Taichung Community Health Study Research Articles

Associations of EDNRA and EDN1 polymorphisms with carotid intima media thickness through interactions with gender, regular exercise, and obesity in subjects in Taiwan: Taichung Community Health Study (TCHS)

Associations of EDNRA and EDN1 polymorphisms with carotid intima media thickness through interactions with gender, regular exercise, and obesity in subjects in Taiwan: Taichung Community Health Study (TCHS)

Heritability of carotid intima-media thickness and inflammatory factors of atherosclerosis in a Chinese population

Carotid intima-media thickness (cIMT), a marker of subclinical atherosclerosis, has been found to be associated with incident stroke. High-sensitivity C-reactive protein (CRP) and fibrinogen have been demonstrated to be associated with atherosclerosis. Previous studies on heritability estimates of IMT, CRP, and fibrinogen among Chinese populations are limited. This study aims to estimate the heritability of these risk factors in residents who participated in the Taichung Community Health Study (TCHS) and their family members. A total of 2671 study subjects from 805 families were enrolled in the study, selected from a random sample of TCHS participants and their family members. CRP, and fibrinogen were obtained from each participant, and a questionnaire interview was conducted. cIMT was measured by high-resolution B-mode ultrasound and expressed as the mean of the maximum. Heritability estimates and the familial correlation of cIMT, CRP, and fibrinogen among family pairs were determined with SAGE software. With multivariate adjustments, significant heritability was found for cIMT (h2 = 0.26, P < 0.001), CRP (h2 = 0.34, P < 0.001), and fibrinogen (h2 = 0.48, P < 0.001). The intrafamilial correlation coefficients for the three indexes in the parent–offspring pairs were significant (P < 0.001) and ranged from 0.17 to 0.41. The full sibship correlations were also significant (P < 0.001) for the three indexes and ranged from 0.19 to 0.47. This study indicates that a moderate proportion of the variability in CRP, fibrinogen, and cIMT can be attributed to genetic factors in Chinese populations. The findings suggest that CRP is associated with cIMT, whereas no significant association exists between fibrinogen and cIMT.

Association of time-varying sleep duration and cognitive function with mortality in the elderly: a 12-year community-based cohort study

BackgroundSleeping problems and cognitive impairment are common in elders. Baseline sleep duration and cognitive status are predictors of mortality. But few studies have explored whether longitudinal changes in sleep duration and cognitive function are related to mortality in older adults. The present study investigated the time-varying relationships of sleep duration and cognitive function with subsequent mortality among community-dwelling elders by using 12 years of repeated-measure data.MethodsTaichung Community Health Study for Elders (TCHS-E) is a retrospective, population-based cohort that started in 2009 (wave 1) with a total of 912 elders aged 65 years or above. Follow up was conducted in 2010 (wave 2), 2018 (wave 3), and 2020 (wave 4). Sleep duration and Mini-Mental State Examination (MMSE) forms were executed at baseline and three visits during follow-up. Time-varying Cox proportional hazards regression estimated adjusted hazard ratios (HRs) of mortality with 95% confidence intervals (CIs).ResultsDuring about 12 years (9,396 person-years) follow-up, 329 deaths from all causes were documented, including 102 deaths due to expanded cardiovascular disease (CVD). In the multivariable-adjusted, time-varying Cox proportional hazard model, the adjusted HR values of all-cause mortality were 1.47 (1.02–2.12) for sleep duration > 9 h/day (vs. 7 h/day) and 1.81 (1.26–2.59) for MMSE < 27 (vs. 30). The adjusted HR values of the expanded CVD mortality were 2.91 (1.24–6.83) for MMSE of 29; 2.69 (1.20–6.05) for MMSE of 27–28; and 4.32 (95% CI: 1.92–9.74) for MMSE < 27. The dose-dependent relationship was significant (p < 0.001). The combinations of sleep duration longer than 9 h/day and MMSE < 27 were linked with the highest risks for expanded CVD and all-cause mortality.ConclusionsLong sleep duration and low cognitive function were jointly and independently linked with higher risk of mortality in elders residing in community.

