Adult Population In Taiwan Research Articles

The association between smoking cessation and lifestyle/genetic variant rs6265 among the adult population in Taiwan

Recent studies showed significant associations between socio-demographic, lifestyle factors, polymorphic variant rs6265, and smoking cessation behaviours. We examined rs6265 TT, TC and CC genotypes and their association with socio-demographic and other variables, including mental health status, drinking, exercise, and smoking behaviour among Taiwanese adults. Data on rs6265 were retrieved from the Taiwan Biobank, which contained genetic data collected between 2008 to 2019 from 20,584 participants (aged 30–70 years). Participants who smoked for more than 6 months prior to enrolment were categorized as smokers. If they had smoked and later quit for more than 6 months, they were classified as former smokers. Information regarding drinking, exercise, depression, and bipolar disorder were obtained through questionnaires and were categorized as either as affirmative (yes) or negative (no) responses. In contrast to previous studies, we found that the association between the polymorphism rs6265 and smoking behaviour was not significant (P-value = 0.8753). Males with lower education levels, young persons, and alcohol drinkers showed significant smoking behaviours (P-value < .0001). This population-based study indicates that rs6265 has no significant correlations with smoking cessation behaviour among adults in Taiwan.

Differences in the healthcare needs of older adults attending primary health centers in urban and rural areas of Taiwan

PurposeAs the older adult population in Taiwan continues to increase, primary health centers (PHCs) play a crucial role in geriatric care. This study explored the differences in the PHC experiences and usage needs of older adults in urban versus rural areas.MethodsA qualitative study was conducted. Twenty-one older adults were recruited from PHCs in northern, central, southern, and eastern Taiwan. Semistructured interviews were used to collect data, and the interview guidelines included their reasons for visiting PHCs, the health-care services they received, their evaluation of the services, and the advantages and disadvantages of these centers. The data were analyzed using thematic content analysis.ResultsThe PHC usage needs of older adults in urban areas differ from those of older adults in rural areas in the following 3 aspects: (1) Medical services: older adults in rural areas demand clinics specializing in various medical domains, mobile and home medical care, and case management, whereas those in urban areas demand mobile health examinations. (2) Environment and transportation: older adults in rural areas demand diverse medical equipment, shuttle services, and accessible facilities, whereas those in urban areas demand recreational facilities. (3) Active aging: older adults in rural areas demand health education courses, and those in urban areas demand diverse senior citizen courses as well as opportunities to volunteer and build interpersonal relationships.ConclusionThe older adults in urban and rural areas had different PHC usage needs. The older adults in rural areas generally focused on medical care and transportation services in PHCs, whereas those in urban areas generally focused on health promotion as a means of social participation and active aging.

Exposure assessment of the relationship between urinary paraben and early renal injury in a middle-aged adult population in Taiwan

Exposure assessment of the relationship between urinary paraben and early renal injury in a middle-aged adult population in Taiwan

#5395 ASSOCIATION BETWEEN PARABEN EXPOSURE AND EARLY RENAL INJURY IN A MIDDLE-AGED ADULT IN TAIWAN

Abstract Background and Aims Parabens are a class of preservatives used in the cosmetics industry and are widely used in people's daily lives, including personal care products (PCPs), pharmaceuticals and food. Epidemiological studies concerning the relations of exposure to parabens with renal function were limited. We aimed to investigate the potential sources of paraben exposure, estimate the daily intake (DI) of four parabens based on their urinary levels and the association between urinary paraben and renal function in a middle-aged adult population in Taiwan. Method We recruited 591 subjects aged from ≥40 to &amp;lt;65 years old (yrs) who have participated in Taiwan Environmental Survey for Toxicants (TEST) study from 2013-2016. Urinary parabens including methylparaben (MeP), ethylparaben (EtP), propylparaben (PrP), and butylparaben (BuP) are measured by liquid chromatography/ tandem mass spectrometry. The cross-sectional analysis of the association between urinary paraben and biomarkers of renal function have also been established. Results The urinary MeP, EtP, PrP and BuP (median) levels were measured at 442, 42.9, 107 and 5.92 μg/L, respectively, which were also 10 times higher than those in other countries. Subjects aged from ≥55 to &amp;lt;65 yrs had higher urinary MeP and EtP levels and DI than those aged from ≥40 to &amp;lt;55 yrs (Fig. 1 &amp; Fig. 2). The median of DI was higher in lotion, perfume and nail polish users than those seldom used (Fig. 3). However, there was no significant difference between DI and PCPs usage, or the cumulative usage of PCPs by gender. The median of creatinine, microalbumin, urinary protein and uric acid were significantly higher in men than in women, the albumin to creatinine ratio was significantly higher in women (3.73 mg/g) than in men (3.05 mg/g). Conclusion The urinary paraben concentration of middle-aged adults in Taiwan was significantly higher than those in US, Canada, and Korea. There was no significant difference among paraben levels, age and gender. PCPs usage was a source of paraben exposure.

