Casual Serum Research Articles

Associations between serum trace elements and the risk of nasopharyngeal carcinoma: a multi-center case-control study in Guangdong Province, southern China.

Associations between trace elements and nasopharyngeal carcinoma (NPC) have been speculated but not thoroughly examined. This study registered a total of 225 newly diagnosed patients with NPC and 225 healthy controls matched by sex and age from three municipal hospitals in Guangdong Province, southern China between 2011 and 2015. Information was collected by questionnaire on the demographic characteristics and other possibly confounding lifestyle factors. Eight trace elements and the level of Epstein-Barr virus (EBV) antibody were measured in casual (spot) serum specimens by inductively coupled plasma-mass spectrometry (ICP-MS) and enzyme-linked immunosorbent assay (ELISA), respectively. Restricted cubic splines and conditional logistic regression were applied to assess the relationship between trace elements and NPC risk through single-and multiple-elements models. Serum levels of chromium (Cr), cobalt (Co), nickel (Ni), arsenic (As), strontium (Sr) and molybdenum (Mo) were not associated with NPC risk. Manganese (Mn) and cadmium (Cd) were positively associated with NPC risk in both single-and multiple-element models, with ORs of the highest tertile compared with the reference categories 3.90 (95% CI, 1.27 to 7.34) for Mn and 2.30 (95% CI, 1.26 to 3.38) for Cd. Restricted cubic splines showed that there was a linear increasing trend between Mn and NPC risk, while for Cd there was a J-type correlation. Serum levels of Cd and Mn was positively related with NPC risk. Prospective researches on the associations of the two trace elements with NPC ought to be taken into account within the future.

Serum triglyceride levels and incidence of hypertension in a general Japanese population: ISSA-CKD study.

The aim of this study was to clarify the relationship between fasting and nonfasting serum triglyceride (TG) levels and the incidence of hypertension in a general Japanese population. We conducted a population-based retrospective cohort study using annual health check-up data of residents of Iki City, Nagasaki Prefecture, Japan. A total of 3202 participants without hypertension at baseline were included in the present analysis. TG levels were classified as quartile 1 (<0.82 mmol/L), quartile 2 (0.83-1.13 mmol/L), quartile 3 (1.14-1.70 mmol/L) and quartile 4 (≥1.71 mmol/L) for men, and as quartile 1 (<0.70 mmol/L), quartile 2 (0.71-0.96 mmol/L), quartile 3 (0.97-1.34 mmol/L) and quartile 4 (≥1.35 mmol/L) for women. The outcome was incident hypertension. During an average follow-up of 4.4 years, 983 participants developed hypertension, according to the Cox proportional hazards model. The annual incidence of hypertension increased with an elevation in TG levels for men (5.88% in quartile 1, 8.30% in quartile 2, 7.62% in quartile 3, and 9.82% in quartile 4). This association was significant, even after adjustment for other risk factors: hazard ratio 1.41 [95% CI 1.07-1.85] for quartile 2, 1.30 [0.99-1.71] for quartile 3, and 1.59 [1.22-2.08] for quartile 4 compared with quartile 1 (p = 0.041 for trend). In contrast, there was no clear association between serum TG levels and the incidence of hypertension after adjustment for confounding factors among women (p = 0.240 for trend). High levels of serum TG were associated with the future incidence of hypertension in a general population of Japanese men but were not associated with that in women. Casual serum triglyceride levels and incidence of hypertension in a general Japanese population: ISSA-CKD study.

Casual Serum Triglyceride Concentrations and New-Onset Chronic Kidney Disease in the General Japanese Population: The Iki City Epidemiological Study of Atherosclerosis and Chronic Kidney Disease Study

