Relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults: a cross-sectional study.

BACKGROUND: Many recent studies suggest the existence of a relationship between oral health and the occurrence of depressive symptoms. The aim of this study was to assess the relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults. METHODS: An analysis was performed on the data obtained from the PONS project (POlish-Norwegian Study), conducted in the Swietokrzyskie Province in Poland in 2010-2011. The research material included the cross-sectional data of 11,901 individuals aged 40-64 years (7967 women). Depressive symptoms, used as outcome variables, were assessed with a questionnaire. The participants provided the responses to questions concerning the occurrence of eight symptoms over the last 12 months. The answers were scored as 1 point or 0 points. The participants were divided into three tercile groups based on their total scores: no or mild (0-2 points), moderate (3-5 points), and severe depressive symptoms (6-8 points). The self-reported number of lost teeth was analysed according to the following categories: 0-4, 5-8, 9-27, and a complete lack of natural teeth. Multivariable logistic regression analysis for depressive symptoms was used in relation to the number of lost teeth. The following covariates were included in the adjusted model: age, sex, place of residence, education, marital status, BMI, diabetes status, stressful life events in the last year, use of antidepressants, smoking, and sugar and sweet consumption. RESULTS: The likelihood of both moderate (OR = 1.189; 95%CI: 1.028-1.376; p < .020) and severe (OR = 1.846; 95%CI: 1.488-2.290; p < .001) depressive symptoms showed the strongest relationship with a total lack of natural teeth. A loss of more than 8 natural teeth was also significantly associated (OR = 1.315; 95%CI: 1.075-1.609; p < .008) with the occurrence of severe depressive symptoms. CONCLUSIONS: The loss of natural teeth was positively related to the occurrence of depressive symptoms in middle-aged adults. Thus, there is an urgent need to intensify stomatological prophylaxis, education and treatment for middle-aged individuals.

Breastfeeding and Prevalence of Metabolic Syndrome among Perimenopausal Women.

Little is known about the long-term benefits of breastfeeding for mother's metabolic health. This study aimed to investigate the links between breastfeeding duration and the prevalence of metabolic syndrome (MetS) and its components in perimenopausal women. The analysis included a group of 7621 women aged 55.4 ± 5.4 years. MetS and its components were defined according to the International Diabetes Federation guidelines. Women who breastfed for 13-18 months and beyond 18 months were at lower risk of MetS (odds ratio OR) = 0.76, 95% CI 0.60-0.95; p = 0.017 and OR = 0.79, 95% CI 0.64-0.98; p = 0.030, respectively) than those who never breastfed. Meanwhile, women who breastfed for 7-12 months showed increased glucose concentration (OR = 0.77, 95% CI 0.63-0.94; p = 0.012) compared with those who had never breastfed. The additional analysis involving parity showed that women who had given birth to two babies and breastfed them had lower odds of MetS than those who never breastfed (p < 0.05), although there was no significant difference among women who breastfed for >18 months. Women who had given birth to at least three children and breastfed for 1-6 and 13-18 months had lower odds of MetS and increased triglyceride concentration (p < 0.05). Moreover, participants having breastfed for 1-6 months were found to have a reduced risk of abdominal obesity compared with those who had not breastfed (p < 0.05). Breastfeeding is associated with lower prevalence of MetS in perimenopausal women and can be recommended as a way of reducing the risk of MetS and its components.

The Effect of Bariatric Surgery on Weight Loss and Metabolic Changes in Adults with Obesity.

