Physical Check-up Research Articles

Reflections on an Australian Journey: Evangelism in the City

This article shares the personal reflections of a member of the Hong Kong Council of the Church of Christ in China on her participation in Evangelism in the City in Sydney, Australia. In which many church leaders came together from different parts of the world. Her experience of the passion and mission of those she met give her hope for the vision and passion of the church, especially for Evangelism in the City. "You Cannot Go Back!" The plane was taking off; I had just finished my nine-day journey in Australia. As I boarded the plane, I was overwhelmed with feelings and thoughts; I had just been caught carrying four kilos of honey, which of course was confiscated. Previously, at the airport check-in counter, when telling the staff person that I had some honey inside my backpack, I was clearly told that only 100 ml would be allowed. Nevertherless, I did not seem to care much about these words, feeling that there is hardly any difference between 100 ml and 4 kg. When I was going through security, the customs officer told me that honey was forbidden to carry on board. I was shocked and asked, "Can I put it back in my luggage?" They replied, "Yes, but you cannot go back now!" For quite some time, I could not stop blaming myself for my negligence, resulting in my failure to bring the honey back home and share it with my family. I also blamed myself for not taking the words of the airport staff seriously. I truly learned an important lesson: rules are rules and there is no other way around them. This incident deeply touched my heart and made me wonder how we treat the word of God. Do we take it lightly, just as I did with the words I was told in the airport, even though I heard the message as early as the check-in counter, though never took it seriously? Are we clear on what we shall bring to the kingdom of God and what we shall not? "If any man's work shall be burned, he shall suffer loss: but he himself shall be saved; yet so as through fire" (1 Cor. 3:15). If we look forward to entering the kingdom of God, we must take his words seriously because "Heaven and earth shall pass away: but my words shall not pass away" (Luke 21:33). How do we treat the word of God today? Do we take it lightly or take it seriously into our heart? Today, we must make a choice! Prayer Gardener! Insist or let go? On 6 September, Sunday morning, we went to an Orthodox Church for Sunday worship. The three-hour worship service was presided over by a number of bishops, priests, monks, and a choir of more than 50 adults and children chanting psalms and prayers. It was the first time I took part in Orthodox worship. The priests and the choir's chanting seemed rather strange to me and almost reminded me of a Chinese Taoist funeral. Though I am more comfortable with free-style worship (with guitar and drums), my heart was very much touched by this Orthodox worship and personally by the priest, Father Shenouda. His cautiousness, his humility, his love for people as he was sharing clearly, profoundly, and personally the values of the Bible deeply touched me. For so many years, churches have been debating the form of worship--whether it should be traditional or the free modern style. …

Significance of adjusting salt intake by body weight in the evaluation of dietary salt and blood pressure

The close association between dietary salt and hypertension is well established. However, previous studies generally assessed salt intake without adjustment for body weight. Herein, we investigated the significance of body weight–adjusted salt intake in the general population. The present cross-sectional study included 7629 participants from our yearly physical checkup program, and their salt intake was assessed using a spot urine test to estimate 24-hour urinary salt excretion. Total salt intake increased with increasing body weight. Body weight–adjusted salt intake was greater in participants with hypertension than in those without hypertension. Systolic blood pressure, estimated glomerular filtration rate, and urinary albumin were independently correlated with body weight–adjusted salt intake after adjustment for possible cardiovascular risk factors. Excessive body weight–adjusted salt intake could be related to an increase in blood pressure and hypertensive organ damage. Adjustment for body weight might therefore provide clinically important information when assessing individual salt intake.

Serum levels of Mac-2 binding protein increase with cardiovascular risk and reflect silent atherosclerosis

Background and aimsMac-2 binding protein (M2BP) was reported to be a useful biomarker for liver fibrosis and malignant tumors. We hypothesized that expression of M2BP might also change in the process of atherosclerosis. MethodsThis study included subjects who visited our hospital for a physical checkup. ResultsThe M2BP levels in subjects with hypertension, dyslipidemia, or abnormal glucose metabolism were higher than those in subjects without such risk factors. Moreover, the M2BP levels were associated with severity of cardiovascular risk. Subdivision of M2BP levels into quartiles revealed that M2BP was significantly associated with reactive oxygen metabolites, central systolic blood pressure, and radial augmentation index (AI). Logistic regression analysis with the endpoint of high radial AI (above mean value) showed that high radial AI was independently associated with high M2BP. ConclusionsAlthough the spectrum was narrow as compared to that in cases of hepatic fibrosis, serum M2BP may reflect silent atherosclerosis in apparently healthy subjects.

Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas - Behavioral Risk Factor Surveillance System, United States, 2012.

Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas - Behavioral Risk Factor Surveillance System, United States, 2012.

Common Sports Injuries among Physical Activities Practitioners at the Physical Fitness Centers in Jordan (Comparative Study)

<p>The aim of the study was to investigate the common sports injuries among physical activities practitioners at the physical fitness centers in Jordan. Study sample consisted of (272) volunteered male (n=221) and female (n=51) (age 30±3). Researchers used a special form used to evaluate athletic injuries. After collecting and analyzing the data. Results showed that the most common sports injuries among sample of the study was muscular tears 27.7%, muscle spasm 20.7%, and tears ligament 20.2%. And the most exposed parts of the body to injury is the lumbar area 26.8%, elbows 16.9%, followed by shoulders 8.9%. Also the study results revealed that the most cusses of injuries was over training 24.14%. Poor warm-up 22.1% and bad technic 11.3%. Bodies-building was the most type of activities subjects to injury with 18.8%. Physical Fitness 6.6% and weight loss 27.7. Results also showed that physical therapy was the most means of treating injuries 54.14%, drugs therapy 33.3% and surgical intervention 4.2%. Also the study shows that males are more exposed to injuries than females.</p><p>Conclusions: These finding indicate that sports injures is part of physical</p><p>Activities participations, preventive measures should be taken by participant's the researchers recommended the need for physical and medical checkup before participation in physical activity at the physical fitness centers.</p>

Fever, poor response, convulsions, and hepatomegaly

Objective To investigate the differential diagnosis of Reye syndrome and the characteristics of primary carnitine deficiency, and to provide diagnostic strategy for similar cases. Methods There was a case presented with fever, poor response, convulsions and hepatomegaly hospitalized in Wuhan Children's Hospital, and the clinical manifestations were described, the physical examination was comprehensively conducted, the auxiliary examination results were recorded, some pediatric specialists from ICU, neurology department, genetic metabolic department, digestive system department were invited to discuss the case.The treatment was adjusted according to the suggested opinions; the treatment effects and the final diagnosis were tracked. Results The primary diagnosis of the case was central nervous system infection or toxic encephalopathy at the time of admission, but Reye syndrome could not be excluded.Although the cerebrospinal fluid test and brain MRI examination detected nothing abnormal, liver function suggested alanine aminotrans ferase ALT increase, blood sugar decrease, the liver volume increase, which was detected by liver ultrasound.Blood amino acids examination revealed the carnitine level decreased, and it was confirmed as primary carnitine deficiency in the end.L-carnitine was used to treat the disease, and its effect was good. Conclusions Great importance should be attached to children with onset age, physical check-up, and multidisciplinary cooperation.Use monism to explain the illness and the auxiliary inspection as far as possible, so that it can get early diagnosis and treatment, and the outcome is good. Key words: Reye syndrome; Primary carnitine deficiency; Hereditary metabolic disease

Use of Electrocardiography to Predict Future Development of Hypertension in the General Population.

Cardiac muscle responds to increased afterload by developing hypertrophy. During the early stages of hypertension, the heart can be transiently, but frequently, exposed to increased afterload. This study was designed to test the hypothesis that left ventricular hypertrophy (LVH) assessed by electrocardiography (ECG) can be used to predict future development of hypertension.Sokolow–Lyon voltage and Cornell product were calculated using ECG in 5770 normotensive participants who visited our hospital for a physical checkup (age 52.7 ± 11.3 years). LVH was defined as a Sokolow–Lyon voltage of >3.8 mV or a Cornell product of >2440 mm × ms. After baseline examination, participants were followed up with the endpoint being the development of hypertension.During the median follow-up period of 1089 days (15,789 person-years), hypertension developed in 1029 participants (65.2/1000 person-years). A Kaplan–Meier analysis demonstrated a significantly higher incidence of hypertension in participants with LVH than in those without LVH as assessed by Sokolow–Lyon voltage or Cornell product (P < 0.0001 for both). The hazard ratios for incident hypertension in participants with LVH defined by Sokolow–Lyon voltage and Cornell product were 1.49 (95% confidence interval [CI] 1.16–1.90, P < 0.01) and 1.34 (95% CI 1.09–1.65, P < 0.01), respectively, after adjustment for possible risk factors. Furthermore, in multivariable Cox hazard analysis, where Sokolow–Lyon voltage and Cornell product were taken as continuous variables, both indices were independent predictors of future hypertension (P < 0.0001).Both Sokolow–Lyon voltage and Cornell product are novel predictors of future development of hypertension in the general population.

