Underwent Health Checkups Research Articles

Prevalence of Thyroid Nodules and Associated Clinical Characteristics: Findings from a Large Sample of People Undergoing Health Checkups at a University Hospital in Vietnam.

Thyroid nodule is a common disorder normally detected by ultrasound. However, little is known about the population prevalence of thyroid nodules in a Vietnamese population. This study aimed to estimate the prevalence of thyroid nodules, its characteristics, and associated factors in a large number of people undergoing annual health checkups. A retrospective, cross-sectional descriptive study was conducted, based on electronic medical records of people undergoing health checkups at the Health Checkup Department, University Medical Center at Ho Chi Minh City. All of the participants underwent thyroid ultrasonography, anthropometric measurements, and serum examinations. A total of 16,784 participants (mean age: 40.4 ± 12.7 years, 45.1% female) were included in this study. The overall prevalence of thyroid nodules was 48.4%. The mean diameter of nodules was 7.2 ± 5.8 mm. The prevalence of nodules with malignant characteristics was 36.9%. Women had a significantly higher prevalence of thyroid nodules than men (55.2% vs 42.9%, p<0.001). Advanced age, hypertension, and hyperglycemia were significantly associated with thyroid nodules in both genders. In men, significant factors also included increased body mass index. In women, these included increased total cholesterol and LDLc, hypertriglyceridemia, and hyperuricemia. This study showed a high prevalence of TNs in Vietnamese people undergoing general health checkups. Importantly, the proportion of TNs with malignant risk was quite high. Therefore, screening for TNs should be added to annual health checkups to improve early detection of TNs, targeting those who have a high-risk profile based on factors identified in this study.

Association between lifestyle habits and glaucoma incidence: a retrospective cohort study

Background/ObjectivesAlthough lifestyle habits may represent modifiable risk factors of glaucoma, the association between lifestyle factors and glaucoma is not well understood. The aim of this study was to investigate the association between lifestyle habits and the development of glaucoma.Subjects/MethodsParticipants who underwent health check-ups from 2005 to 2020 using a large-scale administrative claims database in Japan were included in the study. Cox regression analyses were performed where glaucoma development was regressed on the lifestyle (body mass index, current smoking, frequency and amount of alcohol consumption, eating habits, exercise habits and quality of sleep), age, sex, hypertension, diabetes mellitus and dyslipidaemia.ResultsAmong the 3,110,743 eligible individuals, 39,975 developed glaucoma during the mean follow-up of 2058 days. Factors associated with increased risk of glaucoma were overweight/obese (vs. moderate weight: hazard ratio, 1.04 [95% confidence interval, 1.02–1.07]), alcohol consumption of 2.5–4.9 units/day, 5–7.4 units/day, and ≥7.5 units/day (vs. <2.5 units/day: 1.05 [1.02–1.08], 1.05 [1.01–1.08] and 1.06 [1.01–1.12], respectively), skipping breakfast (1.14 [1.10–1.17]), late dinner (1.05 [1.03-1.08]) and daily walking of 1 h (1.14 [1.11–1.16]). Factors associated with decreased risk of glaucoma were daily alcohol consumption (vs. rarely: 0.94 [0.91–0.97]) and regular exercise (0.92 [0.90–0.95]).ConclusionsModerate body mass index, having breakfast, avoiding late dinner, limiting alcohol intake to <2.5 units/day, and regular exercise were associated with a reduced risk of developing glaucoma in the Japanese population. These findings may be useful for promoting glaucoma prophylaxis.

Association of body weight change with all-cause and cause-specific mortality: A nationwide population-based study

AimsWeight gain and loss increase the risk of all-cause mortality. This study explored the association of short-term weight change with all-cause and cause-specific mortality in middle-aged to older people. MethodsThis was a 8.4-year retrospective cohort study of 645,260 adults aged 40 to 80 who underwent health checkups twice within a 2-year interval between January 2009 and December 2012. Cox analyses were used to analyze the association between short-term weight change and all-cause and cause-specific mortality. ResultsWeight gain and loss were associated with an increased risk of all-cause mortality: the hazard ratios were 2.05 (95% confidence interval [CI], 1.93–2.16), 1.21 (95% CI, 1.16–1.25), 1.12 (95% CI 1.08–1.17), and 1.60 (95% CI, 1.49–1.70) for the severe weight loss, moderate weight loss, moderate weight gain, and severe weight gain groups, respectively. This U-shaped association was also seen between weight change and cause-specific mortality. Within the weight loss group, those who regained weight after two years had a reduced mortality risk. ConclusionsIn a middle-aged and elderly population, weight gain or loss of more than 3% during a 2-year interval was related to an elevated risk of all-cause and cause-specific mortality.

