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Sheng YH, Wu TY, Liaw CK, Hsiao SH, Kuo KL, Tsai CY. Real world fracture prediction of fracture risk assessment tool (FRAX), osteoporosis self-assessment tool for Asians (OSTA) and one-minute osteoporosis risk test: An 11-year longitudinal study. Bone Rep 2024; 20:101742. [PMID: 38404728 PMCID: PMC10884405 DOI: 10.1016/j.bonr.2024.101742] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Fractures affect people's quality of life especially in the elders. One of the most important risk factors is osteoporosis. There are many screening tools to predict osteoporosis and fractures. We aimed to compare the predictive validity of three commonly used screening tools: fracture risk assessment tool (FRAX), osteoporosis self-assessment tool for Asians (OSTA) and one-minute osteoporosis risk test. Among them, OSTA and one-minute osteoporosis risk test were originally developed to predict osteoporosis risks and FRAX was to predict fracture risks. Methods This is an 11-year longitudinal study. We enrolled 708 senior people from health examinees in Taiwan in 2010. A standardized questionnaire and blood tests were provided. Annual telephone interview was conducted to assess the real fracture status. We calculated risk scores of FRAX, OSTA, and one-minute osteoporosis risk test and compared with real-world fracture records. Results The mean age of the participants were 74.9 (SD 6.4). There were 356 (50.3 %) men. From 2010 to 2020, a total of 105 (14.8 %) persons suffered from fractures. Compared to people without fractures, people with fractures had higher FRAX major osteoporotic fracture risk scores (14.0 % ± 7.6 % vs.11.3 % ± 5.7 %), higher hip fracture risk scores, and higher OSTA risk (5.9 % ± 1.4 % vs. 5.3 % ± 1.3 %). Cox regression analysis showed that hazard ratios for fracture of high FRAX risk was 1.53 (95 % confidence interval (CI) 1.05-2.21), and for high OSTA risk was 1.37 (95 % CI 1.04-1.82). Conclusions Only OSTA and FRAX scores were satisfactory in predicting 10-year fractures.
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Affiliation(s)
- Yueh-Hsuan Sheng
- Department of Family Medicine, Renai Branch, Taipei City Hospital, No. 10, Sec. 4, Renai Rd., Daan Dist., Taipei City, Taiwan
| | - Tai-Yin Wu
- Department of Family Medicine, Zhongxing Branch, Taipei City Hospital, No. 145, Zhengzhou Rd., Datong Dist., Taipei City, Taiwan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei City, Taiwan
- Department of Health and Welfare, University of Taipei, No. 101, Sec. 2, Zhongcheng Rd., Shilin Dist., Taipei City, Taiwan
| | - Chen-Kun Liaw
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City, Taiwan
- Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe Dist., New Taipei City, Taiwan
- Research Center of Biomedical Device, College of Biomedical Engineering, Graduate Institute of Biomedical Optomechatronics, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City, Taiwan
- TMU Biodesign Center, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City, Taiwan
| | - Sheng-Huang Hsiao
- Department of Neurosurgery, Taipei City Hospital, Renai Branch, No. 10, Sec. 4, Ren'ai Rd., Da'an Dist., Taipei City, Taiwan
- Department of Psychology, National Chengchi University, No. 64, Sec. 2, Zhinan Rd., Wenshan Dist., Taipei City, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Renai Branch, Taipei City Hospital, No. 10, Sec. 4, Renai Rd., Daan Dist., Taipei City, Taiwan
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei City, Taiwan
- The Bachelor's Program in Medical Informatics and Innovative Applications, Fu Jen University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, Taiwan
| | - Ching-Yao Tsai
- Department of Health and Welfare, University of Taipei, No. 101, Sec. 2, Zhongcheng Rd., Shilin Dist., Taipei City, Taiwan
- Department of Ophthalmology, Taipei City Hospital, No. 145, Zhengzhou Rd., Datong Dist., Taipei City, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei City, Taiwan
- Department of Business Administration, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, Taiwan
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Yeh CH, Chen CY, Kuo YE, Chen CW, Kuo TBJ, Kuo KL, Chen HM, Huang HY, Chern CM, Yang CCH. Role of the autonomic nervous system in young, middle-aged, and older individuals with essential hypertension and sleep-related changes in neurocardiac regulation. Sci Rep 2023; 13:22623. [PMID: 38114517 PMCID: PMC10730708 DOI: 10.1038/s41598-023-49649-2] [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: 10/25/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
Essential hypertension involves complex cardiovascular regulation. The autonomic nervous system function fluctuates throughout the sleep-wake cycle and changes with advancing age. However, the precise role of the autonomic nervous system in the development of hypertension during aging remains unclear. In this study, we characterized autonomic function during the sleep-wake cycle in different age groups with essential hypertension. This study included 97 men (53 with and 44 without hypertension) aged 30-79 years. They were stratified by age into young (< 40 years), middle-aged (40-59 years), and older (60-79 years) groups. Polysomnography and blood pressure data were recorded for 2 min before and during an hour-long nap. Autonomic function was assessed by measuring heart rate variability and blood pressure variability. Data were analyzed using t tests, correlation analyses, and two-way analysis of variance. During nonrapid eye movement (nREM), a main effect of age was observed on cardiac parasympathetic measures and baroreflex sensitivity (BRS), with the highest and lowest levels noted in the younger and older groups, respectively. The coefficients of the correlations between these measures and age were lower in patients with hypertension than in normotensive controls. The BRS of young patients with hypertension was similar to that of their middle-aged and older counterparts. However, cardiac sympathetic activity was significantly higher (p = 0.023) and BRS was significantly lower (p = 0.022) in the hypertension group than in the control group. During wakefulness, the results were similar although some of the above findings were absent. Autonomic imbalance, particularly impaired baroreflex, plays a more significant role in younger patients with hypertension. The nREM stage may be suitable for gaining insights into the relevant mechanisms.
