Prevalence and Associated Factors with Frailty Using the Kihon Checklist among Community-Dwelling Older Adults in Taiwan.

Background and Objectives: Frailty in older adults is associated with adverse health outcomes. This study aimed to analyze the frailty status of community-dwelling older adults in Taiwan using the Kihon Checklist (KCL) and explore associations with demographic, physiological, and functional factors. Materials and Methods: In this cross-sectional study, 278 community-dwelling older adults were classified as robust, prefrail, or frail based on their KCL scores. Participants underwent physical fitness assessments including muscle strength and endurance tests, walking speed tests, and flexibility tests. One-way ANOVA and logistic regression analyses were used to examine differences and associations between frailty status and physical fitness indicators. Results: 36% of participants were robust, 47.1% prefrail, and 16.9% frail. The robust group significantly outperformed the prefrail and frail groups in the 30 s sit-to-stand test, 2.44 m sit-to-walk test, and walking speed (p < 0.001). The 2.44 m sit-to-walk test was a significant predictor of prefrailty (OR = 1.18, 95% CI = 1.02-1.36) after adjusting for other physical fitness indicators. Conclusions: Lower limb functional capacity, particularly in the 2.44 m sit-to-walk test, was significantly associated with pre-frailty among community-dwelling older adults in Taiwan. Early screening, the classification of frailty by the Kihon Checklist, and targeted interventions focusing on lower limb strength, endurance, and mobility are crucial for preventing and delaying frailty progression in older populations.

Translation and Validation of the Gaming Disorder Test and Gaming Disorder Scale for Adolescents into Chinese for Taiwanese Young Adults.

PURPOSE: To translate and cross-culturally adapt the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A) for use in Taiwan and to validate their internal consistency, construct validity, measurement invariance, and convergent validity in Taiwanese young adults. METHODS: The GDT and GADIS-A were translated into traditional (unsimplified) Chinese characters and culturally adapted according to standard guidelines. A sample of 608 Taiwanese university students were recruited online. All participants completed the GDT, GADIS-A, Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and Depression Anxiety Stress Scale-21 (DASS-21). Internal consistency was assessed using Cronbach's α and McDonald's ω. Factor structure was examined using Confirmatory Factor Analysis (CFA). Measurement invariance in gender was assessed by three nested models in CFA. Convergent validity was determined by calculating Pearson's r among the GDT, GADIS-A, IGDS9-SF, and DASS-21. RESULTS: The GDT and GADIS-A showed adequate internal consistency (both α and ω = 0.90). The CFA results supported a one-factor structure for the GDT and a two-factor structure for the GADIS-A. Measurement invariance across gender was supported for both the GDT and GADIS-A. The convergent validity of the GDT and GADIS-A were acceptable. CONCLUSIONS: The Chinese versions of the GDT and GADIS-A are valid and reliable tools that can be used to assess gaming disorder in Taiwanese young adults. Measurement invariance across genders was supported for both tools. The convergent validity of the GDT and GADIS-A were also satisfactory.

Effects of Fecal Occult Blood Immunoassay Screening for Colorectal Cancer-Experience from a Hospital in Central Taiwan.

Background and Objectives: In 2004, the Health Administration of Taiwan began to promote a hospital-based cancer screening quality improvement program, under the principle that "prevention is better than therapy". The aim of this study was to evaluate the effectiveness of colorectal cancer (CRC) screening in patients who received a fecal immunochemical test (FIT) at a hospital in central Taiwan. Materials and Methods: This was a retrospective study. Results: Fecal occult blood immunoassays for CRC screening were conducted in 58,891 participants, of whom 6533 were positive (positive detection rate 11.10%). The positive patients then underwent colonoscopy, and the detection rates of polyps and CRC accounted for 53.6% and 2.4% of all colonoscopy-confirmed diagnoses (3607), respectively. We further enrolled data from patients diagnosed with CRC at our hospital from 2010 to 2018. The patients with CRC were divided into two groups according to whether or not they had received fecal occult blood screening. Among the 88 patients with CRC by screening, 54 had detailed medical records including cancer stage. Of these 54 patients, 1 (1.8%) had pre-stage, 11 (20.4%) had stage I, 24 (44.4%) had stage II, 10 (18.5%) had stage III, and 8 (14.8%) had stage IV CRC. The early cancer detection rates of the screening and non-screening groups were 66.7% and 52.7%, respectively, and the difference was significant (p = 0.00130). Conclusions: In this study, screening with FIT significantly increased the early detection of CRC. The main advantage of FIT is the non-invasiveness and low cost. It is hoped that the further adoption of early screening can increase the detection rates of colorectal polyps or early cancer to improve survival, reduce the high cost of subsequent cancer treatment, and reduce the burden on the patient and healthcare system.

