Hospital-based Case-control Study Research Articles

Exploring Serum Zinc and Copper Levels as Potential Biomarkers in Polycystic Ovary Syndrome: A Cross-Sectional Study From Northeast India.

Introduction Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder characterized by irregular menstrual cycles, ovarian cysts, and elevated androgen levels. The potential association between trace elements, specifically copper (Cu) and zinc (Zn), and PCOS has been explored, but a definitive relationship remains unclear. This study aims to investigate the levels of these trace elements in women with PCOS and their potential implications. Methods The study, conducted at Gauhati Medical College & Hospital, involved 60 individuals with PCOS and a matched control group. Ethical approval was obtained, and participants provided written informed consent. The study spanned from July2021to June2022, utilizing a hospital-based case-control study design. Diagnostic criteria adhered to the Rotterdam criteria, and serum copper and zinc levels were quantified using a double-beam UV spectrophotometer. Results In the PCOS group, the mean age was 23.01 ± 3.60 years, while the control group had a mean age of 23.34 ± 3.59 years, with no significant age difference. Mean copper levels were 147.32 ± 16.53 μg/dl in PCOS and 106.88 ± 15.60 μg/dl in controls, indicating a significant increase in PCOS (p < 0.0001). Mean zinc levels were 93.99 ± 6.76 μg/dl in PCOS and 85.42 ± 12.69 μg/dl in controls, also significantly higher in PCOS (p < 0.0001). Conclusion The study highlights significant differences in serum copper and zinc levels between women with PCOS and healthy controls, suggesting potential implications for the syndrome's pathophysiology. Further research is warranted to elucidate the precise roles of these trace elements in PCOS and explore therapeutic interventions.

Migraine among women with endometriosis: a hospital-based case-control study in Bangladesh

BackgroundEndometriosis is a disease among women of reproductive age, which causes several health problems like dysmenorrhoea, dyspareunia and subfertility. It also increases psychological stress and often results in marital disharmony. Similarly, migraine is more frequent among this group of women. Several studies have shown an association between endometriosis and migraine among groups of population completely different from Bangladesh. ObjectiveThe present study was conducted to identify the association between endometriosis and migraine among Bangladeshi population. Study DesignThis non-randomized case-control study was performed with cases of endometriosis and controls without endometriosis who were confirmed by laparoscopy or laparotomy. Among the study participants, we identified as cases of migraine in one group of respondents who were already diagnosed as patients of migraine and the others with complaints of headache were further confirmed by a medicine specialist. Patients were recruited from the department of obstetrics and gynaecology at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital & Ibrahim Medical College. The study was approved by the Ethical Review Committee of BIRDEM. Multivariate logistic regression was used to identify the association between endometriosis and migraine using odds ratios and 95% confidence intervals. ResultsIn our study, out of the 1496 patients who underwent laparoscopy or laparotomy during the study period, the frequency of endometriosis was found to be 12.7%. We enrolled 190 confirmed endometriosis cases and an equal number of controls without endometriosis, maintaining the age distribution of the controls similar to that of the cases. The distribution of age, BMI, education and marital status of the patients with endometriosis were similar to that of controls. The average ages of respondents were 30.6 years in both the case and control groups. Regarding occupation, cases included more students than in controls (12% vs 0%). The odds of suffering from dysmenorrhoea and dyspareunia among the cases were 3.3 (P value <0.001, 95% CI: 2.66-4.15) and 9.5 (P value <0.001, 95% CI: 5.3-17.9) times higher than that of controls respectively. In addition, the odds of menstrual irregularity was 60% lower among the cases compared to that of controls (OR = 0.4, P value <0.001 95% CI: 0.24-0.64). No significant difference was observed in having primary subfertility and secondary subfertility among the two groups of respondents. Univariate regression analysis showed patients with endometriosis have 6.13 times higher odds (P value <0.001, 95% CI: 2.5-18.4) of having migraine, 2-time higher odds for headache (P value = 0.01, 95% CI: 1.2-3.2) compared to control patients. Further, the age and BMI-adjusted multivariate model showed subjects with endometriosis have 5.4 times higher odds of having migraine compared to non-endometriosis patients (P value <0.001, 95% CI: 2.11-16.4). Also, the higher the age of reproductive age of women, the more the odds of having migraine. For one year increase in age increases the odds of having migraine by 23% (OR = 1.23. 95% CI: 1.13-1.16, p-value = <0.001). ConclusionThe study results support the association between endometriosis and migraine among the Bangladeshi population, which is similar to relevant studies conducted in other geographical locations. The groups of physicians who treat patients suffering from the two diseases, endometriosis and migraine, should keep this interrelationship in mind to ensure a better quality of a patient's life.

