | |
Collapse
|
30
|
Jiang LL, Chen CC, Yang K. Lessons learned from an unusual condition of incidental synchronous multiple hernias of indirect inguinal hernia, femoral hernia, and incarcerated obturator hernia. Niger J Clin Pract 2019; 22:281-284. [PMID: 30729956 DOI: 10.4103/njcp.njcp_200_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hernias are one of the most common diseases. The frequency of multiple hernias is much higher than the frequency reported during herniorrhaphy. Multiple hernias may account for some of the so-called recurrences, in which the small hernia may be veiled by the bigger one and omitted. In this study, we present a case of an 83-year-old female who suffered from multiple hernias namely a left-sided indirect inguinal hernia, a right-sided femoral hernia, and a right-sided incarcerated obturator hernia. Additionally, the characteristics and treatment of obturator hernia were discussed. Ultrasound and computed tomography (CT) are capable of accurately diagnosing groin hernia. Preoperative bilateral ultrasound of examinations or abdominopelvic CT should be recommended to perform routinely for patients with suspected hernias to avoid ignoring the concurrent hernias. A careful exploration of the operative field in the operation is mandatory. The CT is also helpful for early diagnosis of obturator hernia. In addition, the intra-abdominal approach through a low midline incision might be a preference for the treatment of obturator hernia.
Collapse
Affiliation(s)
- L L Jiang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - C C Chen
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - K Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
31
|
Chen Q, Chen CC, Bai J. Pathological Changes of Petechial Hemorrhage after High Temperature Treatment. Fa Yi Xue Za Zhi 2019; 34:631-634. [PMID: 30896101 DOI: 10.12116/j.issn.1004-5619.2018.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the main features of mechanical asphyxia--the pathological characteristics of petechial hemorrhage after high temperature effect (roasted, boiled) and its changing rules. METHODS Rabbit model of mechanical asphyxia death with choking neck and death from anteposition hanging was established. The experimental rabbits were randomly divided into roasted group and boiled group (n=4, in each group). The laryngeal ventricles and cardiopulmonary tissues in the roasted group were roasted for 3, 6 and 10 min, and the positions of petechial hemorrhage were observed and photographed. The same organs and tissues in the boiled group were heated in boiling water (100 ℃), and were observed and photographed at 30 and 60 s. Then histopathological examination was performed on all the laryngeal ventricles and cardiopulmonary tissues. RESULTS The petechial hemorrhage originating from laryngeal ventricle, trachea and lung did not disappear after high temperature treatment in the eight rabbits. The deepened color was visible to naked eyes and distinct from the surrounding normal tissues, with bleeding under the microscope. CONCLUSIONS Petechial hemorrhage caused by mechanical asphyxia would not disappear under high temperature, which might be related to the manner of death, the intensity and time of action, and the individual differences.
Collapse
Affiliation(s)
- Q Chen
- Forensic Judicial Appraisal Center of Beijing Public Security Bureau, Beijing 100192, China
| | - C C Chen
- Forensic Judicial Appraisal Center of Beijing Public Security Bureau, Beijing 100192, China
| | - J Bai
- Forensic Judicial Appraisal Center of Beijing Public Security Bureau, Beijing 100192, China
| |
Collapse
|
32
|
Liao WL, Chen YH, Chen CC, Huang YC, Lin HJ, Chen YT, Ban B, Wu CM, Chang YW, Hsieh AR, Tsai FJ. Effect of adiponectin level and genetic variation of its receptors on diabetic retinopathy: A case-control study. Medicine (Baltimore) 2019; 98:e14878. [PMID: 30882695 PMCID: PMC6426570 DOI: 10.1097/md.0000000000014878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Adiponectin (APN) and its receptors have been reported to be associated with metabolic phenotypes. To better understand the effects of APN levels and its receptors on diabetic retinopathy (DR), we investigated the association of the plasma APN level and variations in APN-related genes with DR, individually and in combination.Patients with type 2 diabetes (T2D; N = 1604), above 20 years of age from the Taiwanese population participated in the study. Demographic information, blood pressure, and serological markers were recorded at enrollment. Genomic DNA was isolated and genotyped. The plasma APN levels were measured by enzyme-linked immunosorbent assay.T2D patients with DR (N = 632) had diabetes for a longer duration, and had higher HbA1c, and systolic and diastolic blood pressure compared to those without DR (N = 972) (P < .001, for all the parameters). Overall, 10 single nucleotide polymorphisms (SNPs) in ADIPOQ and CDH13 susceptibility loci were associated with DR. Gene risk score (GRS) was calculated based on 10 SNPs for each subject and the cumulative effect of genes was observed. Among the subjects with plasma APN level (N = 518), natural logarithm (LN) of APN (LN [APN]; odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.19-2.25) and GRS (OR = 1.90, 95% CI = 1.11-3.26 for middle range of GRS, and OR = 2.61, 95% CI = 1.48-4.59 for high range of GRS) were independent risk factors for DR after adjustment for other parameters.In conclusion, the plasma APN level and the genetic variations in adiponectin receptors were associated with DR.
