Association between phthalate exposure and lower handgrip strength in an elderly population: a repeated-measures study

Background Decreased muscle strength can lead to adverse health outcomes in the elderly. A potential association between phthalate exposure and muscle strength was suggested previously, but has not been investigated directly. We hypothesized that phthalate exposure is associated with lower handgrip strength and that the association is modified by the dietary omega-6 to omega-3 ratio. Methods We analyzed 1,228 participants (≥60 years of age) recruited in Seoul and Asan, Republic of Korea. The study participants were surveyed up to three times between 2012 and 2015. At every survey, we collected urine samples and measured handgrip strength twice for each hand. The associations between urine phthalate metabolite concentrations and handgrip strength were evaluated using linear mixed models. Based on dietary information from 391 individuals who participated in the first survey in Seoul, we evaluated the heterogeneity of the association for those with high and low omega-6 to omega-3 ratios, using 8.81 (the 75th quantile) as a cutoff value. Results Log-transformed creatinine-adjusted concentrations of mono-(2-ethyl-5-oxohexyl phthalate (MEOHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-n-butyl phthalate (MnBP) were inversely associated with all measured handgrip strengths (β = −0.69 to −0.42, all p-values < 0.05). Associations between phthalate biomarkers and handgrip strength did not differ by sex. When the dietary subgroup was stratified by the omega-6 to omega-3 ratio, the associations were stronger among participants with high ratios. Conclusions We found inverse associations between phthalate biomarkers and handgrip strength in the elderly; this association was modified by the dietary omega-6 to omega-3 ratio

Clinical significance of preoperative serum vascular endothelial growth factor, interleukin-6, and C-reactive protein level in colorectal cancer

<p>Abstract</p> <p>Background</p> <p>Angiogenesis is a multistep process in which many growth factors and cytokines have an essential role. Vascular endothelial growth factor (VEGF) is a potent angiogenic agent that acts as a specific mitogen for vascular endothelial cells through specific cell surface receptors. The interleukin-6 (IL-6) pathway is another mechanism linking angiogenesis to malignancy. C-reactive protein (CRP), a representative marker for inflammation, is known for its association with disease progression in many cancer types. The aim of this study was to determine preoperative serum levels of VEGF, IL-6, and CRP in colorectal carcinoma, and to correlate them with disease status and prognosis.</p> <p>Methods</p> <p>A 132 of 143 patients who underwent curative resection for colorectal cancer were enrolled in this study. 11 patients with resection margin positive were excluded. Factors considered in analysis of the relationship between VEGF, IL-6, and CRP and histological findings. Patient prognosis was investigated. Serum levels of VEGF and IL-6 were assessed using Enzyme-Linked Immuno-Sorbent Assay (ELISA), and CRP was measured using immunoturbidimetry.</p> <p>Results</p> <p>Median follow-up duration was 18.53 months (range 0.73-43.17 months) and median age of the patients was 62 years (range, 26-83 years). Mean and median levels of VEGF and CRP in colorectal cancer were significantly higher than in the normal control group; 608 vs. 334 pg/mL and 528 (range 122-3242) vs. 312 (range 16-1121) (<it>p </it>< 0.001); 1.05 mg/dL vs. 0.43 mg/dL and 0.22 (range 0.00-18.40) vs. 0.07 (range 0.02-6.94) (<it>p </it>= 0.002), respectively. However mean and median level of IL-6 in patients were not significantly higher than in control; 14.33 pg/mL vs. 5.65 pg/mL and 6.00 (range 1.02-139.17) vs. 5.30 (4.50-13.78) (<it>p </it>= 0.327). Although IL-6 and CRP levels were not correlated with other pathological findings, VEGF level was significantly correlated with tumor size (<it>p </it>= 0.012) and CEA (<it>p </it>= 0.038). When we established the cutoff value for VEGF (825 pg/mL), IL-6 (8.09 pg/mL), and CRP (0.51 mg/dL) by Receiver Operating Characteristic (ROC) curve, we noted that high VEGF levels tended to reduce overall survival (<it>p </it>= 0.053), but not significantly. However, IL-6 and CRP demonstrated no significance with regard to disease free survival (<it>p </it>= 0.531, <it>p </it>= 0.701, respectively) and overall survival (<it>p </it>= 0.563, <it>p </it>= 0.572, respectively). Multivariate analysis showed that VEGF (<it>p </it>= 0.032), CEA (<it>p </it>= 0.012), lymph node metastasis (<it>p </it>= 0.002), and TNM stage (<it>p </it>= 0.025) were independently associated with overall survival.</p> <p>Conclusions</p> <p>Preoperative serum VEGF and CRP level increased in colorectal cancer patients. High VEGF level has been proposed as a poor prognostic factor for overall survival in patients with colorectal cancer.</p