Age- and Sex-Specific Association between Lipoprotein-Related Phospholipase A2 and Cardiometabolic Risk Factors.

(1) Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a risk factor for predicting cardiovascular diseases. Metabolic syndrome is characterized by a state of chronic inflammation that is related to an increased risk of cardiovascular events and death. In the present study, we aimed to analyze the correlation between cardiometabolic risk factors and Lp-PLA2 levels. (2) We collected the related retrospective medical data of Chinese adults, of which 3983 were men and 2836 were women (aged ≥ 18 years), who underwent health check-ups, and discussed the sex and age-related differences. (3) Data analysis showed that Lp-PLA2 was significantly related to lipoproteins and glutamic pyruvic transaminase (GPT), and that a linear trend was observed with increasing Lp-PLA2 levels for all ages and sexes. However, fasting glucose was significantly related to Lp-PLA2 only in the younger population. The two obesity-related parameters (waist-to-height ratio and waist circumference) also had a greater correlation with Lp-PLA2 levels in the younger groups; however, the correlation weakened in the elderly population. Meanwhile, the correlation between mean arterial pressure and creatinine level and Lp-PLA2 was significant only in younger men. (4) The results show that the expression patterns of Lp-PLA2 differ between sexes and across age groups.

Association of blood pressure and hyperuricemia with proteinuria and reduced renal function in the general population.

This study aimed to investigate the effect of hyperuricemia (HU) on the association of systolic blood pressure (SBP) with the prevalence of proteinuria and low estimated glomerular filtration rate (eGFR) in the general population. This cross-sectional study enrolled 24,728 Japanese individuals (11,137 men and 13,591 women) who underwent health checkups in 2010. The prevalence of proteinuria and low eGFR (< 60 mL/min/1.73 m2) among participants classified according to serum uric acid levels and SBP was compared. HU was defined as serum uric acid levels higher than the 75th percentile in male and female participants (> 7.2 and > 5.4 mg/dL, respectively). The odds ratio (OR) for proteinuria increased with elevated SBP. This trend was significantly evident in participants with HU. Moreover, there was an interactive effect of SBP and HU on the prevalence of proteinuria in the male (Pfor interaction = 0.04) and female (Pfor interaction = 0.04) participants. Next, we evaluated the OR for low eGFR (< 60 mL/min/1.73 m2) with and without proteinuria based on the presence of HU. The multivariate analysis revealed that the OR for low eGFR with proteinuria increased with elevated SBP, but that for low eGFR without proteinuria decreased. These trends of OR tended to be prevalent among those with HU. The association between SBP and the prevalence of proteinuria was more pronounced in participants with HU. However, the association between SBP and decreased renal function with and without proteinuria might be different regardless of HU.

Association between antidiabetic drugs and the incidence of atrial fibrillation in patients with type 2 diabetes: A nationwide cohort study in South Korea

BackgroundAlthough diabetes is a risk factor for atrial fibrillation (AF), studies on the AF risk according to the antidiabetic drugs are lacking. This study evaluated the effects of antidiabetic drugs on AF incidence in Korean patients with type 2 diabetes. MethodsWe included 2,515,468 patients with type 2 diabetes from the Korean National Insurance Service database without a history of AF who underwent health check-ups between 2009 and 2012. Newly diagnosed AF incidence was recorded until December 2018 according to the main antidiabetic drug combinations used in the real world. ResultsOf the patients included (mean age, 62 ± 11 years; 60 % men), 89,125 were newly diagnosed with AF. Metformin (MET) alone (hazard ratio [HR] 0.959, 95 % CI 0.935–0.985) and MET combination therapy (HR < 1) significantly decreased the risk of AF compared to the no-medication group. The antidiabetic drugs consistently showing a protective effect against AF incidence were MET (HR 0.977, 95 % CI 0.964–0.99) and thiazolidinedione (TZD; HR 0.926, 95 % CI 0.898–0.956), even after adjusting for various factors. Moreover, this protective effect was more remarkable with MET and TZD combination therapy (HR 0.802, 95 % CI 0.754–0.853) than with other drug combinations. In the subgroup analysis, the preventive effect of MET and TZD treatment against AF remained consistent, regardless of age, sex, duration, and diabetes severity. ConclusionThe combination therapy of MET and TZD is the most effective antidiabetic drug for preventing AF in patients with type 2 diabetes.