Introduction: Non-fasting triglyceride (TG) concentrations are useful for predicting various diseases, but most epidemiological studies investigated the association between fasting TG concentrations and chronic kidney disease (CKD). This study aimed to examine the association between casual (fasting or non-fasting) serum TG concentrations and new-onset CKD in the general Japanese population. Methods: We conducted a population-based, retrospective cohort study using annual health checkup data of residents of Iki City, Nagasaki Prefecture, Japan. Between 2008 and 2019, participants without CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or proteinuria) at baseline were included. Casual serum TG concentrations were classified by sex as tertile 1 (men: <0.95 mmol/L; women: <0.86 mmol/L), tertile 2 (0.95–1.49 mmol/L; 0.86–1.25 mmol/L), and tertile 3 (≥1.50 mmol/L; ≥1.26 mmol/L). The outcome was incident CKD. Multivariable-adjusted hazard ratios and 95% confidence intervals were estimated using the Cox proportional hazards model. Results: 4,946 participants (2,236 [45%] men and 2,710 [55%] women; 3,666 [74%] fasting and 1,182 [24%] non-fasting) were included in the present analysis. During an average follow-up of 5.2 years, 934 participants (434 men and 509 women) developed CKD. In men, the incidence rate (per 1,000 person-years) of CKD increased with an elevation in TG concentrations (tertile 1: 29.4, tertile 2: 42.2, and tertile 3: 43.3). This association was significant, even after adjustment for other risk factors of age, current smoking habits, current alcohol intake, exercise habits, obesity, hypertension, diabetes mellitus, hyper-low-density-lipoprotein cholesterolemia, and use of lipid-lowering therapy (p = 0.003 for trend). In contrast, in women, TG concentrations were not associated with incident CKD (p = 0.547 for trend). Conclusion: Casual serum TG concentrations are significantly associated with new-onset CKD in Japanese men in the general population.

Casual C peptide index: Predicting the subsequent need for insulin therapy in outpatients with type 2 diabetes under primary care.

BackgroundEvaluation of residual beta cell function is indispensable in patients with type 2 diabetes as it informs not only diagnoses but also appropriate treatment modalities. However, there is a lack of convenient biomarkers for residual beta cell function. Therefore, we evaluated endogenous insulin level as a biomarker in outpatients who were being treated with insulin therapy and in patients who were introduced to insulin therapy after 4 years.MethodsData of 174 outpatients with type 2 diabetes (50% male) whose glycemia was moderately controlled (glycated A1c 7.3% [5.2%–14.8%]) were reviewed. Twenty patients whose estimated glomerular filtration rate was lower than 30 ml/min/1.73 m2 were excluded from the evaluation of endogenous insulin level with both casual C‐peptide index (C‐CPI) and urinary C‐peptide/creatinine ratio (determined at any time, generally 1–2 h after breakfast). Patients were stratified based on the provision of insulin therapy.ResultsC‐CPI and UCPCR were significantly lower in the insulin‐treated patients than in the insulin‐untreated patients (0.9 vs. 2.2, p < 0.0001; 24.7 vs. 75.5, p = 0.0003, respectively). Moreover, C‐CPI were significantly lower in the insulin‐requiring patients for 4 years than in the insulin‐unrequiring patients (1.0 vs. 1.7, p = 0.0184). The multivariate logistic regression analysis revealed that both indicators of insulin secretion influenced the requirement for insulin therapy, but C‐CPI could serve as the most convenient and useful biomarker for not only current insulin therapy requirements (p = 0.0002) but also the subsequent requirement for insulin therapy (p = 0.0008).ConclusionsC‐CPI could be determined easily, and it was found to be a more practical marker for outpatients; therefore, our findings would have critical implications for primary care.

Free triiodothyronine /free thyroxine ratio as an index of deiodinase type 1 and 2 activities negatively correlates with casual serum insulin levels in patients with type 2 diabetes mellitus.

Free triiodothyronine/free thyroxine (FT3/FT4) ratio is considered as an index of the activities of iodothyronine deiodinase types 1 and 2 (DIO1 and DIO2, respectively) and is reportedly associated with insulin resistance in euthyroid adults. Euthyroid women with polycystic ovary syndrome accompanied with insulin resistance have lesser deiodinase activities. Correspondingly, the serum insulin level in a fasted condition positively correlates with the FT3/FT4 ratio, and insulin depletion decreases the DIO2 activity in mice. Selected genetic variants in DIO1 are also associated with insulin resistance measures. Therefore, if insulin positively regulates DIO1 and DIO2, the FT3/FT4 ratio should decrease under impaired insulin action, and the casual insulin level and FT3/FT4 ratio should be negatively correlated. To evaluate this hypothesis, we conducted a single-center retrospective study between 2018 and 2021. All participants visited the selected hospitals monthly for type 2 diabetes mellitus treatment and casual plasma glucose and HbA1c level measurements. Furthermore, their casual serum insulin levels were measured annually. Meanwhile, we excluded patients treated with insulin injection. Ultimately, we evaluated 71 patients, which all exhibited euthyroid conditions. The FT3/FT4 ratio was independently associated with thyroid-stimulating hormone, casual plasma glucose, and casual insulin levels. In terms of the regression coefficients of the univariate linear regression analysis, the FT3/FT4 ratio negatively correlated with the casual serum insulin levels. Therefore, the risk of FT3/FT4 ratio underestimation should be considered when diagnosing Graves' disease, which is often accompanied with insulin resistance.

