Chinese Population In Taiwan Research Articles

The Association between Polymorphisms of B7 Molecules (CD80 and CD86) and Graves' Ophthalmopathy in a Taiwanese Population

This study evaluates whether B7 molecules (CD80 and CD86) could be used as genetic markers for the development of Graves' ophthalmopathy (GO). Cross-sectional study. We included 471 patients with Graves' disease (GD; 200 patients with GO and 271 patients without GO) in a Chinese population in Taiwan. An endocrinologist with substantial experience in thyroid diseases identified GO. Blood samples were taken for DNA extraction from GD subjects. The gene polymorphism of CD80 and CD86 was genotyped by polymerase chain reaction in each patient. Genotypes of CD80 and CD86 polymorphism. We found that the frequency of C allele at position rs_9831894 of the CD86 gene is different in patients with GD (with and without GO; chi-square test, P = 0.0017). In addition, the multifactor dimensionality reduction method was used to identify the best gene-gene interaction to predict the risk of GO. We identified an interaction between CD80_rs9289131 and CD86_rs9872483 (sign test, P = 0.0010). Moreover, the G-A haplotype was shown to have a protective effect in the development of ophthalmopathy among patients with GD (odds ratio, 0.63; 95% confidence interval, 0.44-0.90). Moreover, among patients with GO, the patients carrying the G-A haplotype had a lower level of free thyroxine T(4) than those not carrying the G-A haplotype (P = 0.0001). These results suggest that the polymorphisms of the CD86 gene may be used as genetic markers for making the diagnosis and prognosis of GO. Therefore, GO could be a disease with complex genetic factors, resulting from the existing gene-gene interaction found in the present study.

Prediction model for high glycated hemoglobin concentration among ethnic Chinese in Taiwan

BackgroundThis study aimed to construct a prediction model to identify subjects with high glycated hemoglobin (HbA1c) levels by incorporating anthropometric, lifestyle, clinical, and biochemical information in a large cross-sectional ethnic Chinese population in Taiwan from a health checkup center.MethodsThe prediction model was derived from multivariate logistic regression, and we evaluated the performance of the model in identifying the cases with high HbA1c levels (> = 7.0%). In total 17,773 participants (age > = 30 years) were recruited and 323 participants (1.8%) had high HbA1c levels. The study population was divided randomly into two parts, with 80% as the derivation data and 20% as the validation data.ResultsThe point-based clinical model, including age (maximal 8 points), sex (1 point), family history (3 points), body mass index (2 points), waist circumference (4 points), and systolic blood pressure (3 points) reached an area under the receiver operating characteristic curve (AUC) of 0.723 (95% confidence interval, 0.677- 0.769) in the validation data. Adding biochemical measures such as triglycerides and HDL cholesterol improved the prediction power (AUC, 0.770 [0.723 - 0.817], P = < 0.001 compared with the clinical model). A cutoff point of 7 had a sensitivity of 0.76 to 0.96 and a specificity of 0.39 to 0.63 for the prediction model.ConclusionsA prediction model was constructed for the prevalent risk of high HbA1c, which could be useful in identifying high risk subjects for diabetes among ethnic Chinese in Taiwan.

Superiority of Nitinol Piston Over Conventional Prostheses in Stapes Surgery: First Comparative Results in the Chinese Population in Taiwan