Association between the Severity of Nonalcoholic Fatty Liver Disease and the Risk of Coronary Artery Calcification.

Background and Objectives: There are limited data on the association between severity of non-alcoholic fatty liver disease (NAFLD) and coronary artery calcification. This study investigated sonographic diagnosed NAFLD and coronary artery calcium score (CAC) as detected by cardiac multidetector computed tomography in general populations. Materials and Methods: A total of 545 patients were enrolled in this study. NAFLD was diagnosed by ultrasonography examination and CAC score were evaluated by cardiac multidetector computed tomography. The association between NAFLD and artery calcium score stage was determined by logistic regression analysis and Spearman correlation coefficient analysis. Results: Of all the participants, 437 (80.2%) had ultrasonography-diagnosed NAFLD and 242 (44%) had coronary artery calcification (CAC > 0). After adjustment for cardiovascular risk factors, the risk of developing coronary artery calcification was 1.36-fold greater in the patients with different severity of NAFLD compared to those without NAFLD (OR = 1.36, 95% CI = 1.07-1.77, p = 0.016). The highest OR for separate coronary artery calcification was 1.98 (OR = 1.98, 95% CI = 1.37-2.87, p < 0.001) in the left main artery, and the risk was still 1.71-fold greater after adjustments (OR = 1.71, 95% CI = 1.16-2.54, p = 0.007). Conclusions: This cross-sectional study demonstrated that the severity of NAFLD was associated with the presence of significant coronary artery calcification, especially in the left main coronary artery, suggesting increasing the cardiovascular risk.

What is the impact of metabolic syndrome and its components on reflux esophagitis? A cross-sectional study.

BACKGROUND: The prevalence rate of reflux esophagitis (RE) in Asia, including Taiwan, has increased dramatically in recent years. However, few studies have discussed on its relationship with metabolic syndrome (MetS). This study aimed to evaluate the correlation between RE and MetS and its components. METHODS: We conducted a cross-sectional study during 2013 to 2014 in Taiwan. A total of 4895 subjects who completed upper gastrointestinal endoscopy at the Health Examination Center of Changhua Christian Hospital were enrolled. RE was defined according to the upper gastrointestinal endoscopic findings and MetS was defined according to the Taiwanese criteria. Univariate and multivariate logistic regression analyses were applied to calculate odds ratios and 95% confidence intervals for each variable to assess the associated features for RE. We analyzed the relationship between the number of MetS components and the severity of RE using the chi-square test for trend. RESULTS: The prevalence rates of MetS and RE were respectively 28.5 and 59.6%. According to univariate logistic regression analysis, MetS was significantly associated with RE and remained a positive association in multivariate logistic regression analysis (adjusted ORß = 1.251; 95% CI = 1.071-1.462; p = 0.005). Furthermore, among the five MetS components, elevated blood pressure (adjusted ORγ = 1.163; 95% CI = 1.023-1.323; p = 0.021), abdominal obesity (adjusted ORγ = 1.173; 95% CI = 1.020-1.349; p = 0.026) and hyperglycemia (adjusted ORγ = 1.306; 95% CI = 1.142-1.495; p < 0.001) were positively associated with the presence of RE. A weak association was also found between elevated triglycerides and RE after adjusting for age and gender (adjusted ORα = 1.171; 95% CI = 1.022-1.343; p = 0.023). Reduced high-density lipoprotein cholesterol showed no significant difference between groups with and without RE. Older age (≥65 years), male gender, higher body mass index, higher uric acid, smoking, alcohol drinking, and hiatal hernia were found to be significant associated factors for RE. In addition, a dose-response relation between the number of MetS components and the presence of RE was demonstrated in the multivariate analysis. Furthermore, we performed a trend analysis and found the severity of RE got worse as the number of MetS components increased (p < 0.001). CONCLUSION: This study suggests that MetS is significantly related to the presence and the severity of RE.

