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Hair cortisol concentration (HCC) is a valuable biomarker for evaluating chronic stress in preschoolers. However, few studies have explored early life HCC and its associated factors. This prospective cohort study analysed the HCC in children aged 6-48 months and its associations with parental HCC as well as positive and negative parental mental health outcomes. We used data from the ongoing Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP-HIT) project, conducted in Taipei between 2020 and 2024. Hair samples were collected from both parents and children in 177 families (91 samples obtained during pregnancy and 86 during the postpartum period). The parents also completed self-reported questionnaires. Multiple linear regression was conducted to analyse the data. We observed a significant positive correlation between parents' and preschoolers' HCC. Furthermore, maternal depression (adjusted beta coefficient [aß] = 0.09, 95% confidence interval [CI] = 0.02, 0.16) and perceived stress (aß = 0.15, 95% CI = 0.02, 0.26) were positively associated with preschoolers' HCC. By contrast, higher maternal eudaimonia was associated with lower HCC in preschoolers (aß = -0.11, 95% CI = -0.20, -0.01). For parents, maternal depression, anxiety, and perceived stress were independently associated with an increased HCC during the postnatal period, whereas maternal eudaimonia was negatively associated with HCC. Our results indicate that both mothers and fathers affect children's responses to stress. Assessment of cortisol stress hormone concentrations through hair samples can be a key means of detecting preschoolers' stress levels and enabling early intervention.
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BACKGROUND: In recent years, smart devices have become an integral part of daily life. However, longitudinal studies, particularly those regarding the relationship between toddlers' smart device usage and behavioral outcomes, are limited. Understanding the impact of parent-child interactions on this relationship is crucial for enhancing toddlers' developmental outcomes. Accordingly, this study examined the influence of early screen time and media content exposure on toddlers' behaviors, as well as the positive effects of mother-child interactions on this influence. METHODS: We used relevant data related to 277 children born between November 2016 and July 2020 and who were part of an ongoing prospective follow-up study conducted across five hospitals in Taipei City, Taiwan. We analyzed (1) data from maternal reports regarding children's behavior by using the Child Behavior Checklist (for ages 11/2-5 years), (2) assessments of mother-child interactions by using the Brigance Parent-Child Interactions Scale, and (3) self-reported parental data covering the first 3 postpartum years. Statistical analyses involved group-based trajectory modeling and multiple linear regression. RESULTS: A considerable increase in screen time between the ages of 1 and 3 years was associated with less favorable behavioral outcomes at age 3. These outcomes included somatic complaints [adjusted beta coefficient (aß) = 2.17, 95% confidence interval (CI) = 0.39-3.95, p-value = 0.01], withdrawal (aß = 2.42, 95% CI = 0.15-4.69, p-value = 0.04), and aggressive behavior (aß = 6.53, 95% CI = 0.25-12.81, p-value = 0.04). This association was particularly evident among children with lower levels of mother-child interaction. Nevertheless, positive mother-child interactions mitigated most of the adverse effects. Additionally, increased exposure to games and cartoons was associated with poorer behavioral outcomes in all children except for those experiencing positive mother-child interactions. CONCLUSION: Early mother-child interactions play a crucial role in mitigating the risk of behavioral problems in toddlers who spend prolonged periods looking at screens and who are frequently exposed to game and cartoon content.
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BACKGROUND: Although miscarriage and termination of pregnancy affect maternal mental illnesses on subsequent pregnancies, their effects on the positive mental health (e.g., eudaimonia) of both first-time and multi-time parents have received minimal attention, especially for fathers. This longitudinal study examines the effects of experiences of miscarriage and termination on parental well-being in subsequent pregnancies from prenatal to postpartum years, while simultaneously considering parity. METHODS: Pregnant women and their partners were recruited during early prenatal visits in Taiwan from 2011 to 2022 and were followed up from mid-pregnancy to 1 year postpartum. Six waves of self-reported assessments were employed. RESULTS: Of 1813 women, 11.3 % and 14.7 % had experiences of miscarriage and termination, respectively. Compared with the group without experiences of miscarriage or termination, experiences of miscarriage were associated with increased risks of paternal depression (adjusted odds ratio = 1.6, 95 % confidence interval [CI] = 1.13-2.27), higher levels of anxiety (adjusted ß = 1.83, 95 % CI = 0.21-3.46), and lower eudaimonia scores (adjusted ß = -1.09, 95 % CI = -1.99 to -0.19) from the prenatal to postpartum years, particularly among multiparous individuals. Additionally, experiences of termination were associated with increased risks of depression in their partner. LIMITATIONS: The experiences of miscarriage and TOP were self-reported and limited in acquiring more detailed information through questioning. CONCLUSIONS: These findings highlight the decreased well-being of men whose partners have undergone termination of pregnancy or experienced miscarriage, and stress the importance of interventions aimed at preventing adverse consequences among these individuals.