Collapse
Affiliation(s)
- Wen-Ling Liao
- Graduate Institute of Integrated Medicine, China Medical University
- Center for Personalized Medicine, China Medical University Hospital
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, China Medical University
- Chinese Medicine Research Center, Research Center for Chinese Medicine & Acupuncture, China Medical University
- Department of Medical Research, China Medical University Hospital
- Department of Psychology, College of Medical and Health Science, Asia University
| | - Ching-Chu Chen
- School of Chinese Medicine, China Medical University
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital
| | - Yu-Chuen Huang
- School of Chinese Medicine, China Medical University
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
| | - Hui-Ju Lin
- School of Chinese Medicine, China Medical University
- Department of Ophthalmology, China Medical University Hospital
| | - Yng-Tay Chen
- Graduate Institute of Food Safety, National Chung Hsing University, Taichung, Taiwan
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong, China
| | - Chia-Ming Wu
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
| | - Ya-Wen Chang
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
| | - Ai-Ru Hsieh
- Graduate Institute of Biostatistics, Department of Public Health, China Medical University
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
- Division of Pediatrics Genetics, China Medical University Children's Hospital, Taichung, Taiwan
| |
Collapse
|
33
|
Lee WJ, Chang YC, Almalki O, Chao SH, Lu CH, Chen CC, Huang YY, Lee YC, Hsu CC. Study design and recruitment for a prospective controlled study of diabesity: Taiwan Diabesity Study. Asian J Surg 2019; 42:244-250. [DOI: 10.1016/j.asjsur.2018.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/27/2018] [Accepted: 02/21/2018] [Indexed: 12/30/2022] Open
|
34
|
Liao WL, Chang CT, Chen CC, Lee WJ, Lin SY, Liao HY, Wu CM, Chang YW, Chen CJ, Tsai FJ. Urinary Proteomics for the Early Diagnosis of Diabetic Nephropathy in Taiwanese Patients. J Clin Med 2018; 7:jcm7120483. [PMID: 30486327 PMCID: PMC6306863 DOI: 10.3390/jcm7120483] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/16/2018] [Accepted: 11/22/2018] [Indexed: 12/28/2022] Open
Abstract
Diabetic nephropathy (DN) is a major complication in diabetic patients. Microalbuminuria testing is used to identify renal disease; however, its predictive value is questionable. We aimed to identify urinary biomarkers to early diagnosis nephropathy before identifiable alternations in kidney function or urine albumin excretion occurs. Proteomic approaches were used to identify potential urinary biomarkers and enzyme-linked immunosorbent assay was performed to verify the results. The data identified haptoglobin (HPT) and α-1-microglobulin/bikunin precursor (AMBP) as two biomarkers with the highest ability to distinguish between healthy individuals and patients with nephropathy, and between diabetic patients with and without DN. Further, the HPT-to-creatinine ratio (HCR) was evaluated as an independent predictor of early renal functional decline (ERFD) in a cohort with an average follow-up of 4.2 years. The area under the curve (AUC) value for ERFD prediction was significantly improved when the HCR biomarker was included in the model with albumin to creatinine ratio (ACR) and baseline characteristics (AUC values were 0.803 and 0.759 for HCR and ACR, respectively; p value was 0.0423 for difference between models). In conclusion, our results suggest that HCR represents an early indicator of nephropathy, and a marker related to ERFD among diabetic patients in Taiwan.
Collapse
Affiliation(s)
- Wen-Ling Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404, Taiwan.
- Center for Personalized Medicine, China Medical University Hospital, Taichung 404, Taiwan.
| | - Chiz-Tzung Chang
- Division of Nephrology and Kidney Institute, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan.
- Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung 404, Taiwan.
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 404, Taiwan.
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
| | - Wen-Jane Lee
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 404 Taiwan.
- Department of Social Work, Tunghai University, Taichung 404, Taiwan.
| | - Shih-Yi Lin
- Division of Nephrology and Kidney Institute, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan.
- Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung 404, Taiwan.
| | - Hsin-Yi Liao
- Proteomics Core Laboratory, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan.
| | - Chia-Ming Wu
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan.
| | - Ya-Wen Chang
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan.
| | - Chao-Jung Chen
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404, Taiwan.
- Proteomics Core Laboratory, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan.
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan.
- Department of Health and Nutrition Biotechnology, Asia University, Taichung 404, Taiwan.
