Abnormal Components Research Articles

The Relationship Between Interpersonal Cognitive Distortions and Attribution Styles Among Divorce Applicant Couples and its Impact on Sexual Satisfaction.

BackgroundThe current study aimed to investigate the relationship between cognitive distortions and attribution styles among divorce applicant couples and its impact on sexual satisfaction.Materials and MethodsIt was a cross-sectional study and its statistical samples were 55 divorce applicant couples (110 individuals) referred to Urmia courts, Urmia, Iran, from 2012 to 2013. The required data were gathered by interpersonal cognitive distortions, Larson sexual satisfaction and attribution style questionnaire.ResultsThe findings of the research indicated the existence of a significant relationship between attribution styles for pleasant events and cognitive distortions. The results showed that an increasing amount of pleasant events reduces cognitive distortions among the divorce applicant couples (P < 0.05, r = 0.19). Attribution style has a significant relationship with sexual satisfaction among the divorced couples. As stable-unstable variables increase (P < 0.05, r = 0.22), pleasant events, (P < 0.05, r = 0.19), attribution styles (total) (P < 0.05, r = 0.19) and sexual satisfaction increases and vice versa. Also, there was no significant relationship between sexual satisfaction and cognitive distortions (P < 0.05, r = 0.04).ConclusionsNormal and abnormal cognitive components are among the main factors affecting satisfaction or dissatisfaction in couples who are living together (sexual satisfaction is one of its main elements).

A neurophysiological study of facial numbness in multiple sclerosis: Integration with clinical data and imaging findings

ObjectiveTo integrate neurophysiological findings with clinical and imaging data in a consecutive series of multiple sclerosis (MS) patients developing facial numbness during the course of an MS attack. MethodsNine consecutive patients with MS and recent-onset facial numbness were studied clinically, imaged with routine MRI, and assessed neurophysiologically with trigeminal somatosensory evoked potential (TSEP), blink reflex (BR), masseter reflex (MR), facial nerve conduction, facial muscle and masseter EMG studies. ResultsAll patients had unilateral facial hypoesthesia on examination and lesions in the ipsilateral pontine tegmentum on MRI. All patients had abnormal TSEPs upon stimulation of the affected side, excepting one that was tested following remission of numbness. BR was the second most sensitive neurophysiological method with 6/9 examinations exhibiting an abnormal R1 component. The MR was abnormal in 3/6 patients, always on the affected side. Facial conduction and EMG studies were normal in all patients but one. ConclusionsFacial numbness was always related to abnormal TSEPs. A concomitant R1 abnormality on BR allowed localization of the responsible pontine lesion, which closely corresponded with MRI findings. We conclude that neurophysiological assessment of MS patients with facial numbness is a sensitive tool, which complements MRI, and can improve lesion localization.

The differences of metabolic syndrome in elderly subgroups: A special focus on young-old, old-old and oldest old

BackgroundMetabolic syndrome (MetS) is known to be correlated to future diabetes and cardiovascular disease. Due to the aging society, the increasing prevalence of MetS in the elderly is an important health issue. However, there were few studies focusing in this field. We investigated the changes of MetS components in the subgroups of the elderly. MethodsSubjects aged above 65 years old who underwent routine health checkups in Taiwan (N=18916) were divided into three groups (young-old: ≧65 and <75, old-old: ≧75 and <85 and oldest-old ≧85). By using multiple logistic regressions, the odds ratio (OR) of subjects with abnormal MetS components to have MetS were evaluated. ResultsFor men, the systolic blood pressure (SBP) and high-density lipoprotein cholesterol increased as the age got older. On the contrary, the diastolic blood pressure and triglycerides (TG) decreased. In women, the waist circumference and SBP increased significantly from the young-old to the oldest-old groups. The highest percentage having MetS was 35% in old-old men and 62% in oldest-old women. Finally, subjects with high TG had the highest and BP had the lowest ORs for having MetS in both genders except oldest-old women. ConclusionsIn the elderly, the MetS and its components have different patterns not only in young-, old- and oldest-old groups but also in men and women. Moreover, among the five components, hypertension was always the most prevalent one. Finally, subjects had high TG had the highest ORs to have MetS compared to other components.