Age-Related Changes of Intraocular Pressure in Elderly People in Southern China: Lingtou Eye Cohort Study.

PurposeTo study age-related changes of intraocular pressure (IOP) and assess the cohort effect in both cross-sectional and longitudinal settings among elderly Chinese adults.MethodsParticipants were enrolled from the Lingtou Eye Cohort Study with Chinese government officials aged 40 years and older at baseline and received physical check-up and ocular examinations from 2010 to 2012. IOP was measured using a non-contact tonometer according to standardized protocols, as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI). Participants who had attended IOP measurements in both 2010 and 2012 were included in this study. Cross-sectional association of IOP with age was assessed using multivariate liner regression analyses and based on the data of 2010. Longitudinal changes in IOP were assessed by paired t-test.ResultsA total of 3372 subjects were enrolled in the current analysis (2010 mean [SD] age, 61.9 [7.1] years; 60.2% men). The mean IOP in 2010 was 15.4±2.3 mmHg for women and 15.2±2.3 mmHg for men with an intersex difference (P = 0.029). Cross-sectional analysis showed that IOP was negatively associated with age (P = 0.003, β = -0.033 for women and P<0.001, β = -0.061 for men) adjusted for baseline SBP, DBP and BMI. Paired t-test suggested that IOP was higher in the year 2012 than 2010 in women (P = 0.006) but did not change significantly in men within 2 years (P = 0.345). In addition, the 2-year changes of IOP were not associated with age adjusted for baseline IOP in 2010 (P = 0.249).ConclusionCross-sectional data suggests that IOP is lower in people with older age. Longitudinal data does not support such findings and thus the identified decreasing pattern with age in cross-sectional analysis is likely caused by cohort effects.

Douleur chronique et État de Stress Post-Traumatique chez la personne âgée

BackgroundRecent studies have highlighted the frequent co-occurrence of somatic complaints in Posttraumatic Stress Disorders. Moreover, symptoms of Posttraumatic Stress Disorder are more severe during associated chronic pain. However, the data about the elderly are very scarce. ObjectivesThis study investigates the hypothesis that chronic pains presented by the elderly in retirement/nursing home may be a manifestation of Posttraumatic Stress Disorder. Moreover we argue that the two entities would tend to maintain each other but that a simultaneous treatment could be efficient. PatientsWe present five clinical cases of female patients of 84, 88, 91, 92 and 97 years. Each of these patients has recently entered a nursing home (less than one year) and was complaining about a chronic pain that was unexplained by a medical factor. MethodIn each case, the pain was measured on Algoplus scale, a detailed physical check-up was negative, and a Posttraumatic Stress Disorder was diagnosed using a clinical interview and the Clinician Administered PTSD Scale. After diagnosis, a short treatment protocol was proposed to decrease pain and Posttraumatic Stress Disorder symptoms. The Algoplus scale and the Clinician Administered PTSD Scale were filled again after treatment and after six months of follow-up. ResultsFor each patient the reactivation of a trauma has been evidenced. The trauma was related to a war situation (several decades before) or related to a recent bereavement in the family. Our data highlight some mechanisms involved in the maintenance of pain in relation with a Posttraumatic Stress Disorder, in particular the role of hypervigilance and avoidance. In each case, five to thirteen weeks of specific treatment have improved both the pain and the Posttraumatic Stress Disorder. ConclusionsThese results suggest the interest of a systematic search for a Posttraumatic Stress Disorder when the clinician encounters a painful patient who has recently entered a nursing home, especially for the age groups concerned with war and deportation.