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Affiliation(s)
- Chia-Hsin Yeh
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Yu Chen
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-En Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chieh-Wen Chen
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Clinical Research Center, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Mind and Brain Medicine, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hong-Ming Chen
- Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Yi Huang
- Information Management Office, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chang-Ming Chern
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan.
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
- Department of Neurology, En Chu Kong (ECK) Hospital, 399 Fu-Xing Road, Sanxia District, New Taipei City, 23702, Taiwan.
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan.
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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Chen JM, Wu TY, Wu YF, Kuo KL. Association of the serum calcium level with metabolic syndrome and its components among adults in Taiwan. Arch Endocrinol Metab 2023; 67:e000632. [PMID: 37249460 PMCID: PMC10665046 DOI: 10.20945/2359-3997000000632] [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] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/02/2023] [Indexed: 05/31/2023]
Abstract
Objective An increasing amount of literature indicates that the serum calcium level may be related to metabolic syndrome (MetS) and obesity. This study aimed to examine the relationship between the serum calcium level and MetS in adults in Taiwan. Subjects and methods We conducted a crosssectional study and enrolled 1,580 participants (54.4% women; mean age, 33.28 ± 12.21 years) who underwent health examinations in northern Taiwan between 2012 and 2016. Logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of MetS and its components in groups of patients in the tertiles of the serum calcium level. Results In total, 167 participants (10.6%) had MetS. The odds of high systolic blood pressure (BP), blood glucose, and triglyceride (TG) levels significantly increased as the serum calcium level increased. Compared with the participants in the lowest tertile of the serum calcium level (tertile 1), those in the second tertile (OR = 1.47, 95% CI: 0.97-2.23) and third tertile (OR = 1.63, 95% CI: 1.06-2.53) had a significantly higher risk of MetS. Further analyses revealed a significant association between MetS and an increased serum calcium level in those in the overweight and obese groups. However, there was no association between the serum calcium levels and MetS in those in the normal weight group. Conclusion This study demonstrated that a higher serum calcium level is associated with an increased risk of MetS and its components in adults with overweight and obesity.
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Affiliation(s)
- Jer-Min Chen
- Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei, Taiwan,
- Department of Psychology and Counseling, University of Taipei, Taipei, Taiwan
| | - Tai-Yin Wu
- Department of Family Medicine, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Fan Wu
- Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei, Taiwan
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei, Taiwan
- Institute of BioMedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Wang WJ, Wu TY, Tu YK, Kuo KL, Tsai CY, Chie WC. The optimal dose of oral tranexamic acid in melasma: A network meta-analysis. Indian J Dermatol Venereol Leprol 2022; 89:189-194. [PMID: 36332095 DOI: 10.25259/ijdvl_530_2021] [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] [Received: 05/01/2021] [Accepted: 05/01/2022] [Indexed: 11/04/2022]
Abstract
Background
Melasma is a chronic skin condition that adversely impacts quality of life. Although many therapeutic modalities are available there is no single best treatment for melasma. Oral tranexamic acid has been used for the treatment of this condition but its optimal dose is yet to be established.
Objectives
We used network meta-analysis to determine the optimal dose of oral tranexamic acid for the treatment of melasma.
Methods
We conducted a comprehensive search of all studies of oral tranexamic acid for the treatment of melasma up to September 2020 using PubMed, EMBASE and the Cochrane Library database. The quality of the studies was evaluated using the Jadad score and the Cochrane’s risk of bias assessment tool. Only high quality randomised controlled trials were selected. Some studies lacked standard deviation of changes from baseline and these were estimated using the correlation coefficient obtained from another similar study.
Results
A total of 92 studies were identified of which 6 randomized controlled trials comprising 599 patients were included to form 3 pair-wise network comparisons. The mean age of the patients in these studies ranged from 30.3 to 46.5 years and the treatment duration ranged from 8 to 12 weeks. The Jadad scores ranged from 5 to 8.
The optimal dose and duration of oral tranexamic acid was estimated to be 750 mg per day for 12 consecutive weeks.
Limitations
Some confounding factors might not have been described in the original studies. Although clear rules were followed, the Melasma Area and Severity Index and the modified Melasma Area and Severity Index were scored by independent physicians and hence inter-observer bias could not be excluded.
Conclusion
Oral tranexamic acid is a promising drug for the treatment of melasma. This is the first network meta-analysis to determine the optimal dose of this drug and to report the effects of different dosages. The optimal dose is 250 mg three times per day for 12 weeks, but 250 mg twice daily may be an acceptable option in poorly adherent patients. Our findings will allow physicians to balance drug effects and medication adherence. Personalized treatment plans are warranted.
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Affiliation(s)
| | - Tai-Yin Wu
- University of Taipei and Taipei City Hospital and National Taiwan University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Ching-Yao Tsai
- Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
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Wu TY, Hsiao SH, Huang SJ, Kuo KL, Woung LC, Chen FC. The effect of home visits on healthcare resource utilisation. Aust J Gen Pract 2021; 50:595-602. [PMID: 34333570 DOI: 10.31128/ajgp-07-20-5512] [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: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Home visits may change patients' healthcare resource utilisation, including hospital admission, medications, outpatient and emergency room visits. The aim of the present study was to report changes in healthcare resource utilisation after the provision of home healthcare services. METHOD This was a multicentre follow-up study. Data on health and functional statuses were collected during home visits. Electronic medical records of 12 medical institutions were retrieved (outpatient visits, emergency care use, hospital admissions and prescription medications). The researchers analysed healthcare utilisation and medications before and after enrolment. RESULTS There were 246 participants. The mean age was 85.5 years (52% men). There was an increase in annual outpatient visits and a decrease in hospital admission days after enrolment (13.7-15.3 visits/year and 17.5-15 days/year, respectively). The number of medical institutions visited increased, but specialties and doctors visited decreased. Oral medications also increased (3.3-4.3 types). DISCUSSION Home visits help decrease days of hospital admission, but not medications or outpatient or emergency room visits.