Fat mass index and airway hyperresponsiveness in Korean adults

ABSTRACT Objective Airway hyperresponsiveness (AHR) is associated with asthma and obesity, which is defined as a high body mass index. Body mass mainly comprises fat mass (FM) and muscle mass (MM), which are independent of each other. We investigated the effect of changes in FM over time on the development of asymptomatic AHR in adults. Methods This long-term longitudinal study included adults who were underwent health checkups at the Seoul National University Hospital Gangnam Center. The participants underwent two methacholine bronchial provocation tests with a follow-up period (between the first and second tests) of more than 3 years and bioelectrical impedance analysis (BIA) at all visits. FM index (FMI; FM normalized for height) and MM index (MMI; MM normalized for height) were calculated using BIA. Results The study included 328 adult participants (61 women and 267 men). The mean number of BIA measurements was 6.96 and the follow-up duration was 6.69 years. In total, 13 participants showed a positive conversion of AHR. Multivariate analysis indicated that a high rate of change in FMI ([g/m2]/year), not MMI, was significantly associated with the risk of AHR development (P = 0.037) after adjustment for age, sex, smoking status, and FEV1 predicted. Conclusion A rapid gain of FM over time may be a risk factor for developing AHR in adults. Prospective studies are needed to confirm our results and evaluate the role of FM reduction in preventing AHR development in obese adults.

Effects of additive interactions among obesity, visceral adiposity, and sarcopenia on nonalcoholic fatty liver disease

Although the association of nonalcoholic fatty liver disease (NAFLD) with obesity or sarcopenia is known, few studies have investigated the combined effect of various body composition parameters on the risk of NAFLD. Thus, the aim of this study was to evaluate effects of interactions between various body composition parameters, including obesity, visceral adiposity, and sarcopenia, on NAFLD. Data of subjects who underwent health checkups between 2010 and December 2020 were retrospectively analyzed. Body composition parameters including appendicular skeletal muscle mass (ASM) and visceral adiposity were assessed using bioelectrical impedance analysis. Sarcopenia was defined as ASM/weight beyond two standard deviations below the gender-specific mean for healthy young adults. NAFLD was diagnosed using hepatic ultrasonography. Interaction analyses, including relative excess risk due to interaction (RERI), synergy index (SI), and attributable proportion due to interaction (AP), were performed. Among a total of 17,540 subjects (mean age: 46.7 years, 49.4% males), the prevalence of NAFLD was 35.9%. The odds ratio (OR) of interaction between obesity and visceral adiposity affecting NAFLD was 9.14 (95% CI: 8.29–10.07). The RERI was 2.63 (95% CI: 1.71–3.55), SI was 1.48 (95% CI: 1.29–1.69) and AP was 29%. The OR of interaction between obesity and sarcopenia affecting NAFLD was 8.46 (95% CI: 7.01–10.21). The RERI was 2.21 (95% CI: 0.51–3.90). SI was 1.42(95% CI: 1.11–1.82) and AP was 26%. The OR of interaction between sarcopenia and visceral adiposity affecting NAFLD was 7.25 (95% CI: 6.04–8.71), however, there was no significant additive interaction with RERI = 0.87 (95% CI: −0.76 to 2.51). Obesity, visceral adiposity, and sarcopenia were found to be positively associated with NAFLD. Obesity, visceral adiposity, and sarcopenia were found to have additive interaction effects on NAFLD.

10-year follow-up study on medical expenses and medical care use according to biological age: National Health Insurance Service Health Screening Cohort (NHIS-HealS 2002~2019).