Association between sedentary time and plasma leptin levels in middle-aged and older adult population in Taiwan: A community-based, cross-sectional study.

Association of sedentary behavior and plasma leptin levels is a popular topic in recent research. Aged populations often suffer from cardiometabolic diseases, and leptin is considered a novel marker for many cardiometabolic diseases. To further explore this topic, our research investigates the relationship between sedentary time and serum leptin levels in middle-aged and older populations. A total of 396 middle-aged and older adult Taiwanese participants were included in this study. We recorded their self-reported sitting time as sedentary time. Participants were categorized into low leptin, medium leptin group, and high leptin groups according to the tertile of serum leptin level in the study. We also analyzed the anthropometric and cardiometabolic parameters between the three groups. Spearman's correlation coefficient was used to analyze the correlation between leptin level, sedentary time, and other cardiometabolic risk factors. The relationsip between leptin and sedentary time was also shown in a scatter plot. Multivariate linear regression was performed to determine the association between serum leptin levels and sedentary time after adjusting for age, sex, alcohol consumption, smoking, triglycerides, body mass index (BMI), fasting plasma glucose, systolic blood pressure, uric acid, creatinine, and alanine transaminase (ALT). In our study, data from a total of 396 participants were analyzed. The average age of participants was 64.75 (±8.75) years, and ~41.4% were male. A longer period of sedentary time was observed in the high leptin group. A positive correlation was found between serum leptin level and sedentary time in Spearman's correlation, in all BMI groups. Serum leptin levels were positively associated with sedentary time (B = 0.603, p = 0.016) in the multivariate linear regression after adjusting for age, sex, alcohol consumption, smoking, triglycerides, BMI, fasting plasma glucose, systolic blood pressure, uric acid, creatinine, and ALT. Prolonged sedentary time can be an independent risk factor for high serum leptin levels, and high leptin levels can be a novel marker in future healthcare to screen the individual with prolonged sedentary time. Furthermore, based on our study, future research can further explore the relationship between leptin levels and health promotion, especially decreasing sedentary time in the middle-aged and elder population, which is vulnerable to cardiometabolic diseases.

Iatrogenic Vocal Fold Paralysis: A Population-Based Cohort Study in Taiwan.

Iatrogenic vocal fold paralysis is an important issue in laryngology, yet there are few population-based studies regarding the epidemiology. This study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of iatrogenic unilateral and bilateral vocal fold paralysis (UVFP/BVFP) among the general adult population in Taiwan. This study analyzed patients (20-90 years old) who underwent thyroid, parathyroid, thoracic, cardiac, or anterior cervical spine operations with vocal fold paralysis among adults in Taiwan from January 1, 2007 to December 31, 2013. The codes for vocal fold paralysis were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Claims data in the Taiwan National Health Insurance Research Database were used. The most commonly performed operations which were related to vocal fold paralysis in Taiwan were, in descending order of frequency, thyroid, cervical spine, cardiac, thoracic (esophagectomy), and parathyroid operations. The operations that put laryngeal nerves at risk (ONRs) most commonly associated with a diagnosis of UVFP were, in descending order of frequency, thoracic, thyroid, parathyroid, cardiac, and cervical spine. For both UVFP and BVFP, the most commonly associated age group was 51 to 60. For both UVFP and BVFP, the more commonly associated sex was women. Increased length of stay was associated with a higher incidence of UVFP and BVFP. Charlson medical co-morbidity index (CCI) was not associated with UVFP but BVFP was associated with higher Charlson medical co-morbidity scores. Thyroid operations, age 51 to 60, longer hospital stays are associated with vocal fold paralysis. Overall women are more surgically affected than men. This is the first population-based study of iatrogenic vocal fold paralysis.

