Routine Health Check-up Research Articles

Increasing public awareness through routine health checks for residents of RT 21 Kelurahan 13 Ulu, Palembang

Health check-ups are one of the efforts to detect abnormalities in the body that should be performed routinely with the aim of prevention and early treatment. The purpose of this activity is to increase public knowledge about the importance of health check-ups. With increased public awareness of the importance of health check-ups, their desire to undergo health checks also increases, allowing for earlier disease identification. The method used involves counseling with leaflet media and community health check-ups. Based on health screenings conducted in Kelurahan 13 Ulu RT 021 RW 005, Seberang Ulu II District, Palembang City, the results indicated an increase in knowledge, understanding, and public awareness regarding regular health checks. This is expected to encourage a change in community behavior towards routine health check-ups, leading to earlier disease detection and prevention of more serious illnesses.

Fuzzy rule based classifier model for evidence based clinical decision support systems

Clinicians benefit from the use of artificial intelligence and machine learning techniques applied to health data within health records, which identify commonalities between them. It enables them to get evidence-based support in recommending shared treatment paths for undiagnosed health records. The collective inference from these patterns, drawn from an array of health records, further enhances the capacity to mine essential features, supporting public health experts in their management of population health conditions. This paper presents a novel mapping tool model designed to analyze electronic health records and provide healthcare providers with evidence-based decision support. The work focuses on the analysis of health records from hospital databases, encompassing parameters extracted from routine health checkups. By scrutinizing patterns within examined health records, healthcare providers can seamlessly align with newer health records for diagnosis and treatment recommendations. Core to this approach is the integration of a fuzzy rule-based classifier system within the proposed system. This incorporation facilitates the processing of health records, extracting pertinent features to augment decision-making with the support of knowledge bases. The model architecture provides flexibility and customizability, enabling easy configuration of the system to accurately map new health records to the examined dataset. Additionally, the model utilizes a specially developed distance-measure technique tailored for the proposed fuzzy-based system. Results showcase satisfying performance and robust discriminant capability for accurate recommendations. The alignment of outcomes with expert evaluations underscores the model's efficacy and attainment of benchmarks.

Biological variation of 16 biochemical analytes estimated from a large clinicopathologic database of dogs and cats.

Biochemical measurements are commonly evaluated using population-based reference intervals; however, there is a growing trend toward reassessing results with within-subject variation (CVI). We aimed to estimate the CVI of 16 biochemical analytes using a large database of dogs and cats, which refers to the results of routine health checkups. Pairs of sequential results for 16 analytes were extracted from a database of adult patients. The second result was divided by the first result to produce the ratio of sequential results (rr), and the frequency distribution of rr was plotted. From the plots, the coefficient of variation (CVrr) was calculated. Analytical variation (CVA) was calculated using quality control data, and CVI was estimated as follows: . Estimated CVI was compared with previously reported CVI using the Bland-Altman plot analysis. From the database, 9078 data points from 3610 dogs and 3743 data points from 1473 cats were extracted, with 5468 data pairs for dogs and 2270 for cats. Sampling intervals ranged from 10 to 1970 days (median 366) for dogs and 23 to 1862 days (median 365) for cats. Bland-Altman analysis showed most CVI plots fell within the limits of agreement; however, positive fixed biases were observed in both dogs and cats. Our study introduces a novel approach of estimating CVI using routine health checkup data in dogs and cats. Despite biases, our method holds promise for clinical application in assessing the significance of measurement result differences.

Prevalence and Associated Factors of Depression Symptoms Among Aquaculture Workers in Hai Phong, Vietnam: A Cross-Sectional Study