A growing number of studies conducted on stapes surgery have suggested that firm and adequate attachment of the prosthesis onto the long process of the incus plays a key role in surgical success. For this reason, a new prosthesis made of Nitinol characterized by "self-crimping" has been developed. Although better postoperative outcomes achieved with a Nitinol piston have been previously confirmed, the superiority of the Nitinol piston over the conventional manual-crimping prostheses remains controversial. The aim of this study was to determine the advantages of the Nitinol piston with regard to hearing improvement. We retrospectively compared postoperative hearing in otosclerosis surgeries with the Nitinol piston versus the manual-crimping prostheses. Sixteen surgeries with Nitinol pistons (carried out between April 2007 and August 2009) and 21 surgeries with conventional prostheses (carried out between January 2004 and January 2009) were evaluated. All patients received pure-tone audiograms preoperatively and postoperatively. In the Nitinol piston group, the air-bone gap (ABG) average (7.92 + or - 6.75 dBHL) was significantly smaller postoperatively than preoperatively (26.79 + or - 8.33 dBHL, p < 0.001). Similarly, the ABG average for the conventional piston group (13.09 + or - 6.99 dBHL) was significantly smaller postoperatively than preoperatively (26.19 + or - 6.76 dBHL, p < 0.001). Although both groups demonstrated an improvement in average ABG postoperatively, the Nitinol piston group showed a greater improvement than the conventional piston group (p = 0.018). Additionally, ABG closure within 10 dB was attained in significantly more patients (75%) in the Nitinol piston group compared with the conventional piston group (33.3%, p = 0.012). The Nitinol piston has a distinct advantage over conventional prostheses, providing an easier, safer and more effective treatment option in otosclerosis surgery. To our knowledge, this is the first comparative analysis of hearing results of the Nitinol piston with conventional prostheses in the Chinese population in Taiwan. In this population, there is a much lower prevalence of otosclerosis, leading to a lack of surgical experience in otosclerosis surgery, even at large medical centers. This may explain, in part, the relative lack of studies conducted on stapes prostheses in Asian patients. Therefore, our preliminary research may provide a reference for future investigations on stapes surgery in Asian patients with otosclerosis based on ethnic differences.

Association analysis of GRIN1 and GRIN2B polymorphisms and Parkinson's disease in a hospital-based case–control study

Hyperactivation of N-methyl- d-aspartate receptors (NMDARs) leads to neuronal excitotoxicity and is suggested to play a role in many brain disorders, including Alzheimer's disease and schizophrenia. However, the association between polymorphisms in the genes that code for NMDAR subunits, N-methyl- d-aspartate 1 and 2B ( GRIN1 and GRIN2B) and Parkinson's disease (PD) remains unclear. In a hospital-based case–control study of PD, DNA samples were collected from 101 PD patients and 205 healthy controls. Genotyping assays were used to screen for polymorphisms in the GRIN1 (rs2301364 T > C, rs28489906 T > C, and rs4880213 T > C) and GRIN2B ( C366G, C2664T, and rs1805476 T > G) genes, and logistic regression analysis was then used to assess the association between these single nucleotide polymorphisms (SNPs) and PD susceptibility. None of the 6 SNPs were significantly associated with PD risk on their own. However, in conjunction with putative low-risk genotypes for the GRIN1 gene, the GRIN2B C366G variant was significantly associated with reduced PD risk compared with the homozygous genotype 366CC (OR = 0.38, 95%CI = 0.17–0.93, P = 0.033). A synergistic effect on risk reduction was observed in subjects who carried multiple polymorphisms of GRIN1 and the GRIN2B C366G polymorphism (OR = 0.78, 95%CI = 0.59–1.02, P trend = 0.073). Our results suggest that polymorphisms in the GRIN1 and GRIN2B genes may serve as potential biomarkers for a reduced risk of PD among the Chinese population in Taiwan.

Population-specific functional variant of the TPH2 gene 2755C&gt;A polymorphism contributes risk association to major depression and anxiety in Chinese peripartum women

The rate-limiting enzyme of serotonin biosynthesis, tryptophan hydroxylase 2 (TPH2), is one of the most promising candidate genes for psychiatric disorders. Although evidence strongly suggests that the TPH2 is significant in the etiology of major depression and anxiety disorder, whether it also contributes to the etiology of peripartum major depression and anxiety disorder, a specific subtype influenced considerably by other environmental factors like hormones, is unclear. This study investigated the role of TPH2 in the etiology of peripartum major depression and anxiety disorder in a Han Chinese population in Taiwan. Six single nucleotide polymorphisms were selected from previously profiled genetic information of TPH2 in Han Chinese. A cohort of postpartum Chinese women that included 117 patients with major depression, anxiety disorder, or both and 83 healthy controls were genotyped with selected TPH2 markers. The TPH2 2755A allele was found only in women with peripartum major depression and anxiety disorder (p = 0.043) and exhibited a dominant gene action (p = 0.038) with an estimated disease risk of 1.73. Although the sample size is small, results from this study suggest that the TPH2 C2755A polymorphism may represent a population-specific risk factor for peripartum major depression and anxiety disorder, perhaps by interacting with hormones.

