The Change in Metabolic Syndrome Status and the Risk of Nonviral Liver Cirrhosis

Background: Nonalcoholic fatty liver disease is considered to be the hepatic component of metabolic syndrome (MetS). However, the association between changes in MetS status and the risk of liver cirrhosis (LC) has not been investigated to date. This study assessed the association between changes in MetS and subsequent nonviral LC development. Methods: Data were obtained from the Korean National Health Insurance Service. Individuals who participated in health screenings from both 2009 to 2010 and 2011 to 2012 were included. The primary outcome was LC development according to the static and dynamic MetS status. Subjects were stratified into four groups according to the change in MetS status observed from the two-year interval screening (2009–2011). Cox regression analysis was used to examine the hazard ratios of LC. Results: During a median of 7.3 years of follow-up, 24,923 incident LC cases developed among 5,975,308 individuals. After adjusting for age, sex, smoking, alcohol, regular exercise, and body mass index, the adjusted hazard ratios (95% confidence intervals) for LC development were 1.39 (1.33–1.44) for the MetS-Developed group, 1.32 (1.26–1.37) for the MetS-Recovered group, and 1.51 (1.45–1.56) for the MetS-Sustained group, relative to the MetS-Free group. Stratified analyses according to age, sex, smoking, alcohol intake, exercise, diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease showed similar results. Conclusions: Both static and dynamic MetS status are independent risk factors for LC development. The risk of LC was the highest in people with sustained MetS and was lower in the MetS-Recovered group than in the MetS-Sustained group. These results suggest that improving a person’s MetS status may be helpful in preventing LC.

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Impact of Metabolic Syndrome on the Development of Cardiovascular Disease among Kazakhs in Remote Rural Areas of Xinjiang, China: A Cohort Study

10.21203/rs.3.rs-34700/v1 ◽

2020 ◽

Author(s):

Wenwen Yang ◽

Shuxia Guo ◽

Haixia Wang ◽

Yu Li ◽

Xianghui Zhang ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Rural Areas ◽

Cox Regression ◽

Baseline Survey ◽

Minority Populations ◽

Cox Regression Analysis ◽

Independent Risk Factors

Abstract Background: Metabolic syndrome (MS) could promote the development of cardiovascular disease(CVD). The aim of this study was to examine the association of MS and its components with CVD among Kazakhs in Xinjiang. Methods: According to the geographical distribution of the minority populations in Xinjiang, we selected the representative prefecture (Yili). A total of 2,644 participants completed the baseline survey between April 2010 and December 2012. The follow-up survey was conducted from April 2016 to December 2016. Only 2,286 out of 2,644 participants were followed-up on, with a follow-up rate of 86.46%. Cox regression was used to evaluate the association of each component and the number of combinations of MS components on the development of CVD. Results: Multivariate Cox regression analysis showed that blood pressure (BP), waist circumference (WC), and triglycerides (TG) were independently associated with CVD. Participants with 1–5 MS components had an increased hazard ratio for developing CVD, from 1.82 to 8.59 (trend P<0.001), compared with those without any MS components. This trend persisted after adjusting for other general risk factors. The risk of developing CVD increased when TG and WC coexisted, or when TG/WC and BP coexisted. However, no significant interactions were found between BP , WC , and TG. Conclusions: BP , WC, and TG were independent risk factors for CVD in Kazakhs. In clinical practice, a more informative assessment may be obtained by taking into account the number of MS components.