Relationship between casual serum triglyceride levels and the development of hypertension in Japanese.

The purpose of the present study was to investigate the effects of serum triglyceride levels on the risk of new-onset hypertension in Japanese. Five thousand nine hundred and thirty-three Japanese workers without hypertension at baseline, who participated in medical check-ups from 2006 to 2018, were followed retrospectively. The participants were divided into quartiles of casual serum triglyceride levels and were followed from the first to last visit of the study period. The outcome was development of hypertension. Risk estimates were computed using Cox's proportional hazards model. During the follow-up period (average: 6.7 years), 946 individuals developed hypertension. The crude incidence rates of hypertension (per 1000 person-years) increased with rising serum triglyceride levels: 10.1 for quartile 1 (<0.76 mmol/l), 19.6 for quartile 2 (0.76-1.17 mmol/l), 26.0 for quartile 3 (1.18-1.84 mmol/l), and 36.5 for quartile 4 (>1.84 mmol/l) (P < 0.0001 for trend). These associations remained significant even after adjustment for other risk factors: the multivariable-adjusted hazard ratio was 1.29 (1.01-1.66) for the second quartile, 1.27 (0.99-1.63) for the third quartile, and 1.39 (1.09-1.77) for the highest quartile compared with the lowest. There were comparable effects of serum triglyceride levels for incidence of hypertension between subgroups defined by sex, obesity, and diabetes (all P > 0.1 for interaction), whereas stronger associations were observed for participants under 40 years of age than for those aged 40 or above (P = 0.002 for interaction). Serum triglyceride levels were significantly associated with development of hypertension in a Japanese worksite population.

2115-P: Impact of Body Weight Change on Glycemic Control and Lipid Profiles in Obese Japanese Patients with Type 2 Diabetes

Objective: Body weight (BW) reduction is recommended for improvement of metabolic control in obese patients with type 2 diabetes (T2D). However, it is not fully understood to what extent of BW reduction is sufficient in Japanese. The aim of the study was to assess the impact of BW change on glycemic control and lipid profiles in obese Japanese patients with T2D. Methods: The study subjects were 684 patients (65% men, mean age 59 years) with a body mass index (BMI) ≥25 kg/m2 among 8,179 patients with T2D who visited our diabetes clinic in both 2013 and 2015-2016. The changes in the levels for casual blood glucose (CBG), HbA1c, serum lipids, BW and proportions of patients taking medications (oral hypoglycemic agents and injection) between baseline and follow-up periods were determined. The liner regression analysis was performed to assess the relation of the changes in BW and changes in CPG, HbA1c, and serum lipid profiles. ANOVA and ANCOVA were used to compare these changes across five groups classified by the changes in BW as &amp;lt;-3% (n=195), -3 to -1% (n=138), -1 to 1% (n=126), 1 to 3% (n=78), and ≥3% (n=146). Results: During the observational period, median values for BMI, CPG, HbA1c, triglyceride (TG), and LDL-cholesterol (LDL-C) were significantly decreased and HDL-C was significantly increased (all p&amp;lt;0.01). Changes in medications were observed in 72% of the patients. Multivariable liner regression analysis showed significant relations between the changes in BW and the changes in TG (beta=0.12, p&amp;lt;0.01) and LDL-C (beta =0.081, p=0.04). The adjusted mean change in TG in the five groups classified by the changes in BW were -7.8, 1.4, 6.8, 11.2, and 17.5%, and significant difference was found between the groups of BW &amp;lt;-3 and ≥3%. There was no difference in change in other parameters across the five groups. Conclusion: In obese Japanese patients with T2D, change in BW was closely associated with change in TG and LDL-C, with statistically significant change in TG in those exhibiting -3% decrease in BW. Disclosure R. Yoshimura: None. Y. Hasegawa: None. T. Nakagami: None. T. Babazono: None.

Association between Casual Serum Triglyceride Levels and Bone Resorption Activity in Japanese Middle-aged and Elderly Women

Association between Casual Serum Triglyceride Levels and Bone Resorption Activity in Japanese Middle-aged and Elderly Women

Casual serum triglyceride as a predictor of premature type 2 diabetes mellitus: an 8-year cohort study of middle-aged Japanese workers.