Association between early spontaneous abortion and homocysteine metabolism.

The purpose of this study is to explore the effects of homocysteine (HCY) metabolism and related factors on early spontaneous abortion. We conducted a hospital-based case-control study and included a total of 500 cases and 1,000 controls in Shaanxi China. Pregnant women waiting for delivery in the hospital were interviewed to report their characteristics and other relevant information during pregnancy. The unconditional Logisitic regression model was applied to assess the association between early spontaneous abortion and HCY metabolism and related factors. The multiplicative model was applied to assess the effects of interaction of HCY metabolism and related factors on early spontaneous abortion. The logit test method of generalized structural equation model (GSEM) was used to construct the pathway diagram of HCY metabolism and related factors affecting early spontaneous abortion. Folic acid supplementation and adequate folic acid supplementation during periconception were the protective factors of early spontaneous abortion (OR = 0.50, 95% CI: 0.38-0.65; OR = 0.44, 95% CI: 0.35-0.54). The serum folate deficiency, higher plasma HCY in early pregnancy, the women who carried the MTHFR 677TT genotype were the risk factors of early spontaneous abortion (OR = 5.87, 95% CI: 1.53-22.50; OR = 2.94, 95% CI: 1.14-7.57; OR = 2.32, 95% CI: 1.20-4.50). The women's educational level and maternal and child health care utilization affected the occurrence of early spontaneous abortion by influencing the folic acid supplementation during periconception. The folic acid supplementation during periconception affected the occurrence of early spontaneous abortion by influencing the level of serum folate or plasma HCY in early pregnancy. The maternal MTHFR 677 gene polymorphism affected the occurrence of early spontaneous abortion by influencing the level of serum folate in early pregnancy. In terms of the risks for early spontaneous abortion, there was multiplicative interaction between higher plasma HCY in early pregnancy, serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 1.76, 95% CI: 1.17-4.03), and there was multiplicative interaction between higher plasma HCY and serum folate deficiency in early pregnancy (OR = 3.46, 95% CI: 2.49-4.81), and there was multiplicative interaction between serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 3.50, 95% CI: 2.78-5.18). The above interactions are all synergistic. The occurrence risk of early spontaneous abortion was significantly increased if multiple factors existed at the same time. Our study is the first time to construct the pathway of HCY metabolism and related factors affecting early spontaneous abortion, and provides a comprehensively new idea to prevent and reduce the occurrence of spontaneous abortion.

Prevalence of Increased QTc Dispersion Among Hypertensive Patients and Its Correlation to Clinical Risk Factors: A Hospital-Based Case-Control Study.

Background In Ghana and other sub-Saharan African countries, hypertension (HTN) prevalence is rapidly increasing. Hypertensive left ventricular hypertrophy (LVH) is associated with excess fibrous tissue deposition throughout the myocardium. This could lead to ventricular arrhythmias and sudden cardiac death. Increased corrected QT dispersion (QTcd) can cause ventricular repolarization and be used to identify patients at risk of ventricular tachyarrhythmia. The measurement of increased QTcd among hypertensive patients is a simple screening tool to stratify patients at cardiovascular risk. Methods A case-control hospital-based study was conducted on 200 consecutive hypertensive patients. Age- and sex-matched control groups of 200 normotensive individuals who gave informed consent were also recruited. The baseline clinical and demographic characteristics of participants were acquired using structured questionnaires. A physical examination and a resting 12-lead ECG were performed. Increased QTcd and LVH were determined. Results The mean age of hypertensive patients was 50.99±6.73 and 48.19±7.17 for the controls (p-value 0.63). The study population was predominantly female (1:2.4 male:female ratio). Higher mean values for QTcd and LVH (Sokolow-Lyon) were observed among hypertensive patients compared to controls. The prevalence of increased QTcd was 45.0% among hypertensive patients compared to 16.5% in controls (χ2=38.14, p-value <0.0000001, odds ratio = 4.14). Conclusion Increased QTcd is prevalent among hypertensive Ghanaians. Its measurement can be an effective non-invasive screening tool to risk-stratify hypertensive patients.

Pesticide exposure and risk of cholangiocarcinoma: A hospital-based matched case-control study.