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The Importance of Metabolic Syndrome Status for the Risk of Non-Viral Hepatocellular Carcinoma: A Nationwide Population-Based Study

10.21203/rs.3.rs-1072970/v1 ◽

2021 ◽

Author(s):

Yuri Cho ◽

Eun Ju Cho ◽

Jeong-Ju Yoo ◽

Young Chang ◽

Goh Eun Chung ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Metabolic Syndrome ◽

Cox Regression ◽

Positive Association ◽

Population Based ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

Development Data ◽

Baseline Status ◽

Korean National Health Insurance

Abstract The positive association between metabolic syndrome (MetS) and hepatocellular carcinoma (HCC) has been suggested. However, no studies have yet looked at how the risk of developing HCC varies with changes in MetS status. Therefore, we aimed to investigate the association between changes in MetS and subsequent HCC development. Data were obtained from the Korean National Health Insurance Service. 5,975,308 individuals who participated in health screenings both in 2009–2010 and 2011–2012 were included. Subjects were divided into four groups according to change in MetS status during the two-year interval screening (from 2009 to 2011): sustained non-MetS, transition to MetS, transition to non-MetS, and sustained MetS. Cox regression analysis was used to examine the hazard ratios of HCC. During a median of 7.3 years follow-up, 25,880 incident HCCs were identified. Compared to the sustained non-MetS group, age, sex, smoking, alcohol, regular exercise, and body mass index-adjusted hazard ratios (95% confidence interval) for HCC development were 1.01 (0.97–1.05) for the transition to MetS group; 1.05 (1.003–1.09) for the transition to non-Met group; and 1.07 (1.03–1.10) for the sustained MetS group. Stratified analyses according to age, sex, smoking, alcohol intake, exercise, diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease showed similar results. A significantly increased HCC risk was observed in the sustained MetS and transition to non-MetS groups. The baseline status of MetS was associated with the risk of HCC development. Strategies to improve MetS, especially targeting insulin resistance might prevent HCC development.

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Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽

10.1177/0333102413513181 ◽

2013 ◽

Vol 34 (5) ◽

pp. 327-335 ◽

Cited By ~ 22

Author(s):

Knut Hagen ◽

Eystein Stordal ◽

Mattias Linde ◽

Timothy J Steiner ◽

John-Anker Zwart ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Cox Regression ◽

Subsequent Development ◽

Population Based ◽

Health Study ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

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Mortality in Patients with Diabetic Foot Ulcers: Causes, Risk Factors, and Their Association with Evolution and Severity of Ulcer

Journal of Clinical Medicine ◽

10.3390/jcm9093009 ◽

2020 ◽

Vol 9 (9) ◽

pp. 3009

Author(s):

José Antonio Rubio ◽

Sara Jiménez ◽

José Luis Lázaro-Martínez

Keyword(s):

Diabetic Foot ◽

Cox Regression ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Hazard Ratios ◽

History Of

Background: This study reviews the mortality of patients with diabetic foot ulcers (DFU) from the first consultation with a Multidisciplinary Diabetic Foot Team (MDFT) and analyzes the main cause of death, as well as the relevant clinical factors associated with survival. Methods: Data of 338 consecutive patients referred to the MDFT center for a new DFU during the 2008–2014 period were analyzed. Follow-up: until death or until 30 April 2020, for up to 12.2 years. Results: Clinical characteristics: median age was 71 years, 92.9% had type 2 diabetes, and about 50% had micro-macrovascular complications. Ulcer characteristics: Wagner grade 1–2 (82.3%), ischemic (49.2%), and infected ulcers (56.2%). During follow-up, 201 patients died (59.5%), 110 (54.7%) due to cardiovascular disease. Kaplan—Meier curves estimated a reduction in survival of 60% with a 95% confidence interval (95% CI), (54.7–65.3) at 5 years. Cox regression analysis adjusted to a multivariate model showed the following associations with mortality, with hazard ratios (HRs) (95% CI): age, 1.07 (1.05–1.08); HbA1c value < 7% (53 mmol/mol), 1.43 (1.02–2.0); active smoking, 1.59 (1.02–2.47); ischemic heart or cerebrovascular disease, 1.55 (1.15–2.11); chronic kidney disease, 1.86 (1.37–2.53); and ulcer severity (SINBAD system) 1.12 (1.02–1.26). Conclusion: Patients with a history of DFU have high mortality. Two less known predictors of mortality were identified: HbA1c value < 7% (53 mmol/mol) and ulcer severity.

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Early and Midterm Outcome of TEVAR for Thoracic Aortic Pseudoaneurysm

10.21203/rs.3.rs-659146/v1 ◽

2021 ◽

Author(s):

Hui Wang ◽

Tun Wang ◽

Hao He ◽

Xin Li ◽

Yuan Peng ◽

...

Keyword(s):

Risk Factors ◽

Clinical Outcome ◽

Cardiac Disease ◽

Cox Regression ◽

Cox Regression Analysis ◽

Aortic Pseudoaneurysm ◽

Significant Difference ◽

Independent Risk Factors ◽

The Mean

Abstract Backgrounds: The prognosis of thoracic aortic pseudoaneurysm (TAP) after thoracic endovascular aortic repair (TEVAR) remains unclear. This study investigates the early and midterm clinical outcome as well as relevant risk factors of TAP patients following TEVAR therapy.Methods: From July 2010 to July 2020, 37 eligible TAP patients who underwent TEVAR were selected into our research. We retrospectively explored their baseline, perioperative and follow-up data. Fisher exact test and Kaplan-Meier method were applied for comparing difference between groups. Risk factors of late survival were discerned using Cox regression analysis.Results: There were 29 men and 12 women, with the mean age as 59.5±13.0 years (range, 30-82). The mean follow-up time was 30.7±28.3 months (range, 1-89). For early result, early mortality (≦30days) happened in 3(8.1%) zone 3 TAP patients versus 0 in zone 4 (p= 0.028); acute arterial embolism of lower extremity and type II endoleak respectively occurred in 1(2.7%) case. For midterm result, survival at 3 months, 1 year and 5 years was 88.8±5.3%, 75.9±7.5% and 68.3±9.9%, which showed significant difference between zone 2/3 versus zone 4 group (56.3±14.8% versus 72.9±13.2%, p= 0.013) and emergent versus elective TEVAR groups (0.0±0.0% versus 80.1±8.0%, p= 0.049). On multivariate Cox regression, lesions at zone 2/3 (HR 4.605, 95%CI 1.095-19.359), concomitant cardiac disease (HR 4.932, 95%CI 1.086-22.403) and emergent TEVAR (HR 4.196, 95%CI 1.042-16.891) were significant independent risk factors for worse late clinical outcome. Conclusions: TEVAR therapy is effective and safe with satisfactory early and midterm clinical outcome for TAP patients. Lesions at zone 2/3, concomitant cardiac disease and emergent TEVAR were independent risk factors for midterm survival outcome.

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Incidence and Risk Factors for Amputation in Patients With Diabetes in Japan: A Historical Cohort Study Using a Nationwide Claims Database

10.21203/rs.3.rs-125853/v1 ◽

2020 ◽

Author(s):

Masanori Kaneko ◽

Kazuya Fujihara ◽

Taeko Osawa ◽

Masahiko Yamamoto ◽

Mayuko Yamada Harada ◽

...

Keyword(s):

Cox Regression ◽

Historical Cohort ◽

Cox Regression Analysis ◽

Claims Database ◽

Hazard Ratios ◽

Patients With Diabetes ◽

Mortality Predictors ◽

Hba1c Levels

Abstract Background: Because amputation negatively affects the quality of life of patients with diabetes and increases the risk of cardiovascular events and mortality, predictors of amputation must be identified. However, no large cohort studies have been conducted regarding the incidence of amputation in patients with diabetes in East Asia.Methods: We analyzed data from a nationwide claims database in Japan accumulated from 2008–2016, involving 17,288 patients with diabetes aged 18–72 y (2942 women, mean age 50.2 y, HbA1c 7.2%).Results: The mean follow-up time was 5.3 years, and 16 amputations occurred (0.17/1000 person-years). Multivariate Cox regression analysis showed that age and HbA1c levels were independent predictors of amputation (hazard ratios [HRs], 1.09 and 1.43; 95% confidence intervals [CIs], 1.01–1.16 and 1.12–1.82, respectively). Compared with patients aged <60 y and with HbA1c <8%, the HR for patients aged ≥60 y and with HbA1c ≥8% was 32.1 (95% CI, 7.30–141.2).Conclusions: Improved glycemic control may lower amputation risk.

