Family History In First-degree Relatives Research Articles

Ethnic disparities in breast cancer: A comprehensive analysis of socio-demographic and clinical characteristics among African American, Hispanic, and Caucasian women.

e13698 Background: Despite advancements in breast cancer therapy leading to a decline in mortality rates within certain ethnic populations, there exists a concerning trend of increasing cancer incidence among African American (AA) and Hispanic women. This persistent rise highlights the urgent need to explore and comprehend the socio-demographic and breast cancer characteristics specific to these populations. Methods: We assembled a 10-year database of women diagnosed with breast cancer in the community hospital in Chicago. After excluding minority ethnic groups, specifically AA, Hispanic, and Caucasian cohorts were included in this study, comprising 786 patient records analyzed. Results: The distribution revealed a predominance of AA patients at 49.7%, Hispanics at 42.1%, and Caucasians at 8.14%. Noteworthy differences across the three ethnic groups were observed in age categories at cancer diagnosis, BMI categories, family history of first-degree relatives with breast cancer, marital status, smoking habits, menopausal status, and alcohol use at the time of diagnosis (p < 0.05). Within the molecular subtypes, 14.5% were identified as triple-negative breast cancer (TNBC), with a higher prevalence of 18.7% among the AA subgroups. 19.6% of patients had advanced disease, proportion was higher in AA ethnic group (22.8%; p = 0.83) compared to other ethnicities. Breast conservative procedures were prevalent in almost half of the patient population on average (52.1 %), with a slightly higher frequency of mastectomies noted in the Hispanic patient group (44.1%, p < 0.05). In logistic regression analysis, compared to the reference AA ethnicity, Hispanics exhibited higher odds of having HER-2 positive breast cancer (OR 1.74; CI 1.04 – 2.94; p < 0.05), as did Caucasians (OR 2.35; CI 1.05 – 5.04; p < 0.05). Conclusions: In summary, our study underscores substantial socio-demographic and breast cancer characteristic differences among AA and Hispanic populations compared to Caucasians, revealing notable ethnic disparities in breast cancer. Despite these variations, our findings highlight promising healthcare equity, with comparable access to surgical and chemotherapy interventions across ethnicities. TNBC demonstrates molecular heterogeneity and a higher prevalence among AA women, contributing to significant racial disparities.

Association Between Family History and Early-Onset Atrial Flutter Across Racial and Ethnic Groups.

Genetic and familial contributions to early-onset atrial fibrillation are described primarily in individuals of European ancestry. However, the role of racial and familial contributions in the pathogenesis of early-onset atrial flutter (EOAFL) is unclear. In this cross-sectional study, participants were enrolled prospectively from 2015 to 2021 in multiple academic centers with a diagnosis of atrial flutter (AFL) confirmed by ECG. EOAFL was defined as a diagnosis of AFL before age 66 years with no concomitant or previous diagnosis of atrial tachyarrhythmias. Family history was adjudicated through baseline questionnaires and direct family interviews about the diagnosis of atrial tachyarrhythmias, stroke, and cardiomyopathy. The primary exposure was a positive family history in first-degree relatives, and the primary outcome was the odds of EOAFL versus late-onset AFL. A total of 909 patients were enrolled. Participants with a positive family history of atrial tachyarrhythmias were younger, less likely to be of Black race, and more likely to have EOAFL. The adjusted odds ratio (OR) for EOAFL in those with a positive family history was 1.8 (95% CI, 1.1-3.0). There was an increased odds of EOAFL in those of Black race (OR, 2.1 [95% CI, 1.4-3.2]), alcohol use (OR, 1.6 [95% CI, 1.0-2.6]), and obstructive sleep apnea (OR, 1.9 [95% CI, 1.0-3.4]). Use of cardioselective β blockers or calcium channel blockers before the diagnosis of AFL were associated with a lower odds of EOAFL (OR, 0.5 [95% CI, 0.2-0.9]). These findings suggest a potentially hereditary predisposition to EOAFL across race and ethnicity, warranting further study of the genetic contributions to AFL.

