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1.
Mil Med ; 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32239167

RESUMO

INTRODUCTION: Psychological stress is associated with sedentary behavior, which may impair exercise performance. The aim of our study was to examine the association between psychological stress and physical fitness in military personnel. METHOD: A military cohort of 4080 subjects in Taiwan was used for the analysis. The Brief Symptoms Rating Scale (BSRS-5) includes items of anxiety, depression, hostility, interpersonal sensitivity, and insomnia measured by a five-point Likert-type scale of 0-4. Psychological stress was defined as normal (n = 3657), slight (n = 314), and great (n = 109) by BSRS-5 score ≤5, 6-9, and ≥10, respectively. Aerobic fitness and anaerobic fitness were evaluated by the time of 3000-meter running and the numbers of 2-min sit-ups and 2-min push-ups, respectively. Multiple linear and logistic regression analyses were used to determine the relationship. RESULTS: As compared with normal stress, slight and great stress were positive dose-dependently correlated with 3000-meter running time (ß = 9.09 and 14.44; P = 0.0032 and 0.048, respectively) after adjusting for age, sex, service specialty, body mass index, systolic blood pressure, cigarette smoking, alcohol intake, hemoglobin levels, and exercise frequency. Similarly, those with slight stress were more likely to be the worst 10% performers in the 3000-meter run test relative to the normal individuals (odds ratio and 95% confidence intervals: 1.50, 1.00-2.24). By contrast, there was no relationship of psychological stress with the numbers of 2-min sit-ups and 2-min push-ups. CONCLUSIONS: Our findings suggest that the presence of higher psychological stress on military personnel may reduce their cardiorespiratory fitness but not affect the anaerobic fitness.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32324581

RESUMO

Military personnel have greater psychological stress and are at higher suicide attempt risk compared with the general population. High mental stress may cause suicidal ideations which are crucially driving suicide attempts. However, traditional statistical methods could only find a moderate degree of correlation between psychological stress and suicidal ideation in non-psychiatric individuals. This paper utilizes machine learning techniques including logistic regression, decision tree, random forest, gradient boosting regression tree, support vector machine, and multilayer perceptron to predict the presence of suicidal ideation by six important psychological stress domains of the military males and females. The accuracies of all the six machine learning methods are over 98%. Among them, the multilayer perceptron and support vector machine provide the best predictions of suicide ideation approximately to 100%. As compared with the BSRS-5 score ≥ 7, a conventional criterion, for the presence of suicidal ideation ≥ 1, the proposed algorithms can improve the performances of accuracy, sensitivity, specificity, precision, the AUC of ROC curve and the AUC of PR curve up to 5.7%, 35.9%, 4.6%, 65.2%, 4.3% and 53.2%, respectively; and for the presence of more severely intense suicidal ideation ≥ 2, the improvements are 6.1%, 26.2%, 5.8%, 83.5%, 2.8% and 64.7%, respectively.

3.
Sci Rep ; 10(1): 6082, 2020 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-32269281

RESUMO

Low-grade inflammation, which is related to obesity and toxic substance use in young adults, may be associated with poor physical fitness. We investigated the association between total leukocyte count and physical fitness in a military cohort of 3,453 healthy young Taiwanese males aged 20-50 years in a cross-sectional study in 2014. Low-grade inflammation was defined according to equally sized quartiles of total leukocyte counts within the suggested normal limits (4.00-9.99 × 103/mm3). Aerobic fitness was assessed by the time for a 3-kilometer run test, and anaerobic fitness was evaluated by the numbers of sit-ups and push-ups performed in 2 minutes. Automatic monitoring systems were used to verify the scores for all procedures. Multiple linear regression was utilized to identify the associations among variables. When compared with the lowest counts (4.00-5.49 × 103/mm3), the second highest (6.50-7.49 × 103/mm3) and highest normal leukocyte counts (7.50-9.99 × 103/mm3) were correlated with longer times for a 3-kilometer run (ß and 95% confidence intervals =4.93 (1.61, 8.25) and 4.65 (2.20, 7.10), respectively) and fewer numbers of push-ups performed in 2 minutes (ß = -0.59 (-1.15, -0.03) and -0.56 (-0.96, -0.17), respectively), after adjustments for age, service specialty, waist circumference, body mass index, alcohol consumption, tobacco smoking, and physical activity. However, the association with 2-minute sit-ups was null. Our study suggested an inverse association between total leukocyte count and not only aerobic fitness but also parts of anaerobic fitness in young males. The temporal association needs confirmation in longitudinal studies.