Association of physical activity with risk of metabolic syndrome: findings from a cross-sectional study conducted in rural area, Nantong, China

ABSTRACTThe prevalence of metabolic syndrome increases rapidly worldwide, and its association with physical activity (PA) varies with race and lifestyles. Little is known about the association in rural China. The Nantong Metabolic Syndrome Study recruited 13,505 female and 6997 male participants in 2007 and 2008. Socio-demographic characteristics, and physiological and behavioural data were collected. Logistic regression model was applied to estimate associations of metabolic syndrome and its components with different PAs. The overall metabolic syndrome prevalence was 21.6% in current study. Increasing total PA or moderate-to-vigorous-intensity occupational PA was associated with decreasing 5%–60% risk of having metabolic syndrome and abnormal metabolic syndrome components in both genders. An association between leisure-time PA and blood pressure was found in men, but no associations between leisure-time PA and metabolic syndrome components were found in women. Commuting PA, such as walking and taking bus, by bicycle and walking only, was associated with decrease of 20%–45% risk of several abnormal metabolic syndrome components in women. This study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce the prevalence of metabolic syndrome and its components among rural population in China.

The impact of symptomatic mild traumatic brain injury on complex everyday activities and the link with alterations in cerebral functioning: Exploratory case studies

ABSTRACTThe objective of the study was to explore the neurophysiological correlates of altered functional independence using functional magnetic resonance imaging (fMRI) and event-related potentials (ERP) after a mild traumatic brain injury (mTBI). The participants consisted of three individuals with symptomatic mTBI (3.9 ± 3.6 months post-mTBI) and 12 healthy controls. The main measures used were the Instrumental Activities of Daily Living (IADL) Profile observation-based assessment; a visual externally ordered working memory task combined to event-related potentials (ERP) and fMRI recordings; neuropsychological tests; post-concussion symptoms questionnaires; and the Activities of Daily Living (ADL) Profile interview. Compared to normal controls, all three patients had difficulty with a real-world complex budgeting activity due to deficits in planning, ineffective strategy use and/or a prolonged time to detect and correct errors. Reduced activations in the right mid-dorsolateral prefrontal cortex on fMRI as well as abnormal frontal or parietal components of the ERP occurred alongside these deficits. Results of this exploratory study suggest that reduced independence in complex everyday activities in symptomatic mTBI may be at least partly explained by a decrease in brain activation in the prefrontal cortex, abnormal ERP, or slower reaction times on working memory tasks. The study presents an initial attempt at combining research in neuroscience with ecological real-world evaluation research to further our understanding of the difficulties in complex everyday activities experienced by individuals with mTBI.

Single and mixed dyslipidaemia in Canadian primary care settings: findings from the Canadian primary care sentinel surveillance network database

ObjectivesDyslipidaemia is a major risk factor to cardiovascular disease (CVD)—the leading cause of death worldwide. Limited data are available about the prevalence of various dyslipidaemia in Canada. The objective of...

Auditory evoked potentials in patients with major depressive disorder measured by Emotiv system.

In a previous study (unpublished), Emotiv headset was validated for capturing event-related potentials (ERPs) from normal subjects. In the present follow-up study, the signal quality of Emotiv headset was tested by the accuracy rate of discriminating Major Depressive Disorder (MDD) patients from the normal subjects. ERPs of 22 MDD patients and 15 normal subjects were induced by an auditory oddball task and the amplitude of N1, N2 and P3 of ERP components were specifically analyzed. The features of ERPs were statistically investigated. It is found that Emotiv headset is capable of discriminating the abnormal N1, N2 and P3 components in MDD patients. Relief-F algorithm was applied to all features for feature selection. The selected features were then input to a linear discriminant analysis (LDA) classifier with leave-one-out cross-validation to characterize the ERP features of MDD. 127 possible combinations out of the selected 7 ERP features were classified using LDA. The best classification accuracy was achieved to be 89.66%. These results suggest that MDD patients are identifiable from normal subjects by ERPs measured by Emotiv headset.

Acute pulmonary embolism caused by highly aggregated intravenous immunoglobulin.