Prognostic Significance of CDCP1 Expression in Colorectal Cancer and Effect of Its Inhibition on Invasion and Migration.

BACKGROUND: To assess the correlations and functions of complement C1r/C1s, Uegf, Bmp1 domain-containing protein-1 (CDCP1) in identifying colorectal cancer (CRC) patients who are at high risk for metastasis. METHODS: Tumor specimens from 101 patients were analyzed by real-time polymerase chain reaction to detect CDCP1 expression. CDCP1 expression plasmids and shRNA were used to knock down CDCP1 expression in this study to investigate migratory and invasive abilities by Boyden chambers. The mRNA expression profiles in shCDCP1 transfectants were compared to those in control cells by conducting microarray analysis. Its downstream effectors were also invested in this study. RESULTS: CRC patients with a high CDCP1 expression had a statistically significant lower overall survival and disease-free survival compared to those exhibiting low CDCP1 expression. In vitro, knock-down CDCP1 expression significantly decreased migratory and invasive abilities in HCT116. Aberrant expression of CDCP1 increased cancer cell migration and invasion. By using integrated genomics, we identified ROCK1 (rho-associated, coiled-coil-containing protein kinase 1 pseudogene 1) as a downstream effector in CDCP1-mediated migration and as an invasion mediator. Clinically, ROCK1 and CDCP1 mRNA expression exhibited a strong positive correlation in CRC patient samples. CONCLUSIONS: Our results implicated CDCP1 as a key regulator of CRC migration and invasion, and suggest that it is a useful prognostic factor for patients with CRC. Improved identification of a high-risk subset of early metastatic patients may guide indications of individualized treatment in clinical practice.

The association of metabolic syndrome and its factors with gallstone disease.

BACKGROUND: To investigate the association between metabolic syndrome, including its factors, and gallstone disease (GSD) in a Taiwanese population. METHODS: We conducted a cross-sectional study during 2011 ~ 2012. A total of 12050 subjects who completed a questionnaire and underwent physical examination, laboratory tests and abdominal ultrasonography formed the study population. RESULTS: The prevalences of metabolic syndrome and gallstone disease were 24.09% and 6.16%. In an age- and sex-adjusted logistic regression model, metabolic syndrome was associated with gallstone disease (OR = 1.61; P < 0.0001). Age, abdominal obesity, and lower high-density lipoprotein cholesterol were associated with gallstone disease after adjusting for other factors. Females had a higher odds ratio than males in waist circumference for GSD, whereas males had a lower odds ratio than females in HDL-C for GSD. CONCLUSIONS: The present study suggests that metabolic syndrome is related to gallstone disease. Waist circumference and high-density lipoprotein cholesterol are all associated with GSD. Men and women may possibly have different priorities and strategies to reduce the burden of GSD.

Deciphering microbial communities and their unique metabolic repertoire across rock-soil-plant continuum in the Dayoukeng fumarolic geothermal field of the Tatun Volcano Group.