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Affiliation(s)
- Tai-Yin Wu
- MD, PhD, Attending Physician, Department of Family Medicine, Taipei City Hospital, Zhongxing Branch, Taiwan; Assistant Professor, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan; Assistant Professor, University of Taipei, Taiwan; Assistant Professor, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Sheng-Huang Hsiao
- MD, PhD, Attending Physician, Department of Neurosurgery, Taipei City Hospital, Renai Branch, Taiwan
| | - Sheng-Jean Huang
- MD, Attending physician, Department of Neurosurgery, Taipei City Hospital, Taiwan
| | - Kuan-Liang Kuo
- Attending Physician, Department of Family Medicine, Taipei City Hospital, Renai Branch, Taiwan
| | - Lin-Chung Woung
- MD, PhD, Attending physician, Department of Ophthalmology, Taipei City Hospital, Renai Branch, Taiwan
| | - Fang-Chun Chen
- MD, Attending Physician, Department of Family Medicine, Taipei City Hospital, Renai Branch, Taiwan
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6
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Wu YF, Fan HY, Chen YC, Kuo KL, Chien KL. Adolescent Tri-ponderal Mass Index Growth Trajectories and Incident Diabetes Mellitus in Early Adulthood. J Clin Endocrinol Metab 2021; 106:e2919-e2927. [PMID: 33839769 DOI: 10.1210/clinem/dgab235] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 10/31/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE Studies have reported the influence of adolescent obesity on development of adult diabetes, but the effect of the growth pattern during this period has rarely been explored. Also, the tri-ponderal mass index (TMI) was thought to be a better estimation of adolescent body fat levels than the body mass index (BMI), so we sought to investigate whether growth trajectories derived by these two indices could predict incident diabetes. METHODS We conducted a study by using the Taipei City Hospital Radiation Building Database, a longitudinal cohort established in 1996. Physical exam results including blood test results were collected annually and the BMI z-score/TMI growth trajectory groups during 13 to 18 years of age were identified using growth mixture modeling. A Cox proportional hazard model for incident diabetes was used to examine the risk of baseline obese status and different BMI/TMI growth trajectories. RESULTS Five growth trajectory groups were identified for the BMI z-score and the TMI. During approximately 20 400 person-years follow-up, 33 of 1387 participants developed diabetes. Baseline obesity defined by the BMI z-score and the TMI were both related to adult diabetes. The persistent increase TMI growth trajectory exhibited a significantly increased risk of diabetes after adjusting for baseline obese status and other correlated covariates (hazard ratio: 2.85, 95% confidence interval: 1.01-8.09). There was no association between BMI growth trajectory groups and incident diabetes. CONCLUSIONS A specific TMI growth trajectory pattern during adolescence might be critical for diabetes prevention efforts.
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Affiliation(s)
- Yi-Fan Wu
- Department of Family Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Hsien-Yu Fan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Tsou HT, Wu TY, Kuo KL, Hsiao SH, Huang SJ, Tsai CY. Ten-year trends in lifestyle habits among community-dwelling older people in Taiwan. Australas J Ageing 2021; 41:e67-e73. [PMID: 34192403 DOI: 10.1111/ajag.12969] [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] [Received: 06/18/2020] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Different lifestyles may contribute to chronic diseases or a health condition. We aimed to study trends in lifestyle habits among community-dwelling older people. METHODS This retrospective time-trend study enrolled 429 108 participants from the Senior Citizen Health Examination in Taiwan over ten years (2001-2010). We analysed lifestyle habits including smoking, alcohol, betel nut chewing, milk drinking, fruit and vegetable intake, car driving and motorcycle riding. Joinpoint regression was used to identify changes in trend. RESULTS The overall rate of smoking, alcohol and betel nut chewing was 8.2%, 18.1% and 0.3%, respectively. Smoking rates decreased gradually, but alcohol and betel nut chewing increased. We found that milk drinking, fruit and vegetable intake and car driving initially increased and then later decreased. The change in the trend was in 2003. CONCLUSION There were significant turning points in milk drinking, fruit and vegetable intake and car driving. Implementation of strategies to change the behaviors of citizens about the intake of fruit and vegetable and milk drinking is important.
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Affiliation(s)
- Hsiao-Ting Tsou
- Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Tai-Yin Wu
- Department of Family Medicine, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.,National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,University of Taipei, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Sheng-Huang Hsiao
- Department of Neurosurgery, Renai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Sheng-Jean Huang
- Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan
| | - Ching-Yao Tsai
- Community Medicine Research Center & Institute Of Public Health, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
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Chen CW, Wu CH, Liou YS, Kuo KL, Chung CH, Lin YT, Kuo TBJ, Yang CCH. Roles of cardiovascular autonomic regulation and sleep patterns in high blood pressure induced by mild cold exposure in rats. Hypertens Res 2021; 44:662-673. [PMID: 33742169 DOI: 10.1038/s41440-021-00619-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/08/2020] [Accepted: 12/18/2020] [Indexed: 11/09/2022]
Abstract
Increased blood pressure (BP) caused by exposure to cold temperatures can partially explain the increased incidence of cardiovascular events in winter. However, the physiological mechanisms involved in cold-induced high BP are not well established. Many studies have focused on physiological responses to severe cold exposure. In this study, we aimed to perform a comprehensive analysis of cardiovascular autonomic function and sleep patterns in rats during exposure to mild cold, a condition relevant to humans in subtropical areas, to clarify the physiological mechanisms underlying mild cold-induced hypertension. BP, electroencephalography, electromyography, electrocardiography, and core body temperature were continuously recorded in normotensive Wistar-Kyoto rats over 24 h. All rats were housed in thermoregulated chambers at ambient temperatures of 23, 18, and 15 °C in a randomized crossover design. These 24-h physiological recordings either with or without sleep scoring showed that compared with the control temperature of 23 °C, the lower ambient temperatures of 18 and 15 °C not only increased BP, vascular sympathetic activity, and heart rate but also decreased overall autonomic activity, parasympathetic activity, and baroreflex sensitivity in rats. In addition, cold exposure reduced the delta power percentage and increased the incidence of interruptions during sleep. Moreover, a correlation analysis revealed that all of these cold-induced autonomic dysregulation and sleep problems were associated with elevation of BP. In conclusion, mild cold exposure elicits autonomic dysregulation and poor sleep quality, causing BP elevation, which may have critical implications for cold-related cardiovascular events.