Thyroid Autoimmune Disease among Emirati Patients: A Retrospective Analysis of the Patients’ Characteristics

Background: Autoimmune thyroid disease (AITD) is a serious and treatable disease that could be associated with other autoimmune disorders. It is a common cause of hypothyroidism in adult females. The diagnosis is established by detecting serum antithyroid antibodies. The disease slowly progresses, and the treatment includes thyroid hormone replacement in cases of hypothyroidism. Objective: The aim of this study is to investigate the clinical presentation, laboratory findings, and comorbidity factors involved in autoimmune thyroid disease among Emirati citizens in the UAE. Methods: Medical records from Advanced Cure Diagnostic Centers were reviewed in a retrospective study over the period of four years from 2018 to 2022. The patients population included those who attended the Endocrinology Unit and others seen by the rest of the medical staff. Patients were considered to have AITD if they tested positive for thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), or both. The data collected was evaluated using descriptive analysis to provide a basic summary of the patients sample and dataset. Unpaired t-test was used to compare the mean value of elevated autoantibodies in males and females. Results: Of the 366 Emirati nationals who were tested for autoimmune thyroiditis, 220 (60%) had an abnormal result for TPOAb and/or TgAb. Among the 220 patients who had an abnormal result for TPOAb and/or TgAb, 188 (85.5%) were females, and 100 patients (45.5%) were in the age group between 31 and 40 years. 42% were in a euthyroid state and 42% presented with hypothyroidism. Only 7% presented with hyperthyroidism, 5% with subclinical hypothyroidism, and 2% with subclinical hyperthyroidism. An analysis of the comorbidity factors revealed that 142 (65%) patients with obesity, 82 (37%) with a family history of thyroid disease, 77 (35%) with hyperlipidemia, 14 (6%) with hypertension, and 11 (5%) with diabetes. Conclusion: This is the first publication intended to address AITD in Emirati citizens. Our findings concur with the international data regarding the prevalence among middle-aged females. Eighty-four percent of the positive patients either presented with no abnormality of their thyroid gland function or with hypothyroidism. With the alarming increase of obesity in the UAE, we found it to be the single most important and preventable comorbidity factor present in 65% of the studied population. This is followed by a family history of first-degree relatives with thyroid disease in 37% of the participants, due to the high rate of consanguineous marriages in the UAE.

Risk of Gastric Cancer is Highly Dependent on Type of First-Degree Family Member Affected by Cancer: Lessons from a High-Risk Population in Iran.

Family history of gastric cancer (GC) in first-degree relatives may increase the risk of GC. This study aimed to assess how family history of GC in first-degree relatives really affects the risk of GC in an extremely high-risk population. A large population-based case-control study was carried out on 1222 incident GC cases and 1235 controls in Ardabil Province-a high-risk area in North-West Iran-to assess the associations of GC family history in first-degree relatives with the risk of GC (2003-2017). GC family history did not significantly associate with the risk of GC overall (ORadj=1.09, 95% CI: 0.80-1.47, P=0.589). It found no significant association of GC family history in a parent, and in a father, mother, and sister separately, with the risk of GC. However, GC risk was significantly associated with a history of GC in a sibling (ORadj=1.61, 95% CI: 1.11-2.35, P=0.013), especially brother (ORadj=2.24, 95% CI: 1.41-3.64, P=0.0008). The risk was greatly increased in subjects with two or more affected brothers (ORadj =5.56, 95% CI: 2.33-14.20, P=0.0002). We did not find a familial tendency to cardia GC and non-cardia GC as well as histopathologic features. Determining the type of first-degree relationships with GC may, therefore, be more important than assessing family history alone for predicting the risk of GC in this high-risk area.

Mutual association between family history of gastric and colorectal cancer and risk of gastric and colorectal cancer.

We evaluated the associations between gastric cancer (GC) family history (FH) and colorectal cancer (CRC) risk and between CRC FH and GC/gastric adenoma risk. We used data of participants who underwent national cancer screening between 2013 and 2014. Participants with GC or CRC FH in first-degree relatives (n=1 172 750) and those without cancer FH (n=3 518 250) were matched 1:3 by age and gender. Of the 1 172 750 participants with a FH, 871 104, 264 040, and 37 606 had FHs of only GC, only CRC, and both GC and CRC, respectively. The median follow-up time was 4.8years. GC and CRC FHs were associated with increased GC and CRC risks, respectively. GC FH was associated with CRC risk (adjusted hazard ratio 1.05; 95% confidence interval [CI] 1.01-1.10), whereas CRC FH was not associated with the risk of GC or gastric adenoma. However, gastric adenoma risk increased 1.62-fold (95% CI 1.40-1.87) in participants with FHs of both GC and CRC, demonstrating a significant difference with the 1.39-fold (95% CI 1.34-1.44) increase in participants with only GC FH. Furthermore, GC risk increased by 5.32 times (95% CI 1.74-16.24) in participants with FHs of both GC and CRC in both parents and siblings. GC FH was significantly associated with a 5% increase in CRC risk. Although CRC FH did not increase GC risk, FH of both GC and CRC further increased the risk of gastric adenoma. FHs of GC and CRC may affect each other's neoplastic lesion risk.