Diabetic nephropathy and risk factors for peripheral artery disease in Chinese with type 2 diabetes mellitus

The risk for peripheral arterial disease (PAD) is increased in patients with chronic kidney disease. We investigated the effects of renal function on PAD in Chinese with type 2 diabetes mellitus. This study enrolled a total of 2983 (1342 men and 1641 women) Chinese adults with diabetes. The mean age was 63.2 ± 11.9 years. Peripheral arterial disease was diagnosed by an ankle-brachial index less than 0.9. Renal function was evaluated by serum creatinine (SCr), estimated glomerular filtration rate, and urinary albumin-creatinine ratio (ACR). Risk factors for PAD were evaluated using multiple logistic regression analysis. Age, cholesterol, and high-density lipoprotein cholesterol (HDL-C) (inverse association) were significant risk factors in men, whereas age, body mass index (inverse association), low-density lipoprotein cholesterol, and HDL-C (inverse association) were significant risk factors for diabetic women. After adjustment for age, body mass index, blood pressure, glycosylated hemoglobin, cholesterol, HDL-C, low-density lipoprotein cholesterol, and triglyceride levels, we found that SCr levels greater than 1.5 mg/dL, estimated glomerular filtration rate less than 60 mL/min, and urinary ACR greater than 30 mg/g were independent risk factors for PAD in diabetic men and that SCr levels greater than 1.4 mg/dL and urinary ACR greater than 30 mg/g were independently associated with PAD in diabetic women. The risk factors for PAD are somewhat different between men and women with diabetes in Chinese population in Taiwan. Diabetic nephropathy is significantly associated with PAD in this patient population.

CAG Repeat Polymorphism of the MEF2A Gene is not Associated With the Risk of Coronary Artery Disease Among Taiwanese

A 21-bp deletion mutation of the exon 11 of the myocyte enhancer factor-2A (MEF2A) gene was shown to cause familial coronary artery disease. This finding raises the possibility that MEF2A variants may contribute to the risk of coronary artery disease. In total, 258 patients with coronary artery disease and 258 controls were analyzed for the MEF2A variants. The analysis revealed that all patients were negative for Pro279Leu and 21-bp deletion mutations in exons 7 and 11, respectively. The distribution of the allele frequencies of MEF2A exon 11 CAG repeat (CAG)n polymorphism was similar in both patients and controls; Further, no significant association was noted between MEF2A exon 11 (CAG)n polymorphism and the risk of myocardial infarction. Our data suggest that there is no evidence of an association between the MEF2A exon 11 (CAG)n polymorphism and the risk of coronary artery disease/myocardial infarction in the Chinese population in Taiwan.

The type-2 variant of human cytomegalovirus glycoprotein N (gN-2) is not the rarest in the Chinese population of Taiwan: Influence of primer design

Studies of the human cytomegalovirus (HCMV) glycoprotein N (gpUL73-gN) showed that genotypic variations exist in different geographic areas, with gN-2 unidentified in Chinese population. The purpose of this study was to determine the HCMV gN variants in the Chinese population of Taiwan. Primers were designed and a polymerase chain reaction (PCR) was carried out on the UL73 gene. The PCR products were subjected to restriction fragment length polymorphism (RFLP) analysis. The same PCR-RFLP assay was repeated using primers published previously to demonstrate the influence of primer design. Of the 48 clinical HCMV isolates, 33 were positive for PCR products by both primer sets. Fifteen were positive only by the “in-house” PCR. The distribution of gN-1, gN-2, gN-3, and gN-4 by RFLP analysis was 14:11:7:17, with one isolate positive for both gN-1 and gN-2. The published primers detected the four genotypes with the number of 14:0:2:17. The under-representation of gN-2 and gN-3 by the method published previously may be due to inappropriate primer design when re-examining the sequences. On the basis of the results of this study, gN-2 is not the rarest gN genotype in the Chinese population of Taiwan. The design of primers used for PCR-RFLP genotyping may have a great influence on the frequency distribution of HCMV genomic variants.