4.
Medicine (Baltimore) ; 99(12): e19535, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195957

RESUMO

Hyperuricemia has been associated with metabolic syndrome, and the association with various cardiometabolic risk factors may be affected by sex.We made a cross-sectional examination in a military cohort of 6738 men and 766 women, aged 18 to 50 years of Taiwan in 2013 to 2014. Hyperuricemia were defined as serum uric acid levels ≥7.0 mg/dL for men and ≥5.7 mg/dL for women, respectively. Multivariable logistic regression analyses were used to determine the associations between hyperuricemia and various metabolic abnormalities.In the overall population, hyperuricemia was associated with high blood pressure (odds ratio [OR]: 1.59, and 95% confidence intervals: 1.42-1.77), low high-density lipoprotein (OR: 1.75, 1.56-1.97), high triglycerides (OR: 2.14, 1.90-2.42), high low-density lipoprotein (OR: 1.71, 1.51-1.93), high fasting plasma glucose (OR: 1.29, 1.13-1.48), and central obesity (OR: 2.85, 2.55-3.18) after adjusting for age and serum creatinine concentrations. However, the associations with atherogenic lipid profiles including high triglycerides and high low-density lipoprotein were merely significant in men but not in women. In addition, there was a tendency for a sex difference in the association of hyperuricemia and raised blood pressure ≥130/85 mm Hg, which was greater in women than that in men (OR: 2.92, 1.37-6.25 and 1.54, 1.37-1.72, respectively; P for interaction = .059).Our findings suggest that the association between hyperuricemia and various cardiometabolic abnormalities in young adults may differ by sex, possibly due to a regulation of sex hormones and uneven effects of uric acid at the same levels between sexes on lipid metabolisms and arterial stiffness.


Assuntos
Hiperuricemia/etiologia , Síndrome Metabólica/complicações , Militares/estatística & dados numéricos , Rigidez Vascular/fisiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertrigliceridemia/complicações , Hiperuricemia/epidemiologia , Masculino , Síndrome Metabólica/epidemiologia , Obesidade Abdominal/complicações , Fatores de Risco , Caracteres Sexuais , Taiwan/epidemiologia , Ácido Úrico/sangue , Adulto Jovem
5.
Can Respir J ; 2020: 5968189, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31998426

RESUMO

Tobacco smoking has been found associated with lower cardiorespiratory fitness in white and black males; however, few studies have not been conducted to clarify such relationship in Asian males. We performed a cross-sectional study to investigate the association between tobacco smoking status and physical fitness in 3,669 military males, averaged 29.4 years of age, from the cardiorespiratory fitness and hospitalization events in armed forces (CHIEF) study in Taiwan during 2014. There were 1,376 current smokers, and the others were noncurrent smokers. The effective sample size estimated was 1,230 participants, as the margin of error was ±3% at the 99% confidence level. Physical fitness was evaluated by time for a 3000-meter run test (aerobic fitness) and repetitive numbers of 2-minute sit-ups and 2-minute push-ups (anaerobic fitness) where all procedures were standardized by using computerized scoring systems. A multiple linear analysis adjusting for age, service specialty, body mass index, heart rate, alcohol intake, and training frequency was used to determine the relationship. As compared with noncurrent smoking, current smoking was inversely correlated with longer time for a 3000-meter run (ß = 15.66 (95% confidence intervals (CI): 10.62, 20.70)) and fewer repetitive numbers of 2-minute sit-ups and 2-minute push-ups (ß = -1.53 (95% CI: -2.08, -0.97) and -1.31 (95% CI: -2.12, -0.50), respectively). Our finding reconfirms the concept that tobacco smoking might reduce both aerobic and anaerobic fitness among young Asian males.