Six patients died and one patient survived following infusion of a specific lot of intravenous immunoglobulin (IVIG) within half an hour in May 2008. This study elucidated the underlying pathogenesis. A variety of protein fractionation and identification approaches were employed to determine the abnormal components in IVIG products obtained from the hospital where the patients were treated. Animal studies using mice and monkeys were conducted to elucidate the pathophysiological mechanisms. In animal experiments, the effect and distribution of immunoglobulin was investigated using HE staining and immunohistochemistry (IHC) separately, while platelets and fibrinogen depletion were utilized to determine a possible link between thromboembolism formation in animals and the lethal effect of the IVIG. The size and distribution of the protein aggregates were determined with Coulter Counter Multisizer-3 after the dilution of the IVIG with plasma, and the lethal effect of the protein aggregates was simulated with artificial microparticles. The IVIG retrieved from the hospital was found to have striking similarities to the heat-treated IVIG in terms of protein aggregation profiles and lethal effects. Post-mortem examination indicated that immunoglobulin aggregates were mainly found in the lung of the animals, while depletion of platelets and fibrinogen from the IVIG preparations failed to prevent the death of the animals. Similar amount of artificial microparticles caused animal death in similar fashion. Our findings indicate that the retrieved IVIG exerted its lethal effects by blocking the pulmonary circulation without markedly altering the coagulation cascade or immunological events.

Abnormal Electromagnetic Noise of Motors depending on Fixing Methods of Permanent Magnets

Abnormal electromagnetic noise of traction motor in hybrid electric vehicle (HEV) occurred after the endurance test is experimentally investigated. Theoretical model explains that the abnormal components, which are ±1 orders of the number of slots, can be sourced from an unbalanced rotor. Experimental approach confirms that the abnormal noise is mainly from the rotor. Since there are no variations in the strength of the magnet flux, the vibration of the magnets is strongly believed as the main reason of the abnormal noise. Finally, the magnetic fixing method is changed from bond to mold, and the improvement of the noise is demonstrated.

고장전류의 누적 에너지를 이용한 저압직류 배전계통의 고저항 지락고장 검출 알고리즘 개발

Recently, new Low Voltage DC (LVDC) power distribution systems have been constantly researched as uses of DC in end-user equipment are increased. As in conventional AC distribution system, High Impedance Fault (HIF) which may cause a failure of protective relay can occur in LVDC distribution system as well. It, however, is hard to be detected since change in magnitude of current due to the fault is too small to detect the fault by the protective relay using overcurrent element. In order to solve the problem, this paper presents an algorithm for detecting HIF using accumulated energy in LVDC distribution system. Wavelet Singular Value Decomposition (WSVD) is used to extract abnormal high frequency components from fault current and accumulated energy of high frequency components is considered as the element to detect the fault. LVDC distribution system including AC/DC and DC/DC converter is modeled to verify the proposed algorithm using ElectroMagnetic Transient Program (EMTP) software. Simulation results considering various conditions show that the proposed algorithm can be utilized to effectively detect HIF.

Partial Protection from Metabolic Syndrome in Chronic Hepatitis C Elderly Subjects Due to Lower Triglyceride Level.

In Taiwan, persons over 65 years old have higher prevalence of hepatitis C. Among these patients, around 50% have non-alcoholic fatty liver disease (NAFLD). Since cardiovascular diseases and diabetes are main causes of death in this age group, in this cross-sectional study, we tried to evaluate the effects of NAFLD and hepatitis C on the risk of metabolic syndrome (MetS). In total, 25 116 subjects over 65 years old who presented for routine health check-ups were enrolled. From the results of seropositivity for hepatitis C and abnormal echogenicity, they were classified into four groups: normal (N), subjects with only hepatitis C (C), subjects with only abnormal echogenicity (E) and subjects with both hepatitis C and abnormal echogenicity (CE). Subjects in both groups E and CE had higher abnormal MetS components than group C. Among all five components, triglyceride (TG) was the one having the highest odds ratio (OR) in determining the incidence of MetS in groups C and E. Finally, compared to group N, both groups E and CE had significantly higher OR for having MetS. However, after adjusting for confounding factors, only the significance between groups E and N remained. In other words, higher MetS was noted in group E compared to group N and there was no difference in incidence of MetS between group CE and group N. Chronic hepatitis C is a protective factor against having MetS and this effect might be due to lower TG level in the elderly. Further studies are warranted for the underlying mechanisms.