Severe OSA associated with higher risk of mortality in stage III and IV lung cancer.

OSA has been associated with increased cancer incidence and mortality. The aim of this study was to investigate cancer-related mortality, overall survival, and progression-free survival in patients with suspected OSA and lung cancer. This was a case series analysis of lung cancer from a sleep cohort with suspected OSA between 2009 and 2014. The AHI, hypoxia index, and survival outcome were recorded. Immunohistochemistry was used to analyze hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor expression in tumor pathology. In the sleep cohort comprising 8,261 patients, a total of 23 patients had lung cancer. The incidence of lung cancer was significantly higher in the sleep cohort than in the entire adult population in Taiwan (crude incidence rate: 242.1 vs 51.5 per 10⁵ persons, P < .01). The 3-year cancer-related mortality was 25% in AHI < 15 events/h, 50% in AHI 15-29 events/h, and 80% in AHI ≥ 30 events/h (χ² test for trend, P = .03). In Kaplan-Meier survival analysis, patients with stage III-IV lung cancer and AHI < 30 events/h exhibited significantly better overall survival (P = .02) and progression-free survival (P = .02) than patients with severe OSA. Overexpression of HIF-1α and vascular endothelial growth factor was shown in 63% and 45% of lung tumor samples. Overexpression of HIF-1α was positively associated with AHI (P = .04). In this preliminary case series, severe OSA is associated with an increased risk of cancer mortality in patients with stage III-IV lung cancer. AHI was significantly associated with HIF-1α overexpression.

Association Between Oral Corticosteroid Bursts and Severe Adverse Events : A Nationwide Population-Based Cohort Study.

Long-term use of oral corticosteroids has known adverse effects, but the risk from brief oral steroid bursts (≤14 days) is largely unknown. To examine the associations between steroid bursts and severe adverse events, specifically gastrointestinal (GI) bleeding, sepsis, and heart failure. Self-controlled case series. Entire National Health Insurance Research Database of medical claims records in Taiwan. Adults aged 20 to 64 years with continuous enrollment in the National Health Insurance program from 1 January 2013 to 31 December 2015. Incidence rates of severe adverse events in steroid burst users and non-steroid users, as well as incidence rate ratios (IRRs) for severe adverse events within 5 to 30 and 31 to 90 days after initiation of steroid therapy. Of 15859129 adult participants, 2623327 who received a single steroid burst were included. The most common indications were skin disorders and respiratory tract infections. The incidence rates per 1000 person-years in steroid bursts were 27.1 (95% CI, 26.7 to 27.5) for GI bleeding, 1.5 (CI, 1.4 to 1.6) for sepsis, and 1.3 (CI, 1.2 to 1.4) for heart failure. Rates of GI bleeding (IRR, 1.80 [CI, 1.75 to 1.84]), sepsis (IRR, 1.99 [CI, 1.70 to 2.32]), and heart failure (IRR, 2.37 [CI, 2.13 to 2.63]) significantly increased within 5 to 30 days after steroid therapy initiation and attenuated during the subsequent 31 to 90 days. Persons younger than 20 years or older than 64 years were not included. Oral corticosteroid bursts are frequently prescribed in the general adult population in Taiwan. The highest rates of GI bleeding, sepsis, and heart failure occurred within the first month after initiation of steroid therapy. National Health Research Institutes, Ministry of Science and Technology of Taiwan, Chang Gung Medical Foundation, and Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The Epidemiology of Benign Voice Disorders in Taiwan: A Nationwide Population-Based Study.