Methods of treating obesity, such as changes in lifestyle, physical activity, restrictive diets, and psychotherapy, are not sufficient. Currently, it is considered that in the case of patients who meet the eligibility criteria for surgery, the treatment of choice should be bariatric surgery. The aim of this study was to assess the weight loss and metabolic changes in a group of adults with obesity undergoing bariatric surgery. The study involved 163 patients whose body mass index (BMI) exceeded 40 or 35 kg/m2, concurrent with at least one metabolic sequelae. In 120 of the cases (74%), sleeve gastrectomy was used; in 35 (21%), gastric bypass was used; and in 8 (5%), laparoscopic Roux-en-Y bypass was used. Metabolic parameters such as total cholesterol, LDL-cholesterol (low-density lipoprotein cholesterol), HDL-cholesterol (high-density lipoprotein cholesterol), triglycerides, and glucose were measured preoperatively and postoperatively, as well as the creatinine, creatine kinase (CK-MB), and leptin activity. In patients undergoing bariatric surgery, a significant decrease in excess weight (p < 0.001) was observed at all the analyzed time points, compared to the pre-surgery value. Weight loss after surgery was associated with a significant improvement in glycemia (109.6 ± 48.0 vs. 86.6 ± 7.9 mg/dL >24 months after surgery; p = 0.003), triglycerides (156.9 ± 79.6 vs. 112.7 ± 44.3 mg/dL >24 months after surgery; p = 0.043) and leptin (197.50 ± 257.3 vs. 75.98 ± 117.7 pg/mL 12 months after surgery; p = 0.0116) concentration. The results of the research confirm the thesis on the effectiveness of bariatric surgery in reducing excess body weight and improving metabolic parameters in patients with extreme obesity.

Anthropometric indices and cut-off points in the diagnosis of metabolic disorders.

OBJECTIVE: Identifying metabolic disorders at the earliest phase of their development allows for an early intervention and the prevention of serious consequences of diseases. However, it is difficult to determine which of the anthropometric indices of obesity is the best tool for diagnosing metabolic disorders. The aims of this study were to evaluate the usefulness of selected anthropometric indices and to determine optimal cut-off points for the identification of single metabolic disorders that are components of metabolic syndrome (MetS). DESIGN: Cross-sectional study. PARTICIPANTS: We analyzed the data of 12,328 participants aged 55.7±5.4 years. All participants were of European descent. PRIMARY OUTCOME MEASURE: Four MetS components were included: high glucose concentration, high blood triglyceride concentration, low high-density lipoprotein cholesterol concentration, and elevated blood pressure. The following obesity indices were considered: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), body fat percentage (%BF), Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), body roundness index (BRI), and a body shape index (ABSI). RESULTS: The following indices had the highest discriminatory power for the identification of at least one MetS component: CUN-BAE, BMI, and WC in men (AUC = 0.734, 0.728, and 0.728, respectively) and WHtR, CUN-BAE, and WC in women (AUC = 0.715, 0.714, and 0.712, respectively) (p<0.001 for all). The other indices were similarly useful, except for the ABSI. CONCLUSIONS: For the BMI, the optimal cut-off point for the identification of metabolic abnormalities was 27.2 kg/m2 for both sexes. For the WC, the optimal cut-off point was of 94 cm for men and 87 cm for women. Prospective studies are needed to identify those indices in which changes in value predict the occurrence of metabolic disorders best.

The Usefulness of Anthropometric Indices to Identify the Risk of Metabolic Syndrome.

Despite several papers having been published on the association between adiposity and the risk of metabolic syndrome (MetS), it is still difficult to determine unambiguously which of the indices of nutritional status is the best to identify MetS. The aim of this study was to analyze the ability of six anthropometric indices to identify MetS in the Polish population. The highest odds ratios for the occurrence of MetS, according to International Diabetes Federation (IDF), were noted for the following indices: waist-to-height ratio (WHtR, OR = 24.87) and Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE, OR = 17.47) in men and WHtR (OR = 25.61) and body roundness index (BRI, OR = 16.44) in women. The highest odds ratios for the modified definition of MetS (without waist circumference) were found for the following indices: WHtR (OR = 7.32), BRI (OR = 6.57), and CUN-BAE (OR = 6.12) in women and CUN-BAE (OR = 5.83), WHtR (OR = 5.70), and body mass index (BMI, OR = 5.65) in men (p < 0.001 for all). According to the Receiver Operating Characteristic (ROC) analyses conducted for the identification of MetS, defined in accordance with IDF, the largest areas under the curve (AUCs) in men were observed for WHtR and CUN-BAE indices, whereas in women, they were observed for WHtR and BRI. In the analysis carried out for the identification of MetS (according to modified definition, without waist circumference), the AUCs were larger for WHtR and BRI in women, while in men, they were larger for CUN-BAE, BMI, and WHtR. BMI was also characterized by a relatively strong discriminatory power in identifying individuals with MetS. An optimal cut-off point for MetS, in accordance with the conventional definition, for both sexes was the value of BMI = 27.2 kg/m2. The weakest predictor of the syndrome was the ABSI (a body shape index) indicator. The most useful anthropometric indicator for the identification of MetS, both in men and in women in the Polish population, was WHtR. The optimal cut-off points for WHtR equaled 0.56 in men and 0.54 in women.