Objective: This study aimed to determine the prevalence and factors associated with depression symptoms among aquaculture workers in Hai Phong, Vietnam. Material and Methods: The study involved 1,220 aquaculture workers in coastal and offshore areas of Hai Phong, Vietnam; from March 2022 to September 2022. It was a cross-sectional descriptive epidemiological study, utilizing direct interviews with aquaculture workers to identify depression symptoms and associated factors. The Depression-Anxiety- Stress Scale (DASS 21) was used to assess depression symptoms. Results: The prevalence of depression symptoms among aquaculture workers was 28.7%, with 20.9% experiencing mild depression, 6.3% moderate depression and 1.5% severe depression. Several factors were associated with depression symptoms; including gender (OR=2.03; 95% CI 1.56-2.63), being single or divorced (OR=1.44; 95% CI 1.04-1.99), age ≥60 (OR=1.63; 95% CI 1.05-2.55) compared to those under 40, chronic illnesses (OR=3.16; 95% CI 2.43-4.11), poor sleep quality (OR=2.84; 95% CI 2.13-3.79), alcohol abuse (OR=1.36; 95% CI 1.06-1.75), and irregular physical exercise (OR=2.09; 95% CI 1.62-2.70). Conclusion: Depression disorder is a mental health concern among aquaculture workers. To alleviate depression symptoms, workers should consider lifestyle adjustments, incorporate regular physical exercise, and undergo routine health check-ups for timely counseling and treatment.

#842 Validation of the excessive salt intake screening questionnaire in CKD patients

Abstract Background and Aims Excessive salt intake is implicated in the progression of hypertension, chronic kidney disease (CKD), diabetic nephropathy, cardiovascular diseases, cerebrovascular diseases, and increased mortality. In Japan, average salt consumption surpasses the levels recommended by national guidelines and the WHO. However, individuals seldom have the chance to gauge their salt intake accurately. This study aimed to validate a screening tool initially developed by Sasaki et al. to identify individuals with excessive salt intake using health check-up data from Asahi City, Chiba Prefecture, Japan. Method This study was conducted as a part of the Cities Changing Diabetes (CCD). CCD is Novo Nordisk's commitment to drive action against type 2 diabetes and obesity in cities globally. It is a partnership program to accelerate the prevention of diabetes and obesity by addressing the systemic change in urban environments. Participants of this study were drawn from specific health examinations in Asahi City. Consent was obtained, and dialysis patients were excluded. Spot urine samples were analyzed for sodium and creatinine to estimate daily salt intake via Tanaka's formula. The screening tool incorporated risk factors such as age, gender, Body Mass Index (obesity), hypertension (use of antihypertensive drugs), frequency of soup intake, saltiness of home-cooked meals compared to restaurants, efforts to reduce salt intake, and frequency of dining out. The primary outcome was excessive salt intake, defined as an intake exceeding one standard deviation above the mean. Discrimination was assessed using the Area Under the Curve (AUC), while calibration was evaluated with a calibration plot and the Hosmer-Lemeshow test. Results Of the 1532 CKD participants, the mean age was 76.3 years, with males comprising 46%. The average daily salt intake was 9.3 g (SD: 2.39), and the estimated Glomerular Filtration Rate (GFR) was 50.6 ml/min/1.73 m² (SD: 14.5). The distribution of CKD stages included 1198 stage 3a, 285 stage 3b, 43 stage 4, and 5 stage 5 patients. The AUC of screening tool was 0.65 (95% CI: 0.61 to 0.69), and its calibration slope (with an intercept) was 0.98 (95% CI: 0.72 to 1.25). The Hosmer-Lemeshow test yielded a p-value of 0.626. Conclusion The predictive capability of the existing model for excessive salt intake was limited in the CKD population, which may suggest a need for a screening method distinct from that used in the general population. Factors such as changes in sodium excretion due to reduced renal function and the effects of diuretics should also be considered when interpreting these results. Integrating this questionnaire into routine health check-ups could enhance dietary monitoring and intervention, potentially attenuating the progression of CKD and its associated complications. There remains scope for further refinement of the tool's accuracy by incorporating additional predictors.

Elevated LDL-c may warn of the risk of gallbladder stones in the patients with metabolic dysfunction-associated steatotic liver disease: A case-control study