Serum Folate Related to Five Measurements of Obesity and High-Sensitivity C-Reactive Protein in Korean Adults

This study investigated the effects of folic acid on obesity and high-sensitivity C-reactive protein (CRP) levels. Using data from the Korea National Health and Nutrition Examination Survey (KNHANES VII 2016–2018), 6394 adults (aged 19–80 years) who met the study criteria were identified and divided into young, middle-aged, and older adult groups. The analysis assessed associations using logistic regression for complex samples. Obesity was measured using body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI). The odds ratio (OR) of obesity based on BMI were statistically significant for young adults and older participants with low levels of folic acid compared to those with high levels (OR: 1.33 and 1.58, respectively). The OR of obesity based on BMI, WC, WHtR, ABSI, and BRI was significant with low levels of folic acid in middle-aged individuals (OR: 1.36, 1.32, 1.41, 1.29, and 1.47, respectively). Low folate levels were related to higher high-sensitivity CRP levels in middle-aged patients. In conclusion, folate level showed a significant inverse association with obesity and inflammatory biomarkers, especially in the middle-aged group. Further longitudinal or randomized controlled trials are needed to confirm and expand our results

Obstructive sleep apnea related to mental health, health-related quality of life and multimorbidity: A nationwide survey of a representative sample in Republic of Korea.

ObjectivesThis study assessed the effects of obstructive sleep apnea (OSA) on mental health, health-related quality of life (HRQoL), and multimorbidity in Korean adults.MethodsThe study included 8030 participants from the Korea National Health and Nutrition Examination Survey Ⅷ (2019-2020). The risk of OSA was assessed using STOP-BANG questionnaire. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9), and stress was measured using a questionnaire. HRQoL was determined by EuroQol 5-dimension (EQ-5D) and Health-related Quality of Life Instrument with 8 Items (HINT-8) scores. Multimorbidity was defined as the presence of 2 or more chronic diseases. A complex sample multivariate logistic regression analysis was conducted.ResultsParticipants with a high OSA risk were more likely to a have high PHQ-9 score (OR 4.31, 95% confidence interval [CI] 2.80-6.65), total depression (OR 4.07, 95% CI 2.67-6.19) stress (OR 2.33, 95% CI 1.85-2.95), lower EQ-5D (OR 2.88, 95% CI 2.00-4.15) and HINT-8 scores (OR 2.87, 95% CI 1.65-4.98), and multimorbidity (OR 2.62, 95% CI 2.01-3.41) than participants with low OSA risk. High OSA risk was significantly associated with all EQ-5D and HINT-8 items.ConclusionsThis study adds to the few population-based studies showing associations between mental health, HRQoL, and multimorbidity using nationwide data. OSA prevention might be helpful for good mental health, improving HRQoL, and comorbidity burdens. The results provide novel insights regarding the association between sleep apnea and multimorbidity

The Efficacy of Porous Hydroxyapatite Granule as a Carrier of E.coli-derived Recombinant Human Bone Morphogenetic Protein-2