| |
Collapse
|
35
|
Gorham PW, Rotter B, Allison P, Banerjee O, Batten L, Beatty JJ, Bechtol K, Belov K, Besson DZ, Binns WR, Bugaev V, Cao P, Chen CC, Chen CH, Chen P, Clem JM, Connolly A, Cremonesi L, Dailey B, Deaconu C, Dowkontt PF, Fox BD, Gordon JWH, Hast C, Hill B, Hughes K, Huang JJ, Hupe R, Israel MH, Javaid A, Lam J, Liewer KM, Lin SY, Liu TC, Ludwig A, Macchiarulo L, Matsuno S, Miki C, Mulrey K, Nam J, Naudet CJ, Nichol RJ, Novikov A, Oberla E, Olmedo M, Prechelt R, Prohira S, Rauch BF, Roberts JM, Romero-Wolf A, Russell JW, Saltzberg D, Seckel D, Schoorlemmer H, Shiao J, Stafford S, Stockham J, Stockham M, Strutt B, Varner GS, Vieregg AG, Wang SH, Wissel SA. Observation of an Unusual Upward-Going Cosmic-Ray-like Event in the Third Flight of ANITA. Phys Rev Lett 2018; 121:161102. [PMID: 30387639 DOI: 10.1103/physrevlett.121.161102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/14/2018] [Indexed: 06/08/2023]
Abstract
We report on an upward traveling, radio-detected cosmic-ray-like impulsive event with characteristics closely matching an extensive air shower. This event, observed in the third flight of the Antarctic Impulsive Transient Antenna (ANITA), a NASA-sponsored long-duration balloon payload, is consistent with a similar event reported in a previous flight. These events could be produced by the atmospheric decay of an upward-propagating τ lepton produced by a ν_{τ} interaction, although their relatively steep arrival angles create tension with the standard model neutrino cross section. Each of the two events have a posteriori background estimates of ≲10^{-2} events. If these are generated by τ-lepton decay, then either the charged-current ν_{τ} cross section is suppressed at EeV energies, or the events arise at moments when the peak flux of a transient neutrino source was much larger than the typical expected cosmogenic background neutrinos.
Collapse
Affiliation(s)
- P W Gorham
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - B Rotter
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - P Allison
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - O Banerjee
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - L Batten
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - J J Beatty
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - K Bechtol
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - K Belov
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - D Z Besson
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
- National Research Nuclear University, MEPhI (Moscow Engineering Physics Institute), Kashirskoe shosse 31, Moscow 115409, Russian Federation
| | - W R Binns
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - V Bugaev
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - P Cao
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - C C Chen
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - C H Chen
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - P Chen
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - J M Clem
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - A Connolly
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - L Cremonesi
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - B Dailey
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - C Deaconu
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - P F Dowkontt
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - B D Fox
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - J W H Gordon
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - C Hast
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Hill
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - K Hughes
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J J Huang
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - R Hupe
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - M H Israel
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - A Javaid
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - J Lam
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - K M Liewer
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - S Y Lin
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - T C Liu
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - A Ludwig
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - L Macchiarulo
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - S Matsuno
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - C Miki
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - K Mulrey
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - J Nam
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - C J Naudet
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - R J Nichol
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - A Novikov
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
- National Research Nuclear University, MEPhI (Moscow Engineering Physics Institute), Kashirskoe shosse 31, Moscow 115409, Russian Federation
| | - E Oberla
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - M Olmedo
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - R Prechelt
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - S Prohira
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - B F Rauch
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - J M Roberts
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - A Romero-Wolf
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - J W Russell
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - D Saltzberg
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - D Seckel
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - H Schoorlemmer
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - J Shiao
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - S Stafford
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J Stockham
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - M Stockham
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - B Strutt
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - G S Varner
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - A G Vieregg
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - S H Wang
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - S A Wissel
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| |
Collapse
|
36
|
Wu VC, Chen SW, Wu M, Liu CH, Chang CW, Chen CC, Wu KP, Chang SH, Lin MS, Lee TH, Hsieh IC, Chu PH, Lin YS. P5138Resuming anticoagulation in patients with atrial fibrillation experiencing hemorrhage stroke or nontraumatic intracranial hemorrhage. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V C Wu
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - S W Chen
- Chang Gung Memorial Hospital, Department of Cardiothoracic and Vascular Surgery, Taoyuan City, Taiwan ROC
| | - M Wu
- Brown University, Division of Cardiovascular Medicine, Providence, United States of America
| | - C H Liu
- Chang Gung Memorial Hospital, Department of Neurology, Taoyuan City, Taiwan ROC
| | - C W Chang
- Chang Gung Memorial Hospital, Department of Neurology, Taoyuan City, Taiwan ROC
| | - C C Chen
- Chang Gung Memorial Hospital, Department of Neurosurgery, Taoyuan City, Taiwan ROC
| | - K P Wu
- Chang Gung Memorial Hospital, Department of Physical Medicine and Rehabilitation, Taoyuan City, Taiwan ROC
| | - S H Chang
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - M S Lin
- Chang Gung Memorial Hospital, Department of Cardiology, Chiayi, Taiwan ROC
| | - T H Lee
- Chang Gung Memorial Hospital, Department of Neurology, Taoyuan City, Taiwan ROC
| | - I C Hsieh
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - P H Chu
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - Y S Lin
- Chang Gung Memorial Hospital, Department of Cardiology, Chiayi, Taiwan ROC
| |
Collapse
|
37
|
Bao C, Wang XC, Hu XL, Hou DN, Chen CC, Song YL, Yang D. [Clinical manifestations analysis of patients diagnosed with primary pulmonary mucosa-associated lymphoid tissue lymphoma]. Zhonghua Yi Xue Za Zhi 2018; 98:1419-1423. [PMID: 29804405 DOI: 10.3760/cma.j.issn.0376-2491.2018.18.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical features of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: A total of 14 cases diagnosed with primary pulmonary MALT lymphoma were collected from May 2007 to May 2017 in Zhongshan Hospital, Fudan University. The clinical features, pathological characteristics, diagnosis, treatment and prognosis were retrospectively analyzed. Results: All 14 cases were pathologically diagnosed with primary pulmonary MALT lymphoma. The biopsy tissues were obtained through the Video-assisted Thoracoscopic Surgery (VATS) (4 cases), percutaneous puncture (2 cases), and bronchoscopy (8 cases). Cell types of these tumors were centrocyte-like cells (10 cases), lymphocytoid cells (2 cases), and monocytoid B cells (2 cases). The B cell clonality was detected by IgH cloning test in 4 cases and 3 of them were demonstrated with monoclonal strips. MALT1 breakup gene was positive in 3 out of 6 examined cases using fluorescence in situ hybridization (FISH). As for the treatment, 8 patients underwent chemotherapy, 5 patients underwent surgical resection and 1 patient abandoned treatment. Twelve patients were followed up to 9 years. The tumor recurrence occurred in 2 patients and resulted their death. Conclusions: The clinical manifestations of primary pulmonary MALT lymphoma are lack of specificity. The pathology, immunohistochemistry, IgH cloning test and MALT1 breakup gene tested by FISH are the criteria for diagnosis.
