Overweight and Obesity-related Metabolic Disorders in Hospital Employees

BackgroundObesity is associated with metabolic disorders and cardiovascular diseases. This study investigated the relationship between overweight and obese status and the incidence of type 2 diabetes, hypertension, hyperlipidemia and hyperuricemia.MethodsThis prospective cohort study comprised 1749 hospital employees who received baseline health check-ups in 1993. Data from the 1027 participants (832 women, 195 men; mean age, 36 ± 7 years) who repeated check-ups in 2003 were used in the analysis. Relative risks (RRs) for development of metabolic disorders during follow-up associated with different body mass index (BMI) categories at baseline as defined by Asia-Pacific recommendations and the Department of Health in Taiwan were calculated after adjustment for covariates.ResultsThe prevalence of overweight and obesity at baseline check-up were 17.6% and 14.5%, respectively. Obese subjects with baseline BMI ≥ 25 kg/m2 had a significant multivariate-adjusted RR of 2.7 for hypertension, 14.8 for type 2 diabetes, 3.2 for hypertriglyceridemia, and 2.8 for hyperuricemia, compared to subjects with baseline BMI < 23.0 kg/m2. RR for diabetes was higher in women than in men, but RR for hypertriglyceridemia was higher in men. The risks of hypertension and hyperuricemia significantly increased for subjects with baseline BMI ≥ 23 kg/m2, while RRs for type 2 diabetes increased significantly for baseline BMI ≥ 24 kg/m2 and hypertriglyceridemia increased for baseline BMI ≥ 25 kg/m2. The risks attributable to obesity (baseline BMI ≥ 25 kg/m2) were 23.0% for hypertension, 70.8% for diabetes, 27.9% for hypertriglyceridemia, and 24.1% for hyperuricemia.ConclusionThis study revealed that a high prevalence of overweight and obesity was associated with significantly increased risk of development of type 2 diabetes, hypertension, hypertriglyceridemia and hyperuricemia in hospital employees, suggesting the need for programs to improve weight management

Effect of Acupressure and Trigger Points in Treating Headache: A Randomized Controlled Trial

Abstract: The efficacy of acupressure in relieving pain has been documented; however, its effectiveness for chronic headache compared to the muscle relaxant medication has not yet been elucidated. To address this, a randomized, controlled clinical trial was conducted in a medical center in Southern Taiwan in 2003. Twenty-eight patients suffering chronic headache were randomly assigned to the acupressure group (n = 14) or the muscle relaxant medication group (n = 14). Outcome measures regarding self-appraised pain scores (measured on a visual analogue scale; VAS) and ratings of how headaches affected life quality were recorded at baseline, 1 month after treatment, and at a 6-month follow-up. Pain areas were recorded in order to establish trigger points. Results showed that mean scores on the VAS at post-treatment assessment were significantly lower in the acupressure group (32.9 ± 26.0) than in the muscle relaxant medication group (55.7 ± 28.7) (p = 0.047). The superiority of acupressure over muscle relaxant medication remained at 6-month follow-up assessments (p = 0.002). The quality of life ratings related to headache showed similar differences between the two groups in the post treatment and at six-month assessments. Trigger points BL2, GV20, GB20, TH21, and GB5 were used most commonly for etiological assessment. In conclusion, our study suggests that 1 month of acupressure treatment is more effective in reducing chronic headache than 1 month of muscle relaxant treatment, and that the effect remains 6 months after treatment. Trigger points help demonstrate the treatment technique recommended if a larger-scale study is conducted in the future

Beneficial Effect of Consecutive Screening Mammography Examinations on Mortality from Breast Cancer: A Prospective Study