The association between DRD2/ANKK1, 5‐HTTLPR gene, and specific personality trait on antisocial alcoholism among Han Chinese in Taiwan

Cloninger suggested that type II alcoholism was associated with higher novelty seeking and less harm avoidance behaviors, which was similar to antisocial alcoholism. Most previous studies have failed to recruit subjects that have antisocial personality disorder without alcoholism due to the high coexisting likelihood of having antisocial personality disorder with alcoholism in the majority of the examined populations. Thus, recruitment of individuals with antisocial non-alcoholism (antisocial personality disorder) served as an important control group in examining Cloninger's hypothesis. Due to the documented protective effects against alcoholism of ALDH2*1/*2 or *2/*2 genotype among the Han Chinese population, we recruited antisocial non-alcoholics from the Han Chinese population in Taiwan to verify Cloninger's hypotheses. A total of 127 Han Chinese subjects were recruited who met the diagnosis of antisocial alcoholism (n = 43) or antisocial non-alcoholism (n = 84). We found that the antisocial alcoholism group scored higher on the novelty seeking behavior than did the antisocial non-alcoholism group (t = 2.61, P = 0.01), but no difference was observed on the harm avoidance dimension between these two groups (t = 0.15, P = 0.88). In the novelty seeking scores, after stratification of DRD2 TaqI A genotypes, only a significant difference in 5-HTTLPR polymorphisms between antisocial alcoholics and antisocial non-alcoholics was found, indicating an interaction between DRD2 TaqI A1+ (include A1/A1 or A1/A2) and 5-HTTLPR S/S genotype (t = 2.75, P = 0.01) However, no significant difference was found in the harm avoidance personality trait between these two groups of Han Chinese in Taiwan.

Prevalence and Associated Risk Factors of Age-Related Macular Degeneration in an Elderly Chinese Population in Taiwan: The Shihpai Eye Study

To assess the prevalence and associated risk factors of age-related macular degeneration (AMD) in an elderly Chinese population in Taiwan. The Shihpai Eye Study was a survey of vision and ocular disease in an elderly Chinese population 65 years of age or older residing in Shihpai, Taipei, Taiwan. Of 2045 elderly residents randomly sampled from the household registration databank, 1361 (66.6%) underwent a detailed ophthalmic examination that included fundus color slides by fundus camera after pupil dilatation. Photographs were graded according to the Wisconsin Age-Related Maculopathy Grading System. Fundus photographs were available for 1105 (54.0% in the eligible, 81.2% in the ocular examined) participants. The 47 (4.3%) participants who had ungradable fundus images were older and had more lens opacity. Of the 1058 gradable photographs, the prevalence of early AMD was 9.2% (95% confidence interval [CI], 7.8-10.8); of late AMD, 1.9% (95% CI, 1.3-2.7); of soft drusen, 42.2% (95% CI, 39.7-44.8); of soft indistinct drusen, 4.1% (95% CI, 3.1-5.2); and of any pigmentary change, 8.6% (95% CI, 7.2-10.2). Age was the most significant factor associated with both early and late AMD. The prevalence of early AMD rose from 5.0% in the 65- to 69-year age group to 24.4% in those 80 years of age and older; and for late AMD, from 1.0% to 9.0%. Those who currently drank alcohol had a lower rate of early AMD than did the nondrinker (adjusted odd ratio 0.32, 95% CI: 0.11-0.93, P = 0.037). AMD is a common eye disease in the elderly Chinese people in Taiwan. The adjusted prevalence rate of exudative AMD is comparable to that in the Chinese people in the Multiethnic Study of Atherosclerosis (MESA) in the United States but is higher than in the Chinese people in the Beijing study in China. Further studies are needed to clarify the incidence and associated risk factors.