6.
Curr Hypertens Rev ; 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31702494

RESUMO

AIM: To investigate the association of physical fitness with long-term blood pressure variability (BPV) in young male adults. METHODS: We included 1,112 healthy military males, ages 18-40 years (mean age, 32 years) in Taiwan for the current analysis. Resting blood pressures were measured over right upper arm in a sitting position every two-year interval from 2012 to 2018 (2012-14, 2014-15, 2015-16, 2016-18). We assessed long-term BPV by standard deviation (SDSBP and SDDBP) and average real variability (ARVSBP and ARVDBP) across 4 visits during the study period. Aerobic fitness was evaluated by time for a 3000-meter run test, and anaerobic fitness was evaluated by numbers of 2-minute sit-ups and 2-minute push-ups, respectively. RESULTS: After adjusting for systolic and diastolic blood pressure, time for a 3000-meter run was associated with ARVSBP, SDSBP, and SDDBP (ß [SE]: 0.007 [0.002], 0.004 [0.002], and 0.005 [0.002], respectively, all p <0.05) but not with ARVDBP. In addition, numbers of 2-minute sit-ups were inversely associated with ARVSBP (ß [SE]: -0.041 [0.017], p =0.01) but not with ARVDBP, SDSBP, and SDDBP. There was no association of numbers of 2-minute push-ups with the BPV indexes. After additionally adjusting for age, body mass index, and other covariates, all the associations were not significant. CONCLUSION: We found that there was no association of physical fitness with long-term BPV in young male military personnel. Previous studies have shown no association with cardiorespiratory fitness in the elderly. This study further extended the knowledge of a null association between anaerobic fitness and long-term BPV.

7.
Am J Mens Health ; 13(5): 1557988319883766, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31646931

RESUMO

Myopia has been linked to body weight and sedentary status, but the association with quantitatively measured physical fitness in adults has not been examined. Cross-sectional analyses were performed to investigate the association between physical fitness and myopia in 3,669 military men (aged 29.4 years) in Taiwan. The severity of myopia obtained from the left eye was classified as mild (-0.5 to -3.0 diopters; n = 544), moderate -3.1 to -6.0 diopters; n = 563), and high (<-6.0 diopters; n =150); others were defined as nonmyopia (n = 2,412). Aerobic fitness was evaluated by time for a 3000-meter run test, and muscular endurance was evaluated by numbers of 2-min sit-ups and 2-min push-ups. A value of p < .0125 was considered significant. A multiple linear regression analysis was used to determine the relationship. Individuals who were less physically fit had higher risk of myopia. The associations were dose-dependently significant with mild, moderate, and high myopia for 3000-meter running time (ß = 9.64; 95% confidence intervals [3.22, 16.05], ß = 12.41; 95% CI [6.05, 18.76], and ß = 20.87; 95% CI [9.22, 32.51], respectively) after controlling for the potential covariates. There tended to be an inverse association with moderate and high myopia for numbers of 2-min push-ups (ß = -1.38; 95% CI [-2.43, -0.34] and ß = -2.10; 95% CI [- 3.97, -0.22], respectively) and 2-min sit-ups (ß = -0.83; 95% CI [-1.54, -0.12] and ß = -1.29; 95% CI [-2.56, -0.02], respectively), respectively. This study suggested that physical fitness, particularly aerobic fitness of the military males who received regular training, is inversely associated with myopia severity, independent of service specialty, body mass index, and educational level.

8.
Sci Rep ; 9(1): 11165, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31371766

RESUMO

Anemia defined as reduced hemoglobin levels of red blood cells may carry less oxygen to skeletal muscle and impair physical performance. Previous studies have shown that exercise intolerance was related to moderate or severe anemia, however, the relationship to mild anemia was unknown. We investigated the cross-sectional association of mild anemia defined as a hemoglobin level of 10.0-13.9 g/dL with physical fitness in 3,666 military young males in Taiwan in 2014. Aerobic fitness was evaluated by 3000-meter run test, and anaerobic fitness was evaluated by 2-minute sit-ups and 2-minute push-ups, respectively. Multiple logistic regressions for the best 10% and the worst 10% performers were used to determine the relationship. There were 343 mild anemic males in whom 47.8% were microcytic anemia and 3,323 non-anemic males for the analysis. The multiple logistic regression shows that as compared with non-anemic males, mild anemic males were more likely to be the worst 10% performers in the 3000-meter run test (odds ratios (OR) and 95% confidence intervals: 1.47, 1.01-2.14) after adjusting for age, service specialty, body mass index, waist size, mean blood pressure, unhealthy behaviors, lipid profiles, and exercise frequency. On the contrary, mild anemic males had higher possibility to be the best 10% performers in the 2-minute push-ups test (OR: 1.48, 1.08-2.04). However, there was no association between mild anemia and 2-minute sit-ups. Our findings suggest that unspecified mild anemia might be associated with lower cardiorespiratory fitness but not with anaerobic fitness in physically active military males.