PurposeThis study aimed to explore the relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and the development of new-onset gallbladder stone disease (GSD) and to identify factors that influence the occurrence of new-onset GSD in patients with MASLD. MethodsIn this retrospective case-control study, patients who underwent asymptomatic GSD screening during annual routine health check-ups at two hospitals in China between August 2017 and July 2022 were included. Patients with new-onset GSD and controls without GSD were matched 1:1 based on age, sex, race, occupation, diet, drinking habits, systolic blood pressure, diastolic blood pressure, and fasting blood glucose levels. ResultsThe study comprised 1200 patients with new-onset GSD and 1200 controls without GSD. Patients with new-onset GSD had higher rates of MASLD (33.8% vs. 22.2 %, P < 0.001) and hypercholesterolemia (12.6% vs. 7.2 %, P < 0.001) compared to controls. Waist circumference (WC) (OR = 1.042, 95 % CI: 1.022–1.063, P < 0.001), high-density lipoprotein cholesterol (HDL-c) (OR = 0.048, 95 % CI: 0.037–0.062, P < 0.001), triglycerides (OR = 0.819, 95 % CI: 0.699–0.958, P = 0.013), and hypercholesterolemia (OR = 5.023, 95 % CI: 2.735–9.225, P < 0.001) were independently associated with new-onset GSD. Among patients with MASLD, WC (OR = 1.075, 95 % CI: 1.026–1.127, P = 0.003), total cholesterol (TC) (OR = 2.094, 95 % CI: 1.259–3.484, P = 0.004), HDL-c (OR = 0.088, 95 % CI: 0.054–0.142, P < 0.001), and low-density lipoprotein cholesterol (LDL-c) (OR = 4.056, 95 % CI: 2.669–6.163, P < 0.001) were independently associated with new-onset GSD. ConclusionsThe findings indicate that hypercholesterolemia is independently associated with GSD. Among patients with MASLD, hypercholesterolemia also showed an independent association with GSD. Notably, this study is the first to identify serum LDL-c levels as potentially the most significant risk factor for GSD, highlighting that elevated LDL-c could serve as an important indicator for individuals with MASLD.

Awareness of HPV vaccine and its socio-demographic determinants among the parents of eligible daughters in Bangladesh: A nationwide study

BackgroundVaccination against Human papillomavirus (HPV) is recommended to avoid HPV infections and its associated diseases, including cervical cancer. However, there is no awareness study among Bangladeshi population. Hence, this nationwide study was conducted to explore HPV vaccine awareness and its determinants among parents of eligible adolescent girls. MethodsThis study was conducted among the parents of daughters aged 9–15 years from 42 out of 64 randomly selected districts of Bangladesh between June 28 to August 2, 2023. A multistage sampling method was used to enroll 2151 study participants from all eight divisions of Bangladesh. A semi-structured questionnaire was used for face-to-face interviews in this study. The statistical software Stata (Version 17) was used for statistical analyses. ResultsThe average age of the participants was 38.18 (±5.86) years. Only 22.32 % of the participants were aware of the HPV vaccine. Every additional year of age increased the likelihood of being aware of the HPV vaccine by 3 % (AOR: 1.03; 95%CI: 1.00–1.06). Participants residing in the urban area had 3.56 times higher odds of awareness than rural and semi-urban people. Businessmen and housewives had 60 % (AOR: 0.40; 95 % CI: 0.22–0.69) and 77 % (AOR: 0.23; 95 % CI: 0.16–0.33) lower odds in comparison to job holders. The lower-income group exhibited significantly higher odds of awareness (AOR: 0.25, 95%CI: 0.16–0.39) compared to the middle and the higher-income group. Participants who never went through routine health check-ups had 77 % lower odds of being aware than those who availed of regular routine check-ups (AOR: 0.23; 95%CI: 0.16–0.34). ConclusionAwareness of the HPV vaccine among the general population of Bangladesh is very low. Age, residence, occupation, monthly income, and routine medical check-ups were associated with HPV vaccine awareness. A nationwide awareness campaign would increase this awareness level among the Bangladeshi population, especially among the parents of daughters.