Because there are few population-based studies regarding the epidemiology of benign voice diseases, the present study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of benign voice diseases among the general adult population in Taiwan. Study participants were retrieved for those patients who were 20 to 90 years old with a diagnosis of benign voice diseases that were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from 2006 to 2014. Patient visits were grouped into infectious (ICD-9-CM: 012.3, 032.3, 034.0, 090.5, 095.8,101, 464.0, 464.20, 464.21, 465.x, 476.0, 476.1) and noninfectious (ICD-9-CM: 306.1, 478.3x, 478.4, 478.5, 748.3, 784.4x) dysphonia groups. Benign voice disorders have a prevalence of approximately 3.6% in Taiwan as of 2014. The year-to-year prevalence decreased gradually in the query period. Infectious dysphonia diagnoses were higher than noninfectious ones. Dysphonia caused by noninfectious diagnoses was most prevalent in the 60 to 79 years age group. Dysphonia caused by infectious diagnoses was highest in 20 to 39 years group. Noninfectious dysphonia diagnoses were more common in women. The prevalence of voice disorders among the adult population in Taiwan was 3.6% in 2014. Voice disorders are more common in women and occur primarily in the 20 to 39 years age group. Infectious dysphonia is more common than noninfectious dysphonia. The results may be underestimated due to limitation of the database. This is the first population-based epidemiology study of adult voice disorders.

Age and sex differences in the relationship between neutrophil-to-lymphocyte ratio and chronic kidney disease among an adult population in Taiwan

BackgroundThis study investigated the association between systemic inflammation and chronic kidney disease (CKD), and whether this association changes with aging in adults, by using neutrophil-to-lymphocyte ratio (NLR) as an inflammation marker. Materials and methodsA total of 2954 adults (1815 men and 1139 women) who attended a health examination at a medical center in central Taiwan were included for the final cross-sectional analysis. ResultsCompared with participants aged <60 years, participants aged ≥60 years had a markedly higher prevalence rate of CKD in both men (7.6% vs. 37.8%, p < .001) and women (3.8% vs. 28.0%, p < .001). In men aged <60 years, multivariable logistic regression analysis revealed that, after adjusting for conventional CKD risk factors, higher NLR (per 1 unit increment) was independently associated with higher risk of CKD [adjusted OR = 1.48 (95% C.I.: 1.10 to 1.99, p = .009)]. There was no such association in both men and women aged ≧60 years, and woman aged <60 years. ConclusionsOur study showed a differential effect that aging has on the relationship between NLR and CKD in men but not in women. Being inexpensive and readily available, NLR may potentially be used for CKD risk assessment in men younger than 60 years of age.

Visceral Adiposity Index as a Predictor of Chronic Kidney Disease in a Relatively Healthy Population in Taiwan

Abdominal obesity is an independent risk factor for cardiovascular disease and chronic kidney disease (CKD). Visceral adiposity index (VAI), a simple formula representing visceral adipose dysfunction, has already been proven to have a strong correlation with various cardiometabolic disorders. Limited studies are available regarding the relationship between VAI and renal function decline. Therefore, the purpose of this study was to evaluate the relationship between VAI and renal function and to estimate the risk of chronic kidney disease in a relatively healthy adult population in Taiwan. The design of the study is retrospective cross-sectional analysis. This study involved 23,570 subjects aged ≥18years who underwent annual heath checkups between January and December 2013. A multivariate logistic regression model was used to assess the relationship between VAI and CKD. Receiver-operating characteristic curve and Youden index were developed to determine the discrimination power of VAI for metabolic syndrome and CKD. None, observational study. The main outcome measure of this study was CKD. In our study, the adjusted odds ratio (OR) of abnormal VAI for CKD was 1.5 (95% confidence interval [CI], 1.08-2.08; P=.016) in all subjects. A higher VAI was superior in association with CKD in men than women (OR, 1.62; 95% CI, 1.13-2.32; P=.009 vs. OR, 1.28; 95% CI, 0.66-2.47; P=.469, respectively). The area under the curve for VAI was 0.694 (95% CI, 0.660-0.729; P<.001), and using a Youden index with a cut-off VAI value of 2.96 for CKD discrimination obtained a sensitivity of 67.7% and specificity of 65.1%. A higher VAI score was associated with increased risks of CKD. VAI would be an applicable tool for early detection of CKD in relatively healthy adults in Taiwan, especially men.

Development of Activity and Participation Norms among General Adult Populations in Taiwan.