9.
Eur J Sport Sci ; 19(9): 1214-1220, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30955480

RESUMO

AIM: To investigate the association of electrocardiographic (ECG) left and/or right ventricular hypertrophy (LVH and RVH) with physical fitness of military males. METHODS: We used a military cohort of 2587 males, who were on average 29.1 years of age, from the cardiorespiratory fitness and hospitalization events in armed forces (CHIEF) study in Taiwan for the analysis. Isolated ECG-LVH (n = 779) was diagnosed by either the Sokolow-Lyon or Cornell voltage criteria. Isolated ECG-RVH (n = 234) was defined by either the Sokolow-Lyon or Myers et al. voltage criteria. Combined ECG-LVH/RVH (n = 140) was defined as those who met the voltage criteria for both LVH and RVH. The other ECGs were defined as unaffected (n = 1434). Physical fitness was evaluated by the upper and lower 16% exercise performance (beyond 1-standard deviation) in 3000-meter run, 2-minute sit-ups, and 2-minute push-ups. All procedures were standardized and monitored by unified computerized scoring systems. A multiple logistic regression was used to determine the relationship. RESULTS: Compared with unaffected participants, those with an isolated ECG-LVH were tended to have a better 3000-meter run performance (odds ratio (OR) and 95% confidence intervals: 1.22 [0.99-1.50], p-value = 0.064) after adjusting for age, service specialty, body mass index, mean blood pressure, smoking status, alcohol intake, hemoglobin level, and exercise frequency. By contrast, those with an isolated ECG-RVH were tended to have a worse 2-minute sit-up performance (OR: 1.46 [0.99-2.16], p-value = 0.054). CONCLUSION: Military males with ECG-LVH and/or ECG-RVH compared to unaffected participants may have diverse exercise performances. However, these observations narrowly failed to reach statistical significance.


Assuntos
Aptidão Cardiorrespiratória , Ventrículos do Coração/diagnóstico por imagem , Militares , Remodelação Ventricular , Adulto , Eletrocardiografia , Humanos , Masculino , Estudos Retrospectivos
10.
Artigo em Inglês | MEDLINE | ID: mdl-30499423

RESUMO

AIM: The study was conducted in order to examine the sex-specific association of serum uric acid (SUA) levels with elevated serum alanine aminotransferase (ALT) in a Taiwanese military cohort. METHODS: We made a cross-sectional examination of the sex-specific relationship using 6728 men and 766 women, aged 18-50 years from a large military cohort in Taiwan. SUA levels within the reference range (<7.0 mg/dL for men and <5.7 mg/dL for women respectively) were divided into quartiles and SUA levels greater than the upper reference limits were defined as hyperuricemia. Elevated ALT levels were defined as ≥40 U/L. Multivariate logistic regression analysis was performed to determine the association between each SUA category and elevated ALT levels in men and women, respectively. RESULTS: The prevalence of hyperuricemia and elevated ALT in men were 18.7% and 12.7%, respectively, and in women were 3.3% and 2.1%, respectively. As compared with the lowest SUA quartile, hyperuricemia was associated with elevated ALT in men (odds ratios (OR): 1.62, 95% confidence intervals (CI): 1.19-2.20) after controlling for age, service specialty, body mass index, metabolic syndrome components, current cigarette smoking, alcohol intake status, and weekly exercise times, but the associations for the other SUA quartiles were null. By contrast, the associations of hyperuricemia (OR: 0.81, 95% CI: 0.10-6.64) and the other SUA quartiles with elevated ALT were null in women. CONCLUSION: Our findings suggest that the relationship between each SUA level and elevated ALT may differ by sex among military young adults. The mechanism for the sex difference requires further investigations.