Longitudinal changes in optic disc cupping from the baseline in chiasmal lesion optic neuropathy and glaucoma

We aimed to investigate the changes in cupping in chiasmal lesion optic neuropathy (chON) compared to baseline optic disc and glaucoma. We used a novel study design to enroll patients who had fundus photographs incidentally taken during routine health check-ups prior to the onset of optic neuropathy. In 31 eyes (21 patients) with chON and 33 eyes (30 patients) with glaucoma, we investigated the change in cup-to-disc (C/D) area from the baseline to overt cupping using flicker analysis. Compared to the baseline, 23 eyes (74.2%) had increased cup size and 3 (9.7%) had vascular configuration changes in the chONgroup; in contrast, all glaucoma eyes exhibited changes in cup size and vascular configuration. The increase in C/D area ratio was significantly smaller in chON (0.04 ± 0.04) compared to glaucoma (0.10 ± 0.04, P < 0.001); the minimum residual neuroretinal rim width showed a more pronounced difference (29.7 ± 8.2% vs 7.1 ± 3.9%, P < 0.001). The changes distributed predominantly towards the nasal direction in chON, contrasting the changes to the arcuate fibers in glaucoma. In conclusion, our results provide the first longitudinal evidence of true pathological cupping in chONcompared to photographically disease-free baseline. The marked difference in the residual minimum rim width reaffirms the importance of rim obliteration in the differential diagnosis between the two diseases.

Investigation of Fourier Transform Infrared (FT-IR) Spectroscopy and Chemometric Analysis Method as an Alternative Method in the Diagnosis of Prostate Cancer

Prostate cancer is one of the most common types of cancer in men. It usually grows slowly and may not show obvious symptoms at first. Prostate cancer can be diagnosed by symptoms or by a doctor performing certain tests during routine health checkups. These tests include physical examination, PSA (Prostate Specific Antigen) Test, biopsy, imaging techniques, and Gleason score. In addition, Fourier transform infrared spectroscopy (FT-IR) is an analysis method used for prostate cancer diagnosis. This study aims to demonstrate FT-IR spectroscopy as an alternative method to other diagnostic methods in the diagnosis of prostate cancer. The FT-IR spectroscopy method is used to examine the molecular structure of samples. For prostate cancer diagnosis, FT-IR spectroscopy can be used to identify molecular changes in prostate tissue and identify characteristics by which cancerous cells differ from healthy cells. FT-IR spectroscopy is based on spectral data obtained by exposing samples to infrared radiation. These spectral data are based on properties associated with the movements of the molecules contained in the samples, such as vibration, rotation and bending. Molecular changes caused by diseases such as prostate cancer may be evident in these spectral data. These changes can provide information about the presence or stage of cancerous cells. Data obtained using FT-IR spectroscopy is processed with statistical analysis methods. These analyses are used to identify molecular differences between cancerous and healthy prostate tissues. In this way, FTIR spectroscopy can help obtain sensitive and accurate results in the diagnosis of prostate cancer.

Machine learning-based predictive model for abdominal diseases using physical examination datasets

Abdominal ultrasound is a key non-invasive imaging method for diagnosing liver, kidney, and gallbladder diseases, despite its clinical significance, not all individuals can undergo abdominal ultrasonography during routine health check-ups due to limitations in equipment, cost, and time. This study aims to use basic physical examination data to predict the risk of diseases of the liver, kidney, and gallbladder that can be diagnosed via abdominal ultrasound. Basic physical examination data contain gender, age, height, weight, BMI, pulse, systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, triglycerides, fasting blood glucose (FBG), and uric acid—we established seven single-label predictive models and one multi-label predictive model. These models were specifically designed to predict a range of abdominal diseases. The single-label models, utilizing the XGBoost algorithm, targeted diseases such as fatty liver (with an Area Under the Curve (AUC) of 0.9344), liver deposits (AUC: 0.8221), liver cysts (AUC: 0.7928), gallbladder polyps (AUC: 0.7508), kidney stones (AUC: 0.7853), kidney cysts (AUC: 0.8241), and kidney crystals (AUC: 0.7536). Furthermore, a comprehensive multi-label model, capable of predicting multiple conditions simultaneously, was established by FCN and achieved an AUC of 0.6344. We conducted interpretability analysis on these models to enhance their understanding and applicability in clinical settings. The insights gained from this analysis are crucial for the development of targeted disease prevention strategies. This study represents a significant advancement in utilizing physical examination data to predict ultrasound results, offering a novel approach to early diagnosis and prevention of abdominal diseases.

Modification effect of receipt of diabetes care on the association between COVID-19 infection and HbA1c level during the first year of the coronavirus pandemic using a nationwide population-based database.

