Multiple-adjusted Odds Ratio Research Articles

Soy Food Consumption Is Inversely Associated with Handgrip Strength: Results from the TCLSIH Cohort Study.

Background: Soy foods contain high levels of soy protein or isoflavones, which can stimulate muscle protein synthesis and increase antioxidant capacity, and thus ameliorate muscle strength decline. However, data from epidemiological studies investigating the association of habitual soy food consumption with muscle strength decline among general Chinese adults are limited. Methods: This study included 29,525 participants (mean age: 41.6 years; 16,933 (53.8%) males). Soy food consumption was evaluated using a validated 100-item food frequency questionnaire. Handgrip strength (HGS) was assessed with a hand dynamometer. Analysis of covariance were performed to assess the multivariable-adjusted least square means (LSM) and 95% confidence interval (CI) for HGS. Results: The multiple adjusted LSM (95% CI) of HGS across soy food consumption were 35.5 (34.2, 37.1) kg for <1 time per week, 36.1 (34.6, 37.6) kg for 1 time per week, 36.3 (34.8, 37.8) kg for 2−3 times per week, and 36.6 (35.1, 38.0) kg for ≥4 times per week (p for trend < 0.001). Compared to participants with soy food consumption less than one time per week, the multiple adjusted odds ratio (95% CI) of low HGS was 0.638 (0.485, 0.836) when the weekly consumption was ≥ 4 times (p for trend < 0.01). Conclusions: Higher habitual soy food consumption was positively associated with HGS in general Chinese adults. Consumption of soy foods may have beneficial effects on muscle health.

PS-C32-6: ASSOCIATION BETWEEN BLOOD PRESSURE COMPONENTS AND RENAL HISTOLOGIC FINDINGS IN PATIENTS WITH IGA NEPHROPATHY

Objective: The diverse histological findings in IgA nephropathy are often evaluated using the Oxford classification for glomerular, tubular/interstitial, and vascular lesions. Patients with IgA nephropathy are prone to hypertension, but the relationship between the histological findings and blood pressure (BP) is not well known. In addition to systolic BP (SBP) and diastolic BP (DBP), mean arterial pressure (MAP) as a steady component and pulse pressure (PP) as a pulsatile component are also important BP components. Therefore, we investigated the detailed relationship between these BP components and renal histological findings. Design and method: Among 340 patients with IgA nephropathy diagnosed by renal biopsy between June 1996 and December 2008, 230 patients aged 15–65 years who were not taking antihypertensive medications other than renin-angiotensin-aldosterone system (RAAS) inhibitors and had serum creatinine levels &lt; 2.0 mg/dL were included in this cross-sectional analysis. Multiple logistic regression analysis was used to examine the association between four BP components and pathological factors. Pathological factors were evaluated using parameters included in the Oxford classification: mesangial hypercellularity (mesangial score &gt; 0.5 or ≦ 0.5), segmental glomerulosclerosis (yes/no), endocapillary hypercellularity (yes/no), global glomerulosclerosis (≦ 13.6% of the total number of glomeruli, which indicates the highest quartile of the total population, or &lt; 13.6%), tubular atrophy/interstitial fibrosis (&gt; 10% of cortical area, or ≦ 10%), cellular/fibrocellular crescents (yes/no), and arteriosclerosis (yes/no). Results: The prevalence of mesangial hypercellularity, segmental glomerulosclerosis, endocapillary hypercellularity, tubular atrophy/interstitial fibrosis, cellular/fibrocellular crescents and arteriosclerosis were 47.8%, 84.8%, 37.4%, 20.9%, 33.9%, and 32.2%, respectively. After adjustment for age, sex, smoking status, alcohol status, and use of RAAS inhibitors, global glomerulosclerosis and tubular atrophy/interstitial fibrosis were significantly associated with DBP, and arteriosclerosis was associated with SBP, DBP, and MAP, whereas mesangial hypercellularity, segmental glomerulosclerosis, endocapillary hypercellularity, and cellular/fibrocellular crescents were not associated with any BP component. The multiple-adjusted odds ratio of global glomerulosclerosis for DBP per 10 mmHg was 1.67 (95% CI 1.09–2.55), and that of tubular atrophy/interstitial fibrosis for DBP per 10 mmHg was 1.66 (95% CI 1.06–2.60). The multiple-adjusted odds ratios of arteriosclerosis were 1.58 (95% CI 1.16–2.15), 1.89 (95% CI 1.26–2.83), and 1.62 (95% CI 1.15–2.29) for SBP, DBP, and MAP per 10 mmHg, respectively. Conclusions: In the cross-sectional study of patients with IgA nephropathy, global glomerulosclerosis, tubular atrophy/interstitial fibrosis, and arteriosclerosis were associated with DBP, and arteriosclerosis was also associated with SBP and MAP. On the other hand, segmental glomerulosclerosis, endocapillary hypercellularity, and cellular/fibrocellular crescents had no association with any BP component.