Obesity marker trajectories and cognitive impairment in older adults: a 10-year follow-up in Taichung community health study for elders

BackgroundObesity and cognitive impairment prevalence increases as age increases. Recent growing evidence finds links between obesity and cognitive impairment in older adults. However, the association between the two is controversial. This study aims to identify obesity marker trajectory patterns, and to assess whether these patterns are associated with cognitive impairment and cognitive decline during a 10-year follow-up period among community-dwelling older adults.MethodsA total of 626 older adults aged 65 and older were involved in the study, with at least two repeated measurements at baseline, one-year or 10-year follow-up. Cognitive function was measured through the Mini Mental State Examination. Obesity markers included body mass index, waist circumference, waist-to-hip (WHR), fat mass (FM), and abdominal fat (AF) measured by dual-energy X-ray absorptiometry. Multivariate logistic regression analyses were performed to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of cognitive impairment and cognitive decline for obesity marker trajectory patterns.ResultsAfter a 10-year follow-up, 168 older adults with incident cognitive impairment and 156 with rapid cognitive decline were defined as the top 25th percentile of cognitive decline. Four distinct trajectory groups of obesity markers were identified. In multivariate logistic regression analyses, a low likelihood of cognitive impairment was observed in the consistently high-level group from FM trajectory (ORs = 0.41, 95% CI = 0.20–0.85); the high-level U-shaped group from WHR trajectory (0.43, 0.22–0.84); and the median-level flat inverse U-shaped, consistently high-level, and low-level flat U-shaped groups from AF trajectory (0.44, 0.26–0.77; 0.33, 0.18–0.61; 0.39, 0.18–0.82). In addition, a low likelihood of rapid decline was found in the low-level, slightly increasing trend group from WHR trajectory (0.43, 0.22–0.85).ConclusionFM and AF trajectories with consistent high levels and WHR trajectory with high level with U-shaped group are associated with low risks of incident cognitive impairment in older adults. Similarly, WHR trajectory with a low but slowly increasing trend is associated with a decreased risk of cognitive decline.

Derivation and validation of 10-year all-cause and cardiovascular disease mortality prediction model for middle-aged and elderly community-dwelling adults in Taiwan.

Prediction model mainly focused on specific diseases, such as diabetes, hypertension, cardiovascular disease, or patients with cancer, or populations of Europe and America, thereby limiting its generalization. This study aimed to develop and validate a 10-year mortality risk score by using data from a population-representative sample of adults. Data were collected from 2,221 Taichung Community Health study participants aged ≥40 years. The baseline period of the study was 2004, and all participants were followed up until death or in 2016. Cox’s proportional hazards regression analyses were used to develop the prediction model. A total of 262 deaths were ascertained during the 10-year follow-up. The all-cause mortality prediction model calculated the significant risk factors, namely, age, sex, marital status, physical activity, tobacco use, estimated glomerular filtration rate, and albumin-to-creatinine ratio, among the baseline risk factors. The expanded cardiovascular disease (CVD) mortality prediction model consisted of six variables: age, sex, body mass index, heart disease plus heart disease medication use, stroke plus medication use, and ankle–brachial index. The areas under receiver operating curves of the 3-, 5- and 10-year predictive models varied between 0.97, 0.96, and 0.88 for all-cause mortality, and between 0.97, 0.98, and 0.84 for expanded CVD mortality. These mortality prediction models are valid and can be used as tools to identify the increased risk for mortality.