Abstract 12110: The Multi-Racial Clinical and Familial Characteristics of Early and Late Onset Atrial Flutter

Introduction: Studies in Whites of European descent have shown that atrial fibrillation (AF) have a strong genetic component especially in probands with early-onset (EO) AF. However, the role of family history in the pathogenesis of EO atrial flutter (EOAFL) across race-ethnicity remains unclear. Here, we sought to determine if African American, European American, and Hispanic/Latino probands with EOAFL have a higher rate of arrhythmia recurrence in first-degree family members than ethnically-matched patients with late-onset AFL (LOAFL). Methods: In this cohort study, 917 adults with AFL were identified between 2015 and 2021 across 3 sites in the Chicagoland area. EOAFL was defined as AFL occurring before 60 years of age. Primary analysis of reported family history in first-degree relatives with sensitivity analysis restricted to those in whom a family history was confirmed by medical record review and electrocardiogram was done. Results: Those with EOAFL were more overweight, Black or White, and had more comorbidities ( Table 1 ). Multivariate analysis showed that BMI ≥ 40 kg/m 2 (odds ratio [OR]: 5.4; 95% confidence interval [CI]: 3.2-9.4, p <0.001) and a family history (OR: 3.7; 95% CI: 2.1-6.9, P <0.001) carried the highest adjusted odds of EOAFL followed by alcohol use (OR: 2.1; 95% CI: 1.5-3.0, P <0.001), Black race (OR: 1.6; 95% CI: 1.1-2.3, P =0.021), and heart failure (OR: 1.4; 95% CI: 1-1.9, P =0.03). Adjusting for effect modification on the association of family history and race, among Whites, the odds of EOAFL in patients with family history was 6.1 (95% CI: 2.1-22.3, P =0.002) comparative to those with no family history, and among Blacks, it was 4.9 (95% CI: 1.6-6.1, P =0.021). Conclusion: Obesity and family history were strongly associated with EOAFL. Whites with EOAFL were more likely to have a first-degree relative with AF/AFL when compared to Blacks or Hispanics/Latinos. These findings support genetic predisposition to EOAFL across all 3 races.

Genomic landscape of Epstein-Barr virus in familial nasopharyngeal carcinoma.

To better understand the genomic characteristics of Epstein-Barr virus (EBV) in familial nasopharyngeal carcinoma (NPC), we sequenced the EBV genomes by whole-genome capture in 38 unrelated patients with NPC family history in first-degree relatives and 47 healthy controls, including 13 with family history and 34 without. Compared with type 1 reference genome, mutation hotspots were observed in the latent gene regions of EBV in familial NPC cases. Population structure analysis showed that one cluster has a higher frequency in familial cases than in controls (OR=5.33, 95 % CI 2.50-11.33, P=1.42×10-5), and similar population structure composition was observed among familial and sporadic NPC cases in high-endemic areas. By genome-wide association analysis, four variants were found to be significantly associated with familial NPC. Consistent results were observed in the meta-analysis integrating two published case-control EBV sequencing studies in NPC high-endemic areas. High-risk haplotypes of EBV composed of 34 variants were associated with familial NPC risk (OR=13.85, 95 % CI 4.13-46.44, P=2.06×10-5), and higher frequency was observed in healthy blood-relative controls with NPC family history (9/13, 69.23 %) than those without family history (16/34, 47.06%). This study suggested the potential contribution of EBV high-risk subtypes to familial aggregation of NPC.