Factors associated with implantable cardioverter-defibrillator shocks in patients suffering from non-ischemic cardiomyopathy.

Although intra-cardiac shocks are a lifesaving approach in patients with systolic heart failure (HF), the probable effective factors related to shock occurrence are less frequently recognized. We designed this study to assess the factors associated with inappropriate or appropriate implantable cardioverter-defibrillator (ICD) shocks in patients with non-ischemic cardiomyopathy (NICM). Ninety-nine patients with NICM who implanted ICD were enrolled from March 2018 to September 2019 and followed up with a three-month interval for up to one year. Shock therapy was defined as either appropriate or inappropriate shock. The odds ratio (OR) of inappropriate shock occurrence was calculated with crude and different adjusted models. The mean age of the population at baseline was 51.9 ± 15.4 years (men: 71%). Baseline data revealed that patients with inappropriate shocks had higher heart rates (HR), worse New York Heart Association (NYHA) class, and anti-tachycardia pacing (ATP) as well as higher percentages of amiodarone usage compared to groups with appropriate or no shock [HR: 96.8 ± 27.8 vs. 79.8 ± 12.1 vs. 76.2 ± 17.6 beats per minute (bpm), P = 0.014; NYHA class IV: 85.7% vs. 74.1% vs. 63.4%, P = 0.041; ATP: 37.5% vs. 29% vs. 5%, P = 0.010; amiodarone usage: 37.5% vs. 25.8% vs. 5%, P = 0.23, respectively]. Further multiple-adjusted OR did not reveal any significant independent association between the aforementioned variables and inappropriate shock incidence. This study indicates no significant independent predisposing factor in the occurrence of inappropriate shocks among patients with NICM. Other studies are required in this regard.

Impact of air pollution exposure on the risk of Alzheimer's disease in China: A community-based cohort study

Alzheimer's disease (AD) is the most common type of dementia. Impact of air pollution (AP) on the risk of AD is unclear. It is unknown which air pollutants are independently associated with AD and whether fish consumption mitigated the association. We carried out a community-based cohort of 6115 participants aged ≥60 years in China to examine the association of PM2.5, PM10, CO, NO2, SO2 and O3 exposure with AD, and differences in the association between people with low and high consumption of fish. The participants were randomly recruited from six counties in Zhejiang province for health survey to document socio-demographic and disease risk factors in 2014, and were followed up to diagnose AD in 2019. A total of 986 cohort members were diagnosed with AD. Based on the daily mean air pollutants monitored in 2013–2015 in the counties, participants were divided into low, middle and high AP exposure groups for subsequent analysis. The multiple adjusted odds ratio (OR) of AD in participants living with the middle and high levels of PM2.5 exposure versus the low exposure were 1.50 (95% CI 0.90–2.50) and 3.92 (2.09–7.37). The increased ORs were also with PM10 (1.74, 0.65–4.64; 3.00, 1.22–7.41) and CO (2.86, 1.32–6.20; 1.19, 0.45–3.18), but not with NO2 (0.63, 0.17–2.27; 0.95, 0.28–3.19), SO2 (0.44, 0.19–1.001; 1.21, 0.56–2.62), and O3 (0.38, 0.20–0.74; 0.50, 0.21–1.21). There were no significant interaction effects of AP with fish consumption on AD. However, participants with low consumption of fish appeared to have higher ORs in PM2.5 exposure (1.80, 1.39–2.33; 5.18, 3.93–6.82) than those high consumption (1.38, 0.78–2.47; 2.89, 1.50–5.59). Our findings of PM2.5, PM10 and CO exposure significantly increased the risk of AD and the potential mitigating effect of fish consumption on the association provide evidence for developing effective strategies for AD reduction and air pollution control.