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Affiliation(s)
- Chieh-Wen Chen
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Han Wu
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Syuan Liou
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Institute of BioMedical Informatics, National Yang-Ming University, Taipei, Taiwan
- Family Medicine Department, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Cheng-Hung Chung
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Ting Lin
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Terry B J Kuo
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan.
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
- Institute of BioMedical Informatics, National Yang-Ming University, Taipei, Taiwan.
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
| | - Cheryl C H Yang
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan.
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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Kuo KL, Chen HM, Hsiao SH, Chu D, Huang SJ, Huang KC, Huang CY. The relationship between anthropometric factors and hyperuricemia in adolescent athletes. Obes Res Clin Pract 2021; 15:375-380. [PMID: 33865745 DOI: 10.1016/j.orcp.2021.03.012] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Hyperuricemia has been increasingly prevalent and linked to future cardio-metabolic risks in adolescent population. The study aims to explore the relationship between anthropometric indices and hyperuricemia among adolescent athletes. METHODS This was a cross-sectional study of 387 student athletes (218 males and 169 females; mean age, 17.4 ± 1.3 years) in Northern Taiwan in 2013-2015. We exhibited the prevalence of hyperuricemia among this population, and tested the association of serum uric acid levels with different anthropometric parameters in males and females respectively. RESULTS A total of 59 (27.1%) male and 37 (21.8%) female adolescent athletes had hyperuricemia. Both in male and female adolescents, several obesity-related anthropometric parameters were significantly higher in hyperuricemia groups than in non-hyperuricemia groups. The odds of having hyperuricemia significantly increased with increasing BMI, BMI z-score, waist circumference and waist-to-height ratio in logistic regression analysis. There was a U-shaped association between uric acid level and body fat percentage (BF%) in both genders. Subjects whose BF% in lowest-body-fat-percentage quintile (quintile 1) and highest-body-fat-percentage quintile (quintile 5) had higher mean serum uric acid level than subjects whose BF% in the middle three quintiles. In both genders, the odds ratio (OR) of having hyperuricemia in subjects whose BF% in quintile 1 remained significantly higher than the OR in the middle three quintiles (the reference) after adjusting for age and BMI z-score. CONCLUSIONS In addition to the positive association between obesity and hyperuricemia, there is a U shape association between BF% and prevalence of hyperuricemia among adolescent athletes of both genders.
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Affiliation(s)
- Kuan-Liang Kuo
- Department of Family Medicine, RenAi Branch, Taipei City Hospital, Taipei, Taiwan; Institute of BioMedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan; The Bachelor's Program in Medical Informatics and Innovative Applications, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Hung-Ming Chen
- Center for Athlete Health Management, Taipei City Hospital, Taipei, Taiwan; Department of Orthopedics, Taipei City Hospital, Taipei, Taiwan
| | | | - Dachen Chu
- Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Department of Health and Welfare, University of Taipei, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Sheng-Jean Huang
- Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan; Department of surgery, Medical College, National Taiwan University, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiao-Yu Huang
- Department of Family Medicine, RenAi Branch, Taipei City Hospital, Taipei, Taiwan; Center for Athlete Health Management, Taipei City Hospital, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Department of Oral Hygiene and Healthcare, Cardinal Tien Junior College of Health and Management, New Taipei City, Taiwan.
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Tsai HJ, Kuo TBJ, Kuo KL, Yang CCH. Failure to de-arouse during sleep-onset transitions in the heart rates of individuals with sleep-onset insomnia. J Psychosom Res 2019; 126:109809. [PMID: 31622837 DOI: 10.1016/j.jpsychores.2019.109809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/01/2018] [Revised: 08/11/2019] [Accepted: 08/11/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Increased cardiovascular risk associated with sleep-onset insomnia has been reported, but the patterns of heart rate (HR) transitions during sleep onset in individuals with sleep-onset insomnia remain uncertain. This study explored the HR dynamics during objective and subjective sleep onset transitions among sleep-onset insomnia. METHODS Seventeen good sleepers and 17 individuals with sleep-onset insomnia had their night-time HR measured. HR and heart rate variability (HRV) were analyzed within 8-min periods of pre- and post-transition of stage N1, stage N2 and subjective sleep onset. RESULTS A significantly higher low-frequency percentage of HRV was observed in pre-N1 period among insomnia group, compared with good sleepers. Decline in HR begins in 160 s prior to N1 onset among good sleepers, whereas the HRs of insomnia group were reduced only after N1 onset in comparison to their HRs at the time of N1 onset. The good sleepers and insomnia group both had their HRs dropped to a level comparable to their HRs at respective stage N2 onset at 220 s and 80 s prior to N2 onset. No differences in HR was found during subjective sleep onset transition in both groups. CONCLUSION During the wake-to-sleep transition, a low and stable HR was observed before cortical alternations in good sleepers; however, a consistently high HR until N1 onset was shown among sleep-onset insomnia. This finding suggests a state-dependent and failure to de-arouse from the high arousal level of wakefulness into light sleep is associated with sleep initiation difficulty.