BackgroundPreviously, the risk of death from breast cancer was analyzed for women participating versus those not participating in the last screening examination before breast cancer diagnosis. Consecutive attendance patterns may further refine estimates.PurposeTo estimate the effect of participation in successive mammographic screening examinations on breast cancer mortality.Materials and MethodsParticipation data for Swedish women eligible for screening mammography in nine counties from 1992 to 2016 were linked with data from registries and regional cancer centers for breast cancer diagnosis, cause, and date of death (Uppsala University ethics committee registration number: 2017/147). Incidence-based breast cancer mortality was calculated by whether the women had participated in the most recent screening examination prior to diagnosis only (intermittent participants), the penultimate screening examination only (lapsed participants), both examinations (serial participants), or neither examination (serial nonparticipants). Rates were analyzed with Poisson regression. We also analyzed incidence of breast cancers proving fatal within 10 years.ResultsData were available for a total average population of 549 091 women (average age, 58.9 years ± 6.7 [standard deviation]). The numbers of participants in the four groups were as follows: serial participants, 392 135; intermittent participants, 41 746; lapsed participants, 30 945; and serial nonparticipants, 84 265. Serial participants had a 49% lower risk of breast cancer mortality (relative risk [RR], 0.51; 95% CI: 0.48, 0.55; P P ConclusionWomen participating in the last two breast cancer screening examinations prior to breast cancer diagnosis had the largest reduction in breast cancer death. Missing either one of the last two examinations conferred a significantly higher risk.Published under a CC BY 4.0 license.</p

Association of Androgenetic Alopecia with Metabolic Syndrome in Men: A Community-Based Survey

P>Background Several previous studies have investigated the association between factors related to metabolic syndrome, which is known to increase the risk of type 2 diabetes mellitus and cardiovascular disease, and androgenetic alopecia (AGA). However, the results of these studies have been inconsistent. Objectives To determine if there is an association between metabolic syndrome and AGA after adjustment for potential confounders. Methods A population- based cross-sectional survey was conducted in Tainan, Taiwan . A total of 740 subjects aged 40-91 years participated in the survey between April and June 2005. The Norwood classification was used to assess the degree of hair loss. Information on components of metabolic syndrome together with other possible risk factors was collected. Results A statistically significant association was found between AGA and the presence of metabolic syndrome [odds ratio (OR) 1 center dot 67, 95% confidence interval (CI) 1 center dot 01- 2 center dot 74] as well as between AGA and the number of fulfilled metabolic syndrome components (OR 1 center dot 21, 95% CI 1 center dot 03-1 center dot 42) after controlling for age, family history of AGA and smoking status. Among metabolic syndrome components, high-density lipoprotein cholesterol (HDL- C) (OR 2 center dot 36, 95% CI 1 center dot 41-3 center dot 95; P = 0 center dot 001) was revealed as the most important factor associated with AGA. Conclusions Our population-based study found a significant association between AGA and metabolic syndrome; among the components of metabolic syndrome, HDL-C was found to be of particular importance. This finding may have significant implications for the identification of metabolic syndrome in patients with moderate or severe AGA. Early intervention for metabolic syndrome is critical to reduce the risk and complications of cardiovascular disease and type 2 diabetes mellitus later in life

Absolute Numbers of Lives Saved and Overdiagnosis in Breast Cancer Screening, from a Randomized Trial and from the Breast Screening Programme in England

Objectives To estimate the absolute numbers of breast cancer deaths prevented and the absolute numbers of tumours overdiagnosed in mammographic screening for breast cancer at ages 50-69 years. Setting The Swedish Two-County randomized trial of mammographic screening for breast cancer, and the UK Breast Screening Programme in England, ages 50-69 years . Methods We estimated the absolute numbers of deaths avoided and additional cases diagnosed in the study group (active study population) of the Swedish Two-County Trial, by comparison with the control group ( passive study population) . We estimated the same quantities for the mortality and incidence rates in England (1974-2004 and 1974-2003, respectively). We used Poisson regression for statistical inference. Results A substantial and significant reduction in breast cancer mortality was associated with screening in both the Two-County Trial (P<0.001) and the screening programme in England (P<0.001). The absolute benefits were estimated as 8.8 and 5.7 breast cancer deaths prevented per 1000 women screened for 20 years starting at age 50 from the Two-County Trial and screening programme in England, respectively. The corresponding estimated numbers of cases overdiagnosed per 1000 women screened for 20 years were, respectively, 4.3 and 2.3 per 1000. Conclusions The benefit of mammographic screening in terms of lives saved is greater in absolute terms than the harm in terms of overdiagnosis. Between 2 and 2.5 lives are saved for every overdiagnosed case