Red Cell Distribution Width and Dementia Among Rural-Dwelling Older Adults: The MIND-China Study

Background:Evidence has emerged that anemia is associated with dementia, but data on the relationships of red blood cell distribution width (RDW) with dementia and cognitive function in older adults are sparse.Objective:We sought to investigate the associations of RDW with dementia and global cognitive performance among rural-dwelling Chinese older adults and further to examine their associations by anemia status.Methods:This population-based cross-sectional study included 5,115 participants (age≥65 years, 57.0%women) in the baseline examination (March-September 2018) of the Multimodal Interventions to Delay Dementia and Disability in rural China (MIND-CHINA). We collected data through face-to-face interviews, clinical examinations, and laboratory tests. Global cognitive function was evaluated using the Mini-Mental State Examination (MMSE). We defined dementia, Alzheimer’s disease (AD), and vascular dementia (VaD) following the respective international criteria. Data were analyzed using multinomial logistic and general linear regression models.Results:Of all participants, 300 were diagnosed with dementia, including 195 with AD and 95 VaD. The multiple-adjusted odds ratio of dementia associated with quartiles of RDW were 1.45 (95%CI: 0.87–2.44), 1.00 (reference), 1.77 (1.07–2.93), and 2.28 (1.40–3.72). Similar J-shaped patterns existed for the association of RDW with odds ratio of AD and VaD. Anemia was not significantly associated with dementia. The J-shaped associations of RDW with dementia and subtypes were statistically evident only among participants without anemia. There was an inverted J-shaped relationship between RDW quartiles and β-coefficients of MMSE score.Conclusion:There is a J-shaped association between RDW level and likelihood of dementias among rural-dwelling Chinese older adults, especially among people without anemia.

Association between epicardial adipose tissue and blood pressure: A systematic review and meta-analysis

AimsEpicardial adipose tissue has been reported to be associated with the development of cardiometabolic disease. Whether this is true for hypertension and non-dipper blood pressure remains controversial. Here, we conducted a systemic review and meta-analysis to evaluate the association between EAT and blood pressure. Data synthesisPubmed, Embase, and Web of Science were searched for relevant papers. Studies reported on the difference of EAT thickness between hypertensive and normotensive patients, or those recorded odds ratio (OR) between EAT and hypertension were included. The standard mean difference (SMD) and ORs were extracted and pooled using a random-effects model respectively. We further assessed the effect of EAT on circadian rhythm of blood pressure by combining multiple-adjusted ORs for non-dipper blood pressure. Seven studies with an overall sample of 1089 patients reported the mean difference of EAT thickness between hypertensive and normotensive patients, and the hypertensive patients had higher EAT (SMD = 1.07; 95% CI: 0.66–1.48; I2 = 89.2%) compared with controls. However, the pooled association between EAT and hypertension from two studies was not significant (OR = 1.65, 95%CI 0.62–4.68; I2 = 87.5%). The summary risk effect of EAT on non-dipper blood pressure from six studies comprising1208 patients showed that each 1 mm increment of EAT was associated with a 2.55-fold risk of non-dipper blood pressure. ConclusionHypertensive patients tend to present higher EAT thickness near the right ventricular wall and increased EAT thickness might be associated with high risk of non-dipper blood pressure. Future researches are warranted to determine the causal link between EAT and hypertension and the underlying mechanism.

Abstract 55: Sodium Sensitivity, Sodium Resistance, and Incidence of Hypertension

Background: Blood pressure responses to dietary sodium intake vary among individuals. However, it is unknown whether sodium sensitivity and sodium resistance predict incidence of hypertension. Methods: We conducted a feeding study, including a 7-day low-sodium diet (51.3 mmol/day) and a 7-day high-sodium diet (307.8 mmol/day), among 1,718 Chinese individuals with normal blood pressure in 2003-2005 and follow-up studies in 2008-2009 and 2011-2012. Three blood-pressure measurements and 24-hour urinary sodium excretion were obtained on each of 3 days during baseline, low- and high-sodium interventions, and follow-up visits. Latent class models were used to identify subgroups that share a similar underlying trajectory in blood-pressure responses to dietary sodium intake. Results: Three trajectories of systolic blood pressure responses to dietary sodium intake were identified (Figure). Mean (standard deviation) changes in systolic blood pressure were -13.7 (5.5), -4.9 (3.0), and 2.4 (3.0) mmHg during the low-sodium intervention, and 11.2 (5.3), 4.4 (4.1) and -0.2 (4.1) mmHg during the high-sodium intervention ( P&lt; 0.001 for group differences) in high sodium-sensitive, moderate sodium-sensitive, and sodium-resistant groups, respectively. Compared to individuals with moderate sodium sensitivity, multiple-adjusted odds ratio (95% confidence intervals) for incident hypertension were 1.44 (1.03 to 1.99) for those with high sodium sensitivity and 1.42 (1.02 to 1.97) for those with sodium resistance ( P &lt;0.001 for quadratic trend). Furthermore, a J-shaped association between systolic blood pressure responses to high sodium intake and incident hypertension was identified ( P &lt;0.001). Similar results were observed for diastolic blood pressure. Conclusions: Individuals with either high sodium sensitivity or sodium resistance are at an increased risk for developing hypertension.