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Affiliation(s)
- Hsin-Jung Tsai
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Center for Dynamical Biomarkers, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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11
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Ko YH, Wong TC, Hsu YY, Kuo KL, Yang SH. The Correlation Between Body Fat, Visceral Fat, and Nonalcoholic Fatty Liver Disease. Metab Syndr Relat Disord 2017; 15:304-311. [PMID: 28481662 DOI: 10.1089/met.2017.0001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 12/27/2022] Open
Abstract
BACKGROUND This study investigated the correlation between body fat, visceral fat, and the presence of nonalcoholic fatty liver disease (NAFLD). METHODS In this cross-sectional study, participants were required to be 20 years or older, and free of liver disease (comprising either the hepatitis C virus antibody or hepatitis B surface antigen), cirrhosis, and malignant or biliary diseases. A total of 2759 participants were collected for this study. Demographic and biochemical data were collected by chart review. For estimating body fat and visceral fat, anthropometric and bioelectrical impedance analyses were conducted, whereas fatty livers were diagnosed through an abdominal ultrasound. RESULTS The waist circumference (WC), body mass index (BMI), body fat, visceral fat, and metabolic syndrome (MS) were associated with NAFLD. A larger WC, higher BMI, higher levels of body and visceral fat, and the MS significantly correlated with the presence of a fatty liver. Additionally, the receiver operating characteristic suggested that the visceral fat cutoff point was 70.5 cm2 (Youden's index = 0.4352). CONCLUSIONS Visceral fat is a strong predictor of NAFLD.
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Affiliation(s)
- Yun-Huei Ko
- 1 Department of Nutrition, Songde Branch, Taipei City Hospital , Taipei, Republic of China
| | - Te-Chih Wong
- 2 Department of Nutrition and Health Sciences, Chinese Culture University , Taipei, Republic of China
| | - Ying-Ying Hsu
- 1 Department of Nutrition, Songde Branch, Taipei City Hospital , Taipei, Republic of China
| | - Kuan-Liang Kuo
- 3 Department of Family Medicine, Renai Branch, Taipei City Hospital , Taipei, Republic of China
| | - Shwu Huey Yang
- 4 School of Nutrition and Health Sciences, Taipei Medical University , Taipei, Republic of China .,5 Nutrition Research Center, Taipei Medical University Hospital , Taipei, Republic of China
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Wang WJ, Kuo KL, Liaw CK, Wu TY, Chie WC, Chen JM. Bone health among older adults in Taiwan. Arch Gerontol Geriatr 2017; 70:155-161. [PMID: 28178601 DOI: 10.1016/j.archger.2017.01.003] [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] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/31/2016] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND PURPOSE There has been much discussion about the risk factors for osteoporosis, but studies involving elderly population in Taiwan are minimal. We aimed to describe variables related to osteoporosis among community dwelling older people in Taiwan. METHODS This is a cross-sectional study. The 671 participants were randomly selected from 3680 examinees of the annual Senior Citizens Health Examination in year 2010. Participants were interviewed with a detailed questionnaire, and 91 of them were invited for dual-energy X-ray absorptiometry (DXA). Predictor variables included age, gender and clinical risk factors for osteoporosis. The main outcome was osteoporosis confirmed by DXA. RESULTS The mean age of the participants was 75.7±6.4years old. Overall, the most prevalent variables for osteoporosis were height loss in adulthood (41.0%), lack of dairy products or calcium supplements (32.0%) and insufficient physical activity (10.4%). In multivariate models, we found that underweight (OR=9.80) and lack of dairy products/calcium supplements (OR=3.68) were the main variables for osteoporosis. In the subgroup analysis involving only women, underweight (OR=14.60) was the main variable. DISCUSSION Among community-dwelling older people in Taiwan, osteoporosis was mainly associated with underweight and lack of dairy products or calcium supplements. CONCLUSION We suggest using the key questions of underweight and dietary pattern in clinical settings to identify high risk people who are candidates for further BMD exam.
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Affiliation(s)
- Wei-Jen Wang
- Department of Family Medicine, Renai Branch, Taipei City Hospital, 10F, No. 10, Sec. 4, Ren-Ai Rd., Taipei City 106, Taiwan.
| | - Kuan-Liang Kuo
- Department of Family Medicine, Renai Branch, Taipei City Hospital, 10F, No. 10, Sec. 4, Ren-Ai Rd., Taipei City 106, Taiwan.
| | - Chen-Kun Liaw
- Department of Orthopaedics, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen-Chang Rd., Taipei City 111, Taiwan; National Taiwan University School of Medicine, No.1, Sec.1, Ren-Ai Rd., Taipei City 100, Taiwan; School of Medicine, Fu-Jen Catholic University, No. 510, Zhong-Zheng Rd., Xin-Zhuang Dist., New Taipei City 242, Taiwan.
| | - Tai-Yin Wu
- Department of Family Medicine, Renai Branch, Taipei City Hospital, 10F, No. 10, Sec. 4, Ren-Ai Rd., Taipei City 106, Taiwan; Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, 5F, No. 17, Hsu-Chow Rd., Taipei City 100, Taiwan.
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, 5F, No. 17, Hsu-Chow Rd., Taipei City 100, Taiwan.
| | - Jer-Min Chen
- Department of Family Medicine, Renai Branch, Taipei City Hospital, 10F, No. 10, Sec. 4, Ren-Ai Rd., Taipei City 106, Taiwan.