High temperature and sulfur concentrations in geothermal sulfur fumaroles host unique microbial ecosystems with niche-specific metabolic diversity and physiological functions. In this study, the microbial communities and their functionalities associated with the Dayoukeng geothermal field and the rock-soil-plant continuum were investigated to underpin the microbial modulation at different distances from the fumaroles source. At the phylum level, Bacteroidota, Planctomycetota, Armatimonadota, and Patescibacteria were abundant in plant samples; Elusimicrobiota and Desulfobacterota were in the rock samples while Nitrospirota, Micrarchaeota, and Deinococcota were dominant in the soil samples. Acidophilic thermophiles were enriched in samples within close proximity to the fumaroles, primarily at a distance of 1 m. The sulfur and iron-oxidizing acidophilic bacterial genera such as Acidothiobacillus and Sulfobacillus were abundant in the rock samples. The thermoacidophilic archaeon Acidianus and acidophilic bacteria Acidiphilium were abundant in the soil samples. Additionally, Thermosporothrix and Acidothermus were found abundant in the plant samples. The results of the functional annotation indicated that dark sulfur oxidation, iron oxidation, and hydrogen oxidation pathways were abundant in the soil samples up to 1 m from the fumaroles, while methanogenic and fermentation pathways were more prevalent in the soil samples located 10 m from the fumaroles. Interestingly, the results of this study indicated a higher microbial richness and abundance of acidophilic communities in the soils and plants compared to the rocks of the DYK fumarolic geothermal field.

Chinese version of the Tendency to Avoid Physical Activity and Sport (TAPAS) scale: testing unidimensionality, measurement invariance, concurrent validity, and known-group validity among Taiwanese youths.

BACKGROUND AND OBJECTIVES: Psychosocial factors affect individuals' desire for physical activity. A newly developed instrument (Tendency to Avoid Physical Activity and Sport; TAPAS) has been designed to assess the avoidance of physical activity. Considering cultural differences could be decisive factors, the present study aimed to translate and validate the TAPAS into Chinese (Mandarin) for Taiwanese youths, and further cultural comparisons are expected. METHODS: Standard translation procedure (i.e., forward translation, back translation, and reconciliation) was used to translate the English TAPAS into the Chinese TAPAS. Following translation, 608 youths (mean [SD] age 29.10 [6.36] years; 333 [54.8%] women) participated in the study via a snowballing sampling method with an online survey. All participants completed the Chinese TAPAS and additional instruments assessing weight stigma and psychological distress. Confirmatory factor analysis (CFA) was used to examine the factor structure of the Chinese TAPAS and multigroup CFA to examine measurement invariance across gender (men vs. women) and weight status (overweight vs. non-overweight). Pearson correlations were used to examine the concurrent validity; independent t-tests between gender groups and weight status groups were used to examine the known-group validity. RESULTS: Consistent with the English version, the Chinese TAPAS was found to have a one-factor structure evidenced by CFA results. The structure was invariant across gender and weight status groups evidenced by multigroup CFA results. Concurrent validity was supported by significant associations with the related constructs assessed (r = 0.326 to 0.676; p < 0.001). Known-group validity was supported by the significant differences in TAPAS total scores between gender and weight status groups (p = 0.004 and < 0.001; Cohen's d = 0.24 and 0.48). CONCLUSION: The Chinese version of the TAPAS is a valid and reliable instrument assessing individuals' avoidance of physical activity and sports due to underlying psychosocial issues among Taiwanese youths. It is anticipated to be applied within a large Asian population, as well as cross-cultural comparisons, for further explorations in health, behavioral and epidemiological research and practice.

The tendency to avoid physical activity and sport scale (TAPAS): Rasch analysis with differential item functioning testing among a Chinese sample.