Serum Matrix Metalloproteinase-9 Is Associated With Depression After Acute Ischemic Stroke.

Matrix metalloproteinase-9 (MMP-9), a key determinant of extracellular matrix degradation, might cause cerebral damage after stroke and be involved in the development of depressive symptoms. This study aimed to evaluate the association of serum MMP-9 levels and post-stroke depression (PSD).Methods and Results:Serum MMP-9 levels were determined in 558 acute ischemic stroke patients from 7 hospitals comprising the China Antihypertensive Trial in Acute Ischemic Stroke. We assessed depression status using the 24-item Hamilton Depression Rating Scale and defined PSD as a cutoff score of 8. Logistic regression was performed to estimate the risk of PSD associated with serum MMP-9. Discrimination and reclassification for PSD by MMP-9 were analyzed. A total of 222 (39.8%) stroke patients were categorized as PSD within 3 months. Serum MMP-9 concentrations were higher among PSD patients than those without PSD (658.8 vs. 485.7 ng/mL; P<0.001). The multiple-adjusted odds ratio (95% confidence interval) for the highest MMP-9 quartile compared with the lowest quartile was 4.36 (2.49-7.65) for PSD, and 1 standard deviation higher log-MMP-9 was associated with 68% (37-106%) increased odds of PSD. Adding MMP-9 to the conventional risk factors model substantially improved discrimination and reclassification for PSD (all P<0.05). Elevated serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of PSD, suggesting an important prognostic role of MMP-9 for PSD.

Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents.

There is little investigation on the interaction effects of adverse childhood experiences (ACEs) and social support on non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt in community adolescent populations, or gender differences in these effects.AimsTo examine the individual and interaction effects of ACEs and social support on NSSI, suicidal ideation and suicide attempt in adolescents, and explore gender differences. A school-based health survey was conducted in three provinces in China between 2013-2014. A total of 14 820 students aged 10-20 years completed standard questionnaires, to record details of ACEs, social support, NSSI, suicidal ideation and suicide attempt. Of included participants, 89.4% reported one or more category of ACEs. The 12-month prevalence of NSSI, suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively; all were significantly associated with increased ACEs and lower social support. The multiple adjusted odds ratio of NSSI in low versus high social support was 2.27 (95% CI 1.85-2.67) for girls and 1.81 (95% CI 1.53-2.14) for boys, and their ratio (Ratio of two odds ratios, ROR) was 1.25 (P = 0.037). Girls with high ACEs scores (5-6) and moderate or low social support also had a higher risk of suicide attempt than boys (RORs: 2.34, 1.84 and 2.02, respectively; all P &lt; 0.05). ACEs and low social support are associated with increased risk of NSSI and suicidality in Chinese adolescents. Strategies to improve social support, particularly among female adolescents with a high number of ACEs, should be an integral component of targeted mental health interventions.Declaration of interestNone.

Serum cystatin C, impaired kidney function, and geriatric depressive symptoms among older people living in a rural area: a population-based study

BackgroundThe relationship between kidney function and depressive symptoms among elderly people has been rarely investigated in settings of the general population. The aim of our study was to examine the association of serum cystatin C (cysC) and impaired kidney function with geriatric depressive symptoms among older people living in a rural community in China.MethodsThis population-based cohort study included 1440 individuals (age ≥ 60 years) who were recruited for the Confucius Hometown Aging Project in 2010–2011; of the 1124 persons who were free of depressive symptoms, 669 (59.5%) were re-examined in 2014–2016. At baseline, data on demographics, lifestyle factors, health conditions, and medical history were collected through interviews, clinical examinations, and laboratory tests. We defined impaired kidney function as the cystatin C-based estimated glomerular filtration rate (eGFRcysC) < 60 ml/min/1.73 m2, and depressive symptoms as a score ≥ 5 on the 15-item Geriatric Depression Scale. Data were analyzed using multiple logistic and Cox proportional-hazards models.ResultsOf the 1440 participants, 316 (21.9%) were defined to have geriatric depressive symptoms at baseline. Serum cysC levels of 1.01–1.25 and > 1.25 mg/L (vs. ≤1.00 mg/L) were associated with a multiple-adjusted odds ratio (OR) of 1.41 (95% CI 1.01–1.97) and 3.20 (2.32–4.41), respectively, for having geriatric depressive symptoms (Ptrend < 0.001). Of the 669 people who were free of depressive symptoms at baseline, 157 had incident depressive symptoms at the follow-up examination. The multiple-adjusted hazard ratio (HR) for incident depressive symptoms were 2.16 (95% CI 1.43–3.27) for serum cysC > 1.25 mg/L (vs. < 1.00 mg/L). Impaired kidney function was cross-sectionally (multiple-adjusted OR = 2.95; 95% CI 2.22–3.92) and longitudinally (multiple-adjusted HR 1.54; 95% CI 1.03–2.30) associated with an increased risk of geriatric depressive symptoms.ConclusionElevated serum cysC levels and impaired kidney function are associated with an increased risk of geriatric depressive symptoms among Chinese older people living in a rural community.