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Wu TY, Liaw CK, Chen FC, Kuo KL, Chie WC, Yang RS. Sarcopenia Screened With SARC-F Questionnaire Is Associated With Quality of Life and 4-Year Mortality. J Am Med Dir Assoc 2016; 17:1129-1135. [DOI: 10.1016/j.jamda.2016.07.029] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/25/2016] [Accepted: 07/29/2016] [Indexed: 11/27/2022]
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Hong CH, Kuo TBJ, Huang BC, Lin YC, Kuo KL, Chern CM, Yang CCH. Cold Exposure Can Induce an Exaggerated Early-Morning Blood Pressure Surge in Young Prehypertensives. PLoS One 2016; 11:e0150136. [PMID: 26919177 PMCID: PMC4769082 DOI: 10.1371/journal.pone.0150136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/09/2016] [Indexed: 11/19/2022] Open
Abstract
Prehypertension is related to a higher risk of cardiovascular events than normotension. Our previous study reported that cold exposure elevates the amplitude of the morning blood pressure surge (MBPS) and is associated with a sympathetic increase during the final sleep transition, which might be critical for sleep-related cardiovascular events in normotensives. However, few studies have explored the effects of cold exposure on autonomic function during sleep transitions and changes of autonomic function among prehypertensives. Therefore, we conducted an experiment for testing the effects of cold exposure on changes of autonomic function during sleep and the MBPS among young prehypertensives are more exaggerate than among young normotensives. The study groups consisted of 12 normotensive and 12 prehypertensive male adults with mean ages of 23.67 ± 0.70 and 25.25 ± 0.76 years, respectively. The subjects underwent cold (16°C) and warm (23°C) conditions randomly. The room temperature was maintained at either 23°C or 16°C by central air conditioning and recorded by a heat-sensitive sensor placed on the forehead and extended into the air. BP was measured every 30 minutes by using an autonomic BP monitor. Electroencephalograms, electrooculograms, electromyograms, electrocardiograms, and near body temperature were recorded by miniature polysomnography. Under cold exposure, a significantly higher amplitude of MBPS than under the warm condition among normotensives; however, this change was more exaggerated in prehypertensives. Furthermore, there was a significant decrease in parasympathetic-related RR and HF during the final sleep transition and a higher early-morning surge in BP and in LF% among prehypertensives, but no such change was found in normotensives. Our study supports that cold exposure might increase the risk of sleep-related cardiovascular events in prehypertensives.
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Affiliation(s)
- Cian-Hui Hong
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Institute of Translational and Interdisciplinary Medicine, National Central University, Taoyuan, Taiwan
| | - Bo-Chi Huang
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Cheng Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Taipei City Hospital, Taipei, Taiwan
| | - Chang-Ming Chern
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- * E-mail:
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15
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Liao LY, Kuo KL, Chiang HS, Lin CZ, Lin YP, Lin CL. Acoustic radiation force impulse elastography of the liver in healthy patients: test location, reference range and influence of gender and body mass index. Ultrasound Med Biol 2015; 41:698-704. [PMID: 25638317 DOI: 10.1016/j.ultrasmedbio.2014.09.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 09/18/2014] [Accepted: 09/26/2014] [Indexed: 06/04/2023]
Abstract
The objective of this study was to evaluate the best test location and study factors associated with acoustic radiation force impulse (ARFI) elastography measurements in healthy individuals. When ARFI elastography was performed on 68 healthy patients after controlling for all known test condition factors except segmental location, the median shear wave velocities (SWVs) derived from five valid measurements in the area between S5 and S8 in patients in the supine position had a significantly lower mean and the narrowest 95% confidence interval, followed by those for the S8 supine and S8 semidecubitus locations (p = 0.045). Analysis of mean SWVs revealed similar, although statistically insignificant, findings (p = 0.078). Male patients had significantly higher median SWVs (p = 0.0073) and mean SWVs (p = 0.0043) than female patients. Patients with body mass indexes >22 had significantly lower median SWVs (p = 0.0033) and mean SWVs (p = 0.0008) than those with body mass indexes ≤22. S5/8 supine was the better test location for ARFI. The reference ranges for median and mean SWV were 0.81-1.27 and 0.82-1.27 m/s, respectively. Gender and body mass index, but not age, were the significant factors associated with ARFI SWV values.
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Affiliation(s)
- Li-Ying Liao
- Liver Center, Department of Gastroenterology, Taipei City Hospital Renai Branch, Taipei, Taiwan, Republic of China.
| | - Kuan-Liang Kuo
- Department of Family Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan, Republic of China
| | - Huei-Shin Chiang
- Liver Center, Department of Gastroenterology, Taipei City Hospital Renai Branch, Taipei, Taiwan, Republic of China
| | - Chong-Zong Lin
- Liver Center, Department of Gastroenterology, Taipei City Hospital Renai Branch, Taipei, Taiwan, Republic of China
| | - Yi-Ping Lin
- Taipei Databank for Public Health Analysis, Institute of Clinical Research and Training, Taipei City Hospital, Taipei, Taiwan, Republic of China
| | - Chih-Lin Lin
- Liver Center, Department of Gastroenterology, Taipei City Hospital Renai Branch, Taipei, Taiwan, Republic of China
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Rochau U, Kluibenschaedl M, Stenehjem D, Kuo KL, Oderda G, Brixner D, Siebert U. Decision Analysis on the Cost-Effectiveness of Sequential Treatment Strategies for Patients with Chronic Myeloid Leukemia in the United States. Value Health 2014; 17:A639. [PMID: 27202283 DOI: 10.1016/j.jval.2014.08.2302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- U Rochau
- UMIT - University for Health Sciences, Medical Informatics and Technology/ ONCOTYROL - Center for Personalized Cancer Medicine, Hall in Tyrol/ Innsbruck, Austria
| | - M Kluibenschaedl
- UMIT - University for Health Sciences, Medical Informatics and Technology/ ONCOTYROL - Center for Personalized Cancer Medicine, Hall in Tyrol/ Innsbruck, Austria
| | | | - K L Kuo
- University of Utah, Salt Lake City, UT, USA
| | - G Oderda
- University of Utah, Salt Lake City, UT, USA
| | - D Brixner
- UMIT - University for Health Sciences, Medical Informatics and Technology/ ONCOTYROL - Center for Personalized Cancer Medicine/ University of Utah, Hall in Tyrol/ Salt Lake City, UT, Austria
| | - U Siebert
- Medical Informatics and Technology, and Director of the Division for Health Technology Assessment and Bioinformatics, ONCOTYROL, Hall i. T, Austria
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Yen PN, Lin IF, Chang WP, Wang JD, Chang TC, Kuo KL, Hwang JS, Liu IC, Chen YT, Yang CC. Risk factors of depression after prolonged low-dose rate environmental radiation exposure. Int J Radiat Biol 2014; 90:859-66. [PMID: 24766615 DOI: 10.3109/09553002.2014.916830] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE More than 10,000 Taiwanese people were exposed to excessive protracted low-dose rate radiation from contaminated reinforcement bars, which were installed in buildings before 1992. This study was conducted to assess the prevalence of depression amongst the exposed and identify related determinants now that more than two decades have passed since this population was informed of their exposure to radiation. MATERIALS AND METHODS We used the Beck depression inventory (BDI)-1A questionnaire to survey 2143 eligible people during their annual physical examinations between March 2009 and December 2009. In total, 1621 people participated in the survey. We employed multivariate logistic regression models with generalized estimating equations method to identify the determinants of depression. RESULTS The prevalence of depression (BDI-IA score ≥ 12) was 18.7%. Those who exhibited higher cumulative exposure [adjusted odds ratio (OR): 1.46, 95% confidence interval (CI): 1.02-2.07] and a previous history of depression (adjusted OR: 2.49, 95% CI: 1.36-4.58) were significantly associated with the risk of depression, whereas education level was inversely related to depression (adjusted OR: 0.71, 95% CI: 0.50-0.99). CONCLUSION Long-term, low-dose rate radiation exposure early in life might cause subsequent psychological stress and an increased risk of depression decades later.