BACKGROUND: The benefits of physical activity are well-known to prevent multiple long-term health conditions. Physical appearance and weight-related stigma may influence individuals' decision to engage in physical activity and sport. Therefore, the present study examined the psychometric properties of a newly developed instrument, the Tendency to Avoid Physical Activity and Sport Scale (TAPAS), using modern test theory. METHODS: A total of 2319 university students were recruited from mainland China and they completed the TAPAS. Rasch analysis was used to examine the TAPAS' rating scaling functioning, test unidimensionality, item hierarchy, ceiling and floor effects, and differential item functioning (DIF). Moreover, the concurrent validity of the TAPAS was examined using the Weight Self-Stigma Questionnaire (WSSQ), Weight Bias Internalization Scale (WBIS), and body mass index (BMI). RESULTS: Unidimensionality was confirmed except for one item. Items corresponding to attitude toward physical activity were more easily adopted compared to items corresponding to actual behavioral aspects. No ceiling and floor effects were found. No DIF existed in the TAPAS items. The TAPAS was strongly correlated with both the WSSQ and WBIS, but not BMI. CONCLUSION: The study showed that overall, the TAPAS has robust psychometric properties. However, future research needs to address the misfit item and explore the feasibility of applying the TAPAS to other populations including wider ethnic groups, age ranges, and life stages.

Effects of Weight-Related Self-Stigma and Smartphone Addiction on Female University Students' Physical Activity Levels.

Physical inactivity is a common health problem in female college students, and factors such as weight self-stigma and smartphone addiction may negatively impact physical activity in this population. The aim of the current study was to investigate the associations between these variables and identify the moderating effects of smartphone addiction between weight stigma and physical activity. Using a cross-sectional study, information on the level of physical activity in the past week, weight-related self-stigma, and smartphone addiction, as well as demographics, were collected via an online survey from 391 female college students in Taiwan. Participants in two groups of moderate to high and low physical activity were compared using a zero-order bivariate correlation in terms of independent variables. A moderated mediation model using Model 14 in the Hayes' PROCESS macro with 1000 bootstrapping resamples was applied to assess moderation effects. There were significant differences in terms of weight status, smartphone addiction, and weight stigma between active and inactive groups (p < 0.001). All independent variables except for age were positively correlated (0.14 < r < 0.45). Multivariate regression models indicated that weight status was associated with weight stigma (odds ratio [OR] = 9.13, p < 0.001; 95% CI = 6.90, 11.35). Weight status (OR = 0.47, p = 0.03; 95% CI = 0.23, 0.93), weight stigma (OR = 0.96, p = 0.03; 95% CI = 0.922, 0.997), and smartphone addiction (OR = 0.11, p = 0.003; 95% CI = 0.03, 0.47) were associated with physical activity. The moderating role of smartphone addiction on the association between weight stigma and physical activity was also identified (OR = 1.05, p = 0.049; 95% CI = 1.0001, 1.1004). The moderating effect of smartphone addiction on the association between weight stigma and physical activity suggests that designing interventions to address the negative impacts of both weight stigma and smartphone addiction may help to improve physical activity in female college students.

Molecular and Anti-Microbial Resistance (AMR) Profiling of Methicillin-Resistant Staphylococcus aureus (MRSA) from Hospital and Long-Term Care Facilities (LTCF) Environment.

To provide evidence of the cross-contamination of emerging pathogenic microbes in a local network between long-term care facilities (LTCFs) and hospitals, this study emphasizes the molecular typing, the prevalence of virulence genes, and the antibiotic resistance pattern of methicillin-resistant Staphylococcus aureus. MRSA isolates were characterized from 246 samples collected from LTCFs, medical tubes of LTCF residents, and hospital environments of two cities, Chiayi and Changhua. Species identification, molecular characterization, and drug resistance analysis were performed. Hospital environments had a higher MRSA detection rate than that of LTCF environments, where moist samples are a hotspot of MRSA habitats, including tube samples from LTCF residents. All MRSA isolates in this study carried the exfoliative toxin eta gene (100%). The majority of MRSA isolates were resistant to erythromycin (76.7%), gentamicin (60%), and ciprofloxacin (55%). The percentage of multidrug-resistant MRSA isolates was approximately 50%. The enterobacterial repetitive intergenic consensus polymerase chain reaction results showed that 18 MRSA isolates belonged to a specific cluster. This implied that genetically similar isolates were spread between hospitals and LTCFs in Changhua city. This study highlights the threat to the health of LTCFs' residents posed by hospital contact with MRSA.