Cholangiocarcinoma (CCA) caused by Opisthorchis viverrini is a well-known and significant public health issue in northeastern Thailand; however, a link between pesticide exposure (PE) and CCA risk has not yet been established. Therefore, our research objective was to investigate the relationship between PE and CCA risk. A hospital-based matched case-control study was carried out. All cases (in-patients) and controls (out-patients) were volunteers at a tertiary hospital in northeast Thailand. Between 2015 and 2019, 178 incident cases of pathologically-confirmed CCA and 356 controls were selected from the check-up clinic from the Srinagarind Hospital outpatient database (two controls per case). The recruited controls were individually-matched to the CCA cases based on sex, age (±5 years) and admission date (±3 months). During face-to-face interviews, a standardised pre-tested questionnaire was used to collect data. Multivariable conditional logistic regression was used to analyse the data. The respective frequency of PE between the 178 CCA cases and 356 controls was 77.0% versus 87.6% for never used, 14.6% versus 5.3% for have used but stopped and 8.4% versus 7.0% for currently using. After adjusting for the highest educational attainment, smoking behaviour, alcohol use and family history of cancer, PE was not significantly associated with CCA (p-value = 0.086). Using volunteers who have never used PE as the reference group, the respective odds of developing CCA for those who have ever used but have since stopped and are currently using was 2.04 (adjusted OR = 2.04; 95% CI: 1.03-4.04) versus 0.83 (adjusted OR = 0.83; 95% CI: 0.39-1.76) times more likely to develop CCA than those who had never used PE. There is no association between PE and the risk of CCA. Notwithstanding the finding, future research should focus on enhancing PE assessment methods that consider complex chemical mixtures, chemicals of interest, historical exposure and exposure pathways. Moreover, there is need for more extensive and longer population-based cohort studies that include younger, non-occupationally exposed individuals during periods of developmental susceptibility.

Exploring the association between ultra-processed foods and COPD: a case-control study

BackgroundWhile it is known that the overconsumption of ultra-processed foods (UPFs) is associated with a heightened risk of respiratory ailments, the specific effects of UPF intake on COPD remain unclear. This study was designed to explore the potential link between COPD and the consumption of UPFs among adult individuals in Iran.MethodsIn this hospital-based case-control study conducted at Alzahra University Hospital in Isfahan, Iran, we enrolled 84 patients newly diagnosed with COPD, along with 252 healthy controls matched for age and sex. COPD was defined based on the results of spirometry tests, specifically when the forced expiratory volume per second (FEV1) was less than 80% or the ratio of FEV1 to forced vital capacity (FVC) was less than 70%. To evaluate the dietary intake of the participants, we utilized a validated food frequency questionnaire (FFQ) consisting of 168 items. Additionally, we gathered data on potential confounding factors using a pre-tested questionnaire.ResultsThe mean ages for the case and control groups were 57.07 and 55.05 years, respectively. Our study found no significant association between the intake of ultra-processed foods (UPFs) and the likelihood of COPD, with an odds ratio (OR: 0.78, 95% CI: 0.34–1.77). This lack of association persisted even after adjusting for factors such as energy intake, sex, and age (OR: 0.48; 95% CI: 0.19–1.21). Further controlling for potential confounders like body mass index (BMI), physical activity, and smoking status did not alter this finding (OR: 0.367; 95% CI: 0.123–1.1008, P = 0.074).ConclusionsIn our study, we observed no significant association between the intake of Ultra-Processed Foods (UPFs) and the odds of Chronic Obstructive Pulmonary Disease (COPD). This finding remained consistent even after adjusting for factors such as energy intake, sex, age, Body Mass Index (BMI), physical activity, and smoking status. Therefore, within the scope of our study, it appears that the consumption of UPFs does not significantly impact the likelihood of developing COPD. However, we recommend further research to deepen our understanding of the intricate relationship between dietary habits and respiratory health.

Plasma levels and dietary intake of minerals in patients with type 2 diabetes and chronic kidney disease: A case-control study