Cognitive function and its transitions in predicting all-cause mortality among urban community-dwelling older adults

BackgroundCognitive impairment is accompanied with high rates of comorbid conditions, leading ultimately to death. Few studies examine the relation between cognitive transition and mortality, especially in Asian population. This study evaluated baseline cognition and cognitive transition in relation to all-cause mortality among community-dwelling older adults.MethodsWe conducted a community-based prospective cohort study among 921 participants of Taichung Community Health Study for Elders in 2009. Cognitive function was evaluated by the Mini-Mental State Examination. Cognitive impairment was considered if the total score is less than 27, 24, and 21 for a participant’s educational level of more than 6 years, equal or less than 6 years, and illiteracy, respectively. One-year transition in cognitive function was obtained among 517 individuals who were assessed in both 2009 and 2010. Mortality was followed up until 2016. Cox proportional hazards models were applied to estimate the adjusted hazard ratios of mortality for baseline cognitive impairment and one-year transition in cognitive status.ResultsAfter a follow-up of 6.62 years, 160 deaths were recorded. The multivariate adjusted hazard ratio (95% confidence interval) for baseline cognitive impairment was 2.08 (1.43, 3.01). Significantly increased mortality risk was observed for cognitively impaired–normal and impaired–impaired subgroups over 1 year as compared with those who remained normal [2.87 (1.25, 6.56) and 3.79 (1.64, 8.73), respectively]. The area under the receiver operating characteristic curves demonstrated that baseline cognition and one-year cognitive transition had no differential predictive ability for mortality. Besides, there was an interaction of cognitive impairment and frailty, with an additive mortality risk [5.41 (3.14, 9.35)] for the elders who presented with both.ConclusionBaseline cognitive impairment rather than one-year progression is associated with mortality in a six-year follow-up on older adults.

Frailty, transition in frailty status and all-cause mortality in older adults of a Taichung community-based population

BackgroundPrevious studies have reported the associations of frailty phenotype or its components with mortality. However, studies that explored the effects of transition in frailty status on mortality were far less in Asian or Chinese. The aim of this study was to evaluate baseline frailty status and one-year change of frailty status in relation to all-cause mortality in Taiwanese community-dwelling older adults who participated in the Taichung Community Health Study for Elders.MethodsWe conducted a community-based prospective cohort study. A total of 921 community-dwelling elderly men and women aged 65–99 years in Taichung City were enrolled in 2009–2010 and were followed up through 2016. We adopted the definition of frailty proposed by Fried et al., including five components: shrinking, weakness, poor endurance and energy, slowness, and low physical activity. Cox proportional hazards models were used to determine adjusted hazard ratios (HRs) of mortality with 95% confidence intervals (CIs) for frailty at baseline and one-year change in frailty status.ResultsThere were 160 deaths during the follow-up period. The mortality rates in groups of robust and frail were 20.26 and 84.66 per 1000 person-years respectively. After multivariate adjustment, the HR (CIs) for baseline frailty was 2.67 (1.73–4.12). Poor endurance and energy [1.88 (1.03–3.42)], slowness [2.60 (1.76–3.83)] and weakness [1.65 (1.16–2.33)] were found to be predictors of mortality. Increased risks in mortality for subgroups of robust-to-frail [2.76 (1.22–6.27)], frail-to-robust [3.87 (1.63, 9.19)], and frail-to-frail [4.08 (1.92–8.66)] over one-year period were observed compared with those remaining robust.ConclusionBaseline frailty status and one-year change in frailty status are associated with 6-year all-cause mortality among Taiwanese elderly adults. Frailty may be useful for identifying older adults at high risks for mortality prevention.

Gender Difference in the Relationship of Albuminuria and Arterial Stiffness in Chinese Adults - a 6.6-Year Follow-Up Longitudinal Study

Background/Aims: Brachial–ankle pulse wave velocity (baPWV) reflects the stiffness of muscular arteries. Albuminuria is recognized as a marker of vascular dysfunction. We assessed the association between arterial stiffness and albuminuria in a population-based longitudinal study. Methods: 1116 adults aged ≥ 40 years in the Taichung Community Health Study (TCHS) in 2004 attended a follow-up visit in 2011. Albuminuria was defined as an urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g. Arterial stiffness was defined as BaPWV ≥ 1540 cm/sec in males and BaPWV ≥ 1480 cm/sec in females, respectively. ∆baPWV was calculated as baPWV at follow-up minus baPWV at baseline, while ∆UACR was calculated as UACR at follow-up minus UACR at baseline. Multiple linear and logistic regression analyses were used to explore the relationship between albuminuria and arterial stiffness. Results: Among 652 subjects without arterial stiffness at baseline, 209 (32%) subjects developed incident arterial stiffness after an average of 6.6 years. In male subjects, baseline albuminuria was associated with development of arterial stiffness (odds ratio: 4.47, 95% confidence interval [CI]: 1.04–19.31) and ∆baPWV was modestly positively associated with ∆UACR. Conclusion: Our results indicated that male adults with albuminuria had an increased risk for developing arterial stiffness.