Prevalence, Genetic Diversity, Antimicrobial Resistance, and Toxigenic Profile of Vibrio vulnificus Isolated from Aquatic Environments in Taiwan.

Vibrio vulnificus is a gram-negative, opportunistic human pathogen associated with life-threatening wound infections and is commonly found in warm coastal marine water environments, globally. In this study, two fishing harbors and three tributaries of the river basin were analyzed for the prevalence of V. vulnificus in the water bodies and shellfish that are under the pressure of external pollutions. The average detection rate of V. vulnificus in the river basins and fishing harbors was 8.3% and 4.2%, respectively, in all seasons. A total of nine strains of V. vulnificus were isolated in pure cultures from 160 samples belonging to river basins and fishing harbors to analyze the antibiotic susceptibility, virulence gene profiles, and enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) fingerprinting. All isolates were susceptible to 10 tested antibiotics. The genotypic characterization revealed that 11.1% (n = 1/9) strain was nonvirulent, whereas 88.9% (n = 8/9) isolates were virulent strains, which possessed the four most prevalent toxin genes such as vcgC (88.9%), 16S B (88.9%), vvhA (88.9%), and manIIA (88.9%), followed by nanA (77.8%), CPS1 (66.7), and PRXII (44.4%). Additionally, ERIC-PCR fingerprinting grouped these nine isolates into two main clusters, among which the river basin isolates showed genetically diverse profiles, suggesting multiple sources of V. vulnificus. Ultimately, this study highlighted the virulent strains of V. vulnificus in the coastal aquatic environments of Taiwan, harboring a potential risk of infection to human health through water-borne transmission.

A positive correlation between blood glucose level and bone mineral density in Taiwan.

This study was undertaken to assess the effect of blood glucose on BMD and interactions with age, sex, and BMI in a Taiwanese population. Both obese and non-obese people with type 2 diabetes (T2DM) had higher BMD, at lumbar spine and femoral neck, compared with healthy subjects. In addition, the prevalence of osteoporosis significantly decreased with blood sugar and HbA1c. PURPOSE: This study was undertaken to assess the effect of blood glucose on BMD and possible interactions with age, sex, and BMI in a Taiwanese population. PATIENTS AND METHODS: This study was a retrospective cross-sectional study using data from the Health Examination Database of Changhua Christian Hospital. Data on BMD of the lumbar spine and femoral neck were obtained by dual X-ray absorptiometry (DXA), and other relevant clinical and laboratory data were recorded. RESULTS: The type 2 diabetes (T2DM) group had a higher BMD than the controls. When comparing the prevalence of osteoporosis between subjects by glucose and HbA1c level, the prevalence of osteoporosis significantly decreased with blood glucose and HbA1c. In addition, the BMD of the lumbar spine and femoral neck was higher in the T2DM group than in the controls. Osteoporosis was negatively associated with DM, BMI, and drinking, but positively associated with age, female gender, previous fracture history, and other diseases of the musculoskeletal system and connective tissue. The association between diabetes and osteoporosis remained statistically significant after adjusting for the above factors. T2DM was associated with lower odds of osteoporosis in both obese (OR = 0.77) and non-obese (OR = 0.63) (p for interaction = 0.555). CONCLUSIONS: Both obese and non-obese people with T2DM had higher BMD, at lumbar spine and femoral neck, compared with healthy subjects. In addition, the prevalence of osteoporosis significantly decreased with blood glucose and HbA1c.

Butein induces apoptotic cell death of human cervical cancer cells.