Abstract 9209: Type 1 Brugada Syndrome Diagnosed in a Patient With an Unaffected Identical Twin

Introduction: Brugada syndrome is a rare arrhythmia disorder due to a cardiac channelopathy with a predisposition to ventricular arrhythmias or SCD. It is characterized by an ECG pattern of complete or incomplete right bundle branch block and ST segment elevation in leads V1-V3. It is normally inherited in an autosomal dominant pattern however environmental factors such as viral infections and inflammation may create myocardial cell damage that may induce an ECG pattern consistent with the diagnosis of Brugada syndrome. Case: A 39-year-old male with no significant past medical history presented to the hospital for two weeks of intermittent dizziness and nocturnal symptoms of being “jolted” awake. ECG on admission was suggestive of a Type 2 Brugada pattern. He denied a family history of first-degree relatives with cardiac disease, SCD or unexplained syncope but did note that he had an identical twin brother. Given symptoms and ECG findings, he was given 400 mg of oral flecainide for a sodium blockade challenge. Four hours after administration of flecainide he developed an overt Type 1 Brugada pattern. Due to issues with the MRI, a cardiac CTA was performed to assess for ARVD. Cardiac CTA showed a mild amount of fat in the apex of the right ventricular wall but was otherwise unremarkable. He was discharged with a wearable external defibrillator and outpatient follow up with EP. During outpatient follow up he reported resolution of symptoms. Interrogation of the defibrillator did not reveal any arrhythmias. An ECG was done on his identical twin brother which did not show evidence of a Type 1 Brugada pattern. He completed a cardiac MRI that showed normal morphology and motion of the right ventricle without evidence of fat dysplasia or late gadolinium enhancement. Given resolution of his symptoms with a normal cardiac MRI and an unremarkable ECG from his identical twin, he was diagnosed with an acquired Brugada syndrome likely due to a viral myocarditis. Conclusion: While Brugada syndrome is normally an inherited genetic disorder, there are instances of acquiring the syndrome through environmental factors. As demonstrated by our case of identical twin brothers with the same genetic makeup, one was diagnosed with Brugada syndrome while the other had an unremarkable ECG.

A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression.

Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD).Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients.Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction.Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine.

Epidemiology of Epilepsy in Nigeria: A Community-Based Study From 3 Sites.

We determined the prevalence, incidence, and risk factors for epilepsy in Nigeria. We conducted a door-to-door survey to identify cases of epilepsy in 3 regions. We estimated age-standardized prevalence adjusted for nonresponse and sensitivity and the 1-year retrospective incidence for active epilepsy. To assess potential risk factors, we conducted a case-control study by collecting sociodemographic and risk factor data. We estimated odds ratios using logistic regression analysis and corresponding population attributable fractions (PAFs). We screened 42,427 persons (age ≥6 years), of whom 254 had confirmed active epilepsy. The pooled prevalence of active epilepsy per 1,000 was 9.8 (95% confidence interval [CI] 8.6-11.1), 17.7 (14.2-20.6) in Gwandu, 4.8 (3.4-6.6) in Afikpo, and 3.3 (2.0-5.1) in Ijebu-Jesa. The pooled incidence per 100,000 was 101.3 (95% CI 57.9-167.6), 201.2 (105.0-358.9) in Gwandu, 27.6 (3.3-128.0) in Afikpo, and 23.9 (3.2-157.0) in Ijebu-Jesa. Children's significant risk factors included febrile seizures, meningitis, poor perinatal care, open defecation, measles, and family history in first-degree relatives. In adults, head injury, poor perinatal care, febrile seizures, family history in second-degree relatives, and consanguinity were significant. Gwandu had more significant risk factors. The PAF for the important factors in children was 74.0% (71.0%-76.0%) and in adults was 79.0% (75.0%-81.0%). This work suggests varied epidemiologic numbers, which may be explained by differences in risk factors and population structure in the different regions. These variations should differentially determine and drive prevention and health care responses.

WOMEN WITH BREAST CANCER ATTENDED IN PUBLIC HOSPITAL FROM MACAPÁ, AMAPÁ

Breast cancer is a disease of epidemiological concern worldwide, being considered a serious public health problem. Although it is well established that early diagnosis and adequate treatment interfere with mortality rates and the prevalence of cancer, few data are available regarding the descriptive epidemiology of breast cancer in Brazil, as well as in the various states of the federation, as is the State of Amapá. The general objective was to characterize the risk factors of breast cancer patients treated at Hospital de Clínicas Dr. Alberto Lima (HCAL) from January 2012 to December 2017 in the city of Macapá, Amapá. Cases of breast cancer were reviewed, with an analysis of 194 medical records, and the following variables were studied: age, education level, histological type of the neoplasia, age at first delivery, menarche and menopause, breastfeeding time, alcohol intake, smoking, family history of breast cancer in first-degree relatives. It was noted that the age group most affected was between 41-50 years old and with an education level of elementary education. In these women, the most frequent characteristics were: age at first delivery between 13-20 years, menarche between 10-13 years, menopause from 41-50 years with a significant number of patients at menace (outside menopause), breastfeeding time between 2-22 and 23-42 months, both intervals with the same number of records; most did not drink alcohol, were not smokers and had no family history of first-degree relatives of breast cancer. In the cases studied, the most frequently diagnosed histological type was invasive ductal carcinoma.