The world is witnessing a sharp increase in its elderly population, accelerated by longer life expectancy and lower birth rates, which in turn imposes enormous medical burden on society. Although numerous studies have predicted medical expenses based on region, gender, and chronological age (CA), any attempt has rarely been made to utilize biological age (BA)-an indicator of health and aging-to ascertain and predict factors related to medical expenses and medical care use. Thus, this study employs BA to predict factors that affect medical expenses and medical care use. Referring to the health screening cohort database of the National Health Insurance Service (NHIS), this study targeted 276,723 adults who underwent health check-ups in 2009-2010 and kept track of the data on their medical expenses and medical care use up to 2019. The average follow-up period is 9.12 years. Twelve clinical indicators were used to measure BA, while the total annual medical expenses, total annual number of outpatient days, total annual number of days in hospital, and average annual increases in medical expenses were used as the variables for medical expenses and medical care use. For statistical analysis, this study employed Pearson correlation analysis and multiple regression analysis. Regression analysis of the differences between corrected biological age (cBA) and CA exhibited statistically significant increases (p<0.05) in all the variables of the total annual medical expenses, total annual number of outpatient days, total annual number of days in hospital, and average annual increases in medical expenses. This study quantified decreases in the variables for medical expenses and medical care use based on improved BA, thereby motivating people to become more health-conscious. In particular, this study is significant in that it is the first of its kind to predict medical expenses and medical care use through BA.

Association of the COVID-19 pandemic with changes in objectively measured sedentary behaviour and adiposity

BackgroundSeveral studies have reported that the coronavirus disease (COVID-19) pandemic has increased sedentary behaviour and obesity; however, these analyses used self-reported data, and the association between sedentary behaviour and visceral fat and adipocytokines during the COVID-19 pandemic remains unclear. We aimed to investigate the association of the COVID-19 pandemic with objectively measured sedentary behaviour and these obesity-related factors.MethodsLongitudinal analysis was conducted on 257 Japanese participants who underwent health check-ups in 2018 before and in 2020 during the COVID-19 pandemic. For both time points, sedentary behaviour was measured using an accelerometer for at least 7 days, visceral fat area (VFA) was measured using abdominal bioelectrical impedance analysis, and blood adiponectin level was measured using latex agglutination turbidimetric immunoassay. Multiple linear regression was performed to determine the association between sedentary behaviour and these outcomes.ResultsCompared with data in 2018, sedentary behaviour and VFA were significantly increased (P < 0.001, P = 0.006) whereas adiponectin level was significantly decreased (P < 0.001) in 2020. Increased sedentary behaviour was significantly associated with an increase in VFA (β = 3.85, 95% CI 1.22–6.49, P = 0.004) and a decrease in adiponectin level (β = −0.04, 95% CI −0.06 to −0.01, P = 0.005). However, the association of sedentary behaviour with adiponectin level was not significant after considering the effects of VFA.ConclusionsThe COVID-19 pandemic was associated with objectively measured sedentary behaviour and obesity-related factors in Japanese adults. Additionally, an increase in sedentary behaviour was associated with an increase in VFA, whereas the association of sedentary behaviour with adiponectin was partly mediated by VFA. These results suggest that avoiding increasing sedentary time is important to prevent visceral adiposity thereby ameliorating adiponectin, especially during behavioural limitations such as the COVID-19 pandemic.

Clinical Implications of Cardiac Symptoms and Electrocardiographic Abnormalities for Advanced Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease.