Assuntos
Alanina Transaminase/sangue , Aptidão Cardiorrespiratória/fisiologia , Militares , Caracteres Sexuais , Ácido Úrico/sangue , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
11.
J Am Soc Hypertens ; 12(12): 841-849, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30396853

RESUMO

The study aimed to examine the association between objective estimates of sleep duration and quality and aortic stiffness while accounting for the potential confounding effect of sleep-disordered breathing. Participants were part of the Multi-Ethnic Study of Atherosclerosis Sleep study. Sleep duration and quality were assessed by 7-day wrist actigraphy, sleep-disordered breathing by home polysomnography, and aortic stiffness by magnetic resonance imaging-based aortic pulse wave velocity (aPWV), ascending and descending aorta distensibility. Aortic stiffness of participants with "normal" sleep duration (6-8 hours) were compared with those of "short" (<6 hours) and "long" sleep duration (>8 hours) adjusting for common cardiovascular risk factors and apnea-hypopnea index. The sample consisted of 908 participants (mean age 68.4 ± 9.1 years, 55.3% female). There was a significant linear trend of increased aPWV across short (n = 252), normal (n = 552), and long sleep durations (n = 104) (P for trend = .008). Multivariable analysis showed that people with short sleep duration had 0.94 m/s lower aPWV (95% CI: -1.54, -0.35), compared with those with normal sleep duration. In this ethnically diverse community cohort, habitual short sleep duration as estimated by actigraphy was associated with lower aortic stiffness.

12.
Indian Heart J ; 70(5): 604-607, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30392495

RESUMO

PURPOSE: To investigate the association of preexisting hypertension at admission with the mortality in patients with systolic heart failure (HF). METHOD: We prospectively investigated the association of preexisting hypertension with the mortality among 1351 patients with HF in Taiwan during an average 12 months (range: 8 months-18 months) follow-up period. A multivariate cox regression analysis for the overall cohort and a subgroup analysis by age were performed. RESULTS: After adjustment for all potential risk factors, the associations of preexisting hypertension with cardiovascular mortality were significantly reduced in the overall cohort and those aged less than 65 years (hazard ratios (HR): 0.53, 95% confidence intervals (CI): 0.33-0.84, and 0.28, 95% CI: 0.11-0.67, respectively). However, the associations with all-cause mortality were not significantly different in these two groups (HR: 0.77, 95% CI: 0.54-1.09, and 0.59, 95% CI: 0.32-1.07, respectively). Furthermore, the associations were all nonsignificant in the patients aged older than 65 years. CONCLUSION: Preexisting hypertension have an inverse association with cardiovascular mortality in the Asian patients with systolic HF, particularly for those with younger ages.


Assuntos
Pressão Sanguínea/fisiologia , Insuficiência Cardíaca Sistólica/epidemiologia , Ventrículos do Coração/fisiopatologia , Hipertensão/epidemiologia , Sistema de Registros , Medição de Risco , Idoso , Causas de Morte/tendências , Feminino , Seguimentos , Insuficiência Cardíaca Sistólica/complicações , Insuficiência Cardíaca Sistólica/fisiopatologia , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Prognóstico , Estudos Prospectivos , Volume Sistólico/fisiologia , Taxa de Sobrevida/tendências , Taiwan/epidemiologia
13.
J Ophthalmol ; 2018: 2159702, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30275989

RESUMO

Entropy images, representing the complexity of original fundus photographs, may strengthen the contrast between diabetic retinopathy (DR) lesions and unaffected areas. The aim of this study is to compare the detection performance for severe DR between original fundus photographs and entropy images by deep learning. A sample of 21,123 interpretable fundus photographs obtained from a publicly available data set was expanded to 33,000 images by rotating and flipping. All photographs were transformed into entropy images using block size 9 and downsized to a standard resolution of 100 × 100 pixels. The stages of DR are classified into 5 grades based on the International Clinical Diabetic Retinopathy Disease Severity Scale: Grade 0 (no DR), Grade 1 (mild nonproliferative DR), Grade 2 (moderate nonproliferative DR), Grade 3 (severe nonproliferative DR), and Grade 4 (proliferative DR). Of these 33,000 photographs, 30,000 images were randomly selected as the training set, and the remaining 3,000 images were used as the testing set. Both the original fundus photographs and the entropy images were used as the inputs of convolutional neural network (CNN), and the results of detecting referable DR (Grades 2-4) as the outputs from the two data sets were compared. The detection accuracy, sensitivity, and specificity of using the original fundus photographs data set were 81.80%, 68.36%, 89.87%, respectively, for the entropy images data set, and the figures significantly increased to 86.10%, 73.24%, and 93.81%, respectively (all p values <0.001). The entropy image quantifies the amount of information in the fundus photograph and efficiently accelerates the generating of feature maps in the CNN. The research results draw the conclusion that transformed entropy imaging of fundus photographs can increase the machinery detection accuracy, sensitivity, and specificity of referable DR for the deep learning-based system.