Associations of TNF-α and IL-6 polymorphisms with osteoporosis through joint effects and interactions with LEPR gene in Taiwan: Taichung Community Health Study for Elders (TCHS-E).

Osteoporosis (OST) is a complex multifactorial disease considered to result from interactions of multiple gene and environmental factors. Tumor necrosis factor (TNF)-α and interleukin (IL)-6 are pleiotropic cytokines essential for bone remodeling; and hormone leptin has immunomodulatory effects that stimulate the synthesis of IL-6 and TNF-α. Leptin is involved in the modulation of bone growth and turnover; and its actions are bound by leptin receptor (LEPR). Prior studies evaluated the effects of TNF-α, IL-6, and LEPR gene polymorphisms separately on bone mineral densities (BMD) or OST. In this study, we assessed the roles of TNF-α and IL-6 gene polymorphisms in OST through joint effects and interactions with LEPR gene. We also evaluated possible joint effects and interactions between these polymorphisms and physical activity. Ten tag-SNPs (rs1799964, rs1800629, rs3093662 in TNF-α; rs1880243, rs1800796, rs1554606 in IL-6; and rs1751492, rs8179183, rs1805096, rs1892534 in LEPR) were used to genotype 103 OST cases and 369 controls. BMD of lumbar spine (LS), femoral neck (FN), and total hip (TH) were measured by dual-energy X-ray absorptiometry. Our data showed that TNF-α and IL-6 polymorphisms were associated with overall and site-specific OST in both sexes, and that these associations were dependent on rs1805096 and rs1892534 genotypes of LEPR. In men, LEPR A-G-G-G haplotype was associated with FN OST (OR 4.65, 95% CI 1.61-13.40, p=0.004). Genotype AA/AG of LEPR rs1751492 was associated with overall and FN OST in women without physical activity, but not in women with physical activity (p<0.05 for interaction between physical activity and LEPR rs1751492). In men, we detected significant interactions of IL-6 rs1800796 with LEPR rs1805096 and rs1892534 for FN and TH OST (all p<0.05). Our data indicate that LEPR gene may play joint and interactive roles with TNF-α and IL-6 genes and physical inactivity in development of OST. Haplotype analyses revealed that the correlations tended to be prominent in men with FN OST.

Associations of EDNRA and EDN1 polymorphisms with carotid intima media thickness through interactions with gender, regular exercise, and obesity in subjects in Taiwan: Taichung Community Health Study (TCHS).

The aim of this study was to evaluate the interacted association between EDNRA and EDN1 polymorphisms and gender, regular exercise, and obesity status on carotid intima media thickness (IMT) in community- dwelling subjects of the Taichung Community Health Study. Five single-nucleotide polymorphisms (SNPs rs1395821, rs1878406, rs5333, rs1800541, and rs5370) of the EDNRA and EDN1 gene were examined in 480 participants from 160 families. The IMT protocol involves scanning the common carotid arteries (CCAs), the carotid bifurcations (bulb), and the origins (first 1 cm) of the internal carotid arteries (ICAs). Generalized linear models with a generalized estimating equation were employed to consider the dependence among family members. After multivariate adjustment, the effects of interactions between EDNRA and EDN1 gene with gender, obesity, and exercise were observed. For gene-gender interaction on CCA IMT, the adjusted mean for men carrying the GA/GG genotype of EDNRASNP rs1878406 was 1.18 times higher than that for men carrying the AA genotype (95% CI: 1.01, 1.37). As for bulb and ICA IMT, the adjusted mean values for women carrying the AC/AA genotype of EDN1 rs5370 was lower than those carrying the CC genotype: 0.89, [0.82, 0.98]; and 0.90 [0.83, 0.99], respectively. We did observe significant effects of EDNRA SNPs rs1395821 and rs5333 in individuals who regularly exercised. A significantly lower adjusted mean in CCA IMT for non-obese individuals carrying EDNRA SNP rs5333 was observed (0.92 [0.86, 0.99]) compared with non-obese individuals carrying the AA genotype. This study first reported significant interactions of EDNRA and EDN1 polymorphisms with gender, regular exercise, and obesity on carotid IMT in Han Chinese participants.