Background and Objectives: Advanced liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) can be a major predictor of cardiovascular disease (CVD) events and cardiac complications. However, the clinical significance of cardiac symptoms and abnormal electrocardiography (ECG) findings in patients with NAFLD associated with advanced liver fibrosis is unclear. Therefore, our study was aimed to evaluate the clinical implications based on the association between cardiac symptoms with ECG abnormalities for advanced liver fibrosis in patients with NAFLD. Materials and Methods: Of 31,795 participants who underwent health checkups, 6293 were diagnosed with NAFLD using ultrasound and inclusion criteria in a retrospective cross-sectional study. Advanced liver fibrosis was assessed based on a low NAFLD fibrosis score (NFS) and fibrosis-4 index (Fib-4) cut-off values (COVs). Cardiac data were assessed using a cardiac symptom questionnaire and 12-lead electrocardiography (ECG). Results: Among 6293 NAFLD patients with NAFLD, 304 (4.8%) experienced cardiac symptoms. NFS and Fib-4 indicated higher rates of advanced fibrosis in the cardiac-symptomatic group than in the non-symptomatic group (NFS: 7.3 vs. 4.1%; Fib-4: 7.8 vs. 3.7%; both p < 0.001). Cardiac symptoms were independently associated with advanced liver fibrosis using a step-wise-adjusted model and NFS and Fib-4 (final adjusted odds ratio (aOR), 1.40; 95% CI, 1.06-1.85; p = 0.018 for NFS; aOR, 1.67; 95%, 1.30-2.15; p < 0.001 for Fib-4). Cardiac symptoms with abnormal ECG findings independently predicted advanced liver fibrosis (aOR, 2.43; 95% CI, 1.72-3.39; p < 0.001 for NFS; aOR, 3.02; 95% CI, 2.19-4.15; p < 0.001 for Fib-4). Conclusions: Patients who have had cardiac symptoms and some ECG abnormalities may have a higher association with advanced liver fibrosis.

Association of intraabdominal fat with the risk of incident chronic kidney disease according to body mass index among Korean adults.

The association between abdominal visceral adipose tissue and the risk of incident chronic kidney disease according to body mass index in the Asian population, remains unclear. We evaluated the impact of abdominal adiposity stratified by body mass index on the risk of incident chronic kidney disease. A cohort study included 11,050 adult participants who underwent health check-ups and re-evaluated the follow-up medical examination at a single university-affiliated healthcare center. Cross-sectional abdominal adipose tissue areas were measured using computed tomography. The primary outcome was progression to chronic kidney disease (estimated glomerular filtration rate <60 ml/min/1.73m2). The highest quartile of visceral adipose tissue was used for the cut-off of central obesity. During the mean of 5.6 follow-up years, 104 incident chronic kidney disease cases were identified. The risk for chronic kidney disease incidence was significantly increased in the 3rd and 4th quartile ranges of visceral adipose tissue [hazard ratio (95% confidence interval)]: 4.59 (1.48-14.30) and 7.50 (2.33-24.20), respectively. In the analysis stratified by body mass index, the chronic kidney disease incidence risk was increased in the highest quartile range of visceral adipose tissue in the normal weight group: 7.06 (1.35-37.04). However, there was no significant relationship between visceral adipose tissue and chronic kidney disease in the obese group. Compared to the subjects with normal weight and absent central obesity, the hazard ratio for chronic kidney disease incidence was 2.32 (1.26-4.27) among subjects with normal weight and central obesity and 1.81 (1.03-3.15) among subjects with obesity and central obesity. Visceral adipose tissue was a significant risk factor for subsequent chronic kidney disease progression, and the association was identified only in the normal weight group. Normal-weight central obesity was associated with excess risk of chronic kidney disease, similar to the risk in the group with obesity and central obesity.

Obesity and risk for its comorbidities diabetes, hypertension, and dyslipidemia in Japanese individuals aged 65 years

Diabetes, hypertension, and dyslipidemia are obesity-related comorbidities that contribute to the development of cardiovascular disease, one of the leading causes of death. In addition to obesity, the underweight condition is a concern because it can give rise to sarcopenia, particularly after the age of 65 years. We examined the risk for diabetes, hypertension, and dyslipidemia due to obesity in individuals of this age. We retrospectively investigated the relation between obesity and its three major comorbidities in 10,852 individuals aged 65 years who underwent health checkups implemented by Kobe City between April 2017 and March 2021. The prevalence of diabetes, hypertension, and dyslipidemia with and without hyper-low-density lipoprotein-cholesterolemia was 9.7%, 41.0%, 63.8%, and 19.5%, respectively, and the prevalence of these conditions increased with increasing obesity. The risk for diabetes and hypertension was increased markedly (odds ratios of 12.95 and 19.44, respectively), and that for dyslipidemia with and without hyper-low-density lipoprotein-cholesterolemia was modestly increased (odds ratios of 2.59 and 3.65, respectively) at a BMI of ≥ 35 kg/m2 compared with normal weight. Analysis by gender revealed that the obesity-related risk for dyslipidemia with hyper-low-density lipoprotein-cholesterolemia was small compared with other comorbidities in women, while the risk for all comorbidities elevated similarly in men. Our results suggest the importance of public health intervention for obesity to suppress its comorbidities, especially diabetes and hypertension, at this age.