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Aborto Espontáneo , Masculino , Femenino , Embarazo , Humanos , Aborto Espontáneo/epidemiología , Depresión/epidemiología , Estudios Longitudinales , Ansiedad/epidemiología , Padre/psicologíaRESUMEN
INTRODUCTION: Although mobile devices are used ubiquitously, studies on their detrimental effects on preschoolers are limited. Furthermore, no study has considered shared reading and mobile device usage simultaneously. Therefore, this study examined the effects of mobile devices and shared reading on preschoolers' development along with the effects of maternal depression on this association. MATERIALS AND METHODS: Mothers of 202 children aged 2-5 years were recruited in Taiwan. Maternal self-reported questionnaires on mobile device usage, shared reading, and child's emotional and behavioral development were collected. Multiple linear regression models were used for analyses. RESULTS: Mothers' higher usage time on mobile devices and an education level of college or less were significantly associated with the child's exceeding recommended use of mobile devices. Particularly among depressed mothers, preschoolers' exceeding recommended use of mobile devices was associated with more sleep (ß = 9.87, 95% confidence interval [CI] = 1.34, 18.40) and attention (ß = 7.20, 95% CI = 1.50, 12.91) problems, whereas shared reading was associated with less somatic complaints (ß = -16.19, 95% CI = -32.22, -0.15) and withdrawn (ß = -21.50, 95% CI = -40.52, -2.47), compared with their respective counterparts. CONCLUSION: Our study suggested the beneficial effects of shared reading. Moreover, we highlighted the adverse effects of preschoolers' exceeding recommended use of mobile device on sleep and attention problems, especially for children of mothers with depression.
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Problema de Conducta , Femenino , Humanos , Computadoras de Mano , Depresión , Emociones , Madres/psicología , Problema de Conducta/psicología , Lectura , PreescolarRESUMEN
Adiponectin, an adipokine secreted by adipocytes, has anti-atherosclerotic and antithrombotic activities. AdipoRon is synthetic small molecule adiponectin receptor agonist. In this study, we investigated the effect of AdipoRon on platelet activation and thrombus formation. Washed human platelets were prepared from the peripheral blood of healthy donors. In a series of in vitro platelet functional assays, pre-treatment with AdipoRon (10, 20, 40 µg/mL) dose-dependently inhibited the aggregation, granule secretion and spreading of washed human platelets. We showed that AdipoRon (20, 40 µg/mL) significantly inhibited AMPK, Syk, PLCγ2, PI3K, Akt, p38-MAPK and ERK1/2 signalling pathways in washed human platelets. In addition, we demonstrated that the phosphorylation of CKII at Tyr255 was an important mechanism of the integrin αIIbß3-mediated platelet activation. Meanwhile, AdipoR1 deficiency impaired the inhibitory effect of AdipoRon on mouse platelets. In ferric chloride-induced carotid injury model, injection of AdipoRon (5 or 12.5 mg/kg, iv) significantly attenuated arterial thrombosis. In conclusion, AdipoRon attenuates platelet function via the AdipoR1/AMPK/CKII/PI3K/AKT signalling pathways, while exerting a protective effect against arterial thrombosis. This study offers new insights into the fields of cardiovascular disease and antiplatelet drug discovery.Schematic model of AdipoRon regulating platelet activation. (BioRender.com).