Angiotensinogen and Angiotensin II Type 1 Receptor Gene Polymorphisms and Changes in Repolarization Parameters in Elderly Chinese: A 4-Year Follow-up Study

Ventricular repolarization abnormality plays a crucial role in cardiac arrhythmia. Polymorphisms in renin-angiotensin system genes are associated with occurrence of ventricular arrhythmia. We previously demonstrated that subjects carrying the angiotensin converting enzyme (ACE) D-allele but not the angiotensinogen (AGT) M235T polymorphism had a higher magnitude of QT dispersion (QTd) prolongation. The aim of this study was to test whether the AGT [-6G > A] and angiotensin II type 1 receptor (AT1R) [1166A > C] polymorphisms influence repolarization parameters, including QTd and the peak and end of the T wave interval (Tpe). Of 1,500 people screened, 106 normotensive, non-diabetic participants aged > or = 60 were recruited. ECGs were recorded at baseline and in the second and fourth years. QTd and Tpe were manually calculated. Gene polymorphisms were analyzed by polymerase chain reaction. Mean age was 72.7 +/- 4.1 years (range, 62-81 years). QTd and Tpe were significantly prolonged in the second and fourth years (all p < 0.001). Neither gene polymorphism was associated with the magnitudes of QTd and Tpe prolongations. This longitudinal study shows that the AT1R [1166A > C] and AGT [-6G > A] polymorphisms do not influence repolarization parameters in this Chinese population in Taiwan, and so are not suitable markers to identify individuals susceptible to changes in these parameters.

Association between P478S polymorphism of the filaggrin gene and risk of psoriasis in a Chinese population in Taiwan

Abnormal keratinocyte terminal differentiation is one of the important characteristics of psoriatic lesions. Filaggrin (FLG) is a key protein that facilitates the terminal differentiation of the epidermis. Thus, FLG genetic variants may modify the risk of psoriasis. In total, 314 patients with psoriasis and 611 control subjects were analyzed for the presence of FLG R501X, 2282del4 mutations, and P478S (rs11584340, C/T base change) polymorphism by polymerase chain reaction (PCR). The analysis revealed that both the R501X and 2282del4 mutations were not present in a subset of 200 patients (64%) with psoriasis. In contrast, a marginally significant difference (P = 0.020) was found in the distribution of rs11584340 genotype frequencies between psoriatic patients and controls. The frequency of the TT genotype in psoriasis patients was significantly higher than in controls (37.9% vs. 29.1%, respectively, P = 0.007). The T allele frequency of patients (60.5%) was also significantly higher than that of controls (53.9%) (P = 0.007). After adjusting for age and gender, carriers of the TT genotype were 1.46 (95% CI, 1.08-1.96) times more likely than non-carriers to have psoriasis (P = 0.013). In conclusion, our results suggest that FLG P478S polymorphism may confer susceptibility to the development of psoriasis among Taiwanese Chinese.

The Prevalence and Risk Factors of Reflux Esophagitis Among Adult Chinese Population in Taiwan