Background and aimDiabetic kidney disease (DKD) is the primary cause of chronic kidney disease (CKD) worldwide. Altered mineral levels leading to adverse outcomes are widely reported in diabetes but limited in DKD, in the Indian scenario, hence this study was taken up to address this issue. MethodsA hospital-based case-control study was taken up with 54 healthy controls (C) and 140 subjects with type 2 diabetes wherein 74 subjects with diabetes and CKD formed the DKD group, and 66 subjects with diabetes but no CKD formed the diabetic no-chronic kidney disease (DNCKD) group. High-resolution inductively coupled plasma mass spectrometry was used to evaluate the blood levels of minerals (calcium (Ca), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), copper (Cu), zinc (Zn), and selenium (Se)), and a raw food-based food frequency questionnaire for dietary intakes. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation (mL/min/1.73 m2) and albuminuria. Spearman’s rank correlation was used to evaluate the relationship between the categorical variables. ResultsThe median values of plasma Ca in the DKD group were significantly lower compared with the DNCKD and C groups (10.5 mg/dL vs. 11.0 mg/dL and 11.7 mg/dL, p<0.001). Furthermore, plasma Ca levels lowered with declining kidney function, as evidenced by the eGFR and albuminuria segregation. Dietary intake of minerals did not correlate with the corresponding plasma levels. However, in the DKD group, eGFR correlated positively with the plasma levels of Ca (r= 0.422, p=0.001), Cr (r= 0.351, p=0.008), Mn (r= 0.338, p=0.011), Fe (r= 0.403, p=0.002), Cu (r= 0.274, p=0.041) and negatively with Se (r= −0.486, p<0.001). ConclusionPlasma Ca levels are lower in the DKD group with a strong positive association with eGFR, indicating its role in predicting the onset and progression of kidney function decline.

Role of PON1 L55M Gene Polymorphism in Parkinson's Disease among North Indian Population.

The role of various genetic markers including alpha synuclein, Parkin, etc., is known in the pathogenesis of Parkinson's disease (PD). Novel genetic markers including paraoxonase 1 (PON1) have also been linked to PD pathogenesis in recent studies. The PON1 L55M allele carriers may have defective clearance of environmental toxins and may result in increased susceptibility to PD. Hence, we studied the role of PON1 L55M polymorphism in PD among a North Indian population. Seventy-four PD patients and 74 age- and sex-matched controls were recruited in this hospital-based case-control study. Baseline characteristics were recorded using structured questionnaire. DNA was extracted from 3-4 ml of venous blood, followed by PCR and restriction digestion. PON1 L55M genotypes were visualized as bands: LL (177 bp), LM (177, 140 bp) and MM (140,44 bp) on 3% agarose gel. Mann-Whitney U test and Chi-squared test were used for comparing two groups of skewed and categorical variables, respectively. Measures of strength of association were calculated by binary regression analysis. P value < 0.05 was considered as significant. Parkinson's disease patients had significantly higher exposure to pesticides (12.2%; P (organophosphate exposure) < 0.001) and well water drinking (28.4%; P = 0.006) compared to controls. Frequency distribution of LL, LM, MM genotypes was 67.5% (50/74), 28.4% (21/74), and 4.1% (3/74), respectively, for cases and 72.6% (54/74), 26% (19/74) and 1.4% (1/74), respectively, for controls. PON1 L55M genotype distribution between Parkinson's disease cases and controls was not significant (P = 0.53). PON1 L55M polymorphism was not associated with PD after adjusting for confounders by binary regression analysis. There was no significant association between PON1 L55M polymorphism and PD. Larger population-based studies would be required from India before drawing any definite conclusions.

Predictive model for identifying mild cognitive impairment in patients with type 2 diabetes mellitus: A CHAID decision tree analysis.

As the population ages, mild cognitive impairment (MCI) and type 2 diabetes mellitus (T2DM) become common conditions that often coexist. Evidence has shown that MCI could lead to reduced treatment compliance, medication management, and self-care ability in T2DM patients. Therefore, early identification of those with increased risk of MCI is crucial from a preventive perspective. Given the growing utilization of decision trees in prediction of health-related outcomes, this study aimed to identify MCI in T2DM patients using the decision tree approach. This hospital-based case-control study was performed in the Endocrinology Department of Xiangya Hospital affiliated to Central South University between March 2021 and December 2022. MCI was defined based on the Petersen criteria. Demographic characteristics, lifestyle factors, and T2DM-related information were collected. The study sample was randomly divided into the training and validation sets in a 7:3 ratio. Univariate and multivariate analyses were performed, and a decision tree model was established using the chi-square automatic interaction detection (CHAID) algorithm to identify key predictor variables associated with MCI. The area under the curve (AUC) value was used to evaluate the performance of the established decision tree model, and the performance of multivariate regression model was also evaluated for comparison. A total of 1001 participants (705 in the training set and 296 in the validation set) were included in this study. The mean age of participants in the training and validation sets was 60.2 ± 10.3 and 60.4 ± 9.5 years, respectively. There were no significant differences in the characteristics between the training and validation sets (p>.05). The CHAID decision tree analysis identified six key predictor variables associated with MCI, including age, educational level, household income, regular physical activity, diabetic nephropathy, and diabetic retinopathy. The established decision tree model had 15 nodes composed of 4 layers, and age is the most significant predictor variable. It performed well (AUC=.75 [95% confidence interval (CI): .71-.78] and .67 [95% CI: .61-.74] in the training and validation sets, respectively), was internally validated, and had comparable predictive value compared to the multivariate logistic regression model (AUC=.76 [95% CI: .72-.80] and .69 [95% CI: .62-.75] in the training and validation sets, respectively). The established decision tree model based on age, educational level, household income, regular physical activity, diabetic nephropathy, and diabetic retinopathy performed well with comparable predictive value compared to the multivariate logistic regression model and was internally validated. Due to its superior classification accuracy and simple presentation as well as interpretation of collected data, the decision tree model is more recommended for the prediction of MCI in T2DM patients in clinical practice.