Porous hydroxyapatite (HA) has great osteoconductivity, which allows it to be used as a bone graft extender. Porous HA enables bone formation by binding with recombinant human bone morphogenetic protein-2 (rhBMP-2). This research is to assess the capability of porous HA granules as a carrier of E.coli-derived rhBMP-2 (E.BMP-2). We compared the release of E.BMP-2 from porous HA of both block and granular forms for 120 min by using an ELISA. Using alkaline phosphatase (ALP) activity assay of human mesenchymal stem cells (hMSC), and the rat abdominal ectopic bone formation model, we also examined the osteogenic capacity of granular HA containing E.BMP-2.The result has shown that the rate of E.BMP-2 released from porous HA for 120 min indicated 42% of HA granules and 27.9% of HA block; the amount of HA granules was larger than HA block. At each set time interval of 10 min, 20 min, 40 min, 80 min, and 120 min, the amount of E.BMP-2 released from HA granules were significantly higher than those from HA block. The ALP activity on the third day of porous HA granules treated with 100 mu g E.BMP-2 was significantly higher than that of pure HA granules. In addition, in the rat in vivo model, bony tissue was confirmed in the all of the cases in the E.BMP-HA group but not in the pure HA group, according to the micro-CT and the histology 8 weeks after the surgery. Moreover, in contrast to the pure HA group, the E.BMP-HA group showed a higher level of bone volume, percent bone volume, structure model index, trabecular thickness, and trabecular number in the micro-CT scan. In conclusion, porous HA granules can be bound with E.BMP-2 and can properly release E.BMP-2, so that it can increase the osteoblastic differentiation of hMSC and induce the ectopic bone formation, consequently qualifying as a carrier of E.BMP-2.This study was supported by a Grant-in-Aid(No.03-2011-300) from the SNUH Research Fund.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000007273/7SEQ:7PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000007273ADJUST_YN:YEMP_ID:A077517DEPT_CD:801CITE_RATE:.345FILENAME:첨부된 내역이 없습니다.DEPT_NM:의학과EMAIL:[email protected]_YN:NCONFIRM:

Fabrication and Evaluation of Osteoblastic Differentiation of Human Mesenchymal Stem Cells on Novel CaO-SiO2-P2O5-B2O3 Glass-Ceramics

Apatite-wollastonite glass-ceramics have high mechanical strength, and CaO-SiO2-B2O3 glass-ceramics showed excellent bioactivity and high biodegradability. A new type of CaO-SiO2-P2O5-B2O3 system of bioactive glass-ceramics (BGS-7) was fabricated, and the effect and usefulness was evaluated via bioactivity using simulated body fluid and human mesenchymal stem cells (hMSCs). The purpose of this study was to compare BGS-7 and hydroxyapatite (HA) using hMSCs in order to evaluate the bioactivity of BGS-7 and its possibility as a bone graft extender. Alkaline phosphatase (ALP) staining, ALP activity, cell proliferation 3-(4,5-dimethylthiazol-2-yl)-5-(3carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt (MTS) assay, Alizarin Red-S (AR-S) staining, calcium levels, the mRNA expression of ALP, osteocalcin, osteopontin, and runt-related transcription factor 2 (runx-2) using reverse-transcription polymerase chain reaction (RT-PCR) and the protein expression of osteocalcin and runx-2 using Western blot were measured by transplanting hMSC onto a tissue culture plate, HA, and BGS-7. The ALP staining and AR-S staining of BGS-7 was greater than that of HA and control. The ALP value of BGS-7 was significantly higher than that of HA and control. The MTS results showed that BGS-7 had a higher value than the groups transplanted onto HA and control on day 15. The calcium level was higher than the control in both HA and BGS-7, and was especially high in BGS-7. There were more mineral products on BGS-7 than on the HA when analyzed by scanning electron microscopy. The mRNA expression of ALP, osteopontin, osteocalcin, and runx-2 were higher on BGS-7 than on HA and the control when analyzed by RT-PCR. The relative gene expression of osteopontin and runx-2 were found to be higher on BGS-7 than on HA and the control by Western blot. Accordingly, it is predicted that BGS-7 would have high biocompatibility and good osteoconductivity, and presents a possibility as a new bone graft extender.This work was supported by a Grant-in-Aid from the Seoul Development Institute (Seoul R&BD Program, No. ST100012).OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000007273/3SEQ:3PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000007273ADJUST_YN:YEMP_ID:A077517DEPT_CD:801CITE_RATE:1.964FILENAME:첨부된 내역이 없습니다.DEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:

The association between muscular strength and depression in Korean adults: a cross-sectional analysis of the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI) 2014