Risk of type 2 diabetes mellitus in catholic priests compared with general public.

Although Catholic priests have a life of discipline with many responsibilities, there has been little research on the health effects of their lifestyle. Analysis of disease prevalence in priests will help elucidate the influence of religious life and occupational characteristics on the occurrence of diabetes. This retrospective study was performed to examine the differences in the prevalence of diabetes and prediabetes between Catholic priests and the general population. The study population comprised 1845 Catholic priests aged 31-80years who visited the health promotion centers of three university hospitals in Korea between 2010 and 2019. Controls consisted of 1801 adult non-clerics aged 31-80years who underwent health checkups at the screening center during the same period. Logistic regression analysis was performed to compare the differences in the rates of diabetes and prediabetes between the priest and control groups. Priests were younger and had lower rates of smoking, drinking alcohol, and hypertension compared with the control group. However, metabolic markers, such as BMI, waist circumference, body fat mass, insulin, HbA1c, and lipid profiles, were significantly higher in the priest group than the control group (all p < 0.05). After adjusting for covariates, the priest group had a significantly higher likelihood of having diabetes (OR = 1.651, 95% CI 1.146-2.379) or prediabetes (OR = 3.270, 95% CI 2.471-4.327) compared with the controls. This study showed that Catholic priests have higher risks of diabetes and prediabetes compared with the general population, and these risks increase with age. Further large-scale prospective studies are required to confirm these relationships.

Association between metabolic syndrome and participation in colorectal cancer screening in Japan: A retrospective cohort analysis using LIFE study data

BackgroundPeople with metabolic syndrome have an elevated risk of developing colorectal cancer (CRC), and are recommended to undergo cancer screening. This study examined the association between metabolic syndrome and CRC screening participation in Japan. MethodsThis retrospective cohort study was conducted using insurance claims data, health checkup data, and cancer screening data from a Japanese city. The study population comprised persons aged 40–74 years who had undergone health checkups between fiscal years (FY) 2016 and 2019. The exposure was metabolic syndrome risk (high risk, moderate risk, and no risk) as determined during health checkups. The outcome was CRC screening participation. Logistic regression analyses were performed to examine the associations between metabolic syndrome risk and CRC screening participation. ResultsWe analyzed 20,558 people in the FY2016 cohort, 19,065 people in the FY2017 cohort, 17,496 people in the FY2018 cohort, and 15,647 people in the FY2019 cohort. The odds of CRC screening participation were significantly lower in the moderate-risk group (P < 0.05) in all FYs except FY2019 and the high-risk group (P < 0.001) in all FYs when compared with the no-risk group. When analyzed according to age group, older persons aged 65–74 years generally had significantly lower odds of CRC screening participation than persons aged 40–49 years across all metabolic syndrome risk groups. ConclusionThis is the first study from Japan to show that people with metabolic syndrome, especially older persons aged 65–74 years, are less likely to undergo CRC screening than people without metabolic syndrome. These findings indicate a need to develop and implement age-specific measures to increase cancer screening uptake among persons with metabolic syndrome.

The Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and Peripheral Arterial Disease in the Chinese Population.

Emerging evidence suggested that metabolic dysfunction-associated fatty liver disease (MAFLD) was significantly associated with atherosclerotic diseases. Atherosclerosis in the peripheral arteries is the most common cause of peripheral arterial disease (PAD), which has not been substantially controlled in the past. We aimed to investigate the association between MAFLD and PAD in the Chinese population. This observational study covered 102,115 participants who underwent health checkups with detailed examinations for PAD and MAFLD. PAD was measured by ankle-brachial index, and MAFLD was diagnosed by abdominal ultrasound. The generalized linear mixed models and random-effects Cox proportional hazards models were used to analyze the relationship between MAFLD and PAD. The baseline characteristics showed that patients with MAFLD had higher prevalence of PAD compared with those without MAFLD (2.7% vs 2.2%). Compared to non-MAFLD, the individuals with MAFLD were associated with a higher risk of the presence of PAD (adjusted odds ratio: 1.30, 95% confidence interval (CI): 1.19-1.42, P < 0.001). In the prospective cohort study, 6833 participants underwent a follow-up of 2.76 (standard deviation: 1.36) years, and MAFLD at baseline was a higher risk of associated with incident PAD (adjusted hazards ratio: 1.67, 95% CI: 1.17-2.38, P = 0.005). Moreover, with the accumulation of metabolic abnormalities, the risk of the PAD was increased in the individuals with MAFLD. Furthermore, MAFLD attributed risk of PAD was more evident in participants without metabolic comorbidities. MAFLD was associated with a significantly higher risk for the prevalence and incidence of PAD in the Chinese population. The finding suggested that individuals with MAFLD are not only have a higher risk of coronary heart diseases but also have an increased risk of atherosclerosis in peripheral arteries.