Collapse
Affiliation(s)
- C Bao
- Respiratory Department, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | | | | | | | | | | | | |
Collapse
|
38
|
Lin Q, Ge XM, Mo JC, Li SS, Chen CC, Chen SY. [An investigation of psychological state at different stages of occupational AIDS exposure and related influencing factors in Nanning, China]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2018; 34:762-764. [PMID: 28043249 DOI: 10.3760/cma.j.issn.1001-9391.2016.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the changes in psychological state after occupational exposure in the AIDS occupational exposure population and related influencing factors, and to provide baseline data and a basis for related departments to conduct mental health prevention and intervention for personnel with occupational AIDS exposure. Methods: AIDS risk assessment was performed for all personnel with occupational AIDS exposure in 2014 in Nanning, China, and the Symptom Checklist-90 (SCL-90) psychological scale was used for psychological state evaluation at 24 hours, 1 week, and 3 months after occupational exposure in all persons who met the research criteria. Results: Most of the persons with occupational AIDS exposure came from secondary and tertiary hospitals (85%) , and nurses accounted for the highest percentage (78.3% ). The age ranged from 21 to 50 years, and the mean age was 31.02 ± 7.92 years. The persons with occupational AIDS exposure aged 20~29 years accounted for the highest percentage (51.6%) , and most persons (76.7%) graduated from junior colleges. Compared with the adult norm, there was significant increases in the total psychological score and the number of positive items after occupational exposure (P<0.05). The scores of all items at 24 hours were significantly higher than those at the other time points, and the scores of all items gradually decreased over time (F=227.24, 267.57, and 287.46, P<0.05). Compared with the adult norm, there were significant increases in the factor points at 24 hours and significant reductions in the factor points at 3 months (P<0.05). Compared with those at 24 hours, the factor scores at 3 months decreased significantly (P<0.05). Conclusion: Occupational AIDS exposure affects the mental status of related personnel, and the mental status at 24 hours after exposure is poor. Related departments should provide corresponding psychological counseling for the occupational exposure population at different exposure times.
Collapse
Affiliation(s)
- Q Lin
- Nanning Center for Disease Control and Prevention, Nanning 530023, China
| | | | | | | | | | | |
Collapse
|
39
|
Huang YC, Liao WL, Lin JM, Chen CC, Liu SP, Chen SY, Lin YN, Lei YJ, Liu HT, Chen YJ, Tsai FJ. High levels of circulating endothelial progenitor cells in patients with diabetic retinopathy are positively associated with ARHGAP22 expression. Oncotarget 2018; 9:17858-17866. [PMID: 29707151 PMCID: PMC5915159 DOI: 10.18632/oncotarget.24909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/21/2017] [Indexed: 01/08/2023] Open
Abstract
Diabetic retinopathy (DR) is a common microvascular complication of diabetes. Circulating endothelial progenitor cells (EPCs) are derived from bone marrow and are characterized by pathological retinal neovascularization. Rho GTPase Activating Protein 22 (ARHGAP22) is a DR susceptibility gene that interacts with its downstream regulatory protein ras-related C3 botulinum toxin substrate 1 (Rac1), to assist in endothelial cell angiogenesis and increasing capillary permeability. The aim of this study was to elucidate the relationship between ARHGAP22 expression and EPC levels in type 2 diabetes (T2D) patients with DR. Fifty T2D patients with DR were recruited. Circulating EPCs were characterized as CD31+/vascular endothelial growth factor-2+/CD45dim/CD133+ and were quantified using triple staining flow cytometry. Real-time polymerase chain reaction tests were used to quantify ARHGAP22 expression. We found that T2D patients with proliferative DR had significantly lower EPC levels than those with non-proliferative DR (P = 0.028). T2D patients with EPC levels above the median value (> 4 cells/105 events) had higher levels of ARHGAP22 expression (P = 0.002). EPC levels were positively correlated with ARHGAP22 expression (r = 0.364, P = 0.009). Among T2D patients with DR, a higher expression of ARHGAP22 was associated with higher levels of EPCs. ARHGAP22 may be involved in the mobilization or active circulation of EPCs, thus contributing to neovascularization during DR development.