Consumption of Alcoholic Beverages and the Prevalence of Metabolic Syndrome and Its Components.

The relationship between alcohol consumption and the prevalence of metabolic syndrome is not consistent and may vary between populations, depending on age, sex, ethnicity, cultural traditions and lifestyle. We have hypothesized that moderate alcohol consumption will be associated with the lowest risk of the syndrome. The aim of the present study is to examine the relationship between the current consumption of alcohol and the prevalence of metabolic syndrome and its components. The research material includes data obtained from 12,285 men and women, in the age range of 37-66 years. Multiple logistic regression was used in the statistical analysis. Metabolic syndrome (MetS) was defined according to the International Diabetes Federation. In men, a current consumption of >30 g of alcohol/day was significantly associated with a higher risk of metabolic syndrome (OR = 1.73, 95% CI = 1.25-2.39), high blood pressure (OR = 2.76, 95% CI = 1.64-4.65), elevated glucose concentration (OR = 1.70, 95% CI = 1.24-2.32), and abdominal obesity (OR = 1.77; 95% CI = 1.07-2.92). In women, the consumption from 10.1 to 15.0 g of alcohol was associated only with a higher risk of abnormal glucose concentration (OR = 1.65; 95% CI = 1.14-2.38.) In both sexes, current alcohol consumption was associated with higher high-density lipoproteins (HDL)-cholesterol concentration (p < 0.05). No relationship was found between alcohol consumption and triglyceride concentration. It is difficult to formulate unequivocal recommendations regarding alcohol intake in MetS prophylaxis due to its different association with particular MetS components. In order to explain the causal relationship between alcohol consumption and MetS and its components, prospective studies are necessary.

The Consumption of Alcoholic Beverages and the Prevalence of Cardiovascular Diseases in Men and Women: A Cross-Sectional Study.

Associations between alcohol consumption and the prevalence of cardiovascular diseases have been the subject of several studies for a long time; however, the presence and nature of any associations still remain unclear. The aim of the study was to analyze the associations between the consumption of alcoholic beverages and the prevalence of cardiovascular diseases in men and women. The data of 12,285 individuals aged 37-66 were used in the analysis. Multiple logistic regression models were utilized to estimate odds ratios and confidence intervals. The multivariable models included several potential confounders including age, education, marital status, body mass index (BMI), physical activity, smoking, coffee consumption, and statin use. The analyses were performed separately for men and women. In the model adjusted for confounders, the consumption from 0.1 to 10.0 g of alcohol/day was related to a lower risk of coronary disease and stroke (p < 0.05), and the consumption from 0.1 to 15.0 g/day was related to a lower risk of hypertension in women (p < 0.05). In men, in the adjusted model, there were no associations between alcohol consumption and the occurrence of hypertension or stroke. The risk of circulatory failure was significantly lower in the group in which participants drank more than 20.0 g of alcohol/day (p < 0.05) compared to nondrinkers. The risk of coronary disease was lower in drinkers at every level of alcohol consumption (p < 0.05) compared to nondrinkers. Alcohol consumption was related to a lower prevalence of cardiovascular diseases (CVD), both in men and women.

Elderly persons with acute pancreatitis - specifics of the clinical course of the disease.

BACKGROUND: As may readily be inferred from clinical observations, there is an increasing prevalence of severe acute pancreatitis (SAP) in the elderly, even though the precise nature of the relationship between a patient's age and severity of the disease has not been unequivocally determined to date. This study aimed therefore to investigate the incidence, clinical course, and mortality rate among the elderly patients suffering from acute pancreatitis (AP), as compared to younger ones. METHODS: A prospective study, lasting a single calendar year, covered patients with AP successively admitted to hospitals. The final assessment comprised 963 patients. The patients were subsequently divided into three groups corresponding to the three grades of disease severity, based on the Revised Atlanta Classification for Acute Pancreatitis. The actual cause of the disease, its clinical course, results of radiological ultrasonography, computed tomography, and laboratory tests, as well as the duration of hospital stay were assessed in due consideration of patients' age (groups aged 65-79 years and ≥80 years vs <65 years). RESULTS: Cholelithiasis was determined as the main cause of AP among the older patients (54.08% and 58.12% vs 22.46%; P<0.000). Among the oldest patients (≥80 years), its course was often significantly more severe, in comparison with the ones under 65 years of age: 14.53% vs 6.31% (P<0.00); a phenomenon not observed in the age range 65-79 years, nor among the younger patients (7.69% vs 6.31%; P>0.05). Moderate AP occurred significantly more often in the younger patients compared to those aged ≥80 years (16% vs 8.55%; P<0.00), although without any significant differences observed between the group aged 65-79 years and the younger patients (13.27% vs 8.55%). SAP more frequently ended in death among the oldest patients - 11.97% vs 2.31% (P<0.000) than in the group aged 65-79 years (4.59%), as compared to the younger groups (P>0.05). CONCLUSION: An appreciably higher susceptibility of older patients aged ≥80 years to AP, with cholelithiasis being the main cause that results in high mortality rate, is presently acknowledged a serious diagnostic and therapeutic management challenge to a national healthcare system.