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Adiponectina , Trombosis , Humanos , Ratones , Animales , Adiponectina/farmacología , Receptores de Adiponectina/agonistas , Receptores de Adiponectina/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Proteínas Quinasas Activadas por AMP/metabolismo , Fosfatidilinositol 3-Quinasas , Trombosis/tratamiento farmacológico , Agregación PlaquetariaRESUMEN
The objective of this study was to assess relationships between exposure to PAHs at occupational levels and outcomes of human semen quality and sperm DNA integrity. Personal breathing zone air samples were collected to quantify exposure of 16 targeted PAHs to coke-oven workers at a steel company in southern Taiwan. Semen quality, including concentration, motility, morphology, and viability, were assessed. Sperm DNA fragmentation, 8-oxodGuo, bulky PAH adducts, and benzo[a]pyrene diol epoxide-DNA adducts served as biomarkers for assessment of sperm DNA integrity. The Bayesian Kernel Machine Regression modeling was employed to estimate mixture effects of the PAH mixture on the outcomes of semen quality and sperm DNA integrity and to identify individual compounds of PAH mixtures associated with the mixture effects. Exposure to the PAH mixture was inversely associated with sperm viability, while benzo(b)fluoranthene (B[b]F) was identified as the main predictor for sperm viability. Exposure to the PAH mixture also exhibited a positive trend with sperm DNA fragmentation. B[b]F and benzo(a)anthracene (B[a]A) were identified as individual PAH compounds associated with increased sperm DNA fragmentation.
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Exposición Profesional , Hidrocarburos Policíclicos Aromáticos , Masculino , Humanos , Hidrocarburos Policíclicos Aromáticos/análisis , Análisis de Semen , Teorema de Bayes , Semen/química , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Espermatozoides , ADN/análisis , ADN/farmacologíaRESUMEN
BACKGROUND: Some evidences have shown the association between air pollution exposure and the development of interstitial lung diseases. However, the effect of air pollution on the progression of restrictive ventilatory impairment and diffusion capacity reduction is unknown. This study aimed to evaluate the effects of long-term exposure to ambient air pollution on the change rates of total lung capacity, residual volume, and diffusion capacity among the elderly. METHODS: From 2016 to 2018, single-breath helium dilution with the diffusion capacity of carbon monoxide was performed once per year on 543 elderly individuals. Monthly concentrations of ambient fine particulate matters (PM2.5) and nitric dioxide (NO2) at the individual residential address were estimated using a hybrid Kriging/Land-use regression model. Linear mixed models were used to evaluate the association between long-term (12 months) exposure to air pollution and lung function with adjustment for potential covariates, including basic characteristics, indoor air pollution (second-hand smoke, cooking fume, and incense burning), physician diagnosed diseases (asthma and chronic airway diseases), dusty job history, and short-term (lag one month) air pollution exposure. RESULTS: An interquartile range (5.37 ppb) increase in long-term exposure to NO2 was associated with an additional rate of decline in total lung volume (- 1.8% per year, 95% CI: - 2.8 to - 0.9%), residual volume (- 3.3% per year, 95% CI: - 5.0 to - 1.6%), ratio of residual volume to total lung volume (- 1.6% per year, 95% CI: - 2.6 to - 0.5%), and diffusion capacity (- 1.1% per year, 95% CI: - 2.0 to - 0.2%). There is no effect on the transfer factor (ratio of diffusion capacity to alveolar volume). The effect of NO2 remained robust after adjustment for PM2.5 exposure. CONCLUSIONS: Long-term exposure to ambient NO2 is associated with an accelerated decline in static lung volume and diffusion capacity in the elderly. NO2 related air pollution may be a risk factor for restrictive lung disorders.