We assessed the modification effect of adherence to diabetes care on the association between HbA1c levels and the risk of coronavirus disease 2019 (COVID-19) among individuals with diabetes using a population-based database. We retrospectively identified individuals with diabetes during routine health checkups performed in 2019 in Japan using a population-based claims database (JMDC, Tokyo, Japan). We assessed the risk of COVID-19 infection in 2020 in relation to HbA1c levels during routine checkups, stratified by the presence/absence of follow-up for diabetes care in 2019. Several sensitivity analyses were performed. We identified 65,956 individuals with an HbA1c ≥6.5% and fasting glucose ≥126 mg/dL in routine checkups, including 52,637 and 13,319 with and without at least one physician consultation for diabetes care in 2019, respectively. Although high HbA1c levels were associated with an increased risk of COVID-19 infection in a dose-dependent manner among individuals without diabetes care in 2019 (odds ratios, 1.53 and 2.17 in individuals with HbA1c of 7.0-7.9% and ≥8.0%, respectively) with a reference to HbA1c of 6.5-6.9%, individuals with diabetes care had no such trend in 2019 (odds ratios, 0.99 and 0.97 among individuals with HbA1c of 7.0-7.9% and ≥8.0%, respectively). Sensitivity analyses yielded consistent results when the variable definitions were changed and after multivariable adjustment with multiple imputation. This population-based study suggests that adherence to diabetes care may modify the association between HbA1c levels and the risk of COVID-19 infection.

Interesting case report on Chiari network

The Chiari network is a congenital remnant that is typically found in the right atrium and is generally not associated with significant pathophysiological implications. Usually, this is detected on general routine health checkup screening or casual examination. But, occasionally in certain cases, it is possible for this condition to results in diagnostic ambiguity when assessing right atrial disorders. Additionally, it has potential to contribute to the development of thromboembolism by inducing flow blockage. The Chiari network can be accurately diagnosed by echocardiography. This network appear as a highly mobile, highly reflectant echo target at many regions in the right atrium during transthoracic and transesophageal echocardiography. In this study, we provide a case involving an 18 year old male students studying cardiac technology who was diagnosed incidentally during echocardiography practical classes with Chiari network, mild TR and mild PR. The value and precision of echocardiography are becoming more widely recognized and being used more frequently. The potential for finding normal anatomical variations and their potential incorrect interpretation as pathological states coincides with the wider implementation of this imaging method.

Subjective versus objective refraction in healthy young adults

PurposeTo evaluate objective and subjective refraction differences in healthy young adults.MethodsData concerning candidates for the Israeli Air Force Flight Academy, as well as active air force pilots in all stages of service who underwent a routine health checkup between the years 2018 and 2019 were retrospectively analyzed. Objective refraction measured using a single autorefractometer was compared with subjective refraction measured by an experienced military optometrist during the same visit. The results were converted to power vectors (spherical equivalent [SE], J0, and J45). To interpret astigmatism using power vector values, the cylinder power (Cp) was determined.ResultsThis study included 1,395 young adult participants. The average age was 22.17 years (range, 17–39, 84.8% males). The average SE was − 0.65 ± 1.19 diopter (D) compared with − 0.71 ± 0.91D in the auto- and subjective refraction, respectively (p = 0.001). Cp was 0.91 ± 0.52D and 0.67 ± 0.40D, respectively (p < 0.001). This difference was more common in older participants (p < 0.001). J0 and J45 value differences were not significant. The absolute SE value of subjective refraction was lower in the myopic (p < 0.001) and hyperopic (p < 0.001) patients.ConclusionsYoung hyperopic participants tended to prefer “less plus” in subjective refraction compared with autorefraction. Young myopic participants tended to prefer “less minus” in subjective refraction compared with autorefraction. All participants, but mainly older participants, preferred slightly “less Cp” than that measured using autorefraction; The astigmatic axis did not differ significantly between the methods.