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Affiliation(s)
- Pimei Nancy Yen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University , Taipei
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Wu TY, Chie WC, Yang RS, Kuo KL, Wong WK, Liaw CK. Risk factors for single and recurrent falls: a prospective study of falls in community dwelling seniors without cognitive impairment. Prev Med 2013; 57:511-7. [PMID: 23872174 DOI: 10.1016/j.ypmed.2013.07.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 01/28/2013] [Revised: 07/02/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The purpose of this study is to contribute evidence towards heterogeneity in risk factors for single and recurrent falls. METHOD This is a prospective study conducted in Taiwan. Participants were randomly selected from the examinees of the annual health examination in 2010. Participants were interviewed with a detailed questionnaire and followed up one year later. Predictor variables included socio-demographic characteristics, medical conditions, laboratory data, and risk factors for osteoporosis. The outcome was falls in the ensuing 12 months. RESULTS The mean age of the 653 completers was 75.6 ± 6.4. Half (48.7%) were women. Fallers and recurrent fallers comprised 14.5% and 6.0% of the participants, respectively. Blurred vision (adjusted odds ratio (aOR): 1.93, 95% confidence interval (CI): 1.02-3.67), minimal outdoor activities (aOR: 2.28, 95% CI: 1.06-4.88), and overactive thyroid/parathyroid (aOR: 3.49, 95% CI: 1.29-9.50) were associated with single falls. Frailty (aOR: 2.81, 95% CI: 1.11-7.09), decreased body height (aOR: 3.15, 95% CI: 1.52-6.54) and taking sedatives/hypnotics (aOR: 4.23, 95% CI: 2.06-8.67) were associated with recurrent falls. Previous falls (aOR: 2.64, 95% CI: 1.44-4.84 for single falls; aOR: 5.26, 95% CI: 2.61-10.60 for recurrent falls) were associated with all falls. CONCLUSION Different intervention strategies should be developed for single and recurrent fallers.
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Affiliation(s)
- Tai-Yin Wu
- Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, 5F, No. 17, Hsu-Chow Rd., Taipei City 100, Taiwan; Department of Family Medicine, Renai Branch, Taipei City Hospital, 10F, No. 10, Sec. 4, Ren-Ai Rd., Taipei City 106, Taiwan.
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Wu TY, Chie WC, Kuo KL, Wong WK, Liu JP, Chiu ST, Cheng YH, Netuveli G, Blane D. Quality of life (QOL) among community dwelling older people in Taiwan measured by the CASP-19, an index to capture QOL in old age. Arch Gerontol Geriatr 2013; 57:143-50. [DOI: 10.1016/j.archger.2013.03.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 03/16/2013] [Accepted: 03/18/2013] [Indexed: 10/26/2022]
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Yen PN, Yang CC, Chang WP, Wang JD, Hwang JS, Chang TC, Kuo KL, Lin IF. Late effects on the health-related quality of life in a cohort population decades after environmental radiation exposure. Int J Radiat Biol 2013; 89:639-44. [DOI: 10.3109/09553002.2013.784423] [Citation(s) in RCA: 4] [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] [Indexed: 01/17/2023]
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Lin LC, Li SH, Wu YT, Kuo KL, Tsai TH. Pharmacokinetics and urine metabolite identification of dehydroevodiamine in the rat. J Agric Food Chem 2012; 60:1595-1604. [PMID: 22283510 DOI: 10.1021/jf204365m] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study investigates the oral bioavailability and characterizes urine metabolites of dehydroevodiamine (DeHE), one of the bioactive alkaloids isolated from the fruit of Evodia rutaecarpa . A freely moving rat model coupled with an automated blood sample system was used to evaluate the pharmacokinetics of DeHE. High-performance liquid chromatography (HPLC), mass spectrometry (MS), and nuclear magnetic resonance (NMR) spectrometry were applied to determine DeHE and its metabolites. The averaged oral bioavailability of DeHE (100 and 500 mg/kg) in the freely moving rats was approximately 15.35%. Cumulative fecal and urinary excretions of unchanged DeHE were 6 and 0.5%, respectively, after a single oral dose (500 mg/kg) of DeHE. The protein binding of DeHE in rat plasma was 65.6 ± 6.5%. Six metabolites, including five DeHE-O-glucuronides and one DeHE-sulfate, were identified after oral administration. The structures of two glucuronide conjugates, DeHE-10-O-glucuronide (M3) and DeHE-11-O-glucuronide (M4), and one sulfate conjugate, DeHE-12-sulfate (M6), were assigned. The findings indicate that the oral bioavailability of DeHE was much higher than that of evodiamine, and hydroxylation and conjugative metabolism were essential for the urinary elimination of DeHE.