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Contaminantes Atmosféricos , Contaminación del Aire , Asma , Anciano , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Estudios de Cohortes , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Humanos , Pulmón , Dióxido de Nitrógeno , Material Particulado/efectos adversos , Material Particulado/análisisRESUMEN
Previous studies have shown links between heavy metals and many health issues. However, data on the association between heavy metals and mortality in the general population are still limited. Therefore, the aim of this study was to investigate the relationship between heavy metals and overall mortality in the general population. We enrolled 2497 participants (1001 males and 1496 females) living in southern Taiwan, and measured levels of seven heavy metals: lead (Pb) in blood and cadmium (Cd), nickel (Ni), copper (Cu), chromium (Cr), manganese (Mn) and arsenic (As) in urine. The median follow-up period was 41.8 (4-50) months, during which 40 (1.6%) patients died. Compared to the participants who survived, those who died had higher urine Cd, higher urine Cu and lower urine Mn levels. Multivariate analysis showed that high urine Cd (per 1 µg/L; hazard ratio [HR], 1.352; 95% confidence interval [CI], 1.089-1.680; p = 0.006), high urine Cu (per 1 µg/dL; HR, 1.350; 95% CI, 1.151-1.583; p < 0.001), and low urine Mn (per 1 µg/L; HR, 0.717; 95% CI, 0.557-0.923; p = 0.010) were associated with increased overall mortality. In conclusion, our results demonstrated that high levels of urine Cd and Cu and low urine Mn level were associated with increased overall mortality in the general population.
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Metales Pesados/sangre , Metales Pesados/toxicidad , Metales Pesados/orina , Mortalidad , Adolescente , Adulto , Arsénico/orina , Cadmio/orina , Niño , Preescolar , Cromo/orina , Cobre/orina , Femenino , Humanos , Plomo/sangre , Masculino , Manganeso/orina , Persona de Mediana Edad , Níquel/orina , Taiwán/epidemiología , Adulto JovenRESUMEN
Hemophilia A is a hemorrhagic disease due to congenital deficiencies of coagulation factor VIII (FVIII). Studies show that hemophilia patients with anticoagulant deficiency present less severe hemorrhagic phenotypes. We aimed to find a new therapeutic option for hemophilia patients by RNA interference (RNAi) targeting heparin cofactor II (HCII), a critical anticoagulant protein inactivating the thrombin. The optimal small interfering RNA (siRNA) was conjugated to an asialoglycoprotein receptor ligand (N-acetylgalactosamine [GalNAc]-HCII), promoting targeted delivery to the liver. After administration, GalNAc-HCII demonstrated effective, dose-dependent, and persistent HCII inhibition. After 7 days, in normal mice, GalNAc-HCII reduced HCII levels to 25.04% ± 2.56%, 11.65% ± 2.41%, and 6.50% ± 1.73% with 2, 5, and 10 mg/kg GalNAc-HCII, respectively. The hemostatic ability of hemophilia mice in the GalNAc-HCII-treated group significantly improved, with low thrombus formation time in the carotid artery thrombosis models and short bleeding time in the tail-clipping assays. After repeated administration, the prolonged activated partial thromboplastin time (APTT) was reduced. A 30 mg/kg dose did not cause pathological thrombosis. Our study confirmed that GalNAc-HCII therapy is effective for treating hemophilia mice and can be considered a new option for treating hemophilia patients.
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BACKGROUND: Age-related hearing impairment (ARHI) is a major disability among the elderly population. Heat shock proteins (HSPs) were found to be associated with ARHI in animal studies. The aim of this study was to analyze the associations of single nucleotide polymorphisms (SNPs) of HSP genes with ARHI in an elderly population in Taiwan. METHODS: Participants ≥65 years of age were recruited for audiometric tests and genetic analyses. The pure tone average (PTA) of the better hearing ear was calculated for ARHI evaluation. The associations of HSPA1L (rs2075800 and rs2227956), HSPA1A (rs1043618) and HSPA1B (rs2763979) with ARHI were analyzed in 146 ARHI-susceptible (cases) and 146 ARHI-resistant (controls) participants. RESULTS: The "T" allele of HSPA1B rs2763979 showed a decreased risk of ARHI. The "TT" genotype of rs2763979 also showed a decreased risk of ARHI in the dominant hereditary model. For HSPA1L (rs2075800 and rs2227956) and HSPA1A (rs1043618), the haplotype "CAG" was related to a decreased risk of ARHI. CONCLUSION: These findings suggest that HSP70 polymorphisms are associated with susceptibility to ARHI in the elderly population.