Tumor Digital Masking Allows Precise Patient Triaging: A Study Based on Ki-67 Scoring in Gastrointestinal Stromal Tumors.

BACKGROUND: Technological advances constantly provide cutting-edge tools that enhance the progress of diagnostic capabilities. Gastrointestinal stromal tumors belong to a family of mesenchymal tumors where patient triaging is still based on traditional criteria such as mitotic count, tumor size, and tumor location. Limitations of the human eye and randomness in choice of area for mitotic figure counting compel us to seek more objective solutions such as digital image analysis. Presently, the labelling of proliferative activity is becoming a routine task amidst many cancers. The purpose of the present study was to compare the traditional method of prediction based on mitotic ratio with digital image analysis of cell cycle-dependent proteins. METHODS: Fifty-seven eligible cases were enrolled. Furthermore, a digital analysis of previously performed whole tissue section immunohistochemical assays was executed. Digital labelling covered both hotspots and not-hotspots equally. RESULTS: We noted a significant diversity of proliferative activities, and consequently, the results pointed to 6.5% of Ki-67, counted in hotspots, as the optimal cut-off for low-high-grade GIST. ROC analysis (AUC = 0.913; 95% CI: 0.828-0.997, p < 0.00001) and odds ratio (OR = 40.0, 95% CI: 6.7-237.3, p < 0.0001) pointed to Ki-67 16% as the cut-off for very high-grade (groups 5-6) cases. With help of a tumor digital map, we revealed possible errors resulting from a wrong choice of field for analysis. We confirmed that Ki-67 scores are in line with the level of intracellular metabolism that could be used as the additional biomarker. CONCLUSIONS: Tumor digital masking is very promising solution for repeatable and objective labelling. Software adjustments of nuclear shape, outlines, size, etc. are helpful to omit other Ki-67-positive cells especially small lymphocytes. Our results pointed to Ki-67 as a good biomarker in GIST, but concurrently, we noted significant differences in used digital approaches which could lead to unequivocal results.

CTRC gene polymorphism may increase pancreatic cancer risk - preliminary study.

Pancreatic cancer is often fatal due to delayed diagnosis and treatment difficulties. OBJECTIVE: To analyze selected SPINK1, CTRC, CFTR, and PRSS1 gene mutations in cancer tissue and blood samples of patients with pancreatic tumors. MATERIALS AND METHOD: We enrolled 16 consecutive patients diagnosed with pancreatic tumors. We collected cancer tissue, normal pancreatic tissue, and blood samples for genetic tests. The control group consisted of 419 healthy individuals. Peripheral blood samples were collected from all study participants in EDTA-coated tubes. RESULTS: Out of 16 patients with pancreatic tumors, 12 had pancreatic cancer on microscopic examination (mean age, 60.2 years). The CTRC polymorphism Hetero p.G60=(c.180C>T) was found in 5 patients with pancreatic cancer (41.7% vs. 18.6% in the control group). One patient with pancreatic cancer and a positive family history had the SPINK1 (p.N34S) mutation [8.3% vs. 2.9% (12/419) in the control group]. One patient with pancreatic cancer had the CTRC (p.R254W) mutation [8.3% vs. 1% (4/419) in the control group]. CONCLUSIONS: Our preliminary results show that the CTRC polymorphism p.G60= (c.180C>T) is frequent in patients with pancreatic cancer. However, further research is needed to verify our findings.