Socioeconomic Determinants of Health: An Adult Population Based Study in Shiraz, Southern Iran

Background: Noncommunicable diseases (NCDs) are now the most important causes of mortality and morbidity in Iran. Objectives: Therefore, knowing about NCDs status and its socioeconomic determinants are the cornerstone for the interventions that policymakers and health providers apply to improve the health of community. This research includes a full exploration of the relevant data. Patients and Methods: This was a population-based cluster randomized sampling carried out in Shiraz, Iran. In this regard, demographic, socioeconomic status, and medical history of adult participants (at least 18 year old) were collected. In the next step, physical examination and anthropometric data were taken. Finally, fasting blood glucose (FBS), lipid profile, and complete blood count (CBC) measurement were done. Results: Overall, 777 participants, mean age of 42.6 ± 13.8 (ranging from 18 to 88) year, were included in this study while female (451; 58%), middle-aged (203; 26.1%), married (653; 84%), and those with up to 12 years of education (470; 60.5%) were the majorities. Among the participants, 453 (58.3%) were among overweight to severely obese groups, 441 (56.7%) did not have physical activity, 148 (19.3%) were smokers, 280 (36%) had hypercholesterolemia, 239 (30.8%) had hypertriglyceridemia, 54 (6.9%) had high LDL, 93 (11.9%) had low HDL, and 49 (6.3%) were anemic. Women had significantly lower height (P < 0.001), weight (P < 0.001), and waist circumference (P < 0.001), but higher BMI (P < 0.001) compared to those parameters in men. Of total participants, 240 (30.9%) had prehypertension, 62 (8.0%) had stage I hypertension, and 16 (2.1%) had stage II hypertension. Overall, 76 (9.8%) subjects had hypertension, while most of them (57; 75%) were aware of their disease and consumed antihypertensive drugs. Of 777 participants, 148 (19.1%) had impaired glucose tolerance test and 51 (6.5%) were diabetic. However, 46 (5.9%) were aware of their disease and only 35 (4.5%) consumed glucose lowering agents to control plasma glucose. Those with fewer years of education had significantly higher prevalence of obesity (P = 0.001), hypertension (P < 0.001), and DM (P = 0.02). Conclusions: At least 1 out of 2 adult people in Shiraz does not have physical activity and has high BMI, while 1 out of 3 has at least one abnormal components in their lipid profile. Prediabetes, hypertensive, and diabetic groups comprised a significant portion of population. Among different groups, women and less educated people belonged to the high risk groups. Therefore a multidisciplinary approach is needed to control this event, especially in high risk population.

Application of Vibration Signal Analysis Method Based on Wavelet and LMD

This paper proposes a vibration fault diagnosis method based on wavelet preprocessing and Local Mean Decomposition (LMD). In order to obtain time-frequency energy information accurately, flrstly, the original signal is transformed by wavelet. From the viewpoint of energy, using adaptive threshold for denoising, while most of the signal energy is reserved, the in∞uence of most noise is eliminated at the same time. Then, LMD is used to get the signal component which has deflnite physical sense and contains fault information. To identify the abnormal frequency components, the signal component is analyzed in time-frequency domain. Finally, the running state of hydro turbine can be diagnosed by analyzing the time-frequency information of each component signals. This method is applied in the No.1 hydro turbine of a power plant, the analysis shows that this method is efiective, and the running state of the turbine can be correct evaluated.

Molecular Details of the Mechanism of PS Recognition by TIM Proteins

Accumulating evidence suggests that an immune response can be triggered by the presence of abnormal lipid components, such as phosphatidylserine (PS), in the outer leaflet of the cellular membrane. The T-cell immunoglobulin and mucin domain (TIM) family of proteins recognize PS exposed on the surface of the membrane. TIM proteins are expressed by numerous cell types, and despite their close structural similarity, they are involved in triggering different immune responses. These specific roles have been attributed to different factors, including differential binding modes of TIM proteins to anionic membranes and their variable sensitivity to lipid composition of the membrane.In order to study the mechanism of membrane binding by TIM proteins, we have performed MD simulations of TIM1 and TIM3 employing our enhanced-dynamics HMMM membrane model. For each protein, we have performed a total of 30 independent simulations with different lipid compositions (1:1 PC:PS and 7:3 PC:PS), providing robust statistics to characterize the membrane-bound form of these proteins. The results suggest that, despite the overall structural similarity, TIM1 and TIM3 establish different interactions with the membrane upon binding. Moreover, simulations show that in addition to the PS-binding pocket found in TIM proteins, other specific protein-membrane ionic interactions can be formed in each case, suggesting a molecular basis for their different biological roles.In addition to MD simulations, the orientation of TIM1 and TIM3 in model PS-containing membranes has been characterized using X-ray scattering. The agreement between the X-ray experiments and the MD simulations provide a detailed description of the membrane-binding mechanism of TIM proteins.