Risk factors of reflux esophagitis among Chinese in Taiwan are at present not clear and the role of Helicobacter pylori infection in the development of reflux esophagitis is still controversial. The aim of this study was to examine the prevalence of reflux esophagitis, and to identify risk factors associated with reflux esophagitis in a multivariate context and to evaluate if H. pylori is a predictive factor for reflux esophagitis. A total of 482 physical check-up subjects who underwent upper gastrointestinal endoscopy were investigated. The severity of esophagitis was evaluated by Los Angeles classification. H. pylori status was assessed by serology. Twelve percent (58/482) demonstrated reflux esophagitis with 87% of grade A or B. Of those with reflux esophagitis, 48.3% had reflux symptoms whereas 17.4% of those with reflux symptoms had reflux esophagitis. Univariate analysis identified hiatal hernia, male sex, smoking, alcohol drinking, and overweight as risk factors associated with reflux esophagitis. Multivariable logistic regression showed that hiatal hernia [odds ratio (OR)=12.2, 95% confidence interval (CI)=5.0-29.9, P<0.0001], male sex (OR=4.2, 95% CI=1.9-9.0, P<0.001), and chronic obstructive pulmonary disease sufferers (OR=3.4, 95% CI=1.1-10.9, P<0.05) were 3 independent risk factors for development of reflux esophagitis. The prevalence of reflux esophagitis in Taiwanese is 12% and most are mild grade and free from reflux symptoms. Hiatus hernia, male sex, and chronic obstructive pulmonary disease are 3 independent risk factors for development of reflux esophagitis. H. pylori infection did not protect subjects from reflux esophagitis.

Lack of association between interleukin-4 gene polymorphisms and autoimmune thyroid diseases amongst Taiwanese Chinese

Graves' disease (GD) and Hashimoto's thyroiditis (HT) are both common autoimmune diseases of the thyroid gland (AITD). The IL-4 is involved in both humoral and cellular immunity. The aim of this study was to test whether the IL-4 gene could be used as a genetic marker to predict the development of AITD amongst the Chinese population of Taiwan. For this study, a normal control group of 105 healthy subjects and two experimental groups featuring individuals afflicted with either GD (104 patients) or HT (109 patients) were examined. Polymerase chain reaction (PCR) was used to analyze the variable number of tandem repeats (VNTRs) polymorphism for the IL-4 gene intron 3 and PCR-based restriction analysis using endonuclease BsmFI was undertaken for the same gene at the promoter -590 position. We found no significant difference in the frequencies of presence of genotype and allelic variants for the IL-4 gene at both the intron 3 and the promoter regions between the normal control group and each of the two patient groups. These findings suggest that the IL-4 gene polymorphisms that arise at either intron 3 or promoter -590 positions are not suitable genetic markers for AITD among Taiwanese Chinese.

Association of HLA DRB1-DQA1-DQB1 haplotypes with rheumatic heart disease in Taiwan

This case–control study was carried out to investigate the possible relationship between the gene frequencies of HLA-DRB1, -DQA1 and -DQB1 alleles/haplotypes and rheumatic heart disease (RHD) among the Chinese population in Taiwan. A group of 115 patients with RHD documented by echocardiography, and a group of 115 normal controls were studied. The HLA-DRB1, -DQA1 and -DQB1 allele frequencies were determined by polymerase chain reaction and sequence-specific oligonucleotide probe. As compared with controls, patients with RHD had an increased frequency of DR11-05-DQ7 haplotype and a decreased frequency of DR4-03-DQ4 haplotype. The frequencies of DRB1, DQA1 or DQB1 alleles were not significantly different between RHD patients and controls. Further categorization of RHD patients into mitral valve disease and combined valve disease subgroups revealed no statistical difference in these alleles when compared with the two subgroups. Patients with RHD have a higher frequency of DR11-05-DQ7 haplotype and a lower frequency of DR4-03-DQ4 haplotype , which indicates that certain HLA DRB1-DQA1-DQB1 haplotypes in determining the risk/protection of RHD in Taiwan Chinese.