Establishment and validation of reference intervals for tumor markers (AFP, CEA, CA19-9, CA15-3, CA125, PSA, HE4, Cyfra 21-1, and ProGRP) in primary care centers in Korea: A cross-sectional retrospective study.

The reference interval (RI) for a tumor marker may vary between populations, detection systems, and the methods used to obtain their values. The aims of this study were to establish age- and sex-specific RIs for the following nine common tumor markers and to validate the established RIs in Korean adults: alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen (CA)19-9, CA15-3, CA125, Human epididymis protein 4 (HE4), total prostate specific antigen, cytokeratin fragment (Cyfra) 21-1, and progastrin-releasing peptide (ProGRP). This cross-sectional study consecutively selected 214,159 individuals (aged 18-98 years) who underwent health checkups at 16 health-promotion centers in 13 Korean cities. Finally, 62,752 examinees were used to establish the RIs after removing outliers. RIs were established using an indirect method according to the CLSI EP28-A3C guideline. The established RIs were validated by calculating the proportion of individuals outside each RI. Sex-related differences were observed for AFP, CEA, CA19-9, Cyfra 21-1, and ProGRP (p < 0.05): AFP, CEA and Cyfra 21-1 were higher in males, and CA19-9 and proGRP were higher in females. Most of the tumor markers except CA15-3 and CA125 increased with age: CA125 decreased at ≥50 years of age (p < 0.05), while CA15-3 did not vary with age. Less than 5% of subjects were outside all RIs (the 2.5th and 97.5th percentiles) established in the present study. Meanwhile, less than 3% of the healthy reference subjects fell outside the current and manufacturers' RIs of all tumor markers except Cyfra 21-1. This study has determined age- and sex-specific RIs for nine common tumor markers in the healthy Korean population, which could be useful for clinicians making clinical decisions and assessments.

Predictive validity of the Questionnaire for Medical Checkup of Old-Old for functional disability: Using the National Health Insurance Database System.

To enhance health services that can address multifaceted issues, the Questionnaire for Medical Checkup of Old-Old (QMCOO) was strategically developed to ascertain frailty status. Using the National Health Insurance database system, we aimed to clarify whether the QMCOO can predict new certifications for long-term care for disabilities. Of 20 151 adults aged ≥75 years who underwent health checkups in Kashiwa City, Japan, in fiscal year 2020 (examination rate 36.8%), 18 130 persons were included (mean age 80.1 ± 4.1 years, 55.1% women). The outcome was the new certification of long-term care until January 2022. From the medical care receipt data, QMCOO, age, sex, living arrangement, body mass index, comorbidity, and musculoskeletal and connective tissue diseases were evaluated. During the follow-up period, 727 (4.0%) participants had an incident disability (median follow up 457 days [quartile range 408-519 days]). The QMCOO's predictive accuracy for new long-term care needs was optimal when the total score of 3/4 was used as the threshold. Older adults with scores ≥4 had a higher adjusted hazard ratio for incident disability (adjusted hazard ratio 2.5, 95% confidence interval 2.1-2.9). Furthermore, the adjusted hazard ratio was greatly enhanced with comorbidity (6.6, 95% confidence interval 4.8-8.9). The QMCOO, which reflects multifaceted frailty, might be predictive of incident disability, and its predictive accuracy could be improved by considering comorbidities. The comprehensive QMCOO could contribute to extending healthy life expectancy through efficiently assessing health care and preventing long-term care, even among the old-old in the latter stage who tended to suffer from multimorbidity. Geriatr Gerontol Int 2023; 23: 124-130.