Prevalence of Metabolic Syndrome and Its Risk Factors among Urban Sikh Population of Amritsar

ABSTRACT Metabolic syndrome (MS) refers to a cluster of various interrelated cardiometabolic risk factors that promote the development of atherosclerotic cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). South Asians also seem to have a peculiar body phenotype known as South Asian Phenotype, characterized by increased waist circumference, increased waist hip ratio, excessive body fat mass, increased plasma insulin levels and insulin resistance, as well as an atherogenic dyslipidemia, with low levels of HDL cholesterol and increased triglyceride levels. Epidemiologists in India and international agencies such as the world health organization (WHO) have been sounding an alarm on the rapidly rising burden of CVD for the past 15 years. Thus, the primary aim of this study was to identify the prevalence of ms in the Urban Sikh Population of Amritsar by means of a door-to-door survey. A secondary aim was to identify the risk factors for the development of ms. The sample size of 1089 subjects was calculated. This study focused on Urban Sikhs living in Amritsar, Punjab. The overall prevalence of ms in Urban Sikh population of Amritsar was 34.3% with a higher prevalence among women (41.4%) compared with men (28.2%). We also found that the prevalence of ms increases with age in both sexes. We infer that out of 1089 subjects there were only 84 subjects who reported with not a single abnormal component of the ms. The rest 1005 subjects had either one or more component abnormal in them. How to cite this article Singh A, Shenoy S, Sandhu JS. Prevalence of Metabolic Syndrome and its Risk Factors among Urban Sikh Population of Amritsar. J Postgrad Med Edu Res 2015;49(1):18-25.

Periodic Monitoring of Components of the Metabolic Syndrome in Adolescent Survivors of Childhood Cancer

Purpose: The components of metabolic syndrome (MS) have been tended to increase and associated with cardiovascular risks in long-term survivors of childhood cancer. We investigated the prevalence of components of MS in adolescent survivors of childhood cancer and tried to monitor them periodically.Materials and methods: We investigated 44 adolescent survivors of childhood cancer, median age 14.9 years (range 10–19.8 years) and median follow-up time elapsed after off-therapy 7.4 years (range 5–16.5 years). We measured body mass index (BMI), systolic and diastolic blood pressure, triglycerides (TG), high-density lipoprotein (HDL)–cholesterol, and fasting glucose. Fatty liver was evaluated by ultrasound examinations during follow-up period.Results: No survivors demonstrated MS with 3 components, however, 18% of survivors (8/44) have 2 abnormal components and 43% (19/44) have 1 abnormal components, respectively. The frequency of each component was: increased BMI, 11%; elevated blood pressure, 0%; elevated TG level, 41%, low HDL cholesterol, 27%; and elevated fasting glucose, 0%. Among these components, the increased TG levels were highly prevalent in survivors than in general population (p=0.000). Fatty liver was identified in 8 survivors (18.2%). Sixteen of 44 survivors (36.4%) received at least 3 repeated examinations annually. Twelve out of 16 survivors have 1 or 2 abnormal components at initial examination. Their number of metabolic components have been shown to decrease in 4, persisted in 3, and increased in 5 survivors. Three of 4 survivors who have no components of MS at initial examination showed at least 1 abnormal component during follow-up.Conclusions: We observed the high incidence of increased TG level in adolescent survivors of childhood cancer, and detected abnormal components of MS during periodic follow-up. Lifestyle interventions and periodic long-term follow-up monitoring would be needed to reduce the metabolic risks in childhood cancer survivors. DisclosuresNo relevant conflicts of interest to declare.

Abstract 17191: Fragmentation Assessed by Magnetocardiography but not Electrocardiogram Can Predict Future Cardiac Events in Patients with Non-ischemic Dilated Cardiomyopathy and Narrow QRS