Association of SNP of leukocyte differentiation antigen-CD40 gene and its serum level with ischemic stroke

To investigate the association of SNP of CD40 gene and its serum levels with ischemic stroke (IS). A total of 202 IS patients from a hospital of Baise city were enrolled in case group from May 2013 to November 2014. At the same time, 109 healthy people who had physical check-ups in the outpatient department at the same hospital were enrolled in the control group. All participants were from Guangxi Zhuang Autonomous Region and unrelated to each other. 3 ml venous blood were collected on the premise of informed consent. The single nucleotide polymorphisms of CD40 gene rs1883832 C/T, rs13040307 C/T, rs752118 C/T and rs3765459 G/A were analyzed using a Snapshot SNP genotyping assays, and the serum levels of CD40 were tested by ELISA. t-test was used to compare the serum levels of CD40 between the case and control group, and the genotypes at different locuses in case group; χ(2) test was used to compare the distribution differences of the CD40 gene locuses in different genotypes and allele between the case group and the control group; alleles was established as independent variables, the occurrence of the IS as dependent variable, and expressed relative risk with OR (95%CI) value. In the case group, the frequency of CC, CT and TT genotypes in CD40 gene rs1883832 C/T were 21.78% (44/202), 49.51% (100/202) and 28.71% (58/202), respectively, and 33.17% (66/199), 48.74% (97/199), 18.09% (36/199) in the control group, respectively, the differences between the two groups was significant (χ(2)=9.57, P=0.008). The CD40 serum levels were (62.7 ± 24.5) pg/ml in the case group, which was higher than that in the control group (45.3 ± 17.2) pg/ml (t=8.97, P<0.001). The serum levels of TT and CT genotypes in CD40 gene were (65.9 ± 26.3) and (64.3 ± 25.9) pg/ml, respectively, and the differences were significant when comparing with CC genotype (t equaled 5.34 and 5.03, respectively, P<0.001). The risk of developing IS was 1.56 times higher in 1883832 T allele carriers than that in rs1883832 C allele carriers (OR=1.56, 95% CI: 1.18-2.06); Combined genotype analysis displayed that CD40 gene rs1883832 C/T, rs13040307 C/T, rs752118 C/T and rs3765459 G/A polymorphisms showed strong linkage disequilibrium, the case group TCCA haplotype was tested to be associated with a significantly increased risk of IS as compared with that in the control group(OR=2.49; 95%CI: 1.13-5.48). CD40 gene rs1883832 C/T polymorphism and its TCCA haplotype were possibly associated with ischemic stroke, and the susceptibility gene for ischemic stroke may be rs1883832 T allele.

Abstract 239: Receipt of Routine Health Care Among African American Adults With Diabetes and Hypertension: Results from The Jackson Heart Study

Objectives: African Americans (AA) have a high prevalence of chronic diseases including hypertension (HTN) and diabetes (DM). Routine care is necessary to prevent adverse affects of chronic diseases. Few studies have examined patterns of routine care among AA with chronic diseases. This study uses Jackson Heart Study (JHS), a large prospective cohort of AA adults, to understand patterns of routine healthcare among AA adults with HTN and DM. Methods: Using data collected at 1st (2000-2004) and 3rd visit (2009-2012), adults with HTN (n=2,668) and those with DM (n=949) were analyzed. Routine healthcare at visits 1 and 3 by participants self reports of whether or not they have seen a doctor or other health professional for a routine physical exam or general check-up when not sick or pregnant within the past year. Independent variables were self-reported insurance status (private/ public/private and public/none), income status (Poor/Lower-Middle/Upper-Middle/Affluent based on self-reported annual income, family size, year, and poverty levels for 2000-2004), gender (male/female), age (years), healthcare trust (yes/no), difficulty obtaining healthcare (yes/no), and health status (excellent/good/fair/poor). HTN classification (normal/pre-HTN/stage 1/stage 2), DM classification (normal/at risk/diabetic) was based on directly assessed clinic, lab values, and included those on anti medications, regardless of blood pressure and triglyceride control. Logistic regression was used to determine crude and adjusted odds ratios and adjusted cross-sectional odds ratios of having routine care at visits 1 and 3 for those with DM and those with HTN. Findings: Routine care was high for both those with HTN and those with DM at both visits 1 and 3 (78% and 86% for HTN and 80% 87% DM, respectively). For both groups of patients, poor trust in the health care system decreased odds of routine care at visit 1 (DM adjusted Odds Ratio (aOR) 0.53 (95% Confidence Interval (CI) 0.33, 0.86), HTN aOR 0.59 (95% CI 0.45, 0.77) and at visit 3 (DM aOR 0.31 (95% CI 0.14, 0.71), HTN aOR 0.56 (95% CI 0.38, 0.83). Among the HTN sample, those with stages 1 or 2 HTN at visit 1 decreased odds of routine care at both visit 1 (aOR 0.51 (95% CI 0.31, 0.83) and visit 3 (aOR 0.48 (95% CI 0.28, 0.84) and increased severity of HTN at visit 3 decreased odds of routine care at visit 3. For both groups of patients, men had statically significant lower odds of routine care than women at visit 1 and visit 3 and increased age was associated with increased routine care. Insurance status and income status were not significantly associated with routine care in any of the adjusted models. Conclusions: AA with HTN and DM have high rates of routine care regardless of insurance or socioeconomic status. Rates of routine care were associated with trust in the health care system and self-reported difficulty obtaining health care independent of insurance status or income.