Risk of febrile neutropenia and early treatment cessation in men receiving standard and dose-reduced 3-weekly docetaxel for metastatic castration-resistant prostate cancer.

Docetaxel is an effective therapy for metastatic castration-resistant prostate cancer (mCRPC); however, many patients experience febrile neutropenia (FN) and cease treatment early due to toxicity. It is not known whether lower dose (LD) q3-weekly docetaxel impacts toxicity or efficacy. Multicenter retrospective study included 166 patients with mCRPC who received q3-weekly docetaxel between 2010 and 2015. Demographic, disease, chemotherapy (standard dose, SD 60mg/m2 vs LD 60mg/m2 ) and toxicity data were collected. Univariable and multivariable logistic and competing risk regression models evaluated docetaxel-dose association with FN and early treatment cessation (ETC) due to toxicity. Associations between dose and efficacy end points were also evaluated. Analyses were repeated employing inverse propensity score weights. Patients who received LD docetaxel (28.9%) were older with poorer Eastern Cooperative Oncology Group (ECOG) status. Fifteen percent of patients experienced FN, with a nonsignificant trend to lower incidence in the LD group (multiple adjusted odds ratio [OR]=0.42; P=0.21). Neither baseline patient nor prior treatment factors were predictive of FN. ETC due to toxicity occurred in 35%, with risk associated with increasing age, comorbidity count and poorer ECOG. There was no difference between LD and SD with respect to ETC due to toxicity, in unweighted and weighted analyses (LD vs SD, multivariable weighted hazard ratio [HR]=1.47; P=0.08). LD was associated with reduced prostate-specific antigen (PSA) response (50%vs 66.1%, multivariable weighted HR=0.54; P=0.03) and overall survival (median 7.9vs 13.8 months, multivariable weighted HR=2.19; P<0.0001). LD docetaxel for mCRPC did not mitigate the risk of FN or ETC due to toxicity. Dose reduction may result in poorer PSA response and survival.

Abstract P379: Leg Length, Marker of Environmental Exposition During Early Lifetime, and Subclinical Cardiovascular Disease

Introduction: Intrauterine and early life factors such as low birth weight, not being breastfed, smoking parents, and other socioeconomic conditions have been associated with later predisposition to chronic diseases. Although there still exists controversy in which is the best marker for environmental exposition during early lifetime, leg length has been one of the most accepted. Hypothesis: There is an inverse relationship between leg length and subclinical cardiovascular disease (sCVD). Methods: We conducted a cross-sectional analysis of a sub sample of 2,038 women from the Mexican Teacher’s Cohort. Participants underwent anthropometry during clinical assessments. Trunk length was calculated as the height measured in seated position minus the height of the stool participants were sitting on. Leg length was defined as height minus trunk length. Carotid intima media thickness(CIMT) was measured by trained neurologists through standardized ultrasound and log-transformed. We defined sCVD as CIMT ≥0.8 mm or the presence of plaque. We used multivariable linear and logistic regression models to estimate the association between leg length quartiles with CIMT and sCVD respectively. Results: Mean height was 153.8 cm and mean leg length was 72 cm. The prevalence of sCVD was 23%(469 of 2038). Participants with shorter legs were likely to report low birthweight, indigenous origin, rural residence, and low socioeconomic environment. We observed an inverse relationship between leg length and mean IMT when we compared the lowest(median 67cm) to the highest quartile(median 77.1 cm) ( multivariable-adjusted mean % difference= -2.93; 95% CI-5.53,-0.32 ). In contrast to the lowest quartile, the multiple-adjusted odds ratio for sCVD in the highest quartile was 0.58( 95% CI 0.34, 0.98 ). Additional analysis controlling for mediators such as weight, diabetes, hypertension and hypercholesterolemia weakened the association but remained significant. Conclusion: We found a significant association between leg length, CIMT and sCVD in a population of middle-aged Mexican women.

Favorable effect of dietary vitamin C on bone mineral density in postmenopausal women (KNHANES IV, 2009): discrepancies regarding skeletal sites, age, and vitamin D status.