14.
World J Clin Cases ; 6(8): 200-206, 2018 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-30148148

RESUMO

AIM: To examine the accuracy of machine learning to relate particulate matter (PM) 2.5 and PM10 concentrations to upper respiratory tract infections (URIs). METHODS: Daily nationwide and regional outdoor PM2.5 and PM10 concentrations collected over 30 consecutive days obtained from the Taiwan Environment Protection Administration were the inputs for machine learning, using multilayer perceptron (MLP), to relate to the subsequent one-week outpatient visits for URIs. The URI data were obtained from the Centers for Disease Control datasets in Taiwan between 2009 and 2016. The testing used the middle month dataset of each season (January, April, July and October), and the training used the other months' datasets. The weekly URI cases were classified by tertile as high, moderate, and low volumes. RESULTS: Both PM concentrations and URI cases peak in winter and spring. In the nationwide data analysis, MLP machine learning can accurately relate the URI volumes of the elderly (89.05% and 88.32%, respectively) and the overall population (81.75% and 83.21%, respectively) with the PM2.5 and PM10 concentrations. In the regional data analyses, greater accuracy is found for PM2.5 than for PM10 for the elderly, particularly in the Central region (78.10% and 74.45%, respectively), whereas greater accuracy is found for PM10 than for PM2.5 for the overall population, particularly in the Northern region (73.19% and 63.04%, respectively). CONCLUSION: Short-term PM2.5 and PM10 concentrations were accurately related to the subsequent occurrence of URIs by using machine learning. Our findings suggested that the effects of PM2.5 and PM10 on URI may differ by age, and the mechanism needs further evaluation.

15.
Artigo em Inglês | MEDLINE | ID: mdl-29562671

RESUMO

The association of metabolic syndrome (MetS) components with elevated serum alanine aminotransferase (ALT) levels, a marker of hepatic injury, may differ between men and women. However, the sex-specific association in a military young population which has a low prevalence of MetS was unclear. We conducted a cross-sectional examination in 6738 men and 766 women, aged 18-50 years, from the cardiorespiratory fitness study in armed forces (CHIEF) in eastern Taiwan. The components of MetS were defined according to the updated International Diabetes Federation (IDF) ethnic criteria for Asians. Elevated ALT levels were defined as ≥40 U/L for both sexes and ≥30 U/L for women alternatively. Multivariate logistic regression analysis was performed to determine the sex-specific association between MetS components and elevated ALT. The prevalence of MetS and elevated ALT in men were 11.9% and 12.7% respectively, and in women were 3.5%, and 3.8% respectively. In men, high-density lipoprotein < 40 mg/dL, blood pressures ≥ 130/85 mmHg, serum triglycerides ≥ 150 mg/dL, and waist size ≥ 90 cm were associated with elevated ALT (odds ratios (OR) and 95% confidence intervals: 1.59 (1.34-1.90), 1.40 (1.19-1.65), 2.00 (1.68-2.39), and 1.68 (1.38-2.04); all p < 0.001); whereas in women, only fasting plasma glucose ≥ 100 mg/dL was associated with elevated ALT ≥ 40 U/L (OR: 7.59 (2.35-24.51), p = 0.001) and ALT ≥ 30 U/L (2.67 (0.89-7.95), p = 0.08). Our findings suggest that the relationship between metabolic abnormalities and elevated ALT may differ by sex, possibly due to the MetS more prevalent in young adult men than in women.


Assuntos
Alanina Transaminase/sangue , Síndrome Metabólica/sangue , Militares , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático , Biomarcadores/sangue , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Caracteres Sexuais , Taiwan/epidemiologia , Adulto Jovem
16.
Sleep Med Rev ; 39: 134-142, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29029984

RESUMO

Sleep apnea (SA) is a common sleep disorder increasingly recognized as a risk for cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. An increasing number of investigations in recent years have linked SA to AF. In this review, we aim to provide a critical overview of the existing evidence in a question and answer format by addressing the following: What is the prevalent association between the two conditions (separating nocturnally detected AF episodes from AF as a prevalent condition)? Is SA a risk factor for incident AF? Is SA a risk factor for recurrence of AF following cardioversion/catheter-based ablation? What is the association between SA and AF in patients with heart failure? Are there signature electrocardiographic markers of AF found in patients with SA? Are there electrophysiology-based studies supporting the link between SA and AF? What other sleep characteristics (beyond SA) are found in patients with AF? What is the impact of SA treatment on AF? What is the effect of AF treatment on sleep? Finally, we address unsolved questions and suggest future directions to enhance our understanding of the AF-SA relationship.