Collapse
Affiliation(s)
- Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan.,School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Wen-Ling Liao
- Center for Personalized Medicine, China Medical University Hospital, Taichung 404, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung 404, Taiwan
| | - Jane-Ming Lin
- Department of Ophthalmology, China Medical University Hospital, Taichung 404, Taiwan.,School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, China Medical University Hospital, Taichung 404, Taiwan.,School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Shih-Ping Liu
- Center for Translational Medicine, China Medical University Hospital, Taichung 404, Taiwan.,Graduate Institute of Biomedical Science, China Medical University, Taichung 404, Taiwan.,Department of Social Work, Asia University, Taichung 413, Taiwan
| | - Shih-Yin Chen
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan.,School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Yu-Ning Lin
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
| | - Yu-Jie Lei
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
| | - Huan-Ting Liu
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
| | - Yu-Jen Chen
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan.,Department of Radiation Oncology, Mackay Memorial Hospital, Taipei 104, Taiwan.,Department of Medical Research, Mackay Memorial Hospital, New Taipei City 251, Taiwan.,Institute of Traditional Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Fuu-Jen Tsai
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan.,Children's Hospital of China Medical University, Taichung 404, Taiwan.,Department of Medical Genetics, China Medical University Hospital, Taichung 404, Taiwan.,Department of Biotechnology, Asia University, Taichung 413, Taiwan
| |
Collapse
|
40
|
Berglund JA, Gafni RI, Wodajo F, Cowen EW, El-Maouche D, Chang R, Chen CC, Guthrie LC, Molinolo AA, Collins MT. Tumor-induced osteomalacia in association with PTEN-negative Cowden syndrome. Osteoporos Int 2018; 29:993-997. [PMID: 29380000 PMCID: PMC7983154 DOI: 10.1007/s00198-017-4372-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 12/26/2017] [Indexed: 12/30/2022]
Abstract
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic condition in which phosphaturic mesenchymal tumors (PMTs) secrete high levels of fibroblast growth factor 23 (FGF23) into the circulation. This results in renal phosphate wasting, hypophosphatemia, muscle weakness, bone pain, and pathological fractures. Recent studies suggest that fibronectin-fibroblast growth factor receptor 1 (FN1-FGFR1) translocations may be a driver of tumorigenesis. We present a patient with TIO who also exhibited clinical findings suggestive of Cowden syndrome (CS), a rare autosomal dominant disorder characterized by numerous benign hamartomas, as well as an increased risk for multiple malignancies, such as thyroid cancer. While CS is a clinical diagnosis, most, but not all, harbor a mutation in the tumor suppressor gene PTEN. Genetic testing revealed a somatic FN1-FGFR1 translocation in the FGF23-producing tumor causing TIO; however, a germline PTEN mutation was not identified. To our knowledge, this is the first reported case of concurrent TIO and CS.
Collapse
Affiliation(s)
- J A Berglund
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - R I Gafni
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - F Wodajo
- Musculoskeletal Tumor Surgery, Virginia Cancer Specialists, Fairfax, VA, USA
| | - E W Cowen
- Dermatology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - D El-Maouche
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - R Chang
- Nuclear Medicine, Radiology and Imaging Sciences, Hatfield Clinical Research Center, National Institutes of Health, Bethesda, MD, USA
| | - C C Chen
- Nuclear Medicine, Radiology and Imaging Sciences, Hatfield Clinical Research Center, National Institutes of Health, Bethesda, MD, USA
| | - L C Guthrie
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - A A Molinolo
- Department of Pathology, University of California San Diego, San Diego, CA, USA
| | - M T Collins
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
41
|
Fanchiang YT, Chen KHM, Tseng CC, Chen CC, Cheng CK, Yang SR, Wu CN, Lee SF, Hong M, Kwo J. Strongly exchange-coupled and surface-state-modulated magnetization dynamics in Bi 2Se 3/yttrium iron garnet heterostructures. Nat Commun 2018; 9:223. [PMID: 29335558 PMCID: PMC5768741 DOI: 10.1038/s41467-017-02743-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 12/20/2017] [Indexed: 12/03/2022] Open
Abstract
Harnessing the spin–momentum locking of topological surface states in conjunction with magnetic materials is the first step to realize novel topological insulator-based devices. Here, we report strong interfacial coupling in Bi2Se3/yttrium iron garnet (YIG) bilayers manifested as large interfacial in-plane magnetic anisotropy (IMA) and enhancement of damping probed by ferromagnetic resonance. The interfacial IMA and damping enhancement reaches a maximum when the Bi2Se3 film approaches its two-dimensional limit, indicating that topological surface states play an important role in the magnetization dynamics of YIG. Temperature-dependent ferromagnetic resonance of Bi2Se3/YIG reveals signatures of the magnetic proximity effect of TC as high as 180 K, an emerging low-temperature perpendicular magnetic anisotropy competing the high-temperature IMA, and an increasing exchange effective field of YIG steadily increasing toward low temperature. Our study sheds light on the effects of topological insulators on magnetization dynamics, essential for the development of topological insulator-based spintronic devices. Understanding the effects of topological insulators on magnetization dynamics of adjacent magnetic materials is essential for novel spintronic devices. Here, Fanchiang et al. report thickness dependence of interfacial in-plane magnetic anisotropy and damping enhancement in Bi2Se3/yttrium iron garnet (YIG) bilayers, indicating an important role of topological surface states in the magnetization dynamics of YIG.