Background: Fragmented QRS (fQRS) in 12-lead ECG, ascribed to myocardial scar, has been shown to predict future cardiac events in patients with both ischemic and non-ischemic dilated cardiomyopathy (NIDCM). Various definitions and low specificity of fQRS, however, limited its use. We hypothesized that the advantage of 64-channel magnetocardiography (MCG), i.e., high spatio-temporal resolution, enables more accurate detection of fragmented LV conduction (fLV), that would lead to accurate prediction of future events. Methods: In 51 patients with NIDCM and narrow QRS (LVEF, 22±7%; QRS duration, 99±11 ms), we recorded MCG. We defined, in MCG superimposed vector magnitude waveforms, fLV as distinct abnormal components (&gt;20% of maximal amplitude). In current arrow map, fLV corresponded to heterogeneous QRS currents (Figure). We predicted major adverse cardiac events (MACE), including sudden cardiac death (SCD), sustained ventricular tachyarrhythmias (VF/VT), appropriate defibrillator discharge (Def) and left ventricular assist device implantation (LVAD). Results: fLV was present in 27 (Group-F) and not in 24 (Group-N). Age, gender, ECG and echocardiographic findings, laboratory data and medications were similar irrespective of fLV. During a mean follow-up of 2.2 years, MACE occurred in 19 (4 SCD, 9 VF/VT, 2 Def, and 4 LVAD). MACE more frequently occurred with fLV (63%, 17/27) than without (8%, 2/24, Kaplan-Meier analysis, p&lt;0.001). Multivariate analysis revealed fLV as the only independent predictor of MACE (HR 4.82, p=0.015). Conclusion: MCG analysis is a promising noninvasive tool to accurately detect fragmentation and predict MACE in patients with NIDCM and normal QRS.

Serum lipid profiles and aggressive prostate cancer.

The introduction of widespread prostate specific antigen (PSA) screening in western countries led to a sharp increase in prostate biopsies and the subsequent diagnosis of prostate cancer. This phenomenon appears to be repeating itself in countries such as China where economic development in recent decades has resulted in increased access to healthcare and more frequent screening tests. It is now recognized that the majority of prostate cancers diagnosed in PSA-screened men is of the indolent nature that does not impact patients’ quality of life or life expectancy. Unfortunately, due to our inability to image prostate cancer accurately, biopsies have been performed largely in a blind, un-targeted fashion. Some cancers, particularly those located in the anterior prostate, can be missed with this biopsy technique. On the other hand, if biopsies contain low-grade cancer (e.g. combined Gleason score 6) of limited quantity, it can cause serious difficulties in clinical management. Many such patients have indolent cancers that do not require radical treatments such as prostatectomy or radiation that carry potentially serious side effects. However, a small fraction of these patients actually harbor aggressive cancers that were not adequately sampled by the biopsy. Such uncertainties have resulted in over-treatment as well as under-treatment of patients. Currently, prediction of the aggressiveness of prostate cancer relies mostly on certain clinical (e.g. preoperative PSA) and pathologic (e.g. Gleason grade and tumor quantities on biopsy) parameters, which is obviously inadequate for certain patients. It is, therefore, important to develop new modalities, particularly noninvasive biomarkers, for better patient management. A study by Zhang et al.1 represents a step forward in this direction. The authors analyzed serum lipid profiles in 322 consecutive patients who received prostatectomy and extended pelvic lymphadenectomy at their institution. Their analysis reveals that total cholesterol, triglyceride, and low-density lipoprotein levels are significant predictors of the pathologic parameters of the tumor after prostatectomy. Specifically, high levels of total cholesterol were associated with increased risk of lymph node metastasis; elevated levels of triglyceride were associated with a more than twofold increased risk of pT3–4 disease, and high levels of low-density lipoprotein were an independent predictor of high Gleason grade (≥8). Importantly, with the increase of the number of abnormal lipid components, a higher probability of pT3–4 disease and lymph node metastasis was observed. This study thus demonstrates the potential value of serum lipid profile in predicting the aggressiveness of prostate cancer once it is diagnosed by biopsy. Addition of the lipid profile to existing clinical and pathological parameters may increase our ability to determine more accurately which patients may harbor aggressive disease and thus require early intervention. Before this is widely adopted, a few important points need to be raised: (1) this is a retrospective study. A well-controlled prospective study is required to validate the results; (2) this is a single institutional study by a large, well-known tertiary referral center so the potential for bias exists. A larger study involving multiple institutions in different geographic regions with diverse patient populations will provide stronger evidence of the utility of serum lipid profiles in patient management. In addition to serving as potential novel preoperative biomarkers, the study also provides support to the significance of lipid metabolism in the etiology and biology of prostate cancer. Obesity, physical inactivity, high-fat diet, and dyslipidemia have been considered risk factors for prostate cancer. Prostate cancer cells tend to up-regulate de novo lipid synthesis which may contribute to the uncontrolled proliferation of cancer cells. If we consider low-grade, indolent prostate cancer as a normal aging process that occurs in a significant portion of aged men, there may exist different biologic pathways that lead to the development of aggressive prostate cancer, a truly life-threatening disease. Future studies will further pinpoint the exact role of lipids in this disease process. Although serum-based biomarkers remain a useful research direction, validation of any novel biomarkers and their widespread adoption will take a significant amount of time, effort and resources. On the other hand, improving the radiologic detection of prostate cancer and targeted biopsy of prostate cancer will likely yield more immediate benefits. There has been significant advancement in the detection of prostate cancer, particularly those of high grade and/or high volume, by multiparametric magnetic resonance imaging (MRI). Although MRI-guided biopsy remains an option, targeted biopsy of the prostate using MRI-ultrasound fusion technology appears more practical.2 With continuous improvement in the technology, we may eventually be able to detect clinically relevant diseases while ignoring indolent ones, resulting in more optimal management strategy for men diagnosed with prostate cancer. COMPETING INTERESTS The authors declare that they have no competing interests.