The utility of casual serum triglyceride (TG) as a predictor of type 2 diabetes mellitus (DM) is unclear, especially during the most productive years. Participants were 3271 workers (913 men and 2358 women, age 20-57) without DM at baseline. They underwent consecutive annual medical check-ups for 8years. The association between newly diagnosed DM and casual serum TG level was determined by classifying the participants into 4 groups according to casual serum TG level at baseline: below 50mg/dL (group A), 50-100mg/dL (group B), 100-150mg/dL (group C), and ≥150mg/dL (group D). The effects of casual serum TG level in combination with sex, obesity, or serum glucose level on newly diagnosed DM were also evaluated. A total of 222 newly diagnosed type 2 DM cases with a mean age of 50 years old were observed during the follow-up period, i.e., 10/406 in group A, 66/1534 in group B, 58/712 in group C, and 88/619 in group D. Compared with group A, the odds ratio (ORs) for newly diagnosed DM (after adjusting for DM-associated factors) was found to increase with casual serum TG level: 1.38 (group B), 1.79 (group C), and 2.36 (group D). Moreover, the OR for newly diagnosed DM was higher in participants with high casual serum TG levels who were also male (OR 2.46), obese (OR 4.18), or had a high serum glucose level (OR 6.96) than in the reference group. Serum TG level ≥150mg/dL when fasting or nonfasting is a significant predictor of type 2 diabetes in middle-aged Japanese workers.

Glycemic Control and the Risk of Death in 1,484 Patients Receiving Maintenance Hemodialysis

It is controversial whether tighter glycemic control is associated with better clinical outcomes in people with kidney failure. We aim to determine whether worse glycemic control, measured using serum glucose and hemoglobin A(1c) (HbA(1c)) levels, is independently associated with higher mortality in patients undergoing maintenance hemodialysis. Retrospective cohort study. 1,484 patients starting maintenance hemodialysis therapy in Alberta, Canada, between 2001 and 2007. Serum glucose and HbA(1c) levels. All-cause mortality. Monthly casual glucose levels from specimens drawn immediately before the first dialysis treatment were averaged over 3 months before and after hemodialysis therapy initiation. Similarly, monthly HbA(1c) values in patients with or at risk of diabetes were averaged. Overall, median age was 66 years, 41% were women, 75% were white, and 55% had diabetes. All-cause mortality during 8 years (median, 1.5 years) was 43%; it was 49% in those with diabetes. There was no relation between average glucose level and mortality in unadjusted analysis (HR, 1.00 per 18 mg/dL [1 mmol/L]; P = 0.4) or after adjustment for confounders (HR, 0.98 per 18 mg/dL; 95% CI, 0.96-1.01; P = 0.2). Higher HbA(1c) level was not associated with mortality when analyzed in the unadjusted analysis (HR, 1.01 per 1% HbA(1c); P = 0.9) or after adjustment for confounders (HR, 0.98 per 1% HbA1c; 95% CI, 0.88-1.08; P = 0.7). Results were similar when HbA(1c) values were divided into prespecified categories (adjusted P > 0.6 for trend). Markers of malnutrition-inflammation (albumin, hemoglobin, and white blood cell values) or the presence of diabetes did not influence the relation between glycemic control and death (all P for interaction > 0.2). Registry data; casual serum glucose measurements; HbA(1c) values available for only a subset of participants. Higher casual glucose and HbA(1c) levels were not associated with mortality in maintenance hemodialysis patients with or without diabetes. This may have implications for recommended glycemic targets, quality indicators, and how best to assess glycemic control in this high-risk population.

Indices of adipose tissue distribution, apolipoproteins B and AI, lipoprotein (a), and triglyceride concentration in children aged 4–11 years: The Third National Health and Nutrition Examination Survey

This study examined the association of body fat distribution with serum apolipoproteins, lipoprotein (a), and triglyceride, risk factors for cardiovascular morbidity, in a representative sample of U.S. black, white, and Hispanic children. Data from the Third National Health and Nutrition Examination Survey for children aged 4–11 years revealed the mean waist-to-hip ratio (WHR) varied consistently with age, gender, and ethnic group. Levels were highest in Mexican Americans. WHR showed significant negative associations with apo AI concentration and positive associations with apo B and the ratio of apo B to apo AI independent of age but not body mass index (BMI). Associations of WHR with serum triglyceride concentration were independent of age and BMI. Other indices of body fat distribution were not superior to WHR. Lp (a) was not consistently associated with WHR. In conclusion, after controlling for BMI and age, body fat distribution was not significantly associated with apo AI and apo B with few exceptions. Nor was Lp (a) significantly associated with body fat distribution. Casual serum triglyceride levels were significantly positively associated with WHR independent of age and BMI in non-Hispanic white and Mexican American children.

Is serum cholesterol associated with progression of diabetic retinopathy or macular edema in persons with younger-onset diabetes of long duration?