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Proteínas HSP70 de Choque Térmico/genética , Pérdida Auditiva/genética , Polimorfismo de Nucleótido Simple , Anciano , Anciano de 80 o más Años , Envejecimiento , Alelos , Pueblo Asiatico/genética , Estudios de Casos y Controles , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , TaiwánRESUMEN
Activated protein C (APC) is an anticoagulant with potent cytoprotective and anti-inflammatory effects. K150del, a natural variant of APC, is associated with reduced anticoagulant activity. We performed a comprehensive study to analyze the functional alterations of the K150del mutant. Transcriptome analysis of HEK 293T cells treated with wild and mutant APC revealed differentially expressed genes enriched in inflammatory, apoptotic, and virus defense-related signaling pathways. Both wild and mutant APC displayed concentration-dependent cytoprotective effects. Low concentrations of K150del mutant resulted in decreased anti-inflammatory and anti-apoptotic activities, whereas its higher concentrations restored these effects. Expression of virus defense-related genes improved in mouse lung tissues after repeated administration of the APC variant. These results suggest that the APC K150del mutant could help clinicians to accurately predict disease risks and serve as a potential auxiliary therapeutic in viral infections, including 2019 coronavirus disease (COVID-19).
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COVID-19 , Proteína Quinasa C/genética , Proteína Quinasa C/metabolismo , Animales , Células HEK293 , Humanos , Ratones , Polimorfismo de Nucleótido Simple , SARS-CoV-2RESUMEN
BACKGROUND: The prevalence of chronic kidney disease (CKD) is increasing annually in Taiwan. In addition to traditional risk factors, heavy metals contribute to the development of CKD. The aim of this study was to investigate associations among heavy metals and proteinuria and CKD in the general population in Southern Taiwan. We also explored the interaction and synergetic effects among heavy metals on proteinuria. METHODS: We conducted a health survey in the general population living in Southern Taiwan between June 2016 and September 2018. Seven heavy metals were measured: blood lead (Pb) and urine nickel (Ni), chromium (Cr), manganese (Mn), arsenic (As), copper (Cu), and cadmium (Cd). Proteinuria was measured using reagent strips. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. RESULTS: The mean age of the 2447 participants was 55.1 ± 13.2 years and included 977 males and 1470 females. Participants with high blood Pb and high urine Ni, Mn, Cu, and Cd were significantly associated with proteinuria. Interactions between blood Pb and urine Cr, and between urine Cd and Cu, had significant effects on proteinuria. The participants with high blood Pb and high urine Cu were significantly associated with an eGFR of <60 mL/min/1.73 m2. CONCLUSION: High blood Pb and high urine Cu may be associated with proteinuria and an eGFR of <60 mL/min/1.73 m2. High urine Ni, Mn, and Cd were significantly associated with proteinuria. Co-exposure to Cd and Cu, and Pb and Cr, may have synergistic effects on proteinuria.
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Phthalates can leach into indoor and outdoor airborne particulate matter and dust, which can then be ingested or absorbed and induce lung injury. Dermal phthalate levels can be used as a matrix for exposure direct absorption from air, particle deposition, and contact with contaminated products. However, the association between dermal phthalate levels in skin wipes and lung function tests remains unknown. A total of 397 participants were included. Spirometry measurements of forced expiratory volume in 1 s (FEV1, L) and forced vital capacity (FVC, L) were calculated. Dermal phthalate levels of diethyl phthalate (DMP), diethyl phthalate (DEP), di(n-butyl) phthalate (DnBP), butyl benzyl phthalate (BBzP), di(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DiNP), and diisodecyl phthalate (DiDP) on forehead skin wipes were detected. The one-unit increases in logarithm (log) dermal DnBP (ß = - 0.08; 95% CI - 0.16, - 0.003, p = 0.041), BBzP (ß = - 0.09; 95% CI - 0.16, - 0.02, p = 0.009), DEHP (ß = - 0.07; 95% CI - 0.14, - 0.003, p = 0.042), and DiNP (ß = - 0.08; 95% CI - 0.15, - 0.02, p = 0.017) were significantly associated with decreases in FVC. For elderly participants, one-unit increases in log dermal DnBP (ß = - 0.25; 95% CI - 0.46, - 0.04, p = 0.021), BBzP (ß = - 0.17; 95% CI - 0.33, - 0.01, p = 0.042), and DiDP (ß = - 0.19; 95% CI - 0.39, < 0.01, p = 0.052) were associated with decreases in FEV1. In conclusion, dermal phthalate levels were significantly associated with decreases in lung function tests.