Higher serum carotenoid concentrations associated with a lower prevalence of the metabolic syndrome in middle-aged and elderly Chinese adults

The association between serum carotenoids and the metabolic syndrome (MetS) remains uncertain, and little is known about this relationship in the Chinese population. The present study examined the association between serum carotenoid concentrations and the MetS in Chinese adults. We conducted a community-based cross-sectional study in which 2148 subjects (1547 women and 601 men) aged 50-75 years were recruited in urban Guangzhou, China. Dietary data and other covariates were collected during face-to-face interviews. Blood pressure, waist circumference, blood lipids, glucose and serum carotenoids (α-, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin) were examined. We found dose-response inverse relationships between individual serum carotenoid concentrations and total carotenoids and the prevalence of the MetS after adjusting for potential confounders (P for trend < 0.001). The OR of the MetS for the highest (v. lowest) quartile were 0.31 (95% CI 0.20, 0.47) for α-carotene, 0.23 (95% CI 0.15, 0.36) for β-carotene, 0.44 (95% CI 0.29, 0.67) for β-cryptoxanthin, 0.39 (95% CI 0.26, 0.58) for lycopene, 0.28 (95% CI 0.18, 0.44) for lutein+zeaxanthin and 0.19 (95% CI 0.12, 0.30) for total carotenoids. Higher concentrations of each individual carotenoid and total carotenoids were significantly associated with a decrease in the number of abnormal MetS components (P for trend < 0.001-0.023). Higher serum carotenoid levels were associated with a lower prevalence of the MetS and fewer abnormal MetS components in middle-aged and elderly Chinese adults.

Genetic and environmental relationships of metabolic and weight phenotypes to metabolic syndrome and diabetes: the healthy twin study.

We aimed to examine the relationships, including genetic and environmental correlations, between metabolic and weight phenotypes and factors related to diabetes and metabolic syndrome. Participants of the Healthy Twin Study without diabetes (n=2687; 895 monozygotic and 204 dizygotic twins, and 1588 nontwin family members; mean age, 42.5±13.1 years) were stratified according to body mass index (BMI) (<25 vs. ≥25 kg/m(2)) and metabolic syndrome categories at baseline. The metabolic traits, namely diabetes and metabolic syndrome, metabolic syndrome components, glycated hemoglobin (HbA1c) level, and homeostasis model assessment of insulin resistance (HOMA-IR), were assessed after 2.5±2.1 years. In a multivariate-adjusted model, those who had metabolic syndrome or overweight phenotypes at baseline were more likely to have higher HbA1C and HOMA-IR levels and abnormal metabolic syndrome components at follow-up as compared to the metabolically healthy normal weight subgroup. The incidence of diabetes was 4.4-fold higher in the metabolically unhealthy but normal weight individuals and 3.3-fold higher in the metabolically unhealthy and overweight individuals as compared with the metabolically healthy normal weight individuals. The heritability of the metabolic syndrome/weight phenotypes was 0.40±0.03. Significant genetic and environmental correlations were observed between the metabolic syndrome/weight phenotypes at baseline and the metabolic traits at follow-up, except for incident diabetes, which only had a significant common genetic sharing with the baseline phenotypes. The genetic and environmental relationships between the metabolic and weight phenotypes at baseline and the metabolic traits at follow-up suggest pleiotropic genetic mechanisms and the crucial role of lifestyle and behavioral factors.