Insulinlike Growth Factor-1 and Its Binding Protein-3 Polymorphisms Predict Circulating IGF-1 Level and Appendicular Skeletal Muscle Mass in Chinese Elderly

BackgroundPrevious studies have demonstrated the polymorphisms of insulinlike growth factor-1 (IGF-1) and its binding protein-3 (IGFBP3) genes could affect the circulating IGF-1 level. Moreover, the serum IGF-1 level was correlated with muscle size. ObjectivesThis study aimed to explore the effect of polymorphisms of IGF1, IGFBP3, and IGFBP5 genes on appendicular skeletal muscle mass in Taiwanese older adults in a metropolitan area. DesignA community-based cross-sectional study. Setting and subjectsA random sample of 472 elders with complete information of dual energy X-ray absorptiometry examination, genotyping analysis, and serum IGF-1 level from Taichung Community Health Study for Elders (TCHS-E) was included. MeasurementsLow appendicular skeletal muscle mass index (ASMI) was defined as 2 SDs below the mean of young adults from our TCHS study (n = 471). Seven polymorphisms of IGF1, IGFBP3, and IGFBP5 were analyzed by using Illumina GoldenGate Genotyping Assay. The χ2 test, Student t test, and multiple logistic regression were applied for statistical analysis. ResultsThe prevalence of low ASMI was 7.1%, 8.8%, and 23.0% in those aged 70 or younger, 71 to 75, and older than 75 years, respectively. We found that serum IGF-1 level (natural logarithmic transformation) was significantly lower in the low ASMI group compared with the normal ASMI group and the SNP rs2854744 near IGFBP3 gene was significantly associated with low ASMI. Moreover, we discovered the SNP rs6214 on the IGF1 gene would significantly affect the serum IGF-1 level. Therefore, the joint effect of rs6214 and rs2854744 was analyzed. Elders with GG genotype of rs6214 and AC or CC genotypes of rs2854744 had a 3.18-fold (95% CI 1.02–9.89) risk of having low ASMI compared with those with the AA and AA genotype, after adjusting for age, gender, smoking, exercise, hyperlipidemia, and albumin level. ConclusionsOur results suggest that rs6214 on the IGF1 gene and rs2854744 near the IGFBP3 gene potentially play an important role with ASMI in Taiwanese older adults in a metropolitan area.

Association between frailty and subclinical peripheral vascular disease in a community-dwelling geriatric population: Taichung Community Health Study for Elders.

Frailty is a common syndrome in the elderly and is linked to poor outcomes. Walking performance is one of the indicators of frailty and can be associated with peripheral vascular disease (PVD). The association between frailty and PVD is unclear. The present study investigates the association between frailty and PVD in the elderly. This cross-sectional study was carried out in a geriatric population of ≥65-year-old residents of Taichung, Taiwan, in June 2009. The association between frailty and subclinical PVD was analyzed using logistic regression with adjustments for PVD risk factors. The community-based study consisted of 1036 individuals (539 male and 497 female subjects) with a mean age of 74.2 ± 6.6 years. Frailty was found in 143 (13.8%), and subclinical PVD was identified in 74 (7.1%) individuals using the Ankle Brachial Index < 0.9 as a cut-off. Frail individuals were associated with an increased risk for subclinical PVD with an odd ratios (OR) of 3.168 (95% CI 1.803-5.566, P < 0.001). Individuals' diastolic blood pressure (OR 0.975, 95% CI 0.951-0.999, P = 0.038) and high-density cholesterol (OR 0.976, 95% CI: 0.956-0.996, P = 0.019) were independently associated with subclinical PVD. Frailty syndrome in the elderly is associated with subclinical peripheral arterial disease indicated using the Ankle Brachial Index. The association between frailty and PVD is independent of subject's age, blood pressure and serum lipoprotein level.