LASSO-derived model for the prediction of lean-non-alcoholic fatty liver disease in examinees attending a routine health check-up

Background Lean individuals with non-alcohol fatty liver disease (NAFLD) often have normal body size but abnormal visceral fat. Therefore, an alternative to body mass index should be considered for prediction of lean-NAFLD. This study aimed to use representative visceral fat links with other laboratory parameters using the least absolute shrinkage and selection operator (LASSO) method to construct a predictive model for lean-NAFLD. Methods This retrospective cross-sectional analysis enrolled 2325 subjects with BMI < 24 kg/m2 from medical records of 51,271 examinees who underwent a routine health check-up. They were randomly divided into training and validation cohorts at a ratio of 1:1. The LASSO-derived prediction model used LASSO regression to select 23 clinical and laboratory factors. The discrimination and calibration abilities were evaluated using the Hosmer–Lemeshow test and calibration curves. The performance of the LASSO model was compared with the fatty liver index (FLI) model. Results The LASSO-derived model included four variables—visceral fat, triglyceride levels, HDL-C-C levels, and waist hip ratio—and demonstrated superior performance in predicting lean-NAFLD with high discriminatory ability (AUC, 0.8416; 95% CI: 0.811–0.872) that was comparable with the FLI model. Using a cut-off of 0.1484, moderate sensitivity (75.69%) and specificity (79.86%), as well as high negative predictive value (95.9%), were achieved in the LASSO model. In addition, with normal WC subgroup analysis, the LASSO model exhibits a trend of higher accuracy compared to FLI (cut-off 15.45). Conclusions We developed a LASSO-derived predictive model with the potential for use as an alternative tool for predicting lean-NAFLD in clinical settings.

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.

A novel approach to quantifying individual's biological aging using Korea’s national health screening program toward precision public health

Accurate prediction of biological age can inform public health measures to extend healthy lifespans and reduce chronic conditions. Multiple theoretical models and methods have been developed; however, their applicability and accuracy are still not extensive. Here, we report Differential Aging and Health Index (DAnHI), a novel measure of age deviation, developed using physical and serum biomarkers from four million individuals in Korea's National Health Screening Program. Participants were grouped into aging statuses (< 26 vs. ≥ 26, < 27 vs. ≥ 27, …, < 75 vs. ≥ 75 years) as response variables in a binary logistic regression model with thirteen biomarkers as independent variables. DAnHI for each individual was calculated as the weighted mean of their relative probabilities of being classified into each older age status, based on model ages ranging from 26 to 75. DAnHI in our large study population showed a steady increase with the increase in age and was positively associated with death after adjusting for chronological age. However, the effect size of DAnHI on the risk of death varied according to the age group and sex. The hazard ratio was highest in the 50–59-year age group and then decreased as the individuals aged. This study demonstrates that routine health check-up biomarkers can be integrated into a quantitative measure for predicting aging-related health status and death via appropriate statistical models and methodology. Our DAnHI-based results suggest that the same level of aging-related health status does not indicate the same degree of risk for death.

Association of cardiometabolic and triglyceride-glucose index with left ventricular diastolic function in asymptomatic individuals

Background and aimsObesity and insulin resistance are associated with left ventricular diastolic dysfunction (LVDD) and increased risk of heart failure. Cardiometabolic index (CMI) and triglyceride glucose (TyG) are new indexes to assess visceral obesity and insulin resistance, respectively. The study aimed to investigate the clinical usefulness of these indexes for identifying LVDD individuals. Methods and resultsOverall, 1898 asymptomatic individuals were included in this cross-sectional study. Participants underwent anthropometrics, serum biochemical evaluation, and echocardiography. Multiple linear regression analysis revealed that both indexes were independent determinants of diastolic parameters among females; while for males, CMI and TyG were not associated with A velocity. In the multivariate logistic analysis, the proportion of LVDD in the third and fourth quartiles of CMI remained significantly greater than that in the lowest quartile in females (Q3 vs. Q1: odds ratio (OR) = 2.032, 95% confidence interval (CI): 1.181–3.496; Q4 vs. Q1: OR = 2.393, 95% CI: 1.347–4.249); while in males, the incidence of LVDD was significantly greater only in the fourth quartile. For TyG, the presence of LVDD in the fourth quartile was significantly greater in both genders. The discriminant values between the CMI (AUC: 0.704, 95% CI: 0.668–0.739) and TyG (AUC: 0.717, 95% CI: 0.682–0.752) were similar in females. Both indexes performed better in females than in males to identify LVDD. ConclusionThe CMI and TyG might both serve as effective tools to identify LVDD in routine health check-ups in primary care, mainly in females. With simpler parameters, the CMI could be utilized in medically resource-limited areas.