Collapse
Affiliation(s)
- Y T Fanchiang
- Department of Physics, National Taiwan University, Taipei, 10617, Taiwan
| | - K H M Chen
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C C Tseng
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C C Chen
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C K Cheng
- Department of Physics, National Taiwan University, Taipei, 10617, Taiwan
| | - S R Yang
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C N Wu
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - S F Lee
- Institute of Physics, Academia Sinica, Taipei, 11529, Taiwan.
| | - M Hong
- Department of Physics, National Taiwan University, Taipei, 10617, Taiwan.
| | - J Kwo
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan.
| |
Collapse
|
42
|
Liao WL, Lee WJ, Chen CC, Lu CH, Chen CH, Chou YC, Lee IT, Sheu WHH, Wu JY, Yang CF, Wang CH, Tsai FJ. Pharmacogenetics of dipeptidyl peptidase 4 inhibitors in a Taiwanese population with type 2 diabetes. Oncotarget 2017; 8:18050-18058. [PMID: 28160554 PMCID: PMC5392306 DOI: 10.18632/oncotarget.14951] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 01/03/2017] [Indexed: 12/22/2022] Open
Abstract
Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral anti-hyperglycemic drugs enabling effective glycemic control in type 2 diabetes (T2D). Despite DPP-4 inhibitors' advantages, the patients' therapeutic response varies. In this retrospective cohort study, 171 Taiwanese patients with T2D were classified as sensitive or resistant to treatment based on the mean change in HbA1c levels. Using an assumption-free genome-wide association study, 45 single nucleotide polymorphisms (SNPs) involved in the therapeutic response to DPP-4 inhibitors (P < 1 × 10-4) were identified at or near PRKD1, CNTN3, ASK, and LOC10537792. A SNP located within the fourth intron of PRKD1 (rs57803087) was strongly associated with DPP-4 inhibitor response (P = 3.2 × 10-6). This is the first pharmacogenomics study on DPP-4 inhibitor treatment for diabetes in a Taiwanese population. Our data suggest that genes associated with β-cell function and apoptosis are involved in the therapeutic effect of DPP-4 inhibitors, even in the presence of additional oral anti-diabetic drugs. Our findings provide information on how genetic variants influence drug response and may benefit the development of personalized medicine.
Collapse
Affiliation(s)
- Wen-Ling Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.,Center for Personalized Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Jane Lee
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chieh Hsiang Lu
- Department of Internal Medicine, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chiayi City, Taiwan.,Department of Nursing, College of Nursing and Health Sciences, DAYEH University, Taiwan.,Department of Business management, College of Management, National Chung Cheng University, Taiwan
| | - Chien-Hsiun Chen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Yi-Chun Chou
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans Hospital, Taichung, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Medical Technology, National Chung-Hsing University, Taichung, Taiwan
| | - Jer-Yuarn Wu
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Chi-Fan Yang
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Chung-Hsing Wang
- Department of Genetics and Metabolism, Children's Hospital of China Medical University, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Genetics, China Medical University Hospital, Taichung, Taiwan.,Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
| |
Collapse
|
43
|
Hung YC, Lin CC, Chen HJ, Chang MP, Huang KC, Chen YH, Chen CC. Severe hypoglycemia and hip fracture in patients with type 2 diabetes: a nationwide population-based cohort study. Osteoporos Int 2017; 28:2053-2060. [PMID: 28374044 DOI: 10.1007/s00198-017-4021-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 03/27/2017] [Indexed: 02/01/2023]
Abstract
UNLABELLED Hypoglycemia is a major concern in glycemic control. Using the Taiwan National Health Insurance Research Database, we found that the risk of hip fracture was associated with emergency or hospitalization visits of severe hypoglycemia in patients with type 2 diabetes; greater visits were associated with higher incidence of hip fracture. INTRODUCTION The objective of the study was to assess the risk of hip fracture among patients with type 2 diabetes mellitus (T2DM) and severe hypoglycemia. METHODS Using the National Health Insurance Research database in Taiwan, we identified 2588 patients with T2DM who had developed severe hypoglycemia from 2001 to 2009. A comparison cohort who had never developed severe hypoglycemia was frequency matched at a ratio of approximately 1:2. Multivariate Cox proportional hazard regression analysis was used to evaluate the risk of hip fracture. RESULTS During a median follow-up period of 3.9 years, there were 219 hip fracture events in 5173 comparison cohorts and 148 hip fracture events in 2588 hypoglycemia cohorts. The incidence of hip fracture was higher in patients with severe hypoglycemia than without severe hypoglycemia (17.19 vs. 8.83 per 1000 person-years; adjusted HR 1.71, 95% CI = 1.35-2.16). Approximately half of the individuals developed hip fracture within 2 years from the first occurrence of severe hypoglycemia. There was a significant associated trend towards increased hip fracture risk with increasing average visit of severe hypoglycemia per year (p for trend <0.001). Medication analysis showed that patients taking sulfonylurea alone, insulin alone, and insulin secretagogues combined with insulin had a higher associated risk to develop hip fracture. CONCLUSIONS Severe hypoglycemia was associated with a higher risk to develop hip fracture. The more the visits of severe hypoglycemia per year indicated the higher associated risk in patients with T2DM. Fall is likely an important reason for severe hypoglycemia in relation to increased risk of hip fracture.