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Contaminantes Ambientales , Ácidos Ftálicos , Anciano , Polvo , Exposición a Riesgos Ambientales , Humanos , Ácidos Ftálicos/análisis , Pruebas de Función RespiratoriaRESUMEN
Although many heavy metals are necessary for normal biological function, a subset of heavy metals have no role in human physiology, such as lead (Pb) and arsenic (As). Such elements have deleterious effects on physiology and be associated with the incidence of diabetes and related metabolic syndromes. Haemoglobin A1c (HbA1c) is not only a useful diagnostic and prognostic parameter in patients with diabetes, but it is also helpful in prediction of future diabetic risk in non-diabetic patients. However, no studies have evaluated the relationship between heavy metal concentration and HbA1c in non-diabetic patients. Therefore, the present study was designed to address this issue. We performed surveys for general populations living in southern Taiwan from June 2016 to September 2018. All participants received face-to-face interviews, laboratory tests, and measurements of weight and height, waist circumference, heart rate, and systolic and diastolic blood pressures. HbA1c was positively associated with Log blood Pb, after adjustments for age, body mass index, fasting blood glucose, total cholesterol, and triglyceride. Additionally, a Log 1 µg/dL increase in Pb was associated with a small (0.819 mmol/mol, 95% confidence interval = 0.072-1.566) increase in HbA1c (P = 0.032). No association with HbA1c was observed for urine nickel, chromium, manganese, As, copper, and cadmium in the multivariable analysis. In conclusion, after adjusting for important clinical parameters, Log blood Pb was positively associated with HbA1c in our non-diabetic population. This finding implies that high blood Pb might have the potential to predict future diabetic risk in non-diabetic populations. Further prospective studies are necessary to validate this issue.
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Diabetes Mellitus , Hemoglobina Glucada , Plomo , Arsénico , Glucemia , Diabetes Mellitus/epidemiología , Humanos , Plomo/sangre , Metales Pesados , Estudios ProspectivosRESUMEN
OBJECTIVE: HCV prevails in uremic haemodialysis patients. The current study aimed to achieve HCV microelimination in haemodialysis centres through a comprehensive outreach programme. DESIGN: The ERASE-C Campaign is an outreach programme for the screening, diagnosis and group treatment of HCV encompassing 2323 uremic patients and 353 medical staff members from 18 haemodialysis centres. HCV-viremic subjects were linked to care for directly acting antiviral therapy or received on-site sofosbuvir/velpatasvir therapy. The objectives were HCV microelimination (>80% reduction of the HCV-viremic rate 24 weeks after the end of the campaign in centres with ≥90% of the HCV-viremic patients treated) and 'No-C HD' (no HCV-viremic subjects at the end of follow-up). RESULTS: At the preinterventional screening, 178 (7.7%) uremic patients and 2 (0.6%) staff members were HCV-viremic. Among them, 146 (83.9%) uremic patients received anti-HCV therapy (41 link-to-care; 105 on-site sofosbuvir/velpatasvir). The rates of sustained virological response (SVR12, undetectable HCV RNA 12 weeks after the end of treatment) in the full analysis set and per-protocol population were 89.5% (94/105) and 100% (86/86), respectively, in the on-site treatment group, which were comparable with the rates of 92.7% (38/41) and 100% (38/38), respectively, in the link-to-care group. Eventually, the HCV-viremic rate decreased to 0.9% (18/1,953), yielding an 88.3% reduction from baseline. HCV microelimination and 'No-C HD' were achieved in 92.3% (12/13) and 38.9% (7/18) of the haemodialysis centres, respectively. CONCLUSION: Outreach strategies with mass screenings and on-site group treatment greatly facilitated HCV microelimination in the haemodialysis population. CLINICALTRIALSGOV IDENTIFIER: NCT03803410 and NCT03891550.