Heritability of cardiovascular risk factors in a Chinese population – Taichung Community Health Study and Family Cohort

Background and aimPrevious studies reporting on estimates of heritability of cardiovascular risk factors in Chinese are limited. This study aims to estimate the heritability of cardiovascular risk factors in relatives of residents who participated in the Taichung Community Health Study (TCHS) and Family Cohort (TCHS-FC) while controlling as many potential confounders as possible. MethodsA total of 1564 study subjects from 494 families with members aged 12–91 years were enrolled from a random sample of participants of TCHS and their family members (TCHS-FC) from 2009 to 2012. Anthropometric measurement, body composition, blood pressure, plasma lipids, fasting glucose, insulin, highly sensitive C-reactive protein (hs-CRP), brachial-ankle pulse wave velocity (baPWV), and the ankle-brachial index (ABI), as well as a questionnaire interview, were obtained from each participant. ResultsCardiovascular risk factors with estimates of heritability greater than 30% after multivariate adjustment were triglyceride (h2 = 0.41), HDL-C (h2 = 0.49), LDL-C (h2 = 0.47), total cholesterol (h2 = 0.46), hip circumference (h2 = 0.44), weight (h2 = 0.42), insulin (h2 = 0.39), hs-CRP (h2 = 0.38), BMI (h2 = 0.38), and percent body fat mass (h2 = 0.35). Correlation coefficients for significant sibling varied from 0.10 for weight to 0.47 for LDL-C whereas those for significant parent-offspring varied from 0.09 for fasting plasma glucose to 0.43 for baPWV. ConclusionsThis study demonstrated significant heritability and familial aggregation of cardiovascular risk factors in a random sample of ethnic Chinese population.

Three-year incidence of elevated albuminuria and associated factors in a population-based cohort: The Taichung Community Health Study

early-stage elevated albuminuria can be effectively detected by a spot urine albumin-to-creatinine ratio (UACR). Elevated albuminuria is a key predictor of diabetic nephropathy, progression to chronic kidney disease (CKD) or end-stage renal disease (ESRD), plus risk of cardiovascular disease (CVD) and mortality. Understanding these detectors may prevent future renal and cardiovascular disease. This study estimates three-year incidence in a representative sample of Taiwanese metropolitan adults to explore predictors. the Taichung Community Health Study (TCHS) is a representative sample of 2359 Chinese adults aged 40 years and over living in a metropolitan city during 2004-2005. In 2007-2009, a total of 1648 (71.3%) individuals participated in follow-up. This study includes only individuals with normal albumin excretion at baseline examination. Three-year incidence and baseline factors linked with elevated albuminuria were evaluated. about 87.0% (n = 1434) of subjects exhibited normal albumin excretion at baseline. Three-year age- and gender-weighted incidence was 4.5% (95% CI: 3.4-5.6%). Multivariate logistic regression showed subjects with elevated waist-to-hip ratio (WHR) (OR: 2.2, 95% CI: 1.2-3.9), abnormal creatinine (OR: 3.7, 95% CI: 1.1-12.6), hyperuricaemia (OR: 1.8, 95% CI: 1.0-3.3) and elevated baseline UACR (OR: 4.0, 95% CI: 1.1-14.3 for UACR of 3.20-6.39 mg/g; OR: 16.7, 95% CI: 5.0-55.5 for UACR of 6.40-29.99 mg/g) were more likely to have elevated albuminuria. this is the first population-based longitudinal study to rate incidence of elevated albuminuria and identify associated factors in a random sample of a Chinese population. Central obesity, renal function, hyperuricaemia and baseline UACR are independent risk factors.

