RESUMO
BACKGROUND: The vitamin niacin is used as a lipid-regulating supplement, but it is unknown whether niacin has a positive influence on cancer prognosis. In this study, we examine the relationship between niacin intake and mortality among patients with cancer. METHODS: Our study utilized all available continuous data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. Multivariable Cox regression models were applied in order to investigate dietary niacin intake's association with mortality. We compared the survival probability between groups of low and high niacin intake by plotting Kaplan-Meier curves. An analysis of subgroups was used to investigate heterogeneity sources. RESULTS: A total of 3504 participants were included in the cohort, with 1054 deaths. One thousand eight hundred forty-seven participants (52.3%) were female, 2548 participants (73.4%) were white, and the mean age (SE) was 65.38 years (0.32). According to multivariate logistic regression analysis, niacin intake was negatively associated with mortality outcomes in patients with cancer, with P values below 0.05 in all models. In subgroup analyses based on sex, age, and BMI, the association persisted. The Kaplan-Meier curves indicate that high niacin intake groups have better survival rates than low intake groups. Niacin supplementation improved cancer mortality but not all-cause mortality. CONCLUSION: According to our study, higher dietary niacin intake was associated with lower mortality in cancer patients. Niacin supplements improved cancer survival rates, but not all causes of mortality.
Assuntos
Neoplasias , Niacina , Humanos , Feminino , Idoso , Masculino , Niacina/uso terapêutico , Inquéritos Nutricionais , Estudos Retrospectivos , Vitaminas , Dieta , Neoplasias/tratamento farmacológico , Neoplasias/induzido quimicamenteRESUMO
OBJECTIVE: To observe the multiple symptom distribution, severity and quality of life of female pelvic floor dysfunction(FPFD) patients with constipation as chief complaint. METHODS: One hundred FPFD patients with constipation as chief complaint from Speciaty Outpatient Clinic, Pelvic Floor Center of Nanjing Municipal Hospital of Traditional Chinese Medicine between September 2015 and February 2017 were retrospectively enrolled in this study. A comprehensive medical history questionnaire survey and systematical evaluation of severity and quality of life of these patients with constipation was conducted. Constipation scoring system scale (CSS) and patient-assessment of constipation quality of life questionnaire (PAC-QOL) were applied to evaluate the constipation. Other scales included: (1)pain visual analogue scale (VAS) and short form-36 questionnaire (SF-36): if combined with chronic functional anal rectal pain; (2) international consultation on incontinence questionnaire-short form (ICIQ-SF) and urinary incontinence quality of life questionnaires (I-QOL):if combined with urinary incontinence; (3) fecal incontinence severity score scale (Wexner-FIS) and fecal incontinence quality of life questionnaire (FI-QOL):if combined with fecal incontinence. RESULTS: The mean age of 100 FPFD patients was (57.9±13.9) (24-89) years and the mean disease course was (7.0±8.2)(0.5-40.0) years. Seventy-five cases (75%) were complicated with anal pain, 70 with urinary incontinence, 37 with rectocele, 19 with nocturia, 11 with urinary frequency, 10 with defecation incontinence. Complication with only one symptom was observed in 20 cases (20%), and with two or more symptoms was observed in 80 cases (80%). Pelvic floor relaxation syndrome patients were dominant (58 cases, 58%). The severity of constipation (CSS) was 6-22 (13.89±3.79) points and the quality of life (PAC-QOL) was 45-133 (87.13±18.57) points in FPFD patients. VAS and SF-36 of patients combined with chronic functional anal rectal pain were 1-8 (3.0±1.9) points and 14.4-137.0(71.5±31.4) points respectively. ICIQ-SF and I-QOL of patients combined with urinary incontinence were 1-17 (6.1±3.6) points and 52-110 (90.0±15.8) points respectively. Wexner-FIS and FI-QOL of patients combined with fecal incontinence were 1-11 (4.4±3.0) points and 52-116 (83.4±23.3) points respectively. CONCLUSIONS: The symptoms of FPFD patients with constipation as chief complaint are complex. They are mainly complicated with anal diseases, then urinary incontinence, and mostly with more than 2 symptoms. Their quality of life is poor.