Abstract Background There are conflicting researches on the relationship between muscular strength and depression, the most common mental illness. There is no study of relationship between muscular strength and depression using national data from young adults to seniors. For example, there has not been a study done explaining mediating pathways among the influences of handgrip strength on depression. Here, we conducted survey for the association between relative handgrip strength and depression and explain mediated pathways for quality of life. Methods A cross-sectional study was administered to 4298 Korean adult subjects, aged 19–80 years, based on the 6th Korean National Health and Nutrition Examination Survey (KNHANES VI) of 2014. Handgrip strength reported as the average with each hand. The relative handgrip strength is defined as the handgrip strength divided by the body mass index (BMI). We performed analysis for all subjects and age groups (young adult, middle-aged, and elderly). We analyzed the association using multivariate linear regression and logistic regression. We also conducted mediation analysis for quality of life, which was measured by the EuroQol Five-Dimension Questionnaire (EQ5D). Results After adjusting for covariates, handgrip strength was inversely associated with the PHQ-9 score (P < 0.05). The odds ratios (OR) of depression symptoms were statistically significant for participants in the first and second quartile of handgrip strength compared to those with the highest quartile in entire sample, young adult, middle-aged, and elderly. There was about a 50% mediation effect of EQ5D in the relationship between handgrip strength and depression. Conclusions Using a large national sample, our results found that lower handgrip strength is associated with an increased risk of depression in Korean adult (young adult, middle-aged, and elderly). Our results suggest that increasing muscular strength may prevent depression in Korean adults

In Vivo Evaluation of CaO SiO2 P2O5 B2O3 Glass-ceramics Coating on Steinman Pin

Surface coating using ceramics improves the bone bonding strength of an implant. We questioned whether a new type of glass-ceramics (BGS-7) coating (CaO-SiO2-P2O5-B2O3) would improve the osseointegration of Steinman pins (S-pins) both biomechanically and histomorphometrically. An in vivo study was performed using rabbits by inserting three S-pins into each iliac bone. The pins were 2.2-mm S-pins with a coating of 30-μm-thick BGS-7 and 550-nm-thick hydroxyapatite (HA), as opposed to an S-pin without coating. A tensile strength test and histomorphometrical evaluation was performed. In the 2-week group, the BGS-7 implant showed a significantly higher tensile strength than the S-pin. In the 4- and 8-week groups, the BGS-7 implants had significantly higher tensile strengths than the S-pins and HA implants. The histomorphometrical study revealed that the BGS-7 implant had a significantly higher contact ratio than the S-pin and HA implants in the 4-week group. The biomechanical and histomorphometrical tests showed that the BGS-7 coating had superior bone bonding properties than the groups without the coating from the initial stage of insertion. The BGS-7 coating of an S-pin will enhance the bone bonding strength, and there might also be an advantage in human bone bonding.This work was supported by a Grant-in-Aid from the SNUH Research Fund (No. 03-2011-300).OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000007273/4SEQ:4PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000007273ADJUST_YN:NEMP_ID:A077517DEPT_CD:801CITE_RATE:1.964FILENAME:첨부된 내역이 없습니다.DEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:

Effects of porous beta-tricalcium phosphate-based ceramics used as an E-coli-derived rhBMP-2 carrier for bone regeneration

Recombinant human bone morphogenetic protein-2 (rhBMP-2) requires carriers for clinical effectiveness. In this study, whether porous beta-tricalcium phosphate (beta-TCP)-based ceramics are ideal carriers for rhBMP-2 was investigated. Hydroxyapatite (HA), beta-TCP, TCP/HA (80 %/20 %), HA with rhBMP-2, TCP with rhBMP-2, and TCP/HA (80 %/20 %) with rhBMP-2 were manufactured by a sponge method with a pore size of 300 mu m or more and macro-porosity of 83 %. The alkaline phosphatase (ALP) activity and ALP expression of the cells with 100 % beta-TCP granules were more increased than the those of cells with 100 % HA and TCP/HA (80 %/20 %) at the baseline or when treated with 15 ng/ml of rhBMP-2. In an SD rat calvarial defect model, new bone formation was evidently shown in the TCP 100 %-rhBMP-2 and TCP/HA (80 %/20 %)-rhBMP-2 groups, showing that the most affected area was filled with newly-formed bone, that the percent bone volume and trabecular number were larger when compared to the groups without rhBMP-2 treatment at both 4 and 8 weeks after surgery using micro-CT and histology. Porous TCP-based ceramic granules enhanced the osteoblastic differentiation in the hMSC system when treated with 15 ng/ml of rhBMP-2 and accelerated bone-healing by trabecular number in a rat calvarial defect model. Thus, in this study it was proposed that TCP-based ceramics might be useful carriers of rhBMP-2.This study was supported by a Grant-in-Aid from the Korean Ministry of Knowledge Economy/KEIT (No.10033623).OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000007273/8SEQ:8PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000007273ADJUST_YN:YEMP_ID:A077517DEPT_CD:801CITE_RATE:2.141FILENAME:첨부된 내역이 없습니다.DEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM: