The Effect of BMI on Blood Lipids and Dyslipidemia in Lactating Women.

Background: This study aimed to explore the correlation between body mass index (BMI) and dyslipidemia and the optimal cut-off point for BMI to distinguish the risk of dyslipidemia in lactating women. Methods: A total of 2295 lactating women subjects were included in this study, all within 2 years postpartum. All samples were from "China Children and Lactating Mothers Nutritional Health Surveillance (2016−2017)". BMI, blood lipids, demographic information, lifestyle habits, and other serum indicators were obtained in this survey. Generalized linear model, logistic regression, restricted cubic spline (RCS) and ROC curve analysis were used to evaluate the relationship among BMI, blood lipids, and dyslipidemia. Results: BMI in lactating women was positively correlated with total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), but negatively correlated with high-density lipoproteincholesterol (HDL-C) (p < 0.05). Higher BMI in lactating women was associated with higher ORs of dyslipidemia (hypercholesterolemia, hypertriglyceridemia, high-LDL-cholesterolemia, low HDL-cholesterolemia) (p < 0.05). These associations were stable across age groups, breastfeeding child age (months), parity, physical activity level, fasting plasma glucose (FPG), and hemoglobin. These factors did not interact with this relationship (p > 0.05). The optimal cut-off point for BMI was 24.85 kg/m2 determined by using ROC analysis, which can distinguish the risk of dyslipidemia. Conclusions: BMI was positively correlated with risk of dyslipidemia. Maintaining an ideal weight may prevent dyslipidemia in lactating women, and BMI is recommended to be controlled below 24.85 kg/m2.

Association between Serum Vitamin A, Blood Lipid Level and Dyslipidemia among Chinese Children and Adolescents.

Background: To study the relationship between serum vitamin A (VA) level and blood lipid profiles in children and adolescents aged 6−18 years, as well as the effect of VA on dyslipidemia. Methods: The project adopted a multistage stratified cluster sampling method. The Food Frequency Questionnaire (FFQ) was used to obtain dietary factors data. Blood samples of subjects were taken via venipuncture. Generalized linear models were used to explore the correlation be-tween VA and biochemical indicators, as well as stratified and inter-actions analysis to explore the influence of confounders on these relationships. Generalized linear models were constructed to explore the association between VA and blood lipids. Restricted cubic splines were used to characterize dose−response associations between serum VA and dyslipidemia based on logistic regression. Results: Serum VA was positively correlated with TC, TG and HDL-C (p < 0.05), but these associations were influenced by age (p < 0.05). The adjusted odds ratio (OR) values of VA for hypercho lesterolemia, hypertriglyceridemia, mixed hyperlipidemia and low high-density lipoprotein cholesterolemia were 3.283, 3.239, 5.219 and 0.346, respectively (p < 0.01). Meanwhile, significant age interactions affected the relationship between VA and TC, as well as TG and LDL-C (p < 0.01). Conclusion: Serum VA was positively correlated with blood lipids, but these associations were influenced by age. VA was a risk factor for dyslipidemias, such as hypercholesterolemia, hypertriglyceridemia and mixed hyperlipidemia, but was a protective factor for low high-density lipoprotein cholesterolemia.

[Prevalence and the relevant factors of type 2 diabetes mellitus among adults in Guizhou Province in 2010-2012].

OBJECTIVE: To investigate the prevalence and relevant factors of type 2 diabetes mellitus among urban and rural residents over 18 years old in Guizhou Province in 2010-2012. METHODS: A total of 3073 residents over 18 years old were sampled by multi-stage and stratified random cluster sampling in Guizhou Province from"2010-2012 Chinese nutrition and health surveillance", including 1576 people in urban areas and 1497 people in rural areas, 1362 males and 1711 females. The participants were investigated for their basic conditions, lifestyle and behavior, and physical indicators, blood pressure, blood glucose, TC, and TG were also measured, and then the prevalence was calculated. Multivariate analysis was performed using an unconditional logistic regression model. RESULTS: Among the 3073 residents aged 18 years and over in Guizhou Province, 151 were diagnosed with type 2 diabetes mellitus, with a prevalence of4. 9%, among which 80 were urban residents and 71 were rural residents, with a prevalence of 5. 1% and 4. 7%, respectively. There was no statistically significant difference between urban and rural areas( χ~2= 0. 183, P = 0. 669). Age was associated with type 2 diabetes mellitus, and the prevalence increased with age( χ_()~2= 55. 478, P =0. 001). The result of multivariate Logistic regression analysis showed that family history, abdominal obesity, hypertension, abnormal TC and abnormal TG all had statistically significant influences on the prevalence of type 2 diabetes mellitus( OR values were2. 377, 1. 721, 1. 666, 1. 619 and 1. 982, respectively, all P <0. 05). CONCLUSION: The prevalence of type 2 diabetes mellitus in residents aged 18 and over in Guizhou Province was lower than the national average level. The prevention of type 2 diabetes in Guizhou residents should be targeted at middle-aged and elderly people, people with family history, people with abdominal obesity, people with hypertension and dyslipidemia.