Influence of family history, body mass index, selected dietary factors, personal habits, and menstrual history on oily skin in young women

Sebum secretion is affected by many internal and external factors. To identify risk factors in terms of family history, body mass index, selected dietary factors, personal habits, and menstrual history that may be associated with oily skin in young women. We conducted a case-control study of young women aged 18-35 who came to Beijing Tongren Hospital for attending a health checkup. Cases were subjects with subjective skin type as oily skin. Control subjects were people with normal or dry skin. A standardized questionnaire on subjective skin type, family history of oily skin in first-degree relatives, menstrual history, personal habits, and selected dietary factors was administered to 540 subjects. Univariate and multivariate logistic regression analyses were performed for risk factors associated with oily skin. A family history in first-degree relatives and a body mass index of more than 24kg/m2 were risk factors that increases likelihood of oily skin in young women (odds ratio 3.281, 95% confidence interval 2.204-4.882; odds ratio 1.677, 95% confidence interval 1.081-2.600, respectively). For those who consumed more than three servings of milk or sweets per week, the risk increased with the diet (odds ratio 1.634, 95% confidence interval 1.126-2.370; odds ratio 1.970, 95% confidence interval 1.034-3.754, respectively). There was no correlation between smoking, drinking alcohol, or menstrual variables and the risk of oily skin. Family history, overweight and obesity, and a diet rich in milk or sweets are risk factors that increase likelihood of oily skin in young women. These findings may provide an opportunity to better guide skin care for patients.

Clinic, pathologic and molecular landscapes in ultra-young women with breast cancer in the State of São Paulo: a real-world study

Introduction: Breast cancer (BC) centers are increasingly attending “ultra-young” women (UYW) patients (≤ 30 years), who usually present aggressive tumors and face specific problems. Objectives: We aimed to examine a multicentric casuistic view, addressing clinicopathological and molecular characteristics of BC, as well as therapeutic measures and oncological outcomes. Methods: A retrospective multicentric observational study of UYW with infiltrating BC was carried out. The patients were treated between the period from January 1991 to December 2019. Clinical, epidemiological, morphological, molecular, therapeutic and outcomes data were collected from the charts. Results: A total of 293 patients were followed for a average period of 34.5 months. Nulliparity was referred by 204 women (75.5%), of whom 81 (37.1%) were overweight or obese. Positive family history in first-degree relatives was verified in 25 patients (10.1%). Only 30 patients underwent genetic tests, which revealed inherited pathogenic mutations in 12 of them (37.5%). Thirty-two (32) cases were classified as T1 at diagnosis (10.9%), while “De novo” stage IV was found in 29 patients (9.8%). Mastectomy was performed in 175 women (70.2%), quadrantectomy in 46 women (18.4%), and mammary adenectomies in 28 women (11.2%), of which 149 cases were reported after neoadjuvant chemotherapy (56.0%). A total of 111 patients had at least one positive lymph node (47.4%). The rate of patients with estrogen receptor-negative was 32.7% and the rate of patients with Human Epidermal Growth Factor Receptor 2-positive (HER2-positive) was 25%. The frequency of Luminal A neoplasias was 16.6%, Luminal B/HER2- was 35.9%, Luminal B/HER2+ was 15.1%, HER2 overexpressed was 9.3%, and Basal was 22.9%. Taking into account the outcomes, 173 patients were alive without disease (65.7%); 23 patients were alive with any form of recurrence (8.7%); and 67 patients (25.4%) evolved to BC deaths. Conclusions: It was concluded that UYW with BC are commonly diagnosed at advanced stages, present adverse morphological and molecular parameters, and have unfavorable prognosis.

Should Lipoprotein(a) be Measured in Youth?

Should Lipoprotein(a) be Measured in Youth?