Collapse
Affiliation(s)
- Y C Hung
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan
- Department of Medicine, China Medical University, Taichung, 40402, Taiwan
| | - C C Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan
- Veterans General Hospital, Taichung, Taiwan
| | - H J Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan
| | - M P Chang
- Department of Nursing, School of Health, National Taichung University of Science and Technology, Taichung, 40343, Taiwan
| | - K C Huang
- Department of Integration of Traditional Chinese and Western Medicine, China Medical University Hospital, Taichung, 40447, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan
| | - Y H Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan
- Department of Medicine, China Medical University, Taichung, 40402, Taiwan
| | - C C Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan.
- School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan.
| |
Collapse
|
44
|
Chen CC, Chen YW, Zheng JW. [Clinical observation of partial resection and drainage of abscess around tonsils on the upper pole of the tonsils]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:879-880. [PMID: 29775007 DOI: 10.13201/j.issn.1001-1781.2017.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Indexed: 11/12/2022]
|
45
|
Huang KC, Li TM, Liu X, Chen JH, Chien WK, Shiao YT, Tsang H, Lin TH, Liao CC, Huang SM, Li JP, Lin CW, Lin JC, Lin CC, Lai CH, Cheng CF, Liang WM, Hung CH, Chen CC, Lin YJ, Tsai FJ. KCNQ1 variants associate with hypertension in type 2 diabetes and affect smooth muscle contractility in vitro. J Cell Physiol 2017; 232:3309-3316. [PMID: 28059450 DOI: 10.1002/jcp.25775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/23/2016] [Accepted: 01/05/2017] [Indexed: 12/19/2022]
Abstract
KCNQ1 encodes a potassium voltage-gated channel and represents a susceptibility locus for type 2 diabetes mellitus (T2DM). Here, we explored the association between KCNQ1 polymorphisms and hypertension risk in individuals with T2DM, as well as the role of KCNQ1 in vascular smooth muscle cell contraction in vitro. To investigate the relationship between KCNQ1 and the risk of developing hypertension in patients with T2DM, we divided the T2DM cohort into hypertension (n = 452) and non-hypertension (n = 541) groups. The Mann-Whitney U test, chi-square test, and multivariate regression analyses were used to assess the clinical characteristics and genotypic frequencies. In vitro studies utilized the rat aortic smooth muscle A10 cell line. Patients in the hypertension group were significantly older at the time of enrollment and had higher levels of body mass index, waist-to-hip ratio, and triglyceride than those in the non-hypertension group. The KCNQ1 rs3864884 and rs12576239 genetic variants were associated with hypertension in T2DM. KCNQ1 expression was lower in the individuals with the CC versus the CT and TT genotypes. Smooth muscle cell contractility was inhibited by treatment with a KCNQ1 inhibitor. These results suggest that KCNQ1 might be associated with hypertension in individuals with T2DM.
Collapse
Affiliation(s)
- Kuo-Chin Huang
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Integration of Traditional Chinese and Western Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Te-Mao Li
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Xiang Liu
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Jin-Hua Chen
- Biostatistics Center and School of Public Health, China Medical University, Taichung, Taiwan.,Biostatistics Center and School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Wen-Kuei Chien
- National Applied Research Laboratories, National Center for High-Performance Computing, Hsinchu, Taiwan
| | - Yi-Tzone Shiao
- Heart Center, China Medical University Hospital, Taichung, Taiwan
| | - Hsinyi Tsang
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ju-Pi Li
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Rheumatism Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Wen Lin
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Jung-Chun Lin
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chien Lin
- Department of Cosmetic Science, Providence University, Taichung, Taiwan
| | - Chih-Ho Lai
- Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Fung Cheng
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Wen-Miin Liang
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Chien-Hui Hung
- Graduate Institute of Clinical Medical Science, Chang-Gung University, Taipei, Taiwan
| | - Ching-Chu Chen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ying-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Asia University, Taichung, Taiwan
| |
Collapse
|
46
|
Wang F, Fan XL, Chen CC. [The occupational disease hazards prevention and control status survey of tertiary hospitals in Shandong province]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2017; 35:154-156. [PMID: 28355712 DOI: 10.3760/cma.j.issn.1001-9391.2017.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
47
|