[Prevalence of overweight, obesity and its relation to chronic diseases among adults of 5 monitoring areas in Guizhou Province in 2010-2012].

OBJECTIVE: To understand the prevalence of overweight and obesity among adults of 5 monitoring areas in Guizhou Province and to analyze the correlation between overweight, obesity and incidence of related chronic diseases. METHODS: Multistage stratified cluster random sampling was employed, using data from "the 2010- 2012 National Nutrition and Health Survey". The physical measurement and the TC, TG, HDLC and blood glucose were conducted among 3682 resident population aged 18 years and above who from 5 monitoring areas( Yunyan and Baiyun District, Dejiang, Qianxi andSansui County in Guizhou Province). To analyze the distribution of overweight, obesity and central obesity in the population and its relationship with diabetes, dyslipidemia and hypertension. RESULTS: The prevalence rates were 27%, 7. 5% and 16. 9% for overweight, obesity and the central obesity in 5 surveillance areas of Guizhou Provinc. The central obesity rate increase with age, which was the highest in the elderly( over 60years)( χ~2= 32. 03, P < 0. 001), the female were higher than the male( χ~2= 4. 2, P =0. 04). Under controlling for age, gender, regional factors, compared with the normal weight population, the onset risk of diabetes, hyperlipidemia and hypertension in the overweight populations were 1. 4 times, 1. 4 times and 2 times( 95% CI 1. 0- 2. 0, 1. 2-1. 7, 1. 6- 2. 5, P < 0. 05) respectively. The risk of obesity diabetes, hyperlipidemia and hypertension were 2. 6 times( 95% CI 1. 7- 4. 1, P < 0. 001), 1. 5 times( 95% CI 1. 1-1. 9, P < 0. 001) and 3. 7 times( 95% CI 2. 7- 5. 1, P < 0. 001), respectively. Central obesity may increase the risk of diabetes( OR = 2. 18, 95% CI 1. 58- 3. 01, P < 0. 001)and the risk of hypertension( OR = 2. 2, 95% CI 1. 74- 2. 57, P < 0. 001). CONCLUSION: Adult overweight and obesity were risk factors of diabetes, dyslipidemia and hypertension risk factors. Central obesity were risk factors of diabetes and hypertension risk factors.

Association between antidiabetic drugs and psoriasis risk in diabetic patients: results from a nationwide nested case-control study in Taiwan.

BACKGROUND: The risk of psoriasis in diabetic patients has rarely been explored. OBJECTIVES: We sought to investigate the association between antidiabetic therapies and psoriasis. METHODS: The incidence of psoriasis was compared between a representative diabetic cohort and a matched nondiabetic cohort. We next conducted a nationwide cohort study with 1,659,727 diabetic patients using the National Health Insurance Research Database of Taiwan 1997 through 2011. Multivariate conditional logistic regression was used for nested case-control analyses. RESULTS: Incidence rates of psoriasis among diabetic patients and nondiabetic matched control subjects were 70.2 (95% confidence interval [CI] 59.5-80.9) and 42.3 (95% CI 39.5-45.5) per 100,000 person-years, respectively (P < .0001). Frequent insulin use was associated with higher risk of incident psoriasis (adjusted odds ratio 1.29, 95% CI 1.18-1.42) after adjusting for comorbidities, disease duration, and number of hospital visits. Among diabetic patients without history of insulin use, frequent use of thiazolidinedione was associated with lower risk of psoriasis (adjusted odds ratio 0.87, 95% CI 0.77-0.99). LIMITATIONS: The National Health Insurance Research Database did not contain information regarding disease severity, diet, body mass index, lifestyle, or family history. CONCLUSION: Among diabetic patients, regular insulin use is associated with psoriasis development. Frequent use of thiazolidinedione may be associated with modest reduction in psoriasis risk.