Acetylcholinesterase enzyme among cancer patients a potential diagnostic and prognostic indicator a multicenter case–control study

Acetylcholinesterase enzyme (AChE) activity is impaired by a variety of inhibitors including organophosphorus pesticides, leading to the accumulation of acetylcholine. In this study, we aimed to determine the association between cancer and the blood level of the (AChE). This is a multicenter hospital-based case–control study conducted in the Radiation and Isotopes Center Khartoum, and Institute of Nuclear Medicine and Molecular Biology and Oncology Gezira. One hundred and fifty participants, half of them cancer patients and half cancer free were recruited. All participants were screened for demographic, environmental, occupational, and clinical characteristics. Blood for the (AChE) activity test was drawn from participants in the two groups. The mean age of the participants was 40.6 ± 14.8 years. Geographical distribution showed the Central Region of Sudan had the highest rate of cancer, followed by North State, Khartoum State, West State, and East State. The most common tumor subtype was breast cancer, followed by leukemia, colon, esophageal, and prostate cancer. Inferential analysis revealed significantly impaired (AChE) activity among cancer patients compared to controls (53.4 ± 20.3% vs. 93.8 ± 8.8, p-value 0.001). There was a significant statistical association between impaired (AChE) activity and cancer. (AChE) activity might be applied in the future as a diagnostic biomarker and therapeutic target. Further large sample and molecular studies are recommended.

Dietary Patterns and Lifestyle Factors Associated with the Risk of Colorectal Cancer: A Hospital-Based Case-Control Study among Malaysians.

This study aimed to examine the association between dietary patterns, lifestyle factors, and colorectal cancer (CRC) risk among the Malaysian population. We recruited 100 patients and 100 controls from two selected government hospitals. Principal component analysis was used to identify dietary patterns using a 123-item semiquantitative food frequency questionnaire. Tobacco smoking and alcohol consumption questionnaires were modified from the WHO STEPS Survey questionnaire. Physical activity levels were assessed using the revised Global Physical Activity questionnaire. Associations between dietary patterns, lifestyle factors and CRC risk were assessed using logistic regression with SPSS version 24.0. Three dietary patterns were derived from factor analysis: i) vegetables; ii) meat, seafood and processed food; and iii) grains and legumes. High vegetable diet intake was independently and significantly associated with an 81% decreased risk of CRC (odds ratio [OR]: 0.19; 95% confidence interval [CI]: 0.08, 0.46). Both recreational-related physical activity (OR: 2.04; 95% CI: 1.14, 3.64) and vigorous physical activity (OR: 2.06; 95% CI: 1.13, 3.74) are significantly associated with decreased risk of CRC. Increasing the number of cigarettes smoked (≥ 16 cigarettes) per day significantly increased the odds of developing CRC (OR: 2.58; 95% CI: 1.95, 6.75). The duration of alcohol consumption cessation was inversely associated with CRC risk (OR: 2.52; 95% CI: 2.30, 10.57). The protective effects of a fruit and vegetable diet, and a healthy lifestyle can be used to develop interventions that help reduce the risk of CRC in the Malaysian population.

Investigation of occupational risk factors for the development of non-Hodgkin's lymphoma in adults: A hospital-based case-control study.