TRANSGENERATIONAL EFFECTS OF BETEL- QUID CHEWING ON THE DEVELOPMENT OF THE METABOLIC SYNDROME IN THE KEELUNG COMMUNITY-BASED INTEGRATED SCREENING PROGRAM

Background: The transgenerational metabolic effects of betel -quid chewing have been reported in mice but not in humans. Objective: This study aimed to determine whether exposure to paternal chewing of betel nut quids led to an increased risk of early manifestation of the metabolic syndrome (MetS) in human offspring. Design: The subjects were selected from 66 971 residents aged > 19 y who attended a community-based Integrated Screening Program in Taiwan and who were identified as parent-child trios (n = 5037). Using a population-based, parent-child study design, we compared the mean ages of offspring with MetS at entry between those who were exposed and those who were unexposed to paternal chewing of quids containing betel nut. Cox proportional hazards regression models were used to estimate adjusted hazard ratios and to assess dose-response relations for paternal betel-quid exposure. Results: The offspring who were exposed to paternal betel-quid chewing were younger than those who were not exposed, regardless of MetS status; they also had a 2.14-fold increase in the risk of early manifestation of MetS (adjusted hazard ratio = 2.14 ; 95% CI: 1.25, 3.66) after control for environmental and other risk factors, including personal betel chewing. Significant dose- response relations were found between the risk of early MetS and the quantity and duration of paternal exposure to betel quids. In the absence of MetS in either parent and of betel -quid consumption by the offspring, paternal exposure to betel quids increased the risk of early manifestation of MetS in offspring 2.53-fold (95% CI: 1.03, 2.64) compared with paternal nonexposure. Conclusion: Our findings suggest that exposure to paternal betel-quid chewing increases the risk of early manifestation of MetS in human offspring in a dose-dependent manner

THE RELATIVE CONTRIBUTIONS OF SCREEN -DETECTED IN SITU AND INVASIVE BREAST CARCINOMAS IN REDUCING MORTALITY FROM THE DISEASE

We aimed to quantify the benefits of detecting ductal carcinoma in situ (DCIS) and of downwards stage-shifting within invasive tumours in mammographic screening. Using data from the Swedish Two-County Trial of breast cancer screening, we examined the 20-year death rates from invasive tumours of stage II or worse, invasive tumours of stage I and DCIS. We then used these rates and their respective incidences in invited (active study population, ASP) and control (passive study population, PSP) arms of the trial, to estimate the numbers of deaths avoided by downward stage- shifting the larger stage II or worse tumours to stage I and the stage I cancers to DCIS. We also studied the association between the mortality reduction achieved and the proportion of DCIS cases detected in the randomised trials of breast cancer screening. In the Swedish Two County Trial, 141 breast cancer deaths were avoided in the ASP compared with the PSP at approximately 20 years of follow-up. Of these, 65% (91/141) were avoided as a result of stage- shifting from invasive stage II or worse to invasive stage I , and 5% (7/141) as a result of stage-shifting from invasive stage I to DCIS. If we assumed that 10% of stage II or worse tumours avoided were shifted not to stage I, but to DCIS, the estimated number of deaths prevented by shifting from invasive disease to in situ was 17, which is 12% of all deaths prevented. When the results of all the randomised trials of breast cancer screening were reviewed, there was no clear association between the percentage of DCIS cases diagnosed and the observed mortality reduction. We conclude that compared with downward stage-shifting of invasive tumours. detection of DCIS plays a small part in saving lives from breast cancer. Treatment decisions in DCIS , as in invasive carcinoma, should take full account of histopathological, clinical and radiological attributes of the tumour