Association of CRP gene polymorphisms with serum CRP level and handgrip strength in community-dwelling elders in Taiwan: Taichung Community Health Study for Elders (TCHS-E)

Low handgrip strength is one component of frailty, characterized by loss of reserves, including energy, physical ability, cognition and health. This study rated the effect of five single-nucleotide polymorphisms (SNPs) in C-reactive protein (CRP) gene on the serum CRP level and handgrip strength in elderly Taiwanese. Five SNPs (rs2794520, rs1205, rs1130864, rs1800947, and rs3093059) of CRP gene were utilized to genotype 472 unrelated elderly subjects (mean age 73.8years). Handgrip strength was measured by handgrip dynamometer (TTM Dynamometer, Tsutsumi, Tokyo). Our study demonstrated that minor alleles of rs2794520 and rs1205 were C, whereas they were T in most ethnic groups. There exist significant associations of three CRP polymorphisms (rs2794520, rs1205 and rs3093059) with serum CRP level and handgrip strength. All three had simultaneous influence on raising CRP levels and reducing handgrip strength. Genotype and sex interactions emerged for rs2794520 and rs1205 in relation to CRP levels (p<0.05). In addition, haplotype C-C-C-C-C was associated with higher levels of CRP (exp(β)=1.45; p<0.001) and lower handgrip strength (β=−1.00kg, p<0.05). We conclude that SNPs rs2794520, rs1205, and rs3093059 of CRP gene, as well as haplotype C-C-C-C-C may be important biomarkers for susceptibility to low handgrip strength and high serum CRP level in elders; further studies are required.

Vitamin D receptor variability and physical activity are jointly associated with low handgrip strength and osteoporosis in community-dwelling elderly people in Taiwan: the Taichung Community Health Study for Elders (TCHS-E)

We studied 472 elders to assess joint association of vitamin D receptor (VDR) variability and physical activity on low handgrip strength (LHS) and osteoporosis (OST). Our findings showed that higher risks of OST were associated with physically inactive elders with some specific VDR variations, highlighting the importance of promotion program for physical activity. The aim of this study was to determine the joint association between VDR variability and physical activity on LHS and OST in community-dwelling elders. Bone mineral density of the lumbar spine (LS), the femoral neck (FN), and the total hip were measured by dual-energy X-ray absorptiometry. Four single-nucleotide polymorphisms (SNPs) (rs7975232, rs1544410, rs2239185, and rs3782905) of the VDR gene were examined in 472 participants. Physical inactivity and each of the four SNPs were jointly associated with a significantly greater risk of LHS in people than that associated with each of the VDR SNPs or low physical activity alone. Physically inactive men with the AG or AA genotype of rs2239185 had a significantly greater risk of overall, LS, and FN OST than those of physically active men with the GG genotype [odds ratio (OR) 3.57, 95% confidence interval (CI) 1.10-11.65; OR 4.74, 95% CI 1.43-15.70; and OR 5.06, 95% CI 1.08-23.71, respectively]. Similarly, physically inactive women with the CG or CC genotype of rs3782905 and the AG or AA genotype of rs1544410 had a significantly greater risk of FN OST than physically active women with the GG genotype (OR 5.33, 95% CI 1.23-23.06 and OR 5.36, 95% CI 1.11-25.94, respectively). VDR polymorphisms and physical activity are jointly associated with LHS and OST in elders. Health care programs should promote physical activity among elders as a cost-effective way to prevent LHS and OST, especially in those who may be genetically predisposed.

Risks of decreased renal function and increased albuminuria for glycemic status and metabolic syndrome components: Taichung Community Health study.