Based on the International Classification of Functioning, Disability, and Health (ICF) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult) began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of an individual’s activities and participation in daily life. There is a lack of research regarding the profile of activity and participation for the general adult population. The purposes of this study were to establish activity and participation norms for the general adult population in Taiwan and to describe, discuss, and compare the activity and participation profile with other population. Method: A population-based survey was administered in 2013 using a computer-assisted telephone interviewing system (CATI system). Using probability proportional to size (PPS) sampling and systematic sampling with random digit dialing (RDD), 1500 adults from Taiwan’s general population were selected to participate in the survey. The FUNDES-Adult with six domains and two dimensions (performance and capability) was used to obtain data on activities and participation levels. A higher domain score indicated higher participation restriction. Results: Approximately 50% of the respondents were male, and the average age of the respondents was 45.23 years. There were no significant differences in the demographic features between the sample and the population. Among the six domains, the self-care domain score was the lowest (least restriction) and the participation domain score was the highest (most restriction). Approximately 90% of the sample scored were less than 15, and only 0.1% scored more than 80. This is the first cross-national population-based survey to assess norms of activity and participation relevant to the general population of Taiwan. As such, the results of this survey can be used as a reference for comparing the activity and participation (AP) functioning of other countries and subgroups.

Combined body mass index with high-sensitivity C-reactive protein as independent predictors for chronic kidney disease in a relatively healthy population in Taiwan.

Obesity, a chronic inflammatory state, increases risk of cardiovascular disease and insulin resistance, which are the leading cause of end-stage renal disease (ESRD). We evaluated the relationship between body mass index (BMI) and high-sensitivity C-reactive protein (hsCRP) level and impaired kidney function to determine the predictive value of both markers for estimating chronic kidney disease (CKD) risk in a healthy adult population in Taiwan. In a retrospective cross-sectional study of 4100 subjects ⩾18 years, a multivariate logistic regression model was used to assess the relationship among BMI, high hsCRP levels and CKD. Receiver-operating characteristic curve and Youden index were developed to define the discrimination power of combining BMI with hsCRP for CKD prediction and to determine the best predictive index. Overweight/obese subjects with high hsCRP levels had the highest odds ratio for CKD (P=0.048). In females, combining BMI with hsCRP for CKD prediction was superior to that of males (0.890 vs 0.623, respectively; both P<0.001). For females, the Youden index was 25.65 kg/m(2) for BMI and 1.04 μg/ml for hsCRP. Overweight/obesity with higher hsCRP levels is associated with reduced renal function and increased risk for CKD. BMI and hsCRP levels can be used as surrogate markers for CKD risk, especially for females.

Modifiable Lifestyle Behaviors Are Associated With Metabolic Syndrome in a Taiwanese Population.

To explore associations between metabolic syndrome and modifiable lifestyle behaviors among the adult population in Taiwan. This cross-sectional study analyzed data from a nationally representative sample that participated in the 2005-2008 Nutrition and Health Survey in Taiwan. The sample (2,337 participants older than 19 years) provided data on demographic characteristics, modifiable lifestyle behaviors, anthropometric measurements, and blood chemistry panel. These data were analyzed by descriptive statistics, univariate logistic regression, and multivariate logistic regression to determine factors associated with metabolic syndrome. Metabolic syndrome had a prevalence of 25.2%, and this prevalence increased with age. In univariate regression analysis, metabolic syndrome was associated with age, living with family members, educational level, and modifiable lifestyle behaviors (smoking, drinking, betel quid chewing, and physical activity). Individuals with a smoking history and currently chewing betel quid had the highest risk for metabolic syndrome. The risk for metabolic syndrome might be reduced by public health campaigns to encourage people to quit smoking cigarettes and chewing betel quid. Implementing more modifiable lifestyle behaviors in daily life will decrease metabolic syndrome in Taiwan. Considering that betel quid chewing and tobacco smoking interact to adversely affect metabolic syndrome risk, public health campaigns against both behaviors seem to be a cost-effective and efficient health promotion strategy to reduce the prevalence rate of metabolic syndrome.

Serum total bilirubin concentrations are inversely associated with total white blood cell counts in an adult population.