Butein is a chalcone, a flavonoid that is widely biosynthesized in plants. Butein has been identified to possess varied pharmacological activity and is extractable from traditional Chinese medicinal herbs, therefore applicable for disease treatment. Recently, in vitro and in vivo studies have shown that butein may induce apoptotic cell death in various human cancer cells. In this study we investigated the apoptotic effect of butein and the underlying mechanisms in human cervical cancer cells. Two cell lines, C-33A and SiHa cells, were treated with butein at different dosages for different durations. The effect of butein on cell viability was assessed by MTT assay, which revealed that butein exerted cytotoxicity in both cervical cancer cells in a dose- and time-dependent fashion. Apoptotic pathway-related factors in the butein-treated cervical cancer cells were then examined. JC-1 flow cytometry, cytochrome c assay, and caspase activity assays demonstrated that butein disturbed mitochondrial transmembrane potential, and increased cytosolic cytochrome c levels and caspase activities in both cervical cancer cells. Western blot analysis revealed that butein downregulated anti-apoptotic protein Bcl-xL and led to proteolytic cleavage of poly (ADP-ribose) polymerase. In addition, butein decreased expressions of the inhibitor of apoptosis (IAP) proteins, including X-linked IAP, survivin, and cellular IAP-1. The findings of this study suggest that butein can decrease cervical cancer cell viability via a pro-apoptotic effect, which involves inhibition of the IAP proteins and activation of both extrinsic and intrinsic pro-apoptotic pathways. Therefore, butein may be applicable for cervical cancer treatment.

The association of nephrolithiasis with metabolic syndrome and its components: a cross-sectional analysis.

BACKGROUND: Metabolic syndrome is a worldwide disorder and also the major risk factor of several systemic diseases. Evidence identifying the association between metabolic syndrome and nephrolithiasis is lacking, especially in Taiwan. AIM: The aim of this study was to investigate the association between nephrolithiasis and metabolic syndrome and its components. DESIGN AND SETTING: This was a cross-sectional study conducted in the Health Examination Department of a medical center in Changhua, Taiwan, from January 2010 to December 2010. METHODS: We reviewed the medical records of patients who had visited the Health Examination Center of Changhua Christian Hospital in 2010. A total of 3,886 individuals were enrolled. According to the exclusion criteria, those with an age <20 years and an abnormal renal function were excluded. A total of 3,793 subjects were included. All P-values are two tailed, and P<0.05 was defined as statistically significant. RESULTS: The results showed a correlation between nephrolithiasis and metabolic syndrome and its components. The multivariate-adjusted odds ratio (OR) (95% confidence interval [CI]) of metabolic syndrome for nephrolithiasis was 1.318 (1.083-1.604), with a P-value of 0.006. Larger waist circumference (multivariable-adjusted OR 1.338; 95% CI 1.098-1.631; P=0.004), higher blood pressure (multivariable-adjusted OR 1.333; 95% CI 1.106-1.607; P=0.003), and increased fasting glucose (multivariable-adjusted OR 1.276; 95% CI 1.054-1.546; P=0.01) were associated with nephrolithiasis. CONCLUSION: This is the first study in Taiwan to investigate the relationship between metabolic syndrome and nephrolithiasis. The mechanism is controversial, and several hypotheses are offered. Adequate lifestyle modification and proper treatment in metabolic syndrome management may both contribute to nephrolithiasis prevention.

HMGCS2 enhances invasion and metastasis via direct interaction with PPARα to activate Src signaling in colorectal cancer and oral cancer.

Mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (HMGCS2) is the rate-limiting enzyme of ketogenesis. Growing evidence indicates that HMGCS2 may be involved in cancer progression, but its exact role is largely unknown. In this study, we demonstrate that HMGCS2 mRNA expression is associated with poor clinical prognosis and outcomes in patients with colorectal cancer (CRC) and oral squamous cell carcinoma (OSCC). In vitro, ectopic expression of HMGCS2 enhanced cancer cell motility in a ketogenesis-independent manner. Moreover, HMGCS2 promoted Src activity by directly binding to peroxisome proliferator-activated receptor alpha (PPARα), a transcriptional activator of Src. Taken together, these results suggest that HMGCS2 may serve as a useful prognostic marker and vital target for future therapeutic strategies against advanced cancer.