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AST/ALT ratio as a predictor of mortality and future exacerbations of PM/DM-ILD——a retrospective cohort study with 522 cases

10.21203/rs.3.rs-25060/v1 ◽

2020 ◽

Author(s):

Renjiao Li ◽

Wen-Jun Zhu ◽

Faping Wang ◽

Xiaoju Tang ◽

Fengming Luo

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Low Cost ◽

Cox Regression Analysis ◽

Neutrophil Lymphocyte Ratio ◽

Hazard Ratios

Abstract ObjectiveTo assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with Polymyositis/dermatomyositis associated interstitial lung disease (PM/DM-ILD).Patients and MethodsThis was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008 to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73 and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides or low density lipoprotein.ResultsHigher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up.ConclusionHigher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.

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Preoperative prealbumin-to-fibrinogen ratio predict Survival Outcomes in hepatocellular carcinoma patients after hepatic resection

Journal of Medical Biochemistry ◽

10.5937/jomb0-32980 ◽

2021 ◽

Author(s):

Yan Haixi ◽

Chen Shuaishuai ◽

Yang Qiong ◽

Cai Linling

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Cox Regression ◽

Laboratory Data ◽

Disease Free Survival ◽

Factors Affecting ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

Clinicopathologic Factors ◽

Independent Risk Factors

Objective: This study aims to evaluate the clinical application of preoperative prealbumin-to-fibrinogen ratio (PFR) in the clinical diagnosis and prognostic value of hepatocellular carcinoma (HCC) patients. Methods: The clinical and laboratory data of 269 HCC patients undergoing surgical treatment from January 2012 to January 2017 in Taizhou Hospital were retrospectively analyzed. The Cox regression model was used to analyze the correlation between PFR and other clinicopathologic factors in overall survival (OS) and disease-free survival (DFS). Results: Cox regression analysis showed that PFR (hazard ratios [HR] = 2.123; 95% confidence interval [95% CI], 1.271–3.547; P = 0.004)was independent risk factors affecting the OS of HCC patients. Furthermore, a nomogram was built based on these risk factors. The C indices statistics for the OS nomogram was 0.715. Conclusion: Nomograms based on PFR can be recommended as the correct and actual model to evaluate prognosis for patients with HCC.

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Abstract MP015: Resistance Exercise and Incident Metabolic Syndrome in Men

Circulation ◽

10.1161/circ.125.suppl_10.amp015 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Duck-chul Lee ◽

Xuemei Sui ◽

Enrique G. Artero ◽

Steven N. Blair

Keyword(s):