Antiviral treatment for hepatitis C virus infection is associated with improved renal and cardiovascular outcomes in diabetic patients.

UNLABELLED: Hepatitis C virus (HCV) infection is causally associated with insulin resistance and diabetes mellitus. This population-based cohort study aimed to investigate whether antiviral therapy for HCV infection was associated with improved clinical outcomes related to diabetes. From the Taiwan National Health Insurance Research Database, 2,267,270 Taiwanese residents diagnosed with diabetes mellitus were screened for eligibility. HCV infection was defined by a specific diagnosis code and measurement of serum antibody. After excluding patients with serious comorbidity, we enrolled a total of 1,411 eligible patients who received pegylated interferon plus ribavirin (treated cohort), and matched them 1:1 with 1,411 untreated controls by propensity scores (untreated cohort). We also matched the treated cohort 1:4 with 5,644 diabetic patients without HCV infection (uninfected cohort). Participants were followed up for the occurrence of endstage renal disease (ESRD), ischemic stroke, and acute coronary syndrome (ACS) after receiving antiviral treatment or the corresponding calendar date. From 2003 to 2011, the 8-year cumulative incidences of ESRD in the treated, untreated, and uninfected cohorts were 1.1% (95% confidence interval [CI], 0.3-2.0%), 9.3% (95% CI, 5.9-12.7%), and 3.3% (95% CI, 2.3-4.3%), respectively (P < 0.001); those of stroke were 3.1% (95% CI, 1.1-5.0%), 5.3% (95% CI, 3.0-7.5%), and 6.1% (95% CI, 4.8-7.4%), respectively (P = 0.01); and those for ACS were 4.1% (95% CI, 2.1-6.1%), 6.6% (95% CI, 3.7-9.5%), and 7.4% (95% CI, 5.9-9.0%), respectively (P = 0.05). As compared with the untreated cohort, antiviral treatment was associated with multivariate-adjusted hazard ratios of 0.16 (95% CI, 0.07-0.33%) for ESRD, 0.53 (95% CI, 0.30-0.93) for ischemic stroke, and 0.64 (95% CI, 0.39-1.06) for ACS. CONCLUSION: Antiviral treatment for HCV infection is associated with improved renal and cardiovascular outcomes in diabetic patients.

Hepatic resection for hepatocellular carcinoma patients on hemodialysis for uremia: a nationwide cohort study.

BACKGROUND: The association between uremia and survival outcomes of patients undergoing hepatic resection for hepatocellular carcinoma (HCC) has not been well investigated, particularly for perioperative complications. This nationwide cohort study aimed to compare survival outcomes as well as perioperative mortality and complications between uremia-HCC patients and non-uremia-HCC patients who underwent hepatic resection. METHODS: Using Taiwan's National Health Institute Research Database, 149 uremia-HCC patients who underwent hepatic resection between 1996 and 2008 were enrolled. The control group comprised 596 HCC patients who also received hepatic resection during the same time period. The two groups were matched for age, gender, viral hepatitis status, and underlying liver cirrhosis. Disease-free survival, overall survival, and perioperative complications were compared between the two groups. RESULTS: For the uremia-HCC cohort, the 1-, 5-, and 10-year overall and disease-free survival rates were 86, 52, and 38 %, as well as 77, 27, and 18 %, respectively. The survival outcomes were comparable between uremia-HCC cohort and the HCC cohort, regardless of extent of hepatic resection. As for perioperative complications, the uremia-HCC cohort had a higher risk of postoperative infections requiring invasive interventions as well as an increased risk of life-threatening heart-associated complications, compared to the HCC cohort. CONCLUSIONS: Uremia did not influence survival outcomes between the uremia-HCC and the HCC cohorts, irrespective of extent of hepatic resection. This study urges a better perioperative care strategy to avoid potential cardiac and infectious complications in uremia-HCC patients.