Several studies have shown that serum bilirubin has a protective effect against cardiovascular disease and that inflammation plays an important role in its pathogenesis. This cross-sectional study investigated whether there was an association between blood total white blood cell count, a simple indicator of inflammation, and serum total bilirubin concentration in a cohort of an adult population in Taiwan. A total of 2458 apparently healthy adults (1246 men and 1212 women) who attended health examination at a medical centre in central Taiwan were enrolled. We collected anthropometric measurements, fasting blood test results, lifestyle habits and medical history. Total white blood cell counts decreased progressively when the concentrations of total bilirubin increased as demonstrated in the total bilirubin quartiles. Both total bilirubin concentrations and total white blood cell counts showed significant correlations with the components of metabolic syndrome, including triglyceride and high-density lipoprotein cholesterol concentrations. Multivariate linear regression analysis revealed that, for both genders, total bilirubin showed an independent negative correlation with total white blood cell count after adjusting for conventional cardiovascular risk factors. Higher serum total bilirubin concentrations within the reference range were associated with lower blood total white blood cell counts, regardless of other classical cardiovascular risk factors.

The impact of socioeconomic status on the incidence of metabolic syndrome in a Taiwanese health screening population

The purpose of this study was to estimate the incidence of metabolic syndrome (MS) in a 5-year follow-up adult population in Taiwan who were examined at the Major Health Screening Center, and to assess possible socioeconomic determinants of the syndrome in this sample. The longitudinal study included 9,389 adults, aged 35-74 years, who visited the Major Health Screening Center from 1998-2002, and were followed up for 5 years. The 5-year cumulative incidence of MS in this sample was 11.37%, and the weighted incidence was 12.46%; 14.95% for men and 9.89% for women, respectively. After adjustment for behavioral and habits, family history, gender and age, education level was associated with the incidence of MS. With middle school and lower as a baseline, the incidence of MS for high school, junior college, and college and above was OR 0.80, 95% CI 0.64-1.00; OR 0.80, 95% CI 0.62-1.03 and OR 0.65, 95% CI 0.50-0.83, respectively. The standardized cumulative incidence of MS was 12.46%. Lower education level was an important socioeconomic determinant of MS in women.

Epidemiology of Vertigo

To investigate the epidemiology of vertigo among the general adult population in Taiwan using the National Health Insurance claims database. Cross-sectional study. Data were retrieved from the 2006 National Health Insurance claims database.Subjects and Methods. Claims data were retrieved for patients 18 years or older with a diagnosis of vertigo (International Classification of Diseases, Ninth Revision, Clinical Modification codes 078.81, 386.XX, or 780.4) from January to December 2006. The authors describe the prevalence and recurrence of vertigo and the medical resource utilization associated with its treatment. Logistic regression models are used to assess the independent effects of age, sex, seasonal variation, institutional level of care, and specialty of care on the risk of vertigo recurrence. A total of 527,807 adult patients (mean ± SD age, 55.1 ± 17.3 years; 1:1.96 ratio of men to women) experienced vertigo in 2006. The prevalence of vertigo was 3.13 cases per 100 adults. Within 1 year of their index vertigo attack, 199,210 patients (37.7%) experienced recurrence. The prevalence and recurrence of vertigo increased significantly with age (P < .001 for both, x² test). Age, sex, seasonal variation, institutional level of care, and specialty of care had various effects on the risk of vertigo recurrence. Vertigo is a major health burden among the general adult population and tends to recur, particularly among older women

Prevalence of treated epilepsy in western medicine among the adult population in Taiwan: A study conducted using antiepileptic drug prescription data

To determine the prevalence of treated epilepsy in the Taiwan in 2004 using prescription data from the National Health Insurance (NHI) research database and to compare this rate with estimates from other prevalence studies. A cohort was extracted from a group of antiepileptic drug (AED) users who met two inclusion criteria: (1) use of AED more than once and International Classification of Disease (ICD) codes indicating epilepsy or (2) use of AEDs except clonazepam for more than 90 days without ICD codes of epilepsy. In total, 559 AED users were included. The estimated crude prevalence of AED use was 0.42% of the adult population (0.4% for women and 0.45% for men), and 72% of the cohort (n=400) used only one AED. Our estimate of prevalence of treated epilepsy through the NHI system has much larger coverage of population with more credible registration system, and appears to be closer to the truth than two previous small-scaled community-based studies in Taiwan.