Early detection of unhealthy behaviors, the prevalence and receipt of antiviral treatment for disabled adult hepatitis B and C carriers.

BackgroundEvidence indicates that hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the leading causes of liver cirrhosis and hepatocellular carcinoma. Antiviral treatments have recently been reported as successful cures. However, the prevalence rates of HBV or HCV infection, unhealthy behaviors and receipt of adequate treatment in disabled adults have not been described. The aim of this study was to examine the prevalence of HBV or HCV carriers, receipt of antiviral treatment, and early detection of unhealthy behaviors in disabled adults in Taiwan.MethodsA population-based, cross-sectional study was conducted between July and December 2013 with 845 community-dwelling adults with disabilities aged >20 years. Statistical analyses included descriptive statistics, Chi-squared tests, and stepwise regression analysis.ResultsThe prevalence of HBV and HCV infections was 12.9 and 14.1 %, respectively. HCV carriers tended to be older (p < 0.001) and with a lower education (p < 0.001). The majority of HBV/HCV carriers did not know the type of hepatitis infection and did not receive adequate antiviral treatment. After adjusting for potential confounding variables, regression analysis showed that the factors significantly associated with elevated liver function were HCV infection (p < 0.001), HBV infection (p = 0.001), high fasting blood glucose levels (p = 0.001), overweight (p = 0.003), older age (p = 0.027), and alcohol drinking (p = 0.028).ConclusionsThere was a high prevalence of HCV infection among adults with disabilities; few received adequate antiviral treatment or early detection of unhealthy behaviors for the prevention of liver cancer. Clinicians can provide health education to help the participants and caregivers better understand the relationships between specific risk factors and liver health and can encourage HBV and HCV carriers to undergo annual physical check-ups and receive adequate treatment, as covered by the national health insurance.

A New Equation to Estimate Muscle Mass from Creatinine and Cystatin C

BackgroundWith evaluation for physical performance, measuring muscle mass is an important step in detecting sarcopenia. However, there are no methods to estimate muscle mass from blood sampling.MethodsTo develop a new equation to estimate total-body muscle mass with serum creatinine and cystatin C level, we designed a cross-sectional study with separate derivation and validation cohorts. Total body muscle mass and fat mass were measured using dual-energy x-ray absorptiometry (DXA) in 214 adults aged 25 to 84 years who underwent physical checkups from 2010 to 2013 in a single tertiary hospital. Serum creatinine and cystatin C levels were also examined.ResultsSerum creatinine was correlated with muscle mass (P < .001), and serum cystatin C was correlated with body fat mass (P < .001) after adjusting glomerular filtration rate (GFR). After eliminating GFR, an equation to estimate total-body muscle mass was generated and coefficients were calculated in the derivation cohort. There was an agreement between muscle mass calculated by the novel equation and measured by DXA in both the derivation and validation cohort (P < .001, adjusted R2 = 0.829, β = 0.95, P < .001, adjusted R2 = 0.856, β = 1.03, respectively).ConclusionThe new equation based on serum creatinine and cystatin C levels can be used to estimate total-body muscle mass.

Paired comparison of procedural sequence in same-day bidirectional endoscopy with moderate sedation and carbon dioxide insufflation: A prospective observational study.