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Unidades de Hemodiálisis en Hospital/organización & administración , Hepatitis C/prevención & control , Diálisis Renal , Uremia/terapia , Viremia/prevención & control , Viremia/virología , Antivirales/uso terapéutico , Carbamatos/uso terapéutico , Combinación de Medicamentos , Compuestos Heterocíclicos de 4 o más Anillos/uso terapéutico , Humanos , Tamizaje Masivo , Proyectos Piloto , Estudios Seroepidemiológicos , Sofosbuvir/uso terapéutico , Respuesta Virológica Sostenida , TaiwánRESUMEN
Phthalate concentrations in indoor and outdoor dust are associated with respiratory disease. Both immunoglobulin E (IgE) and eosinophil count are associated with airway inflammation from exposure to environmental allergens. Dermal phthalate level can be used as a matrix for assessing personal exposure through direct absorption from the air, particle deposition, or contact with contaminated products. However, the association between dermal phthalate level and changes in lung function test values, as mediated by immunological response, remains unclear. In total, 237 adults in southern Taiwan were recruited. Spirometry measurements (in L) of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were taken on visits 1 (2016-2018) and 2 (2019). Dermal phthalate level, absolute eosinophil count, and IgE level were recorded on visit 1. Mean changes in FVC and FEV1 decrease pear year, as determined through pairwise comparisons, were significant (diffFVCper year: -0.46, 95% CI: -0.51, -0.41; p < 0.001; diffFEV1per year: -0.37, 95% confidence interval [CI]: -0.41, -0.34; p < 0.001). For FEV1 decrease, log-unit increases in dermal diethyl phthalate (DEP) were positively associated with diffFEV1per year (ß = 0.096; 95% CI: 0.042, 0.150; p = 0.001) and negatively associated with absolute eosinophil count (ß= -0.201; 95% CI: -0.380, -0.023; p= 0.027). Log-unit increases in absolute eosinophil count were negatively associated with diffFEV1per year (ß= -0.109; 95% CI: -0.150, -0.068; p < 0.001). Absolute eosinophil count mediated 19.70% of the association between dermal DEP level and diffFEV1per year. For FVC decrease, log-unit increases in dermal DEP were positively associated with diffFVCper year (ß = 0.095; 95% CI: 0.035, 0.155; p = 0.002) and negatively associated with absolute eosinophil count (ß = -0.243; 95% CI: -0.427, -0.060; p = 0.010). Log-unit increases in absolute eosinophil count were negatively associated with diffFVCper year (ß= -0.122; 95% CI: -0.168, -0.076; p < 0.001). Absolute eosinophil count mediated 29.98% of the association between dermal DEP level and diffFVCper year. The results suggest that dermal DEP level is positively associated with changes in lung function test values and is mediated by absolute eosinophil count.
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Eosinófilos , Pulmón , Volumen Espiratorio Forzado , Ácidos Ftálicos , Pruebas de Función Respiratoria , Taiwán , Capacidad VitalRESUMEN
BACKGROUND: Age-related hearing impairment (ARHI) is a major disability among the elder population. Chronic inflammation is an important factor in the development of ARHI. Interleukin-1 (IL-1) plays a key role in inflammation and may be associated with ARHI. The aim of this study is to analyze the associations of single nucleotide polymorphisms (SNPs) of IL-1 receptor genes with ARHI in an elderly population in Taiwan. METHOD: Participants ≥65 years of age were recruited for audiometric tests and genetic analyses. The bilateral pure-tone average (PTA) of high-tone hearing levels was calculated for ARHI evaluation. The associations of SNPs of the IL-1 receptor type 1 gene (IL1R1) (rs3917225 and rs2234650) and type 2 gene (IL1R2) (rs4141134 and rs2071008) with ARHI were analyzed in 182 ARHI-susceptible (case) and 176 ARHI-resistant (control) participants. RESULTS: The G allele of IL1R1 rs3917225 showed a decreased risk of ARHI after adjustments for sex, age, and noise exposure. The GG genotype of IL1R1 rs3917225 in all hereditary models and the TT genotype of IL1R2 rs2071008 in the recessive model also showed decreased risks of ARHI after adjustments. CONCLUSION: These findings suggest that IL1R1 and IL1R2 polymorphisms may contribute to the decreased risk of ARHI in the elderly population.