Non-Hodgkin's Lymphoma (NHL) is a malignancy of the lymphoid lineage of the hematopoietic system has worldwide, especially in developed countries. Better diagnostic and recording techniques, longer life expectancy, and greater exposure to risk factors are hypotheses for this growing incidence curve. Occupational exposures to chemical, biological, and physical agents have also been associated with NHL development, but the results are still controversial. We have investigated the occupational and lifestyle case-control study design with 214 adult patients and 452 population controls. Socio-demographic, clinical, and occupational exposure data were obtained through individual interviews with a standardized questionnaire. Clinical, laboratory, and histopathological data were obtained through medical records. Risk of NHL (any subtype), B-cell lymphoma, DLBCL, Follicular lymphoma and T-cell lymphoma was elevated among the those who had ever been exposed to any solvents, hydrocarbon solvents, pesticides, meat and meat products, and sunlight and tended to increase by years of exposure. A significant upward trend with years of exposure was detected for any solvents and hydrocarbon solvents (NHL (any subtype) p-value for trend<0.001), B-cell lymphoma (p-value for trend<0.001), and T-cell lymphoma (p-value for trend<0.023), pesticides (NHL (any subtype), p for trend<0.001) and T-cell lymphoma (p for trend<0.002), meat and meat products (NHL (any subtype) (p for trend<0.001) and DLBCL (p for trend<0.001), and sunlight (B-cell lymphoma (p for trend<0.001). The results of this study agree line with other international studies, can be extrapolated to other countries that have the same socio-demographic and occupational characteristics as Brazil and support strategies for surveillance and control of work-related cancer.

Metabolic parameters in acne vulgaris: a case control study investigating fasting blood glucose and insulin levels in acne vulgaris

Background: Influence of diet and lifestyle on acne among Indian population. Objectives were to identify the clinico-epidemiological profile of patients with Acne vulgaris and to assess the fasting plasma glucose and serum insulin levels in Acne vulgaris patients and the controls and correlate them. Methods: This was a hospital-based case-control study conducted in the Department of Dermatology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Study included 60 cases of acne and 60 controls (age and sex matched), attending the outpatient department. After complete history, general physical, systemic and cutaneous examination, all cases were subjected to following investigation: fasting blood sugar and serum insulin levels. Results: Acne was common in the age group 18-24 yrs (70%). In almost half the patients the age of onset was between 12-18 yrs. Commonly observed site for acne was cheeks (83.3%), forehead (66.7%), nose (55%) and chin (41.7%). The risk of developing acne was 3.5 times more among smokers than non-smokers. The mean fasting blood sugar values of cases and controls when compared showed a statistically significant difference (p&lt;0.05). Our study did not find any statistically significant difference in fasting insulin levels between cases and controls. Conclusions: There was only significant difference in the Mean fasting blood glucose in cases as compared to controls. Mean fasting serum insulin level though found to be raised in cases compared to controls, does not prove statistical significance. Fasting plasma glucose was significantly raised in grade III acne as compared to other grades.

High-protein diet scores, macronutrient substitution, and breast cancer risk: insights from substitution analysis

BackgroundEvidence from recent studies suggested that variation in the quantity and quality of macronutrients in the diet may potentially play a role in predicting the risk of breast cancer (BC). In the current study, we aimed to assess the association of different high-protein diet scores and replacing fats and carbohydrate (CHO) with protein in the diet with the BC risk among Iranian women.MethodsThe current hospital-based case-control study was conducted on 401 participants, aged ≥ 30 years old, including 134 women in the case group who had been diagnosed with histologically confirmed BC and 267 women in the control group. Dietary intake data was collected using a validated food frequency questionnaire, and high protein diet scores were determined. Logistic regression models were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of high protein diet scores. Also, we assessed how substituting protein with other macronutrients affected BC odds while adjusting for the various confounding variables.ResultsParticipants’ mean ± SD of age and body mass index were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. The scores of high-protein-low-CHO and fat diet, high-protein and CHO-low-fat diet, and high-protein and fat-low-CHO diet in participants were 16.5 ± 3.8, 16.5 ± 6.7, and 16.4 ± 5.9, respectively. In the multivariable model, individuals in the highest tertile of high-protein-low-CHO and fat diet score (OR:0.71;95%CI:0.56–0.90) and high-protein and CHO-low-fat diet (OR:0.76;95%CI:0.60–0.97) had lower odds of BC compared to those in the lowest tertile (P < 0.05). However, no significant association was found between high-protein and fat-low-CHO diet and BC risk. Our results showed that replacing fat by protein (ORdifferences:-0.40;95%CI:-0.73,-0.07) and also replacing refined-CHO by plant protein (ORdifferences:-0.66;95%CI:-1.26,-0.07) in the diet are associated inversely with risk of BC(P < 0.05).ConclusionsThe results of our study suggested that higher adherence to a high-protein-low-CHO and fat diet, characterized by a higher intake of plant proteins and a lower intake of refined grains and saturated fat can play a protective role against the odds of BC.