A point system to predict the future risk of obesity in 10-year-old children

A 4-year longitudinal study was conducted to develop a model and a point system for predicting childhood obesity. This study included 1,504 Japanese 10-year-old children who underwent health check-ups between 2011 and 2015. Multivariable logistic regression analysis was conducted using the explanatory variables overweight and lifestyle. Obesity was defined as percentage overweight (POW) ≥ 20% calculated by the following equation: (actual weight - standard weight by height and sex)/standard weight by height and sex × 100 (%). The model was validated using the Hosmer-Lemeshow test on 10-year-olds. Our prediction model for development of childhood obesity was based on seven binary variables: sex, lack of sleep, ≥2-h use of television/ games/ smartphone, hypertension, dyslipidemia, hepatic dysfunction, and being overweight. The area under the curve of the receiver operating characteristic curve was 0.803 (95% confidence interval, 0.740 to 0.866). When validated in non-obese children (n = 415), there was no significant difference between actual and predicted numbers of children with obesity (Hosmer-Lemeshow chi-square = 7.90, p = 0.18). The validated prediction model and point score for obesity development were shown to be useful tools for predicting the future 4-year risk of developing obesity among 10 years-old children. The point system may be useful for reducing the occurrence of childhood obesity and promoting better health.

PS-BPP02-4: DIFFERENCES IN RISK FACTORS FOR DEVELOPING HYPERTENSION WHEN HYPERTENSION REFERENCE VALUES ARE CHANGED

Objective: In 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) lowered the diagnostic reference value for hypertension to 130/80 mmHg. On the other hand, the Japan Society of Hypertension (JSH) Guidelines for the Treatment of Hypertension 2019 set the diagnostic reference value at 140/90 mmHg because there is insufficient evidence to set it at 130/80 mmHg in Japan. We sought to determine whether there were differences in risk factors predicting future development of hypertension if the diagnostic threshold were lowered in Japan. Method: Of 137,308 subjects who underwent health checkup between 2007 and 2015, 18,657 middle-aged men who were observable for 5 years were included in the study. First, we adapted the JSH2019 criteria and used nominal logistic regression analysis to explore factors involved in the development of hypertension in normotensive subjects who are judged to be normotensive at the first checkup and hypertensive 5 years later. Age, systolic blood pressure, diastolic blood pressure, BMI, uric acid, LDL, HDL, triglycerides, HbA1c (JDS), eGFR, smoking history, daily drinking habit were used as factors for adjustment. Next, the ACC/AHA2017 criteria were adapted and analyzed using the same method to examine the differences in relevant factors from the adaptation of the JSH2019. Results: 12,296 subjects were considered normotensive at first checkup according to JSH2019 criteria. After 5 years, 2,568(20.8%) were diagnosed with hypertension. Age [OR = 1.04, CI = 1.03–1.05, p &lt; 0.001], BMI [OR = 1.08, CI = 1.03–1.13, p &lt; 0.001], uric acid [OR = 1.11, CI = 1.06–1.16, p &lt; 0.001], HbA1c(JDS) [OR = 1.19, CI = 1.10–1.28, p &lt; 0.001], and daily drinking habit [OR = 0.75, CI = 0.66–0.86, p &lt; 0.001] were associated with development of hypertension at 5 years. On the other hands, 7,892 subjects were considered normotensive at first checkup when AHA/ACC2017 criteria were adapted. After 5 years, 5.549(45.1%) were diagnosed with hypertension. Age [OR = 1.03, CI = 1.01–1.04, p &lt; 0.001], BMI [OR = 1.08, CI = 1.02–1.14, p = 0.006], uric acid [OR = 1.15, CI = 1.08–1.21, p &lt; 0.001] and daily drinking habit [OR = 0.69, CI = 0.60–0.80, p &lt; 0.001] were associated with development of hypertension at 5 years. Conclusions: Adapting the AHA/ACC2017 criteria will result in more people developing hypertension than the JSH2019 criteria. Aging, elevated uric acid, and daily drinking habits are risk factors that predict future hypertension, even according to the AHA/ACC2017 criteria.