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Pérdida Auditiva/genética , Polimorfismo de Nucleótido Simple , Receptores Tipo II de Interleucina-1/genética , Receptores Tipo I de Interleucina-1/genética , Anciano , Envejecimiento , Pueblo Asiatico/genética , Audiometría de Tonos Puros , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Masculino , TaiwánRESUMEN
BACKGROUND/PURPOSE: Chronic kidney disease (CKD) has become a worldwide health problem, leading to high morbidity and mortality, and non-alcoholic fatty liver disease (NAFLD) is considered a risk factor for CKD. The aim of this study was to explore the relationship between NAFLD fibrosis score (NFS) and the estimated glomerular filtration rate (eGFR), and identify possible risk factors related to the NFS among Taiwanese subjects. METHODS: Subjects were enrolled from the database of the Department of Preventive Medicine of Kaohsiung Municipal Hsiao-Kang Hospital. The eGFR was calculated according to the Taiwanese Modification of Diet in Renal Disease (TMDRD) equation, and the NFS was employed to evaluate the fibrotic level. RESULTS: In total, 11,376 subjects were enrolled in this study, with a mean age of 52.0 ± 6.81 years, including 4529 (39.8%) males. A fasting sugar level ≥100 mg/dL (OR = 1.70, 95% CI = 1.52-1.87) and an abnormal waist circumference (OR = 1.81, 95% CI = 1.65-1.99) were significant factors associated with NFS (p < 0.05). Trends of a decreasing TMDRD score and an increasing NFS with increasing age were noted (p < 0.05). The NFS was significantly negatively correlated with the TMDRD score (standard coefficients: -0.067, p < 0.001). CONCLUSION: A higher NFS is associated with an impaired eGFR in Taiwanese subjects. Controlling risk factors, especially fasting sugar level and waist circumference, may be useful in preventing NFS deterioration, which is negatively correlated with the eGFR.
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Tasa de Filtración Glomerular , Cirrosis Hepática/epidemiología , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Insuficiencia Renal Crónica/epidemiología , Adulto , Biomarcadores/sangre , Femenino , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/diagnóstico , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Curva ROC , Insuficiencia Renal Crónica/etiología , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Taiwán/epidemiologíaRESUMEN
Impaired lung function is associated with morbidity and mortality in the elderly. However, there is a paucity of data regarding the long-term effects of particulate matter (PM) on lung function among the elderly. This study evaluated the exposure-response relationship between ambient PM and different lung function indices among the elderly in Taiwan. A cross-sectional survey of individuals aged ≥65 years was conducted in Taiwan from October 2015 to September 2016. Those who attended the annual health examination for the elderly in five hospitals of varying background PM concentrations were enrolled. The long-term (2015 annual mean concentration) exposure to air pollution was estimated by the Kriging method at the residence of each subject. The association between ambient PM exposure and lung function was evaluated by linear regression modeling, with adjustments for age, sex, height, weight, educational attainment, presence of asthma or chronic obstructive pulmonary disease, smoking status, season, and co-pollutants. There were 1241 subjects (mean age, 70.5 years). The mean residential PM2.5 and PM2.5-10 in 2015 was 26.02 and 18.01 µg/m3, respectively. After adjustments for confounders and co-pollutants, the FVC decrease was best associated with fine particles (PM2.5), whereas the FEV1, FEF25-75%, FEF25% and FEF50% decreases were best associated with coarse particles (PM2.5-10). An IQR (10 µg/m3) increase in PM2.5 decreased FVC by 106.38 ml (4.47%), while an IQR (7.29 µg/m3) increase in PM2.5-10 decreased FEV1 and FEF25-75% by 91.23 ml (4.85%) and 104.44 ml/s (5.58%), respectively. Among the Taiwanese elderly, long-term PM2.5 exposure mainly decreases the vital capacity of lung function. Moreover, PM2.5-10 has a stronger negative effect on the function of conductive airways than PM2.5.