Dietary vitamin C intake showed significant positive associations with BMD in postmenopausal women, especially with vitamin D deficiency. Although there is a positive role of vitamin C in osteoblastogenesis, debate remains about the contribution of vitamin C to bone mineral density (BMD) in humans. Data were derived from the Fourth Korean National Health and Nutrition Examination Survey. Dietary information was assessed using a 24-h dietary recall questionnaire. BMD was measured by dual-energy X-ray absorptiometry at the lumbar and hip. A total of 1,196 postmenopausal women aged 50 years and older were stratified into tertiles by daily dietary vitamin C intake. After adjusting for traditional confounders, dietary vitamin C intake tertile was significantly positively associated with BMD at all sites (R = 0.513 for lumbar spine (LS) and R = 0.657 for femoral neck (FN), P < 0.05 for each). The subjects with osteoporosis had significantly lower dietary vitamin C intake than did subjects without osteoporosis (74.4 ± 66.2 vs 94.1 ± 78.6 mg/day for LS and 65.5 ± 56.6 vs 94.3 ± 79.2 mg/day for FN, respectively, P < 0.001). The multiple-adjusted odds ratio for osteoporosis for dietary vitamin C <100 mg/day was 1.790 (95 % CI 1.333-2.405, P < 0.001). However, the significant association between vitamin C intake and BMD was only observed in subjects with vitamin D deficiency and aged 50-59 years or >70 years. Dietary vitamin C intake was positively associated with BMD in postmenopausal women, and inadequate vitamin C intake could increase the risk of osteoporosis.

Are middle-age blood pressure levels related to color vision impairment? The Okubo Color Study.

We sought to investigate the association between blood pressure levels and prevalence of acquired color vision impairment in middle-aged Japanese men. Participants underwent color vision testing, ophthalmological examination, standardized interview, physical record examination, and venous blood examination. Cardiovascular disease risk factors were determined based on blood and physical examination results and the interview. Logistic regression analysis was performed after adjusting for body mass index, systemic dyslipidemia, diabetes, cataract, glaucoma, smoking status, and drinking status. Of 1,042 men, 872 were eligible for the study, 130 failed the Lanthony 15-hue desaturated panel (D-15 DS) diagnosed as acquired color vision impairment 15-hue, and 31 failed the Farnsworth-Munsell 100-hue test diagnosed as acquired color vision impairment 100-hue. Diastolic blood pressure was significantly correlated with both acquired color vision impairment in 100-hue patients (adjusted odds ratio (OR) for 10-mm Hg increases = 1.42; 95% confidence interval (CI) = 1.00-2.02) and acquired color vision impairment in 15-hue patients (adjusted OR for 10-mm Hg increases = 1.25; 95% CI = 1.04-1.51). The multiple-adjusted ORs for acquired color vision impairment 100-hue patients and acquired color vision impairment 15-hue patients were 7.13 (95% CI = 1.72-27.88) and 4.37 (95% CI = 1.69-11.03), respectively, for the highest blood pressure category (systolic blood pressure ≥ 160 and diastolic blood pressure ≥ 100 mm Hg) compared with those for the lowest blood pressure category (systolic blood pressure <120 and diastolic blood pressure <80 mm Hg). Tests for trends were significant (P < 0.05) in both analyses. Hypertension in middle-aged men may negatively modify vision-associated neuronal function.

Consumption of Green Tea, but Not Black Tea or Coffee, Is Associated with Reduced Risk of Cognitive Decline

Our objective was to determine whether the consumption of green tea, coffee, or black tea influences the incidence of dementia and mild cognitive impairment (MCI) in older people. We conducted a population-based prospective study with Japanese residents aged >60 years from Nakajima, Japan (the Nakajima Project). Participants received an evaluation of cognitive function and blood tests. The consumption of green tea, coffee, and black tea was also evaluated at baseline. Of 723 participants with normal cognitive function at a baseline survey (2007–2008), 490 completed the follow up survey in 2011–2013. The incidence of dementia during the follow-up period (mean ± SD: 4.9±0.9 years) was 5.3%, and that of MCI was 13.1%. The multiple-adjusted odds ratio for the incidence of overall cognitive decline (dementia or MCI) was 0.32 (95% CI: 0.16–0.64) among individuals who consumed green tea every day and 0.47 (95% CI: 0.25–0.86) among those who consumed green tea 1–6 days per week compared with individuals who did not consume green tea at all. The multiple-adjusted odds ratio for the incidence of dementia was 0.26 (95% CI: 0.06–1.06) among individuals who consumed green tea every day compared with those who did not consume green tea at all. No association was found between coffee or black tea consumption and the incidence of dementia or MCI. Our results indicate that green tea consumption is significantly associated with reduced risk of cognitive decline, even after adjustment for possible confounding factors.

