Mid-Arm Circumference and All-Cause, Cardiovascular, and Cancer Mortality among Obese and Non-Obese US Adults: the National Health and Nutrition Examination Survey III.

Epidemiological studies have shown that mid-arm circumference (MAC) can be used to predict death risk and malnutrition. We performed a retrospective observational study involving 11,958 US participants aged 20-90 years from the National Health and Nutrition Examination Survey III, 1988-1994, to determine the correlation between MAC and all-cause, cardiovascular, and cancer mortality risk in the obese and non-obese population. Death certificate data were obtained up to 2006. The participants were divided into three groups on the basis of body mass index: 19 ≤ BMI < 25 kg/m2 (normal weight group), 25 ≤ BMI < 30 kg/m2 (overweight group) and BMI ≥ 30 kg/m2 (obesity group); each group was then divided into three subgroups depending on their MAC level. In the non-obese population, MAC was inversely associated with all-cause mortality; specifically, in the normal weight group, the multivariate-adjusted hazard ratio of the T3 (29.6-42.0) cm subgroup was 0.72 (95% confidence interval: 0.58-0.90) when compared with the T1 (18.0-27.2) cm, while the multivariate-adjusted hazard ratio of the T2 (27.3-29.5) cm subgroup was 0.76 (95% confidence interval: 0.64-0.91) when compared with the T1 (18.0-27.2) cm subgroup. The results indicate that MAC is inversely associated with all-cause mortality in non-obese individuals in the United States.

Exposure to fine particulate matter causes oxidative and methylated DNA damage in young adults: A longitudinal study.

An increased understanding is needed of the physiological effects and plausible biological mechanisms that link PM2.5 (particulate matter with an aerodynamic diameter below 2.5µm) exposure to mortality and morbidities such as atherosclerosis and respiratory disease. PM2.5 causes carcinogenic health effects. Biomonitoring in humans has suggested that 8-oxo-7, 8-dihydro-2-deoxyguanosine (8-oxodG) and N7-methylguanine (N7-MeG) are correlated with oxidative and methylated DNA damage. Thus, it is meaningful to explore the mechanisms of mutagenesis and carcinogenesis associated with oxidative and methylated DNA damage by simultaneously measuring these two markers. We recruited 72 participants from 2 areas (residential and commercial as well as residential and industrial) in the greater Taipei metropolitan area at baseline. Personal samplers were used to collect 24-hour PM2.5-integrated samples. All participants completed an interview, and blood and urine samples were collected the next morning. All collection procedures were repeated twice after a two-month follow-up period. Urinary 8-oxodG and N7-MeG were assayed as biomarkers of oxidative and methylated DNA damage, respectively. Plasma superoxide dismutase (SOD) and glutathione peroxidase-1 (GPX-1) were measured as biomarkers of antioxidants. Urinary 1-hydroxypyrene (1-OHP) was used as a biomarker of exposure to polycyclic aromatic hydrocarbons (PAHs). The mean PM2.5 level was 37.3µg/m3 at baseline. PM2.5 concentrations were higher during winter than during spring and summer. After adjusting for confounds through a generalized estimating equation (GEE) analysis, N7-MeG was significantly increased by 8.1% (ß=0.034, 95% CIs=0.001-0.068) per 10µg/m3 increment in PM2.5. 8-oxodG levels were positively correlated with N7-MeG according to both cross-sectional and longitudinal analyses, and 1-OHP was significantly associated with increasing 8-oxodG and N7-MeG concentrations. Exposure to PM2.5 increases methylated DNA damage. The mean level of urinary N7-MeG was 1000-fold higher than that of 8-oxodG.

Postprandial Glucose as a Risk Factor for Elevated Intraocular Pressure.

The aim of this study was to investigate the association between postprandial glucose and intraocular pressure in a relatively healthy population. We examined 1,439 adults getting a health check-up in a health promotion center at Tri-Service General Hospital (TSGH) in Taiwan between 2012 and 2013. All participants underwent examinations to measure metabolic variables and intraocular pressure. Multiple linear regression analyses were performed to assess the relationship between postprandial glucose and intraocular pressure. The levels of postprandial glucose were divided into quartiles with subjects in the lowest quartile being regarded as the reference group to perform quartile-based analysis. Covariate adjustment was designed for three models for further analysis. Subjects with higher quartiles of postprandial glucose level had a higher systolic blood pressure, a greater waist circumference and an elevated fasting glucose level (all p < 0.001). The ß coefficient with adjusted covariates showed a significant positive association between postprandial glucose and intraocular pressure. The trends of intraocular pressure across increasing quartiles of postprandial glucose were statistically significant (all p for trend < 0.001). Thus, higher levels of postprandial glucose positively correlated with elevated intraocular pressure.

Increased risk of cognitive impairment in patients with components of metabolic syndrome.

The number of old adults with cognitive impairment or dementia is anticipated to increase rapidly due to the aging population, especially the number of patients with multiple chronic conditions or metabolic perturbation. Metabolic syndrome (Mets) is among the most hazardous risk factors for cardiovascular disease and is linked to a chronic inflammatory disease. We investigated the National Health and Nutrition Examination Survey (NHANES) database for the years 1999 to 2002 to explore the connection between Mets and cognitive decline.A total of 2252 NHANES (1999-2002)-registered individuals who were stroke-free and aged ≧60 years were enrolled in this study. This study surveyed the effects of the existence of diverse characteristics of Mets on the individuals' cognitive performances as measured with the digit symbol substitution test (DSST).The individuals with more features of Mets achieved lower DSST scores than those with fewer constituents of Mets (P < 0.001 for the trend) after adjustments for covariates. The ß coefficients for the DSST scores of the participants with 1, 2, 3, and ≥4 features of Mets were -1.545, -3.866, -4.763, and -5.263, respectively. Cognitive decline was correlated with each of the constituents of Mets, which included high plasma glucose, elevated blood pressure, abdominal obesity, and decreased high-density lipoprotein cholesterol (P < 0.05 for the above factors), with the exception of high triglyceride levels (P > 0.05).Mets was positively associated with cognitive decline in individuals aged ≧60 years. The characteristics of Mets that were most strongly associated with cognitive decline were high plasma glucose and elevated blood pressure.

The Effect of Neurobehavioral Test Performance on the All-Cause Mortality among US Population.

Evidence of the association between global cognitive function and mortality is much, but whether specific cognitive function is related to mortality is unclear. To address the paucity of knowledge on younger populations in the US, we analyzed the association between specific cognitive function and mortality in young and middle-aged adults. We analyzed data from 5,144 men and women between 20 and 59 years of age in the Third National Health and Nutrition Examination Survey (1988-94) with mortality follow-up evaluation through 2006. Cognitive function tests, including assessments of executive function/processing speed (symbol digit substitution) and learning recall/short-term memory (serial digit learning), were performed. All-cause mortality was the outcome of interest. After adjusting for multiple variables, total mortality was significantly higher in males with poorer executive function/processing speed (hazard ratio (HR) 2.02; 95% confidence interval 1.36 to 2.99) and poorer recall/short-term memory (HR 1.47; 95% confidence interval 1.02 to 2.12). After adjusting for multiple variables, the mortality risk did not significantly increase among the females in these two cognitive tests groups. In this sample of the US population, poorer executive function/processing speed and poorer learning recall/short-term memory were significantly associated with increased mortality rates, especially in males. This study highlights the notion that poorer specific cognitive function predicts all-cause mortality in young and middle-aged males.