From Compliance to Innovation: A Comprehensive Analysis of Pos Bloc Medan’s Tourism Infrastructure

This research delves into the spatial arrangement and landscaping considerations for Pos Bloc Medan, an artificial tourist attraction. Employing a qualitative research design, the study assesses the facility’s adherence to tourism business standards stipulated in Minister of Tourism and Creative Economy Regulation No. 4/2021. Findings indicate that elements such as “Special Business Requirements,” “Business Facilities,” and “Organizational Structure and HR” fall short of the prescribed standards. Several areas requiring improvement include the absence of emergency gathering points, limited community involvement, and suboptimal waste management. Recommendations for enhancement encompass routine health check-ups for employees, aligning with established norms for the operations of the tourism sector. Furthermore, the study presents a spatial proposal focusing on emergency gathering points to address safety, accessibility, and visual appeal concerns. The proposed assembly points not only bolster safety protocols but also contribute to enhancing the aesthetic appeal of Pos Bloc Medan, aligning with the objective of establishing a sustainable, multifunctional space. In conclusion, this research underscores the importance of meticulous spatial planning and strict regulatory adherence in optimizing tourist attractions, as exemplified by Pos Bloc Medan, for the betterment of the community, preservation of the environment, and sustainability of the tourism industry as a whole.

Association of High-Sensitivity C-Reactive Protein and Lipoprotein-Associated Phospholipase A2 with Metabolically Unhealthy Phenotype: A Cross Sectional Study.

Whether the combination of high-sensitivity C-reactive protein (hs-CRP) and Lipoprotein-associated Phospholipase A2 (Lp-PLA2) was an independent risk factor for metabolic unhealthy is unknown. This study aimed to evaluate the association between combining hs-CRP and Lp-PLA2 and metabolic unhealthy. A total of 3198 participants who underwent routine health check-up examinations. The participants completed inflammation indicators (hs-CRP and Lp-PLA2) examination and physical assessments. Four phenotypes were determined according to obesity and metabolic health status. Meanwhile, the participants were divided into four groups according to the level of hs-CRP and Lp-PLA2. The cross-sectional association between hs-CRP, Lp-PLA2 and metabolic unhealthy was tested by logistic regression analysis. About 30.48%, 17.35%, 17.32% and 34.83% had MHNO, MUNO, MHO, and MUO, respectively. The combination of the hs-CRP and Lp-PLA2 levels was significantly correlated with metabolic unhealthy in non-obese subjects. However, in obese subjects, only hs-CRP level was significantly correlated with metabolic unhealthy. The hs-CRP and Lp-PLA2 together were significantly associated with metabolic unhealthy in non-obese subjects. hs-CRP level was significantly correlated with metabolic unhealthy in obese subjects.

Association of Serum Uric Acid with Indices of Insulin Resistance: Proposal of a New Model with Reference to Gender Differences.

Insulin resistance (IR) is a key feature of type 2 diabetes (T2D) and an independent risk factor for metabolic syndrome. Previous studies have linked elevated serum uric acid (SUA) to an increased risk of T2D. The purpose of this study was to investigate the relationship between SUA and IR. At the same time, the correlation between New model and SUA compared with other IR alternatives was compared, so as to provide a simple and effective new indicator for early detection and prediction of IR risk and early prevention of T2D. The first cohort was the Discovery Cohort, which included 318 obese patients. And the second cohort was the Verification Cohort, which included a total of 4333 subjects who underwent a routine health checkup at our hospital. Spearman correlation analysis and binary logistic regression analysis were used to discuss the correlation between SUA and IR. Regardless of sex, fasting insulin (FINS) and IR replacement markers increased with SUA (P<0.001). In both cohorts, SUA was associated with IR alternatives, especially with New model, and differed between men and women in all correlation analyses. After adjusting for confounding factors, SUA was still associated with IR (P<0.001). The correlation between SUA and IR was significantly stronger in women than in men. And the correlation between SUA and New model is stronger than other IR replacement models. However, the causal relationship between SUA and IR has not been clearly established.