Assuntos
Fibrilação Atrial/epidemiologia , Síndromes da Apneia do Sono/complicações , Sono/fisiologia , Humanos , Polissonografia , Prevalência , Recidiva , Fatores de Risco
17.
Heart ; 104(2): 135-143, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28814488

RESUMO

OBJECTIVES: Recently, the density score of coronary artery calcium (CAC) has been shown to be associated with a lower risk of cardiovascular disease (CVD) events at any level of CAC volume. Whether risk factors for CAC volume and CAC density are similar or distinct is unknown. We sought to evaluate the associations of CVD risk factors with CAC volume and CAC density scores. METHODS: Baseline measurements from 6814 participants free of clinical CVD were collected for the Multi-Ethnic Study of Atherosclerosis. Participants with detectable CAC (n=3398) were evaluated for this study. Multivariable linear regression models were used to evaluate independent associations of CVD risk factors with CAC volume and CAC density scores. RESULTS: Whereas most CVD risk factors were associated with higher CAC volume scores, many risk factors were associated with lower CAC density scores. For example, diabetes was associated with a higher natural logarithm (ln) transformed CAC volume score (standardised ß=0.44 (95% CI 0.31 to 0.58) ln-units) but a lower CAC density score (ß=-0.07 (-0.12 to -0.02) density units). Chinese, African-American and Hispanic race/ethnicity were each associated with lower ln CAC volume scores (ß=-0.62 (-0.83to -0.41), -0.52 (-0.64 to -0.39) and -0.40 (-0.55 to -0.26) ln-units, respectively) and higher CAC density scores (ß= 0.41 (0.34 to 0.47), 0.18 (0.12 to 0.23) and 0.21 (0.15 to 0.26) density units, respectively) relative to non-Hispanic White. CONCLUSIONS: In a cohort free of clinical CVD, CVD risk factors are differentially associated with CAC volume and density scores, with many CVD risk factors inversely associated with the CAC density score after controlling for the CAC volume score. These findings suggest complex associations between CVD risk factors and these components of CAC.


Assuntos
Cálcio , Doenças Cardiovasculares , Vasos Coronários , Calcificação Vascular , Idoso , Idoso de 80 Anos ou mais , Cálcio/análise , Cálcio/metabolismo , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/prevenção & controle , Estudos de Coortes , Vasos Coronários/metabolismo , Vasos Coronários/patologia , Densitometria/métodos , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos , Estados Unidos/epidemiologia , Calcificação Vascular/diagnóstico , Calcificação Vascular/etnologia , Calcificação Vascular/metabolismo
18.
Indian Heart J ; 69(6): 720-724, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29174248

RESUMO

OBJECTIVE: To investigate the 12-lead surface electrocardiographic (ECG) findings in young male patients with left primary spontaneous pneumothorax (PSP) estimated by the Collins equation. METHODS: From 2003 through 2008, 60 young male patients who had left PSP and 61 age-matched unaffected males were included for 12-lead ECG analyses. The PSP size was estimated by the Collins equation. Those with left PSP were divided into two groups: 1) large PSP ≥30% (n=37), and 2) small PSP <30% (n=23). The ECG in the unaffected was used as the normal control. Baseline demographic, anthropometric, and electrocardiographic findings including heart rate, P-QRS-T axes, wave intervals, and RS voltages were compared among three groups. RESULTS: As compared to the unaffected, patients with left PSP had faster heart rate, longer QTc interval, greater QRS and T axes. With regard to RS amplitudes, greater R in lead aVR and V1, and deeper S in lead II indicating predominant rightward forces, and smaller R in lead I and V3-V6 indicating inferior leftward forces were present in patients with left PSP. Of these ECG findings, heart rate, S voltage in lead II and R voltage in V1 in the large PSP but not in the small PSP had greater values than that in the unaffected group. CONCLUSION: Among young male patients with left PSP estimated by the Collins method, the ECG showed faster heart beat and predominant rightward forces especially for those with large PSP.