Correlation Between Thyroid Profile and Glycated Haemoglobin (HbA1c) in Type 2 Diabetes Mellitus Patients

Diabetes mellitus is a global health problem affecting major populations worldwide. It is a group of metabolic disorders characterized by absolute or relative deficiencies in insulin secretion with chronic hyperglycaemia and disturbances of carbohydrate, lipid, and protein metabolism. Thyroid hormones are secreted from thyroid gland. Thyroid hormone replacement is associated with a decrease in Glycated Hemoglobin (HbA1c) level. The present study was undertaken to study correlation between thyroid profile and glycated Haemoglobin (HbA1c) in Type 2 Diabetes Mellitus patients. A hospital based case control study was carried out in Dept. of Biochemistry, North Bengal Medical College, Sirajganj, Bangladesh from July to December 2022. 100 participants were in the study group and 100 participants in control groups were enrolled by following procedure. Patients aged 30 years or more who came to routine health check-up were taken for the study. Basic information, clinical history was taken from the record files. 50 cases of Type 2 Diabetes mellitus and 50 healthy controls were taken. Blood samples were collected and analyzed for thyroid profile, HbA1c, Fasting Blood Sugar and Renal Function Test. We found that there was a positive correlation between TSH (Thyroid stimulating hormone) and HbA1c levels, and a negative correlation between Thyroid hormones [Triiodothyronine (T3) &amp; Thyroxine (T4)] and Glycated Haemoglobin (HbA1c) in cases of type 2 Diabetes Mellitus. There is a significant decrease in TT3 (Total Triiodothyronine) and TT4 (Total Thyroxine) and significantly increased TSH in cases of Diabetes mellitus as compare to healthy Controls. We found that out of 50 cases of type 2 Diabetes Mellitus, 31% patients showed thyroid disorders. There is a high prevalence of thyroid disorders in Diabetic patients. If not diagnosed early, it could negatively affect diabetes and its complications. Therefore, routine screening of thyroid profile in diabetic patients is advisable to improve quality of life and reduce morbidity rate.

Association Between Body Mass Index and Infertility Among Women: An Age-Matched Case-Control Study

Ample literature exists which time and over has established the association between overweight/ underweight and fertility problems. Further in this context, it should be noted that there are very few studies in the Indian context regarding the effect of body mass index (BMI) on infertility in women. To evaluate the association of BMI with infertility among women in Tamil Nadu, India. An age-matched hospital-based case-control study was conducted including 204 women attending a tertiary care hospital in the Chengalpattu district of Tamil Nadu. Of these, 102 women who had a clinical diagnosis of infertility were selected as cases. Hospital controls were defined as women who did not have a clinical diagnosis of infertility and were selected after matching for age and years of marriage (± 2 years). BMI was calculated from the height and weight measurements taken during the time of recruitment to the study. Basic socio-demographic data were also collected from all the study participants. Among cases, 17.6% were underweight, 25.5% were overweight and 5.9% were obese. Whereas, among controls, 7.8% were underweight, 47.1% were overweight and 11.8% were obese. Among the cases, 68% had primary infertility and 32% had secondary infertility. Overweight and obese women had 2.82 odds (95% CI, 1.48 – 5.38) and 3.06 odds (95% CI, 1.05 – 8.93) respectively of having infertility when compared to women who fell within the normal BMI range. Both overweight and obesity were observed to be significantly associated with infertility. The focus should be given to the prevention and control of both as an effective means of reducing the risk of infertility and other associated disorders.

Association between adherence to a dietary approach to stop hypertension and the Mediterranean diets and risk of colorectal cancer: A matched case-control study

Colorectal cancer (CRC) is one of the most common cancers and is currently the third leading cause of cancer-related deaths worldwide. This study aimed to evaluate whether the dietary approach to stop hypertension (DASH) and Mediterranean (MED) diets are associated with CRC in Iranian adults. This hospital-based case-control study was conducted on 71 cases and 142 controls (40-75 years old) in three general hospitals in Tehran, Iran. The dietary intakes of individuals were collected through face-to-face interviews using a semi-quantitative food frequency questionnaire (FFQ) that included 125 food items. The DASH and MED diet scores were calculated according to food items based on guidelines. Two logistic regression models were applied to evaluate the association between DASH and MED score adherence. After adjusting for confounding factors, a negative association between DASH diet adherence and CRC risk was observed in the second and last tertile compared to the first tertile (T) (T2: odds ratio (OR)=0.33; 95% confidence interval (CI): 0.14-0.77 - T3: OR=0.09; 95% CI: 0.03-0.27). There was no significant association between the MED diet and the risk of CRC. In conclusion, the current study's findings presented that adherence to a DASH diet could reduce the odds of CRC.