Specific personality traits and dopamine, serotonin genes in anxiety–depressive alcoholism among Han Chinese in Taiwan

Background Cloninger [Cloninger CR. 1987. Neurogenetic adaptive mechanisms in alcoholism. Science 236: 410–416.] had proposed a psychobiological model suggesting that three main personality dimensions distinguish the alcoholism into two subtypes (type I and type II). However, the classification was equivocal for clinical diagnosis. Recently, anxiety–depressive alcohol dependence (ANX/DEP ALC) has been posited as a genetically specific subtype of alcoholism. Its clinical characteristics were similar to individuals with type I alcoholism [Cloninger, C.R. 1987. Neurogenetic adaptive mechanisms in alcoholism. Science 236: 410–6.] such as having a high comorbidity with mood disorder, late-onset and more anxious/depressed traits. We attempted to investigate whether the dopamine D2 receptor ( DRD2) and the serotonin transporter promoter region ( 5-HTTLPR) genes were involved in Novelty Seeking (NS) and Harm Avoidance (HA) of ANX/DEP ALC. Methods We recruited 46 pure alcohol dependents (Pure ALC) and 87 anxiety–depression alcohol dependents (ANX/DEP ALC). All participants were diagnosed by DSM-IV criteria, genotyped by the PCR method and assessed with Tridimensional Personality Questionnaire (TPQ). Results Both NS and HA were high in ANX/DEP ALC ( p = 0.021; p = 0.001, respectively). The association between NS and ANX/DEP ALC only existed in subjects with DRD2 TaqI A1 + allele ( A1/A1 or A1/A2 genotypes) ( p = 0.004) and in those with S/S genotype of 5-HTTLPR ( p = 0.005). With the stratification of DRD2 TaqI A1 + allele, high NS of ANX/DEP ALC existed only in carriers of 5-HTTLPR S/S genotype ( p = 0.001). Moreover, ANX/DEP ALC was related to high HA only in samples carrying 5-HTTLPR S/L or L/L genotype ( p = 0.02). Conclusions These findings provided the empirical genetic characterization of the specific personality traits in ANX/DEP ALC among Han Chinese population in Taiwan.

Venlafaxine vs. paroxetine in the acute phase of treatment for major depressive disorder among Han Chinese population in Taiwan

Clinical studies have suggested that venlafaxine induces a higher remission rate than paroxetine. However, very few studies have evaluated relapse episodes over treatment periods longer than a few weeks, and the cut-off score of 7 on the Hamilton Rating Scale for Depression (HRSD) often used to define remission is too high. This score is associated with the high rates of social function impairment. We report on a single centre, open-label, prospective 24-week study to investigate the comparative efficacy of acute treatments with venlafaxine and paroxetine, using different definitions of response and remission rates. Outpatients satisfying DSM-IV criteria for major depression with a baseline HRSD17 score of at least 16 were eligible. Following baseline evaluations, the patients were assigned to receive venlafaxine 75-225 mg/day with the mean dosage 141.35 +/- 26.98 (SD) mg/day (n = 78), or paroxetine 20 mg/day (n = 92) for 24 weeks. Efficacy was assessed using the mean change in HRSD(17) score from baseline, the response rate and the remission rates based on different criteria for remission (HRSD(17) score < or = 7 or 5). One hundred and seventy patients were evaluated for efficacy; 78 treated with venlafaxine and 92 with paroxetine. Over the treatment period, venlafaxine was comparable with paroxetine on most outcome measures, whereas paroxetine produced significantly higher remission rates at weeks 4, 8, 16, 20 and 24 weeks when the lower cutoff of 5 was used. Venlafaxine treatment was similar to paroxetine according to the typical efficacy measures for treating outpatients with major depression. However, based on the stricter remission criterion, paroxetine might be superior to venlafaxine.

Association Study of the Genetic Polymorphisms of the Transcription Factor 7-Like 2 (TCF7L2) Gene and Type 2 Diabetes in the Chinese Population