WOMEN WITH BREAST CANCER CARE AT THE PUBLIC HOSPITAL OF MACAPÁ - AMAPÁ: EPIDEMIOLOGICAL AND CLINICAL ASPECTS

Breast cancer is a disease of widespread epidemiology worldwide and is considered a serious public health problem. Although it is well established that early diagnosis and appropriate treatment interfere with mortality rates and cancer prevalence, few data are available on the descriptive epidemiology of breast cancer in Brazil and in the state of Amapá. The general objective of this dissertation work was to study the epidemiological and clinical aspects of breast cancer patients treated at the Dr. Alberto Lima Clinical Hospital (HCAL), from January 2012 to December 2017 in the city of Macapá, Amapá. Breast cancer cases were reviewed, with analysis of 194 medical records, and the following variables were studied: Annual frequency of breast tumor, age, education level, origin, location of breast lesion, histological type of cancer, age at first childbirth, Menarche and Menopause, breastfeeding time, alcohol intake, smoking, family history of breast cancer in first-degree relatives, clinical staging of the disease, immunohistochemical panel, type of surgical treatment, Chemotherapy, Radiotherapy, Hormone Therapy and Target Therapy " It was noted that the year 2017 had the highest number of diagnosed cases, the age group between 41-50 years was the most affected, women with low education (Elementary Level) and coming from the capital of Amapá. In these women, the most frequent characteristics were: Age at first birth between 13-20 years, Menarche between 10-13 years, Menopause 41-50 years with significant number of patients in Menácme (out of menopause), Breastfeeding time between 02 -22 and 23-42 months, both intervals with the same number of records; Most of them did not drink alcohol, were not smokers, and had no family history of first-degree relatives of breast cancer. In the studied cases, the most common localization of the breast lesion was the Lateral Upper Quadrant, the most diagnosed histological type was Invasive Ductal Carcinoma, with clinical stage IIA, Luminal A molecular subtype, Radiotherapy and Hormomyotherapy were performed most of the time, but Target Therapy was not prevalent.

Difference Analysis Of Related Factors In Macrovascular And Microvascular Complications In Chinese Patients With Type 2 Diabetes Mellitus: A Case-Control Study Protocol.

IntroductionDespite the increasingly young age at diabetes onset and the increasing number of deaths caused by type 2 diabetes mellitus (T2DM), why some patients develop macrovascular complications but others develop microvascular complications remains controversial and unclear. Notably, some patients have good glucose control but still develop vascular complications, whereas some patients have retinopathy with neither nephropathy nor neuropathy. This study will be performed to explore the risk factors for T2DM complications in Chinese patients.Methods and analysisPatients with T2DM and healthy people will be recruited from Hebei General Hospital from September 2019 to September 2020. The subjects will be grouped into a control group, T2DM without vascular complications group, T2DM with macrovascular complications group, and T2DM with microvascular complications group; they will then be further subgrouped. The following data will be collected after admission: demographic information such as age, sex, and education; relevant medical history such as duration of diabetes, family history of first-degree relatives with diabetes, and age at diagnosis of diabetes; and anthropometric and blood indicators such as weight, waist circumference, fasting blood glucose level, C-peptide level, total cholesterol level, and triglyceride level. The statistical analysis will be performed using SPSS 22.0 (IBM Corp., Armonk, NY, USA). A P value of <0.05 will be considered statistically significant. The χ2 test, one-way analysis of variance and the rank sum test will be used to analyze differences between the groups. Logistic regression will be used to analyze the risk factors for macrovascular and microvascular complications of T2DM.

SUN-207 LONGITUDINAL FOLLOW-UP OF INCIDENT CHRONIC KIDNEY DISEASE (CKD) IN THE KEEP MEXICO CKD SCREENING PROGRAM

Mexico's Kidney Early Evaluation Program (KEEP) is a screening and educational initiative aimed at detecting chronic kidney disease (CKD) among adults with risk factors, including diabetes mellitus (DM), hypertension (HTN), or family history in first-degree relatives of DM, HTN, and/or CKD. The National Kidney Foundation developed the KEEP program in the United States, and the Mexican Kidney Foundation adapted it for use in Mexico. Between 2008 and 2017, 8858 individuals have been screened in 76 KEEP campaigns performed in 14 Mexican States.

Risk Scores for Predicting Advanced Colorectal Neoplasia in the Average-risk Population: A Systematic Review and Meta-analysis.