A comprehensive multiplatform metabolomic analysis reveals alterations of 2-hydroxybutyric acid among women with deep endometriosis related to the pesticide trans-nonachlor

BackgroundExposure to persistent organic pollutants (POPs) has been related to the risk of endometriosis however the mechanisms remain unclear. The objective of the present study was to characterize the metabolic profiles underpinning the associations between POPs and endometriosis risk. MethodologyA hospital-based case-control study was conducted in France to recruit women with and without surgically confirmed deep endometriosis. Women's serum was analyzed using gas and liquid chromatography coupled to high-resolution mass spectrometry (HRMS) to measure the levels of polychlorinated biphenyls (PCBs), organochlorinated pesticides (OCPs) and per-/polyfluoroalkyl substances (PFAS). A comprehensive metabolomic profiling was conducted using targeted HRMS and 1H nuclear magnetic resonance (1H NMR) to cover polar and non-polar fractions. A “meet-in-the-middle” statistical framework was applied to identify the metabolites related to endometriosis and POP levels, using multivariate linear and logistic regressions adjusting for confounding variables. ResultsFourteen PCBs, six OCPs and six PFAS were widely found in almost all serum samples. The pesticide trans-nonachlor was the POP most strongly and positively associated with deep endometriosis risk, with odds ratio (95 % confidence interval) of 2.42 (1.49; 4.12), followed by PCB180 and 167. Women with endometriosis exhibited a distinctive metabolic profile, with elevated serum levels of lactate, ketone bodies and multiple amino acids and lower levels of bile acids, phosphatidylcholines (PCs), cortisol and hippuric acid. The metabolite 2-hydroxybutyrate was simultaneously associated to endometriosis risk and exposure to trans-nonachlor. ConclusionsTo the best of our knowledge, this is the first comprehensive metabolome-wide association study of endometriosis, integrating ultra-trace profiling of POPs. The results confirmed a metabolic alteration among women with deep endometriosis that could be also associated to the exposure to POPs. Further observational and experimental studies will be required to delineate the causal ordering of those associations and gain insight on the underlying mechanisms.

Determinants of Overweight Among Type Two Diabetes Mellitus Patients Attending Public Hospitals At Awusi Resu Zone of Afar Region: Unmatched Case-Control Study.

Diabetes is a major cause of morbidity and mortality; affecting More than 415 million people. The primary aim of this study was to assess the determinants of being overweight among Type 2 Diabetic patients attending diabetic clinics of public Hospitals in the Awusi resu zone of Afar region, Northeast Ethiopia. A hospital-based unmatched case-control study design was conducted from May 5 to June 5/2021 by systematic random sampling 286 study participants were involved in the study (96 cases and 190 controls); Logistic regression analysis was performed to identify the best model of factors leading to overweight. The odds ratio and 95% confidence interval were used as a measure of association. Those who have attended college and above have an AOR; of 10.30 CI: (4.16-25.50) ten times higher odds of being overweight when compared to those unable/able to read. Only those who have a family history of diabetes AOR: 3.10 CI (1.04-9.30) have three folds of being overweight when compared to their counterparts. Of those who use insulin for controlling blood glucose (AOR: 0.14 CI (0.03-0.74) 96% at less likely to be overweight compared to those who use exercise. In this study, educational level, Family History, and type of blood glucose controlling mechanism were important predictors of overweight on T2DM. Moreover the diabetes patients were recommended to use insulin for controlling blood glucose.

Vaccine effectiveness against influenza hospitalisation in adults during the 2022/2023 mixed season of influenza A(H1N1)pdm09, A(H3N2) and B circulation, Europe: VEBIS SARI VE hospital network.

We conducted a multicentre hospital-based test-negative case-control study to measure vaccine effectiveness (VE) against PCR-confirmed influenza in adult patients with severe acute respiratory infection (SARI) during the 2022/2023 influenza season in Europe. Among 5547 SARI patients ≥18 years, 2963 (53%) were vaccinated against influenza. Overall VE against influenza A(H1N1)pdm09 was 11% (95% CI: -23-36); 20% (95% CI: -4-39) against A(H3N2) and 56% (95% CI: 22-75) against B. During the 2022/2023 season, while VE against hospitalisation with influenza B was >55%, it was ≤20% for influenza A subtypes. While influenza vaccination should be a priority for future seasons, improved vaccines against influenza are needed.