Genetic polymorphisms of the transcription factor 7-like 2 (TCF7L2) gene is one of the few validated genetic variants with large effects on the risk of type 2 diabetes in the populations of European ancestry. In this study, we aimed to explore the effect of the TCF7L2 polymorphisms in a Han Chinese population. We genotyped 20 single nucleotide polymorphisms (SNPs) across the TCF7L2 gene in 1,520 unrelated subjects from a Han Chinese population in Taiwan. The associations of SNPs and haplotypes with type 2 diabetes and linkage disequilibrium (LD) structure of the TCF7L2 gene were analyzed. The previously reported SNPs rs7903146 T- and rs12255372 T-alleles of the TCF7L2 gene were rare and were not associated with type 2 diabetes in a Chinese population, which may attribute to the low frequencies of these two SNPs. SNP rs290487 located in an LD block close to the 3' end of the gene was associated with type 2 diabetes (allele-specific P = 0.0021; permuted P = 0.03). The odds ratio was 1.36 for the CT genotype (95% CI 1.08-1.71; P = 0.0063) and 1.51 for the CC genotype (1.10 -2.07; P = 0.0085) compared with the TT genotype, corresponding to a population attributable risk fraction of 18.7%. The haplotypes composed of rs290487 were also significantly associated with type 2 diabetes (global P = 0.012). We identified a novel risk-conferring genetic variant of TCF7L2 for type 2 diabetes in a Chinese population. Our data suggested that the TCF7L2 genetic polymorphisms are major determinants for risk of type 2 diabetes in the Chinese population.

Reliability and Validity of a Chinese Version of the Pediatric Asthma Symptoms Scale

As a construct, asthmatic severity provides a framework to understand the different reaction in children to their condition. Assessing asthmatic severity is a challenging task for most researchers and clinicians due to a lack of valid instruments to measure the severity of asthma of children in home settings. The purpose of this study was to examine the psychometric properties of a Chinese version of the Pediatric Asthma Symptoms Scale (C-PASS) as applied to an ethnic Chinese population in Taiwan. Firstly, five pediatric nurses holding masters' degrees assessed consistency between Chinese and English versions of the Pediatric Asthma Symptoms Scale. Secondly, internal consistent reliability, split-half reliability, content validity, criterion-related validity, and construct validity were established. An 8-item C-PASS was completed by mothers of 70 children (65.7% boys) of ages 8.35 years. Both the internal consistency and Guttman split-half reliability were .87. The content validity index (CVI) was over .80. The correlation coefficient between C-PASS and concurrent measures of the rating of lost control of life by mothers was .273 (p = .022). The criterion-related validity was supported for C-PASS. Factor analysis indicated that a scale of two dimensions accounted for 67.92% of the variance. A high inter-correlation was further identified between these two dimensions. Results showed C-PASS to be a reliable and valid instrument when used on Taiwanese children with asthma. It can serve as a valuable assessment tool in clinical practice to identify asthmatic severity levels for which intervention is advised.

Human C-reactive Protein (CRP) Gene 1059 G > C Polymorphism is Associated with Plasma CRP Concentration in Patients Receiving Coronary Angiography

Elevation of C-reactive protein (CRP) level is associated with increased risk of cardiovascular events. The 1059 G>C polymorphism in exon 2 of the CRP gene has been shown to affect plasma concentration of CRP. We want to elucidate the effect of this polymorphism on the development of coronary artery disease (CAD) among the Chinese population in Taiwan. We scrutinized 536 patients undergoing coronary angiography (365 patients with CAD and 171 controls with patent coronaries) and evaluated the association of CRP gene 1059 G>C polymorphism with CAD. Genotyping of the polymorphism was performed by polymerase chain reaction and MaeIII restriction enzyme digestion. The CC genotype was associated with lower plasma CRP concentration (GG, 6.5+/-5.8; GC, 3.3+/-4.4; CC, 2.3+/-3.1 mg/L; p=0.02). Subjects with CAD or myocardial infarction (MI) had significantly higher plasma CRP concentration than that in controls (CAD vs. controls, 8.9+/-18.9 vs. 3.3+/-7.2 mg/L; p<0.001), while patients with MI showed higher CRP when compared to those with chronic stable angina (13.5+/-22.9 vs. 5.2+/-14.1 mg/L; p<0.001). However, this polymorphism was not associated with CAD in our population. Our data suggest that human CRP gene 1059 G>C polymorphism is associated with plasma CRP concentration among Chinese in Taiwan receiving coronary angiography.