Circulating Adipocytokines and Chronic Kidney Disease

BackgroundAdipokines have been associated with atherosclerotic heart disease, which shares many common risk factors with chronic kidney disease (CKD), but their relationship with CKD has not been well characterized.MethodsWe investigated the association of plasma leptin, resistin and adiponectin with CKD in 201 patients with CKD and 201 controls without. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or presence of albuminuria. Quantile regression and logistic regression models were used to examine the association between adipokines and CKD adjusting for multiple confounding factors.ResultsCompared to controls, adjusted median leptin (38.2 vs. 17.2 ng/mL, p<0.0001) and adjusted mean resistin (16.2 vs 9.0 ng/mL, p<0.0001) were significantly higher in CKD cases. The multiple-adjusted odds ratio (95% confidence interval) of CKD comparing the highest tertile to the lower two tertiles was 2.3 (1.1, 4.9) for leptin and 12.7 (6.5, 24.6) for resistin. Median adiponectin was not significantly different in cases and controls, but the odds ratio comparing the highest tertile to the lower two tertiles was significant (1.9; 95% CI, 1.1, 3.6). In addition, higher leptin, resistin, and adiponectin were independently associated with lower eGFR and higher urinary albumin levels.ConclusionsThese findings suggest that adipocytokines are independently and significantly associated with the risk and severity of CKD. Longitudinal studies are warranted to evaluate the prospective relationship of adipocytokines to the development and progression of CKD.

218 INTERACTIONS BETWEEN DIET AND THE C161T POLYMORPHISMS IN THE PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR-GAMMA (PPAR-γ) GENE IN PROSTATE CANCER RISK IN JAPANESE MEN

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History (I)1 Apr 2013218 INTERACTIONS BETWEEN DIET AND THE C161T POLYMORPHISMS IN THE PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR-GAMMA (PPAR-γ) GENE IN PROSTATE CANCER RISK IN JAPANESE MEN Ryosuke Ando, Teruo Nagaya, Sadao Suzuki, Toshiki Etani, Taku Naiki, Noriyasu Kawai, Keiichi Tozawa, Shinkan Tokudome, and Kenjiro Kohri Ryosuke AndoRyosuke Ando Nagoya, Japan More articles by this author , Teruo NagayaTeruo Nagaya Nagoya, Japan More articles by this author , Sadao SuzukiSadao Suzuki Nagoya, Japan More articles by this author , Toshiki EtaniToshiki Etani Nagoya, Japan More articles by this author , Taku NaikiTaku Naiki Nagoya, Japan More articles by this author , Noriyasu KawaiNoriyasu Kawai Nagoya, Japan More articles by this author , Keiichi TozawaKeiichi Tozawa Nagoya, Japan More articles by this author , Shinkan TokudomeShinkan Tokudome Tokyo, Japan More articles by this author , and Kenjiro KohriKenjiro Kohri Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1598AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The C161T polymorphism in the peroxisome proliferator-activated receptor gamma (PPAR-γ) gene has been associated with a reduced risk for coronary artery disease and colorectal adenomas. However, the relationship between C161T polymorphism and cancer risk appears limited and controversial. We examined the associations of diet, PPAR-γ polymorphisms (C161T), and gene-diet interactions with prostate cancer risk in Japanese men. METHODS Samples were obtained from 110 newly diagnosed prostate cancer cases and 214 biopsy-negative controls. Daily consumption of energy and macronutrients was compared between cases and controls. We used logistic regression analysis to estimate the odds ratio (OR) and 95% confidence interval (CI) for prostate cancer risk according to the genotype of the C161T polymorphism. Interactions between low/high nutrient intakes and the PPAR-γ gene polymorphism in prostate cancer risk were proved. RESULTS The daily intake of energy and macronutrients was not different between cases and controls. The C161T substitution was associated with reduced prostate cancer risk. T allele carriers of C161T showed a protective effect (multiple-adjusted OR, 0.53; 95% CI, 0.31-0.93) against prostate cancer. Among the low fat and carbohydrate intake groups, T allele carriers of C161T had reduced prostate cancer risk (multiple-adjusted OR [95% CI], 0.33 [0.13-0.83] and 0.42 [0.18-0.97], respectively); however, there were no interactions between the consumption of nutrients and PPAR-α gene polymorphisms in prostate cancer risk. CONCLUSIONS Prostate cancer can arise from interactions between high fat consumption and gene polymorphisms influencing lipid metabolism, such as in the PPAR-γ gene. PPAR-γ gene C161T substitution was associated with decreased prostate cancer risk in Japanese men. Low intake of fat or carbohydrate may strengthen the risk reduction by C161T substitution. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e89-e90 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryosuke Ando Nagoya, Japan More articles by this author Teruo Nagaya Nagoya, Japan More articles by this author Sadao Suzuki Nagoya, Japan More articles by this author Toshiki Etani Nagoya, Japan More articles by this author Taku Naiki Nagoya, Japan More articles by this author Noriyasu Kawai Nagoya, Japan More articles by this author Keiichi Tozawa Nagoya, Japan More articles by this author Shinkan Tokudome Tokyo, Japan More articles by this author Kenjiro Kohri Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Serum adipocyte fatty acid-binding protein is independently associated with complex coronary lesions in patients with stable coronary artery disease