Assuntos
Constipação Intestinal/etiologia , Incontinência Fecal/etiologia , Distúrbios do Assoalho Pélvico/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Diafragma da Pelve , Distúrbios do Assoalho Pélvico/diagnóstico , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To find out the prevention effects of folic acid supplements during different pregnancy periods on neural tube defects (NTDs) and the relationship of folic acid supplements with the other NTDs' primary preventive measures. METHODS: A 1:1 case-control study was conducted. Four hundred and fifty-nine women who delivered or gestate infants/fetuses with NTDs in the last two years were randomly selected as cases and were matched with women who delivered babies without obvious birth defects as controls. RESULTS: For anencephaly, folic acid supplementation during the periconceptional period and preconceptional period has a 57-83% reduction in risk of NTDs(ORs ranged from 0.17 to 0.43). For spina bifida, folic acid supplementation during the periconceptional period has a 79% reduction in risk of NTDs (OR = 0.21). For encephalocele, folic acid supplementation during the periconceptional period has a 67% reduction in risk of NTDs (OR = 0.33). The prevention effects on NTDs were significant when these preventive measures combined with folic acid supplements during the periconceptional period, with OR 0.04, 0.07, 0.10 and 0.11. CONCLUSION: The specific effects of folic acid supplementation during different periods show the reduction in the risk of NTDs, anencephaly, spina bifida, encephalocele. During periconceptional period, folic acid supplements have preventive effects on all NTDs' subtypes.
Assuntos
Suplementos Nutricionais , Ácido Fólico/uso terapêutico , Defeitos do Tubo Neural/prevenção & controle , Prevenção Primária/métodos , Complexo Vitamínico B/uso terapêutico , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Análise de Regressão , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Preventive measures for neural tube defects (NTDs) have been recommended for many years in China, but the compliance with these measures is unsatisfactory. This study aims to analyze the effects of preconception examinations on NTDs and its primary preventive measures. METHODS: A 1:1 hospital-based case-control study was conducted. Four hundred and fifty-nine women who delivered or gestate infants/fetuses with NTDs from January 2006 to December 2008 were randomly selected and matched with women who delivered babies without obvious birth defects as controls in Shandong and Shanxi province. Multivariate conditional logistic regression was adopted. RESULTS: Significant associations were shown between preconception examinations (OR = 0.461), health education (OR = 0.336), periconceptional folic acid supplement (OR = 0.295), periconceptional rational diet adjustment (OR = 0.278) and NTDs. In the case group, the rates of periconceptional folic acid supplement and health education conduction by women who had preconception examinations were significantly higher than that of those who had not, OR being 3.04 and 4.55, respectively (p < 0.05). Among the preventive effects on NTDs, preconception examinations and other NTDs primary preventive measures had significant combined effects and the combined effects with periconceptional folic acid supplement were the greatest, with OR of 0.04. CONCLUSION: Preconception examinations have preventive effects on NTDs and can significantly improve the compliance of other NTDs primary preventive measures. In addition, preconception examinations and these measures have synergetic prevention effects, indicating the critical role played by preconception examinations on NTDs prevention.
Assuntos
Defeitos do Tubo Neural/prevenção & controle , Cuidado Pré-Concepcional , Adolescente , Adulto , Estudos de Casos e Controles , Suplementos Nutricionais , Feminino , Ácido Fólico/administração & dosagem , Hematínicos/administração & dosagem , Humanos , Gravidez , Adulto JovemRESUMO
There has been considerable professional debate on the association between nausea and vomiting in early pregnancy (NVP) and neural tube defects (NTDs) risk. This study explored the association between NVP and NTDs risk, and the effect of folic acid supplements on the association. A 1:1 matched case-control study was conducted and conditional logistic regression model was used to analyze the associations. The result showed the odds ratio (OR) of severe NVP for NTDs was 2.403 (95%CI 1.437,4.017; P<0.001) and that of moderate NVP was 1.469 (95%CI 1.063,2.031; P = 0.020) compared with light NVP when adjusted by the potential confounders. Stratified by intake of folic acid supplements, the ORs for severe and moderate NVP turned to 2.147 (95%CI 1.140, 4.043; P = 0.018) and 2.055 (95%CI 1.320, 3.199; P = 0.001) in the stratum of non-intake of folic acid supplements while ORs reduced to 1.851 (95%CI 0.729, 4.699; P = 0.195) and 1.003 (95%CI 0.594, 1.694; P = 0.992) in the stratum of intake of folic acid supplements, respectively. We conclude that severe/moderate NVP has an association with the risk of NTDs, which was not found in the group with intake of folic acid supplements. Folic acid supplements should be recommended to use for the prevention of NTDs.