Background/Aims:Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence of the procedure with carbon dioxide insufflation is not well established. In this study, we investigated the optimal sequence for same-day BDE without polypectomy under moderate sedation and carbon dioxide insufflation in terms of sedation doses and colonoscopy performance.Patients and Methods:We performed a prospective observational study of 63 asymptomatic patients who were admitted for physical check-ups. A colonoscopy-esophagogastroduodenoscopy (EGD) examination was performed first and then an EGD-colonoscopy examination was performed within 1.5 years.Results:The total procedure time, procedure complexity, bowel preparation quality, cecal intubation time, colon polyp detection rate, and adverse events were similar between the two study groups. The total doses of fentanyl and midazolam were significantly higher for the colonoscopy-EGD group than that for the EGD-colonoscopy group (70.8 ± 9.6 μg vs. 56.6 ± 9.2 μg and 6.1 ± 1.3 mg vs. 4.6 ± 1.1 mg, P < 0.0001 and P < 0.0001, respectively). The recovery time to discharge was significantly longer for the colonoscopy-EGD group compared to the EGD-colonoscopy group (38.5 ± 3.9 min vs. 31.9 ± 3.2 min, P < 0.001, respectively).Conclusions:EGD-colonoscopy is the optimal sequence for same-day BDE. In this order, the procedures are better tolerated, the sedation doses are reduced, and the recovery time is shorter.

Association of hemoglobin with ankle-brachial index in general population

OBJECTIVES:Previous studies have demonstrated that both low and high hemoglobin concentrations are predictive of adverse cardiovascular outcomes in various populations. However, an association of hemoglobin with the ankle-brachial index, which is widely used as a screening test for peripheral arterial disease, has not yet been identified.METHODS:We examined 786 subjects (236 women and 550 men) who received routine physical check-ups. The ankle-brachial index and several hematological parameters, including the hemoglobin level, hematocrit and red blood cell count and other demographic and biochemical characteristics were collected. Univariate and multivariate linear regression analyses were performed to assess the relationships between the ankle-brachial index and the independent determinants. Receiver operating characteristic curve analysis was conducted to calculate the cut-off level of hemoglobin for a relatively low ankle-brachial index (less than 20% of all subjects, which was 1.02).RESULTS:The hemoglobin level, hematocrit and red blood cell count were correlated with the ankle-brachial index in the males (r=-0.274, r=-0.224 and r=-0.273, respectively, p<0.001 for all), but these associations were not significant in the females. Multivariate linear regression analysis revealed that the independent determinants of the ankle-brachial index included age, total cholesterol, high-density lipoprotein cholesterol and the white blood cell count for the females and age, hypertension, total cholesterol and hemoglobin (β=-0.001, p<0.001) for the males after adjusting for confounding factors. Receiver operating characteristic curve analysis revealed that the cut-off level of hemoglobin for predicting a low ankle-brachial index was 156.5 g/L in the males.CONCLUSIONS:A high hemoglobin concentration was independently correlated with a low ankle-brachial index in the healthy males, indicating that an elevation in this level may be associated with an increased atherosclerosis risk.

Incremental impact of body mass status with modifiable unhealthy lifestyle behaviors on pharmaceutical expenditure.

Overweight/obesity is a growing health risk in Korea. The impact of overweight/obesity on pharmaceutical expenditure can be larger if individuals have multiple risk factors and multiple comorbidities. The current study estimated the combined effects of overweight/obesity and other unhealthy behaviors on pharmaceutical expenditure. An instrumental variable quantile regression model was estimated using Korea Health Panel Study data. The current study extracted data from 3 waves (2009, 2010, and 2011). The final sample included 7148 person-year observations for adults aged 20 years or older. Overweight/obese individuals had higher pharmaceutical expenditure than their non-obese counterparts only at the upper quantiles of the conditional distribution of pharmaceutical expenditure (by 119% at the 90th quantile and 115% at the 95th). The current study found a stronger association at the upper quantiles among men (152%, 144%, and 150% at the 75th, 90th, and 95th quantiles, respectively) than among women (152%, 150%, and 148% at the 75th, 90th, and 95th quantiles, respectively). The association at the upper quantiles was stronger when combined with moderate to heavy drinking and no regular physical check-up, particularly among males. The current study confirms that the association of overweight/obesity with modifiable unhealthy behaviors on pharmaceutical expenditure is larger than with overweight/obesity alone. Assessing the effect of overweight/obesity with lifestyle risk factors can help target groups for public health intervention programs.