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Affiliation(s)
- Lie-Chwen Lin
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Wu TY, Chie WC, Lai MS, Chen CC, Kuo KL, Majeed A. Knowledge of the New Tobacco Hazards Prevention Act Is Associated With Smokers’ Behavior of Seeking Help in Smoking Cessation in Taiwan. Asia Pac J Public Health 2012; 27:NP212-22. [DOI: 10.1177/1010539512436545] [Citation(s) in RCA: 3] [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: 11/16/2022]
Abstract
Evidence that smoking area restrictions and raising cigarette taxes affect smokers’ behavior of seeking help in cessation is limited. The authors conducted a case-control study of 200 participants in Taipei City, Taiwan, from December 2008 to June 2009 to evaluate the association between knowledge on legislation and the behavior of seeking help in smoking cessation. They compared smokers who sought assistance in clinics/classes and smokers who did not, matching for age, gender, and recruitment time. In a univariate model, both banning smoking and increasing prices had positive effects on smokers’ behavior, but the effect size of the latter was larger ( P = .021). A better knowledge of the regulations was associated with cessation effort (odds ratio [OR] = 2.74; 95% confidence interval [CI] = 1.44-5.23), as were being more influenced by increased prices (OR = 2.44; 95% CI = 1.38-4.34) and by smoking bans (OR = 2.32; 95% CI = 1.29-4.16). Increased knowledge of the regulations is associated with seeking help for smoking.
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Affiliation(s)
- Tai-Yin Wu
- National Taiwan University, Taipei City, Taiwan
- Taipei City Hospital, Taipei City, Taiwan
| | | | - Mei-Shu Lai
- National Taiwan University, Taipei City, Taiwan
| | | | | | - Azeem Majeed
- Imperial College London, Charing Cross Campus, London, UK
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Yen PN, Yang CC, Chang PW, Hwang JS, Lee HC, Kuo KL, Lin IF. Perception of quality of life of a cohort population years after relocation from previous low-dose radiation exposure in Co-60 contaminated buildings in Taiwan. Int J Radiat Biol 2011; 87:453-60. [DOI: 10.3109/09553002.2011.544372] [Citation(s) in RCA: 5] [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] [Indexed: 11/13/2022]
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Abstract
Health examinations play a key role in preventive medicine. We propose a health examination system named Health Examination Automatic Logic System (HEALS) to assist clinical workers in improving the total quality of health examinations. Quality of automated inference is confirmed by the zero inference error where during 6 months and 14,773 cases. Automated inference time is less than one second per case in contrast to 2 to 5 min for physicians. The most significant result of efficiency evaluation is that 3,494 of 4,356 (80.2%) cases take less than 3 min per case for producing a report summary. In the evaluation of effectiveness, novice physicians got 18% improvement in making decisions with the assistance of our system. We conclude that a health examination system with a clinical decision system can greatly reduce the mundane burden on clinical workers and markedly improve the quality and efficiency of health examination tasks.
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Affiliation(s)
- Kuan-Liang Kuo
- Family Medicine Department, RenAi Branch, Taipei City Hospital, 10F, No. 10, Sec. 4, RenAi Road, Taipei City 106 Taiwan, Republic of China.
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25
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Abstract
Renal anemia is mainly caused by inadequate synthesis of erythropoietin from diseased kidneys. At the present time, recombinant human erythropoietin (rHuEPO) is used to correct anemia successfully in most patients with end-stage renal diseases. Nevertheless, poor response to rHuEPO still exists in some hemodialysis patients and its mechanism in some cases remains obscure. Herein, we describe a rare case of rHuEPO hyporesponsiveness due to mechanical hemolysis induced by a traumatic carotid-jugular arteriovenous fistula (AVF) in the presence of subclinical aluminum intoxication. Following surgical resection of the traumatic AVF and 8 months of desferrioxamine treatment, the responsiveness to rHuEPO was restored and the rHuEPO dose requirements reduced.
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Affiliation(s)
- K L Kuo
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, and Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
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Affiliation(s)
- K L Kuo
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan
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27
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Abstract
This study presents a high-performance capillary electrophoresis (CE) method to analyze five constituents of Puerariae radix, an important crude herb used in Chinese medicine. Puerarin, daidzin, daidzein, genistein and biochanin A are the bioactive constituents of Puerariae radix. Herein, those analytes were successfully separated within 6 min using a pH 10.1 borax-NaOH buffer. The effects of pH value and concentration of the running buffer on the separation of the five analytes were also examined. The relative standard deviations of the analytes' migration times were less than 0.38% under the optimized separation conditions. Notably, the correlation coefficients of the analytes' linear calibration graphs exceeded 0.998. Moreover, the amounts of the five constituents in three different Puerariae radix samples were determined by the CE method with a relatively simple extraction procedure.
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Affiliation(s)
- C Y Wang
- Department of Applied Chemistry, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
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28
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Abstract
This paper presents a rapid and reliable micellar electrokinetic capillary chromatography (MEKC) method to separate major prostaglandins and thromboxane B2. The running buffer was modified with sodium dodecyl sulfate (SDS). The effects of the SDS concentration on the migration behavior of analytes was also examined. Moreover, the influences of electrolyte concentration and capillary temperature on the separation were investigated. In optimum conditions, seven major prostaglandins and thromboxane B2 could be separated within 8 min. The relative standard deviations of the migration times (reproducibility) of the analytes were less than 0.82%.
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Affiliation(s)
- Y Z Hsieh
- Department of Applied Chemistry, National Chiao Tung University, Hsinchu, Taiwan
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