Lin YC, Wu CY, Chang LY, Chen CC, Chen HH, Lai YL, Hung SL. Levels of high-mobility group box-1 in gingival crevicular fluid in nonsmokers and smokers with chronic periodontitis. J Formos Med Assoc 2017; 116:933-939. [PMID: 28209360 DOI: 10.1016/j.jfma.2017.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/04/2017] [Accepted: 01/12/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/PURPOSE High-mobility group box-1 (HMGB1), a proinflammatory cytokine, plays a role in inflammatory disorders. Smoking is a well-established risk factor for periodontal disease. The aim of this study was to compare the levels of HMGB1 in the gingival crevicular fluid from periodontally healthy nonsmokers, chronic periodontitis nonsmokers, and chronic periodontitis smokers. Furthermore, the relationship between levels of HMGB1 and periodontal parameters was examined. METHODS Periodontal parameters of 17 nonsmokers with chronic periodontitis, nine smokers with chronic periodontitis, and nine periodontally healthy nonsmokers were examined. Gingival crevicular fluid samples were collected, and the levels of HMGB1 were analyzed using the enzyme-linked immunosorbent assay. RESULTS The median level of HMGB1 was statistically significantly higher in chronic periodontitis nonsmokers (37.5 ng/mL) than in chronic periodontitis smokers (9.5 ng/mL) and periodontally healthy nonsmokers (3.7 ng/mL). There was no significant difference in the levels of HMGB1 between chronic periodontitis smokers and periodontally healthy nonsmokers. Levels of HMGB1 were positively correlated with plaque index, gingival index, probing depth, and clinical attachment level of nonsmokers. However, no significant correlations were found between levels of HMGB1 and all periodontal parameters examined in chronic periodontitis smokers. CONCLUSION Chronic periodontitis nonsmokers had elevated levels of HMGB1 in gingival crevicular fluid. Moreover, the levels of HMGB1 were correlated with severity of periodontitis. Chronic periodontitis smokers exhibited lower levels of HMGB1 than chronic periodontitis nonsmokers. Further research is needed for understanding the role of HMGB1 in smoking and pathogenesis of periodontitis.
Collapse
Affiliation(s)
- Yi-Chun Lin
- Department of Dentistry, National Yang-Ming University, Taipei, Taiwan; Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Yi Wu
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Oral Biology, National Yang-Ming University, Taipei, Taiwan
| | - Lien-Yu Chang
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Oral Biology, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Chu Chen
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsuan-Hung Chen
- Department of Dentistry, National Yang-Ming University, Taipei, Taiwan; Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Lin Lai
- Department of Dentistry, National Yang-Ming University, Taipei, Taiwan; Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Shan-Ling Hung
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Oral Biology, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
48
|
Chen CC, Chuang WT, Lin AH, Tsai CW, Huang CS, Chen YT, Chen HW, Lii CK. Andrographolide inhibits adipogenesis of 3T3-L1 cells by suppressing C/EBPβ expression and activation. Toxicol Appl Pharmacol 2016; 307:115-122. [DOI: 10.1016/j.taap.2016.07.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/16/2016] [Accepted: 07/26/2016] [Indexed: 12/22/2022]
|
49
|
Chen CC, Granger CV, Peimer CA, Moy OJ, Wald S. Manual Ability Measure (MAM-16): A Preliminary Report on a New Patient-Centred and Task-Oriented Outcome Measure of Hand Function. ACTA ACUST UNITED AC 2016; 30:207-16. [PMID: 15757777 DOI: 10.1016/j.jhsb.2004.12.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Accepted: 12/06/2004] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to develop an easy-to-use and psychometrically sound outcome instrument that is task-oriented and patient-centred. One hundred fifteen patients with a variety of hand impairments completed a rating scale of perceived manual ability (i.e., the Manual Ability Measure). The first 70 patients also completed two other questionnaires about physical health and psychological well-being. Rasch Analyses were conducted to transform the ordinal ratings into linear measures; Rasch statistics were used to evaluate its measurement properties at both scale and item levels. Eighty-three original items were reduced to 16 common tasks; Rasch reliabilities were good; the easy-to-difficult item hierarchy makes sense clinically. Moderate correlations were found between manual ability, physical function and general sense of well-being. The results of this preliminary study suggest that the MAM is a promising outcome measure that has adequate psychometric properties and can be used to complement other objective clinical measurements.
Collapse
Affiliation(s)
- C C Chen
- Department of Occupational Therapy, New York University, USA.
| | | | | | | | | |
Collapse
|
50
|
Chen CC, Chen YW, He YS. [Report and analysis of 2 cases of nerve paralysis with aspiration pneumonia after infection of herpes zoster virus]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1249-1250. [PMID: 29798342 DOI: 10.13201/j.issn.1001-1781.2016.15.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Indexed: 06/08/2023]
Abstract
Two cases of patients were hospitalized for sore throat with Dysphagia.Check:Wall of the pharynx,tongue and epiglottis scattered the ulcer.The patients were loss of pharynx reflex.Oropharynx and piriform fossa has a lot of saliva retention.Posterior pharyngeal wall was drooping like waterfull.CT scan showed may be the aspiration pneumonia in right lower lung.The admission diagnosiswere pharyngeal herpes zoster virus infection,pharyngeal side muscle paralysis,and inhalation pneumonia.The patients' clinical data were retrospectively analyzed,and the report is as follows.
Collapse
|