Abstract 11988: Waist Circumference and Systolic Blood Pressure Are Predictors of Left Ventricular Hypertrophy in Healthy Individuals

Introduction: Left ventricular hypertrophy (LVH) is considered to be a cause of heart failure. Previous studies indicated that patients with metabolic syndrome (MetS) and obesity might be at risk for cardiovascular disease (CVD). However, little is known about which MetS factors contribute to the development of LVH in healthy adults. Hypothesis: The aim of this study was to identify factors related to CVD and major organ dysfunction that could act as predictors of LVH based on thorough medical examinations of healthy subjects. Methods: A total of 1056 participants without diabetes mellitus, systolic dysfunction, chronic kidney disease, or other heart diseases underwent a thorough physical examination including transthoracic echocardiography. LV mass index (LVMI) ≥ 51 g/m2.7 was considered LVH. Single and multiple logistic regression analyses of LVMI and cardiovascular risk factors, including MetS factors and indicators of major organ dysfunction, were performed. Obese subjects (WC ≥ 85 cm in males and ≥ 90 cm in females) and non-obese subjects were also analyzed separately. Results: A total of 980 adults (age 62.8 ± 12.7 y, male 573) were analyzed, and LVH was observed in 21.5% of subjects (n = 211, male 155). Overall, 33.0% (43 of 434) of obese subjects had LVH. LVH was correlated with age, systolic blood pressure (SBP), diastolic BP, estimated glomerular filtration rate, total bilirubin, fasting blood sugar, HbA1c, and WC. Multiple logistic regression analysis indicated that age, high SBP (≥130 mmHg) and WC were independent predictors of LVMI (odds ratios 1.05, 1.99, 3.03; 95% confidence intervals 1.01-1.06, 1.42-2.79, 2.16-4.25, respectively, P&lt;0.01). In obese subjects, aging, WC, and high SBP were independent predictors of LVMI, but WC was not an independent predictor of LVMI in non-obese subjects. Moreover, the average WC was significantly higher in both males and females in obese (47.7 ± 13.5, 47.9 ± 14.1 g/m2.7) than in non-obese subjects (41.1 ± 10.3, 37.8 ± 10.1 g/m2.7). Conclusions: WC and SBP are independent risk factors for LHV in healthy individuals and, therefore, might be useful for predicting cardiovascular disease during routine physical checkups.

Evaluation of interference of thyroglobulin antibodies on the measurement of thyroglobulin by two chemiluminescence immunoassay

Objective To investigate the interference of thyroglobulin antibodies (TgAb) on the measurement of thyroglobulin (Tg) by 2 chemiluminescence immunoassays (CLIAs). Methods Data of 199 315 individuals with determined TgAb and Tg, including physical checkup subjects, differentiated thyroid carcinoma (DTC) patients and patients with other diseases, were retrospectively collected in Peking Union Medical College Hospital from November 2012 to April 2015. The correlation between serum Tg level and serum TgAb concentration was analyzed and the positive rate of TgAb in physical checkup subjects was calculated. Furthermore, 290 serum samples with different TgAb concentration were applied in the recovery test by adding in confirmed serum Tg. The correlation between the recovery of confirmed serum Tg and TgAb concentrations was evaluated using Pearson correlation analysis. Results The serum Tg was all decreased with the elevated TgAb concentration in each group of subjects. The positive rate of TgAb was 10.84%(8 416/77 634) in physical checkup subjects. It was higher in females than in males and was increased with age. Recovery test showed that the average recoveries of confirmed serum Tg in TgAb–negative serum were 107.28% (86.30%–117.60%) and 107.94% (85.60%–124.10%) respectively in Roche and Beckman systems. But in TgAb–positive serum samples, the average recoveries in Roche and Beckman systems were 88.59% (35.85%–141.53%) and 95.77% (36.48%–131.78%) respectively, and 12.63% (24/190) and 13.68% (26/190) samples displayed a recovery less than 80% . The recovery rate of confirmed serum Tg showed a significantly negative correlation with elevated TgAb concentration, with r=–0.239 (P=0.001) in Roche and r=–0.251 (P<0.001) in Beckman. Conclusions TgAb–positive serum, especially with high concentration of TgAb, significantly interfered the measurement of Tg. Thus, serum TgAb should be determined together with serum Tg to explore whether there was an interference. To avoid misdiagnosis and inappropriate therapy, clinician should be informed once serum TgAb displayed positive.(Chin J Lab Med, 2015, 38: 701–704) Key words: Thyroglobulin; Autoantibodies; Luminescence; Immunoassay; Thyroid neoplasms

Chemical exposure, leukemia related DNA methylation changes and childhood acute leukemia