Prevalence and etiology of elevated serum alanine aminotransferase level in an adult population in Taiwan

The prevalence and etiologies of elevated alanine aminotransferase (ALT) have geographic variations and they are rarely reported in Taiwan. Through a population-based screening study, the prevalence and etiologies of elevated ALT in an adult population of Taiwan were assessed. A cross-sectional community study in a rural village of Taiwan was conducted in 3260 Chinese adults (age >or=18 years) undergoing ultrasonography (US), blood tests, and interviews with a structured questionnaire. The diagnostic criteria of non-alcoholic fatty liver disease (NAFLD) included alcohol intake <20 g/week for women or <30 g/week for men, negative hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, no known etiologies of liver disease, and US consistent with fatty liver. The prevalence of elevated ALT was 11.4% (372/3260). The probable cause of this elevation was excess alcohol consumption in 0.8%, HBV in 28.5%, HCV in 13.2%, both HBV and HCV in 2.2%, NAFLD in 33.6%, and unexplained cause in 21.8%. The etiologic distribution of elevated ALT was similar in both genders, although elevation was more common in men compared to women (17.3%vs 6.1%, P < 0.05). The prevalence of elevated ALT in NAFLD was 18.1% (125/691), and the positive predictive value was 33.6% (125/372). The development of NAFLD was related to increasing age (age between 40 years and 64 years, odds ratio [OR] 1.59, 95% confidence interval [CI]: 1.25-2.01; age >or= 65 years, OR 1.46, 95%CI: 1.08-1.96), fasting plasma glucose (FPG) >or= 126 mg/dL (OR 1.54, 95%CI: 1.11-2.14), body mass index (BMI) >or= 25 kg/m(2) (OR 5.01, 95%CI: 4.13-6.26), triglyceridemia >or= 150 mg/dL (OR 1.96, 95%CI: 1.58-2.42), and hyperuricemia (OR 1.50, 95%CI: 1.22-1.84). Elevated ALT was related to male gender, BMI >or= 25 kg/m(2), and triglyceridemia >or= 150 mg/dL in subjects without known etiologies of liver disease (all P < 0.05). Non-alcoholic fatty liver disease appears to be the commonest cause of elevated ALT and presumed liver injury in Taiwan. The development of NAFLD is closely associated with many metabolic disorders. Metabolic disorders are also related to elevated ALT in subjects without known etiologies of liver disease.

Gender difference on the symptoms, health‐seeking behaviour, social impact and sleep quality in irritable bowel syndrome: a Rome II‐based survey in an apparent healthy adult Chinese population in Taiwan

Little is known about the gender effect on irritable bowel syndrome in Asia. To assess the gender difference in Chinese subjects with irritable bowel syndrome meeting Rome II criteria. Irritable bowel syndrome was identified from an apparently healthy adult population receiving a routine health maintenance program (n = 2018). Female gender is not a factor associated with irritable bowel syndrome or irritable bowel syndrome-related health care-seeking behaviour. Female irritable bowel syndrome subjects, irrespective of consulting behaviour for irritable bowel syndrome, are likely to have < 3 bowel movements/week, hard/lumpy stools and abdominal fullness/bloating (P < 0.05). Female irritable bowel syndrome subjects are prone to be absent from school/work with more days of absenteeism, irrespective of consultation status (P < 0.05). Only female irritable bowel syndrome consulters have more absenteeism for their irritable bowel syndrome-related symptoms, reporting more sleep disturbances than their male counterparts (P < 0.001). In an apparent healthy adult population in Taiwan, gender difference is present in Rome II defined Chinese subjects with irritable bowel syndrome as regards bowel symptoms, social impact and sleep quality. Female predominance was not found in irritable bowel syndrome subjects and irritable bowel syndrome-related health care-seeking behaviour in the current population. Both irritable bowel syndrome non-consulters and consulters have similar gender difference profiles in presenting symptoms, suggesting that bowel symptoms per se may not be the only factor leading to health care-seeking behaviour. The gender differences in sleep problems were observed solely in irritable bowel syndrome consulter.