PURPOSE: To quantitate the relationships of total cholesterol and high-density lipoprotein cholesterol to the incidence and progression of diabetic retinopathy and macular edema 5 years later in those with younger-onset diabetes of long duration. METHODS: Casual serum specimens for lipid values and fundus photography at the time of the lipid determinations were evaluated with regard to retinal lesions in photographs taken 5 years later during the course of a population-based cohort study. RESULTS: Univariable associations were significant for associations of incident retinal lesions with total cholesterol/high-density lipoprotein cholesterol, but multivariable associations considering covariates were not significant. CONCLUSION: Our data suggest that lowering cholesterol by therapeutic means may not be indicated for the sole purpose of decreasing the incidence or progression of these retinal lesions.

Comparison of the casual serum triglyceride levels at health check-up with the values during fasting

Since higher levels of serum triglycerides were frequently found during the UOEH physical check-up for employees and students in 1989, we analysed subjects with higher triglyceride levels and discussed ways of handling them. Blood sampling to determine serum lipids was done between 13:00-15:00. Of the total (males 1257, females 1267), 272 had higher serum triglyceride levels (over 200 mg/dl) (males 246, females 26) (1st TG). One hundred and twenty-one of the group with higher TG levels in the 1st examination were reevaluated by blood sampling the morning after overnight fasting (2nd TG). There was a significant positive correlationship between the TG levels from the 1st examination and those from the 2nd examination (r = 0.62, n = 121, P < 0.0001). The predictive value calculated from the equation between the TG in the first and second measurements was 341.7 mg/dl. There was a 14.9% rate of false negatives in subjects under 341.7 mg/dl on the first TG measurement. However, there were only 6.3% false negatives in the subjects under 250 mg/dl on the first TG measurement. Age, body mass index and serum cholesterol level were significantly higher in the group with the higher TG level on reevaluation (more than 160 mg/dl) than those in the group with the lower TG level on reevaluation (less than 160 mg/dl). We concluded from these results that the casual serum TG levels above 250 mg/dl might be a suitable cut off level in physical check-ups.

Factors associated with changes in serum cholesterol during a community-based hypertension programme.

A cohort of 1019 male and 1232 female hypertensives, aged 25-59 years, based on a random population sample, was followed for five years during a community-based cardiovascular prevention programme. A small mean reduction in serum cholesterol level was found. The observed changes in casual serum cholesterol values were partly due to the regression to the mean. The reductions were most marked in elderly people and in those with high baseline serum cholesterol values. The partial regressions of the cholesterol change were computed in subgroups by age, sex and baseline serum cholesterol level. Changes in weight in men and in age in women were the strongest independent predictors of the change in serum cholesterol. Changes in dietary fat intake were also associated with the change in serum cholesterol. Only a small part of the total variation in the change in serum cholesterol was explained by the regression models. The results indicate that reduction of the serum cholesterol level among hypertensive persons, especially men, was caused by changes in their dietary habits.

Low free serum histidine concentration in rheumatoid arthritis. A measure of disease activity.

A study of sera from 285 patients with definite or classical rheumatoid arthritis (including 37 patients receiving no anti-inflammatory drugs) and sera from 67 healthy subjects has confirmed 10 published reports of a statistically significant decreased blood histidine concentration in patients with rheumatoid arthritis. Contrastingly, in sera from 231 patients with a variety of acute and chronic illnesses other than rheumatoid arthritis, no statistically significant hypohistidinemia was observed either in the group as a whole or in association with the administration of aspirin, prednisone, indomethacin, phenylbutazone, or dextropropoxyphene. In the patients with rheumatoid arthritis there was a statistically significant correlation between the serum histidine concentration and the following: Westergren sedimentation rate (r=-0.33, P smaller than 10- minus 9), grip strength (r=0.26, P smaller than 10- minus 9), hematocrit (r=0.23, P smaller than 10- minus 9), duration of morning stiffness (r=-0.14, P=10- minus 5), walking time (r=-0.13, P=10- minus 4), latex titer of rheumatoid factor (r=-0.11, P=0.001), and the duration of arthritis (r=-0.06, P=0.05). There was no statistically significant association between the serum histidine concentration and the duration of rheumatoid arthritis in the 151 patients with disease of 0-10-yr duration (r=0.02, P=0.5), the sex of the patient, or the presence of antinuclear antibody (R=0.007, P=0.9). The serum histidine concentration was less in rheumatoid patients receiving steroids (P=0.00001), gold (P=0.009), and aspirin (P=0.15) than in rheumatoid patients not receiving these drugs. This study indicates that histidine determinations on properly preserved casual serum samples can be helpful in the diagnosis of rheumatoid arthritis and in the evaluation of the activity of the disease.