Assuntos
Ácido Fólico/uso terapêutico , Náusea/etiologia , Defeitos do Tubo Neural/prevenção & controle , Vômito/etiologia , Adulto , Estudos de Casos e Controles , Suplementos Nutricionais , Feminino , Humanos , Modelos Logísticos , Defeitos do Tubo Neural/patologia , Razão de Chances , Gravidez , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
AIM: To study the influence of maternal body mass index (BMI) on the association between folic acid supplementation and neural tube defects (NTDs) risk in offspring. METHODS: A hospital-based, case-control study was conducted between 2006 and 2008 on 459 mothers with NTDs-affected births and 459 mothers without NTDs-affected births. Logistic regression models examined the associations between folic acid supplementation and the NTDs risk in offspring for all mothers, underweight/normal weight mothers (BMI<24.0) and overweight/obese mothers (BMI ≥24.0). The effects were evaluated by adjusted odds ratio (AOR) and 95% confidence intervals (CIs) with SAS 9.1.3 software. RESULTS: The overall AOR for periconceptional folic acid supplementation was 0.315 (95% CI = 0.172-0.577) when compared with no supplements. Stratified by maternal BMI, the AOR for periconceptional folic acid supplementation in overweight/obese mothers was greater than in underweight/normal weight mothers (0.646 vs. 0.208). The AOR for folic acid supplementation within 3 months before conception was 0.711 (95% CI = 0.323-1.563) in all mothers. Stratified by maternal BMI, the AOR for folic acid supplementation within 3 months before conception in overweight/obese mothers was greater than in underweight/normal weight mothers (0.658 vs. 0.527). CONCLUSION: The association between folic acid supplementation and the reduced NTDs risk was weaker in overweight/obese mothers (BMI ≥24.0) than in underweight/normal weight mothers (BMI <24.0).
Assuntos
Índice de Massa Corporal , Suplementos Nutricionais , Ácido Fólico/administração & dosagem , Defeitos do Tubo Neural/prevenção & controle , Obesidade/epidemiologia , Adulto , Análise de Variância , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Incidência , Recém-Nascido , Modelos Logísticos , Masculino , Bem-Estar Materno , Defeitos do Tubo Neural/epidemiologia , Razão de Chances , Gravidez , Cuidado Pré-Natal/métodos , Prognóstico , Valores de Referência , Medição de Risco , Adulto JovemRESUMO
OBJECTIVE: To explore the periconceptional factors affecting the risk of neural tube defects (NTDs), we carried out a hospital-based case-control study in China. METHODS: A 1:1 matched case-control study was conducted. With self-designed questionnaires, we solicited relevant information from 459 case mothers and 459 control mothers selected in two provinces of China through face-to-face interviews. Univariate and multivariate conditional logistic regression analyses were conducted to evaluate the effect values by odds ratios (ORs) and 95% confidence intervals (95%CIs) with SAS9.1.3.software. RESULTS: Daily passive tobacco smoke exposure was a risk factor for total NTDs (OR = 8.688, 95%CI = 2.329-32.404). Diet adjustment in the first trimester (OR = 0.061, 95%CI = 0.014-0.274), periconceptional folic acid intake (OR = 0.059, 95%CI = 0.011-0.321) and health education (OR = 0.251, 95%CI = 0.081-0.781) were protective factors for total NTDs. Differences in factors and their effects on NTDs were found for the three subtypes of NTDs: anencephaly, spina bifida and encephalocele. CONCLUSIONS: Daily passive tobacco smoke exposure, diet adjustment in the first trimester, periconceptional folic acid intake and health education were associated with NTDs.
Assuntos
Fertilização/fisiologia , Exposição Materna , Defeitos do Tubo Neural/epidemiologia , Defeitos do Tubo Neural/etiologia , Adolescente , Adulto , Estudos de Casos e Controles , China/epidemiologia , Suplementos Nutricionais , Feminino , Ácido Fólico/uso terapêutico , Maternidades/estatística & dados numéricos , Humanos , Recém-Nascido , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Measures for prevention of neural tube defects (NTDs) have been recommended for many years in China, but the compliance with these measures is unsatisfactory. This study aims to compare the effect differences between planned pregnancy and unplanned pregnancy in the compliance with these measures and analyze the interactions between pregnancy planning and these measures for NTD prevention. METHODS: A 1:1 matched case-control study was conducted. We randomly selected 349 women who delivered or gestated babies/fetuses with NTDs in the last two years in two provinces and matched them with 349 women who delivered babies without obvious birth defects as controls. RESULTS: In the case group, 99 women reported that they had planned their pregnancies, accounting for 28.4%, and the proportion who received preconception examinations and took folic acid prior to conception was 13.8 and 8.6%, respectively. According to the multivariate analysis, health education (odds ratio [OR], 0.350), preconception examinations (OR, 0.497) and folic acid consumption prior to conception (OR, 0.257) all had preventative effects on NTDs (for all, p < 0.05). In both groups, the proportions of women who received preconception examinations and reported folic acid intake were much higher for those who reported planning their pregnancies compared to women with an unplanned pregnancy (for all, p < 0.01); and for NTD prevention, synergistic interactions existed between pregnancy planning and the other preventive measures. CONCLUSION: Folic acid consumption prior to conception, preconception examinations, and health education have preventive effects on NTDs. Pregnancy planning can significantly promote compliance with these preventive behaviors. In addition, there are synergistic interactions between pregnancy planning and these measures.