Assuntos
Eletrocardiografia/métodos , Sistema de Condução Cardíaco/fisiopatologia , Pneumotórax/fisiopatologia , Estudos de Casos e Controles , Seguimentos , Frequência Cardíaca , Humanos , Masculino , Pneumotórax/diagnóstico , Radiografia Torácica , Estudos Retrospectivos , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-28883882

RESUMO

Using four-channel photoplethysmography (PPG) for acquiring peripheral arterial waveforms, this study investigated vascular and autonomic impacts of combined acupuncture-far infrared radiation (FIR) in improving peripheral circulation. Twenty healthy young adults aged 25.5 ± 4.6 were enrolled for 30-minute measurement. Each subject underwent four treatment strategies, including acupuncture at ST36 (Zusanli), pseudoacupuncture, FIR, and combined acupuncture-FIR at different time points. Response was assessed at 5-minute intervals. Area under arterial waveform at baseline was defined as AreaBaseline, whereas AreaStim referred to area at each 5-minute substage during and after treatment. AreaStim/AreaBaseline was compared at different stages and among different strategies. Autonomic activity at different stages was assessed using low-to-high frequency power ratio (LHR). The results demonstrated increased perfusion for each therapeutic strategy from stage 1 to stage 2 (all p < 0.02). Elevated perfusion was noted for all treatment strategies at stage 3 compared to stage 1 except pseudoacupuncture. Increased LHR was noted only in subjects undergoing pseudoacupuncture at stage 3 compared to stage 1 (p = 0.045). Reduced LHR at stage 2 compared to stage 1 was found only in combined treatment group (p = 0.041). In conclusion, the results support clinical benefits of combined acupuncture-FIR treatment in enhancing peripheral perfusion and parasympathetic activity.

20.
World J Gastroenterol ; 23(25): 4587-4594, 2017 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-28740347

RESUMO

AIM: To investigate the association of chronic hepatitis B and nonalcoholic steatohepatitis with physical fitness in a Taiwanese military male cohort. METHODS: We made a cross-sectional examination of this association using 3669 young adult military males according to cardiorespiratory fitness and hospitalization events recorded in the Taiwan Armed Forces study. Cases of chronic hepatitis B (n = 121) were defined by personal history and positive detection of hepatitis B surface antigen. Cases of nonalcoholic steatohepatitis (n = 129) were defined by alanine transaminase level > 60 U/L, liver ultrasound finding of steatosis, and absence of viral hepatitis A, B or C infection. All other study participants were defined as unaffected (n = 3419). Physical fitness was evaluated by performance in 3000-m run, 2-min sit-ups, and 2-min push-ups exercises, with all the procedures standardized by a computerized scoring system. Multiple linear regression analysis was used to determine the relationship. RESULTS: Chronic hepatitis B negatively correlated with 2-min push-up numbers (ß = -2.49, P = 0.019) after adjusting for age, service specialty, body mass index, systolic and diastolic blood pressures, current cigarette smoking, alcohol intake status, serum hemoglobin, and average weekly exercise times. Nonalcoholic steatohepatitis was borderline positively correlated with 3000-m running time (ß = 11.96, P = 0.084) and negatively correlated with 2-min sit-up numbers (ß = -1.47, P = 0.040). CONCLUSION: Chronic hepatitis B viral infection and nonalcoholic steatohepatitis affects different physical performances in young adult military males, and future study should determine the underlying mechanism.


Assuntos
Vírus da Hepatite B/imunologia , Hepatite B Crônica/fisiopatologia , Militares/estatística & dados numéricos , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Aptidão Física/fisiologia , Adulto , Alanina Transaminase/sangue , Índice de Massa Corporal , Estudos Transversais , Exercício Físico , Hepacivirus/isolamento & purificação , Vírus da Hepatite A Humana/isolamento & purificação , Antígenos de Superfície da Hepatite B/isolamento & purificação , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/virologia , Humanos , Fígado/patologia , Masculino , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Prevalência , Estudos Retrospectivos , Taiwan/epidemiologia , Ultrassonografia , Adulto Jovem
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