Metabolic Syndrome ◽

Resistance Exercise ◽

Aerobic Exercise ◽

Cox Regression ◽

Density Lipoprotein ◽

Physical Activity Guidelines ◽

Cox Regression Analysis ◽

Muscle Strengthening ◽

Diagnosed Diabetes

Introduction: There is little evidence on the association between resistance exercise and incident metabolic syndrome. Hypothesis: We examined the hypothesis that resistance exercise reduces the risk of developing metabolic syndrome in men. Methods: Participants were 6,098 men aged 18 to 83 years (mean age, 46) who received an extensive preventive medical examination during 1987–2006, and were free of cardiovascular disease, cancer, and metabolic syndrome at baseline. Resistance exercise was assessed by self-reported muscle strengthening activities using either free weights or weight training machines. We used the frequency of resistance exercise (0, 1, 2, 3, 4, and ≥5 days/week) as our main exposure categories. Metabolic syndrome was defined as the presence of ≥3 of the following criteria: waist circumference >102 cm, triglycerides ≥150 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, systolic/diastolic blood pressure ≥130/85 mm Hg or physician-diagnosed hypertension, and fasting glucose ≥100 mg/dL or physician-diagnosed diabetes according to the National Cholesterol Education Program Adult Treatment Panel III. Follow-up was calculated from the baseline examination to the first event of metabolic syndrome or the last examination through 2006. Cox regression analysis was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of incident metabolic syndrome across resistance exercise. Age, examination year, body mass index, current smoking, heavy alcohol drinking (>14 drinks/week), abnormal electrocardiography, and aerobic exercise (inactive, low, medium, and high) were included in the multivariate regression model. Results: During the 5-year mean follow-up, 1,088 men developed metabolic syndrome. About 62% of men did not participate in resistance exercise, 3% of men participated in 1 day/week of resistance exercise, and 35% of men met the Physical Activity Guidelines for resistance exercise (≥2 days/week). Resistance exercise was inversely associated with incident metabolic syndrome after adjusting for possible confounders including aerobic exercise (trend P <0.01). Compared with no resistance exercise, the HRs (95% CIs) of developing metabolic syndrome were 0.83 (0.55–1.26), 0.88 (0.70–1.11), 0.85 (0.72–1.02), 0.62 (0.43–0.88), and 0.74 (0.51–1.07) for 1, 2, 3, 4, and ≥5 days/week of resistance exercise, respectively. Men meeting the recommended resistance exercise (≥2 days/week) had 18% lower risk of developing metabolic syndrome (HR=0.82, 95% CI=0.71–0.94) compared with men not meeting the recommendation (0 or 1 day/week of resistance exercise). Conclusions: Participating in resistance exercise may reduce the risk of developing metabolic syndrome in adult men.

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Prognostic Role and Significance of Paraneoplastic Syndromes in Hepatocellular Carcinoma

The American Surgeon ◽

10.1177/000313481408000230 ◽

2014 ◽

Vol 80 (2) ◽

pp. 191-196 ◽

Cited By ~ 3

Author(s):

Qiang Qu ◽

Shaobin Wang ◽

Shuguang Chen ◽

Li Zhou ◽

Jing-An Rui

Keyword(s):

Hepatocellular Carcinoma ◽

Cox Regression ◽

Clinical Course ◽

Survival Rates ◽

Paraneoplastic Syndromes ◽

Large Tumor ◽

Cox Regression Analysis ◽

Independent Risk Factors

Patients with hepatocellular carcinoma (HCC) may develop paraneoplastic syndromes in the clinical course. These syndromes include hypercholesterolemia, hypoglycemia, hypercalcemia, and erythrocytosis, among others. This study was designed to assess the role of prognostic influence of paraneoplastic syndromes in patients with HCC. In a cohort of 175 patients with HCC patients, we compared the clinical features of patients with HCC with or without paraneoplastic syndromes. In addition, survival rates of patients with individual paraneoplastic syndromes and those without were also evaluated. Moreover, factors independently predicting prognosis among patients with HCC with or without paraneoplastic syndromes were analyzed. Among 175 patients with HCC, 54 patients presented paraneoplastic syndromes, and the prevalence was 30.9 per cent. There was no difference of clinical characteristics between patients with HCC with and without paraneoplastic syndromes on diagnosis. However, the patients with paraneoplastic syndromes had a significantly less survival rate comparing with those without during a 5-year follow-up. Cox regression analysis demonstrated that high Child-Pugh grade, large tumor size, portal vein tumor thrombosis, and distant metastasis were all independent unfavorable prognostic factors for survival of patients with HCC. Paraneoplastic syndromes as independent risk factors play a significant role in the progress of HCC and lead to poor prognosis in patients with HCC.

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