To evaluate the association between chemical exposure, DNA methylation status and gene-environment interactions in the development of childhood acute leukemia (AL). From January 1st 2009 to December 31st 2010, an exploratory case-control study was conducted on childhood AL among children who were less than 15 years of age in Shanghai, China. A total of 131 patients with newly diagnosed AL were recruited from 3 Shanghai children hospitals. The controls selected from the same hospital were healthy children who attended the physical check-up held by the department of Children's Healthcare, or who visited the clinic of developmental pediatrics or orthopedics (excluding blood diseases and malignant tumors). 140 controls matched with cases in gender and age were included in this study. Chemical exposure were investigated by questionnaires, methylation specific polymerase chain reaction (MSP) was adopted to analyze the methylation or deletion status of 8 genes, and gene-environment interactions were analyzed by relative excess risk of interaction (RERI), attributable proportion of interaction (API) and synergy index (S). There were 131 and 140 subjects in case and control group, who were aged (6.9 ± 3.8) and (6.9 ± 3.9) years old (t = 0.01, P = 0.911), respectively. After adjusting age and other potential confounding factors, chemical substances' exposure of children/mother/father were all significantly higher in cases than that in controls (Children: OR = 3.90, 95% CI: 1.69-9.02; Mother: OR = 2.71, 95% CI: 1.12-6.52; Father: OR = 1.91, 95% CI: 1.05-3.47). For the 8 genes analyzed, the methylation status of DAPK and PTEN and P73 in case group were significantly higher than that in control group (cases: 3.1% (4 cases), 16.0% (21 cases), 7.6% (10 cases); controls: 0.7% (1 case), 2.9% (4 cases), 0.7% (1 case); χ²: 7.11, 16.90, 11.38; P value: 0.029, 0.000, 0.003). The methylation status of P16 in case group was significantly lower than that in control group (cases: 3.8% (5 cases); controls: 8.6% (12 cases), χ² = 10.33, P = 0.007). The interactions of children chemical substances' exposure and 3 genes' (PTEN, P16 and P73) methylation status were probably existed after adjusted for confounding factors (PTEN: RERI = -7.01, API = -2.14, S = 0.24; P16: RERI = 4.08, API = 0.53, S = 2.59; P73: RERI = 4.32, API = 0.48, S = 2.19), we also found the potential interaction between maternal chemical substances' exposure and PTEN, P16 gene methylation status (PTEN: RERI = -1.30, API = -0.38, S = 0.65; P16: RERI = 1.70, API = 0.38, S = 1.97). The study suggested the strong combined effects of chemical substances exposure of children and abnormal methylation status were risk factors of childhood AL, and there existed different interaction between them, which may indicate the important role in the pathogenesis process of childhood AL.

The Prevalence of Clinical and Electrocardiographic Risk Factors of Cardiovascular Death Among On-duty Professional Firefighters.

Firefighters have twice as many cardiovascular deaths as police officers and 4 times as many as emergency medical responders. The etiology for this high rate of mortality remains unknown. The electrocardiogram (ECG) is a widely used tool to screen populations at risk, yet there are no available on-duty, high-resolution ECG recordings from firefighters. We sought to evaluate the prevalence of clinical and ECG risk factors among on-duty professional firefighters during 12-lead ECG holter monitoring and exercise stress testing. Firefighters were recruited from Surveying & Assessing Firefighters Fitness & Electrocardiogram (SAFFE) study. This descriptive study recruited firefighters from 7 firehouses across Upstate New York who completed on-duty 24-hour Holter ECG monitoring and a standard exercise stress test. All analyses were completed by a reviewer blinded to all clinical data. A total of 112 firefighters (mean [SD] age, 44 [8] years; mostly white men) completed the study. Although all firefighters were in normal sinus rhythm, more than half of them had at least 1 high-risk ECG risk factor present, including abnormal sympathetic tone (elevated heart rate, 54%), abnormal repolarization (wide QRS-T angle, 25%), myocardial scarring (fragmented QRS, 24%), and myocardial ischemia (ST depression, 24%). Most firefighters tolerated the treadmill exercise stress test well (metabolic equivalent tasks, 11.8 + 2.5]); however, almost one-third had abnormal results of stress tests that required further evaluation to rule out subclinical coronary artery disease. Among on-duty professional firefighters, high-risk ECG markers of fatal cardiac events and abnormal stress test results that warrant further evaluation are prevalent. Annual physical checkups with routine 12-lead ECG can identify those who might benefit from preventive cardiovascular services.