OBJECTIVES:A systematic review and meta‐analysis was performed to summarize the available evidence on risk scores for predicting advanced colorectal neoplasia (advanced adenomas and cancer) in average‐risk and asymptomatic populations undergoing screening colonoscopy.METHODS:PubMed, EMBASE, and Web of Science databases were searched up to 28 March 2018. Studies that developed or validated a risk score to predict the risk of advanced colorectal neoplasia were included. Two reviewers independently extracted study characteristics including diagnostic performance indicators and assessed risk of bias and applicability in the included studies. Metaanalyses were conducted to determine the overall discrimination of risk scores evaluated by more than 1 study.RESULTS:A total of 22 studies including 17 original risk scores were identified. Risk scores included a median number of 5 risk factors. Factors most commonly included were age, sex, family history in first‐degree relatives, body mass index and smoking. The area under the receiver operating characteristic curve of risk scores ranged from 0.62 to 0.77 in the individual studies and from 0.61 to 0.70 in the meta‐analyses.CONCLUSIONS:Although the majority of available risk scores had relatively weak discriminatory power, they may be of some use for risk stratification in CRC screening. Rather than developing more risk scores based on environmental risk factors, future research should focus on exploring possibilities of enhancing predictive power by combining risk factor data with novel laboratory matters, such as polygenetic risk scores.

PO-060 Association between RS10993994 polymorphism in MSMB gene with early-onset prostate cancer in mexican men

IntroductionProstate cancer (PCa) is a public health problem worldwide, which has been related to sexually transmitted infections (STIs). The risk allele (T) of rs10993994 (C>T) polymorphism in the MSMB gene encodes for a prostate secretory protein of 94 amino acids (PSP94), conferring susceptibility to STIs development. This allele has also been associated with an increment (~35%) of PCa risk. Nonetheless, the genetic contribution of this polymorphism has not been evaluated in the Mexican men yet as well as neither whether the STIs history modifies this association.Material and methodsSocio-demographic characteristics, sexual, and reproductive history of incident PCa cases (n=322) and 628 healthy population controls matched by age (±5 years) were analysed as well as the genotyping of rs10993994 polymorphism in Mexico City males. Unconditional logistic regression models were used to estimate the odds ratios for PCa, PCa aggressiveness and age of onset. The interaction between STI history and MSMB polymorphism were evaluated including an interaction term between both variables.Results and discussionsNo frequency differences were found between cases and controls. Nevertheless, when adjusting by age, PCa family history in first-degree relatives, residence place and the STIs history were done, TT genotype carriers had almost three-fold higher odds (OR 2.61; IC 95% 1.06, 6.44; p=0.04) of early-onset PCa (age at diagnosis <60 years). No interaction between STIs history and rs10993994 with early-onset PCa (OR 1.78; IC 95% 0.27, 11.92; p=0.55) was observed.ConclusionTo our knowledge, this is the first study that explores the role of rs10993994 as a risk factor for PCa in Mexican men. Our findings are partially consistent with a previous study that reported association between T allele in MSMB gene and early-onset PCa. Because all STIs were considered together, we do not reject a possible interaction between a specific STI (mainly fungal aetiology) and rs10993994 polymorphism.

Comparison of familial and non-familial suicidal behaviors among people with major depressive disorder: Testing the discriminative predicting role of high-yield clinical variables

BackgroundSuicidal behavior in first-degree relatives of people diagnosed with major depressive disorder (MDD) increases the risk of suicidal behavior. Such an effect may be the result of genetic risk factors or environmental ones, including imitation, or both. Surprisingly few studies have examined this question and thus, there still is little known about the effect of first-degree family history of suicidal behavior on the type of suicidal behavior and profile of risk factors related to the diathesis for suicidal behavior. Even less is known about intra-familial risk transmission. MethodsPatients with MDD (n = 252) experiencing a current major depressive episode and who had a previous suicide attempt were studied. Those with and without a family history of first-degree relatives who had made a suicide attempt or died by suicide were compared across clinical and suicide-related characteristics. ResultsSuicide attempters with (FDR+, n = 59) and without a first-degree relative with suicide attempt or suicide (FDR−, n = 193) were similar in terms of type or frequency of suicide attempts, level of lifetime aggression and impulsivity, age of onset of depression and age at first suicide attempt. LimitationsCross-Sectional study. Lack of additional external validators. ConclusionsContrary to our hypothesis and the concept of “genetic anticipation”, a first-degree family history of suicide attempt or suicide in currently depressed attempters with MDD was not associated with a range of clinical and suicide-related characteristics. Longitudinal studies incorporating external validators and potential biological markers may advance this area of research.