The association between circulating adipocyte fatty acid-binding protein (A-FABP) levels and coronary artery disease (CAD) is reported. We assessed whether plasma A-FABP levels are associated with angiographic coronary lesion morphology in patients with stable CAD. Serum A-FABP levels were analyzed in 115 patients with stable CAD (mean age 69 ± 10 years; 80 % men). These patients were angiographically studied and divided into two groups: simple lesions (n = 34) and complex lesions (n = 81). We also compared 50 age- and gender-matched controls with no evidence of CAD. Serum A-FABP levels in patients with stable CAD were significantly higher than those in controls. In patients with stable CAD, serum A-FABP levels were significantly higher in patients with complex lesions than in those with simple lesions: median (25th-75th percentile), 23.4 (17.7-30.8) vs 18.2 (12.2-24.7) ng/ml, P < 0.01. Serum A-FABP levels were also significantly associated with angiographic scores of extent of coronary lesion (r = 0.21, P = 0.02). Multiple logistic analysis that included dyslipidemia, statin therapy, and extent score demonstrated that serum A-FABP was independently associated with complex lesions. The multiple adjusted odds ratio for a complex lesion with a serum A-FABP level (per doubling) was 2.38 (95 % confidence interval, 1.03-6.41; P = 0.03). High serum A-FABP levels were significantly associated with complex coronary lesions in patients with stable CAD, suggesting that high A-FABP levels may be involved in coronary plaque vulnerability.

Referral to Telephonic Nurse Management Improves Outcomes in Women With Gestational Diabetes

Objective We sought to determine whether, among women with gestational diabetes mellitus, referral to a telephonic nurse management program was associated with lower risk of macrosomia and increased postpartum glucose testing. Study Design There was medical center–level variation in the percent of patients referred to a telephonic nurse management program at 12 Kaiser Permanente medical centers, allowing us to examine in a quasi-experimental design the associations between referral and outcomes. Results Compared with women from centers where the annual proportion of referral nurse management was 70% were less likely to have a macrosomic infant and more likely to have postpartum glucose testing (multiple-adjusted odds ratio, 0.75; 95% confidence interval, 0.57–0.98 and multiple-adjusted odds ratio, 22.96; 95% confidence interval, 2.56–3.42, respectively). Conclusion Receiving care at the centers with higher referral frequency to telephonic nurse management for gestational diabetes mellitus was associated with decreased risk of macrosomic infant and increased postpartum glucose testing.

Gestational bodyweight gain among underweight Japanese women related to small‐for‐gestational‐age birth

The prevalence of underweight women, who have an increased risk for small-for-gestational-age (SGA) birth, is increasing in Japan. We examined the associations of pre-pregnancy body mass index and gestational weight gain (GWG) with SGA birth among Japanese women. We conducted a prospective cohort study of 1391 women who delivered full-term singleton babies. SGA was defined as below the 10th percentile of birthweight at each gestational age, baby sex, and parity. We calculated the 5th percentile of birthweight in the same way for another threshold for SGA. According to pre-pregnancy body mass index, we divided the participants into three groups: underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), and overweight and obese (≥25.0 kg/m(2)). SGA birth was observed most frequently among the underweight group (13.8%). Underweight was associated with an increased risk of SGA birth. The multiple-adjusted odds ratio for underweight was 1.96 (95% confidence interval, 1.23-3.11) compared with normal weight. Sufficient GWG reduced the incidence and the multiple-adjusted odds ratio for 1-kg increase of GWG was 0.86 (0.81-0.92). The same tendency was observed for the delivery of infants below the 5th birthweight percentile. Women with underweight and normal weight who had 9.0 kg or less of GWG had a significantly higher risk of SGA birth than women with normal weight who had 9.1-11.0 kg of GWG. Underweight and poor GWG were associated with a higher incidence of SGA birth. However, the incidence of SGA birth among underweight women was not increased significantly if they had sufficient GWG.