Background. The objective of this study was to assess the association of glycemic status and decreased renal function as determined by estimated glomerular filtration rate (eGFR) and albuminuria in an adult Taiwanese metropolitan population. Methods. We did a cross-sectional survey in a representative sample of 2,350 Taiwanese adults aged 40 years and over living in a metropolitan city in Taiwan from 2004 to 2005. Glycemic status was classified as normal glycemia, hyperglycemia, and type 2 diabetes (T2D). Renal function was assessed with eGFR using modified Modification of Diet in Renal Disease Study equation for Chinese. Albuminuria was determined by the urinary albumin-creatinine ratio. Decreased renal function was defined as eGFR <60 mL/min/1.73 m2 and albuminuria as the albumin-creatinine ratio >30 mg g−1 creatinine. Results. 593 (25.23%) had hyperglycemia and 287 (12.21%) had T2D. As glycemia level increased, the prevalence of albuminuria and decreased eGFR increased. After adjustment, T2D was associated with an OR of 2.93 (95% CI: 2.11–4.07) for albuminuria, and an OR of 2.05 (95% CI: 1.18–3.58) for decreased eGFR. Conclusions. In a representative sample from a metropolitan city in Taiwan, T2D was associated with albuminuria and decreased eGFR.

Habitual Coffee Consumption and Incidence of Central Obesity in Chinese - Taichung Community Health Study

Habitual Coffee Consumption and Incidence of Central Obesity in Chinese - Taichung Community Health Study

The association of alcohol consumption with metabolic syndrome and its individual components: the Taichung community health study

Alcohol has both adverse and protective effects on the individual components of metabolic syndrome (MS). We hypothesize that alcohol consumption increases the risk of developing MS and that the consumption of different types of alcoholic beverages has different effects on the development of MS and its individual components. We enrolled 2358 men for this cross-sectional study. The data were collected from self-reported nutrition and lifestyle questionnaires. Individuals who drank at least once per week for 6 consecutive months were classified as current drinkers. Current drinkers were at a higher risk of developing MS, abdominal obesity, and high triglyceride levels, but they were at a lower risk of developing low levels of high-density lipoprotein cholesterol (HDL-C). The increased risk of developing MS, high triglyceride, and high fasting glucose levels was dose dependent, whereas low HDL-C levels demonstrated a reverse relationship. The dose needed to reduce the risk of having low HDL-C levels was ≧50 g/d. This dose, however, resulted in an increased risk of developing high fasting glucose and high triglyceride levels. Consuming mixed types of alcohol increased the risk of developing MS and abdominal obesity. Meanwhile, those who drank liquor or wine had a greater risk of developing high triglyceride or high fasting glucose levels, respectively. In conclusion, alcohol consumption dose-dependently increased the risk of developing MS and some of its individual components while dose-dependently decreasing the risk of developing low HDL-C levels. The type of alcoholic beverage had different effects on the development of the individual components of MS.

Metabolic syndrome is associated with change in subclinical arterial stiffness - A community-based Taichung Community Health Study

BackgroundThe aim of this study was to evaluate the effect of MetS on arterial stiffness in a longitudinal study.MethodsBrachial-ankle pulse wave velocity (baPWV), a measurement interpreted as arterial stiffness, was measured in 1518 community-dwelling persons at baseline and re-examined within a mean follow-up period of 3 years. Multivariate linear regression with generalized estimating equations (GEE) were used to examine the longitudinal relationship between MetS and its individual components and baPWV, while multivariate logistic regression with GEE was used to examine the longitudinal relationship between MetS and its individual components and the high risk group with arterial stiffness.ResultsSubjects with MetS showed significantly greater baPWV at the end point than those without MetS, after adjusting for age, gender, education, hypertension medication and mean arterial pressure (MAP). MetS was associated with the top quartile of baPWV (the high-risk group of arterial stiffness, adjusted odds ratio [95% confidence interval] 1.52 [1.21-1.90]), and a significant linear trend of risk for the number of components of MetS was found (p for trend < 0.05). In further considering the individual MetS component, elevated blood pressure and fasting glucose significantly predicted a high risk of arterial stiffness (adjusted OR [95% CI] 3.72 [2.81-4.93] and 1.35 [1.08-1.68], respectively).ConclusionsMetS affects the subject's progression to arterial stiffness. Arterial stiffness increased as the number of MetS components increased. Management of MetS is important for preventing the progression to advanced arterial stiffness.