scholarly journals Individual and Combined Effect of Famine Exposure and Obesity Parameters on Dyslipidemia in Mid-Aged and Older Adult: A Population-Based Cross-Sectional Study

Author(s):  
Lin Zhang ◽  
Liu Yang ◽  
Congzhi Wang ◽  
Ting Yuan ◽  
Dongmei Zhang ◽  
...  

Abstract Background: Undernutrition in early life may have a lifelong effect on adult health. The associations between undernutrition and obesity parameters and dyslipidemia were inconsistent. The present study aimed to investigate the individual and combined effects of famine exposure and obesity parameters on dyslipidemia in middle-aged and older Chinese.Method: Data were selected from the China Health and Retirement Longitudinal Study Wave2011. The analytic sample included 9427 subjects aged 45 to 90. The present study analyzed data from 9427 middle-aged and older Chinese selected from the China Health and Retirement Longitudinal Study (CHARLS Wave2011). Differences between baseline characteristics and famine exposure/BMI levels/WC levels were evaluated using the Chi-square test, t-test, and F-test. Then, the difference in the prevalence of dyslipidemia between characteristic groups was also estimated by the Chi-square and t-test. Finally, multivariable-adjusted logistic regression models examined associations of famine exposure and obesity parameters with odds of prevalence of dyslipidemia.Results: Among the 9427 participants, 1097(11.64%) participants had been exposed to the Chinese famine during the fetal stage, whereas 3763(39.92%) participants and 3251(34.49%) participants had been exposed to the famine during childhood and adolescence/adult stage, respectively. Regarding the participants with BMI measurements,2771(29.39%) were overweight and 1105(11.72%) were obese, whereas 3955(41.95%) of the participants with WC measurements were obese, respectively. Furthermore, 1899(43.23%) reported having dyslipidemia in males and 1860(36.95%) in females. In multivariable-adjusted model, famine exposure and obesity parameters were associated with prevalence of dyslipidemia independently in total populations[(1) Model three c, famine exposure with prevalence of dyslipidemia: the fatal exposed vs no exposed group, 1.32 (95% CI 1.12, 1.56); childhood-exposed vs no exposed group, 1.49 (95% CI 1.30, 1.70); the adolescence/adult-exposed vs no exposed group, 1.49 (95%CI 1.30, 1.71) ; P for trend=0.000; (2) Model three e, famine exposure with prevalence of dyslipidemia: the fatal exposed vs no exposed group, 1.29 (95% CI 1 .09, 1.52); childhood-exposed vs no exposed group, 1.39 (95% CI 1.22, 1.59); the adolescence/adult-exposed vs no exposed group, 1.27 (95%CI 1.11, 1.46) ; P for trend=0.002; (3) Model three g, BMI levels with prevalence of dyslipidemia: overweight vs normal, 2.06 (95%CI 1.86, 2.27); obesity vs normal, 2.82(95% CI 2.42, 3.27); P for trend=0.000; (4) WC levels with prevalence of dyslipidemia: overweight vs normal, 2.24 (95% CI 2.05, 2.45)]. When stratified by sex, the results in females were mostly similar to those in the total population. In a multivariable logistic regression model three c, associations between famine exposure and dyslipidemia were not observed [fatal exposed group vs non-exposed group: 0.98 (95% CI 0.75, 1.28); childhood-exposed group vs non-exposed group: 0.96 (95% CI 0.78, 1.19); adolescence/adult exposed group vs non-exposed group: 0.86 (95% CI 0.69, 1.07)] independently of BMI only (P for trend =0.110). However, in a multivariable logistic regression model three e, associations between famine exposure and dyslipidemia in male were partly observed [fatal exposed group vs non-exposed group: 0.97 (95% CI 0.74, 1.26); childhood-exposed group vs non-exposed group: 0.91 (95% CI 0.74, 1.13); adolescence/adult exposed group vs non-exposed group: 0.73 (95% CI 0.59, 0.91)] independently of BMI only (P for trend =0.001). In general, the significant synergism between famine exposure and obesity parameters in lowering the prevalence of dyslipidemia was observed in males while the significant synergism in increasing prevalence of dyslipidemia was observed in females (P-interaction =0.000).Conclusion: Individual and combined associations of obesity parameters and famine exposure with the prevalence of dyslipidemia were observed in middle-aged and elderly Chinese.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S448-S448
Author(s):  
Alison L Blackman ◽  
Sabeen Ali ◽  
Xin Gao ◽  
Rosina Mesumbe ◽  
Carly Cheng ◽  
...  

Abstract Background The use of intraoperative topical vancomycin (VAN) is a strategy aimed to prevent surgical site infections (SSI). Although there is evidence to support its efficacy in SSI prevention following orthopedic spine surgeries, data describing its safety, specifically acute kidney injury (AKI) risk, is limited. The purpose of this study was to determine the AKI incidence associated with intraoperative topical VAN. Methods This is a retrospective cohort study reviewing patient encounters where intraoperative topical VAN was administered from February 2018 to July 2018. All adult patients ( ≥18 years) that received topical VAN in the form of powder, beads, rods, paste, cement spacers, or unspecified topical routes were included. Patient encounters were excluded for AKI or renal replacement therapy (RRT) at baseline, ≤ 2 serum creatinine values drawn after surgery, and/or if irrigation was the only topical formulation given. The primary outcome was the percentage of patients who developed AKI after intraoperative topical VAN administration. AKI was defined as an increase in serum creatinine (SCr) ≥50% from baseline, an increase in SCr >0.5 from baseline, or0 if RRT was initiated after topical VAN was given. Secondary outcomes included analysis of AKI risk factors and SSI incidence. AKI risk factors were analyzed using a multivariable logistic regression model. Results A total of 589 patient encounters met study criteria. VAN powder was the most common formulation (40.9%), followed by unspecified topical routes (30.7%) and beads (9.9%%). Nonspinal orthopedic surgeries were the most common procedure performed 46.7%. The incidence of AKI was 8.7%. In a multivariable logistic regression model, AKI was associated with concomitant systemic VAN (OR 3.39, [3.39–6.22]) and total topical VAN dose. Each doubling of the topical dose was associated with increased odds of developing AKI (OR = 1.42, [1.08–1.86]). The incidence of SSI was 5.3%. Conclusion AKI rates associated with intraoperative topical VAN are comparable to that of systemic VAN. Total topical vancomycin dose and concomitant systemic VAN was associated with an increased AKI risk. Additional analysis is warranted to compare these patients to a similar population that did not receive topical VAN. Disclosures All authors: No reported disclosures.


Author(s):  
Hilary I Okagbue ◽  
Sheila A Bishop ◽  
Anjoreoluwa E Boluwajoko ◽  
Adaeze M Ezenkwe ◽  
Glory N Anene ◽  
...  

<p class="0abstract">Effective study plan is a predictor of good academic performance. However, there are few evidences available on the role of gender and age in the study plan for students. This paper investigated the role of gender and age in the adoption of study plan that can guarantee success. A questionnaire was designed and administered to undergraduate students of a world class privately funded university located in Ogun State, Nigeria. Simple random sampling was used and 294 students responded. Chi-square test of independence revealed that gender and age are not associated with frequency of study, study environment, study content preferences and study motivation. There is no Gender difference in the preference of study type, factors that drive, motivation for study and satisfaction with the study plan whereas, age is significantly associated. The logistic regression model was significant and correctly classified 66.3% of satisfaction with the study plan. Gender was not significant and age of students can predict their satisfaction with their study plan. Older students have more odds to be satisfied with their study plan. As students progressed from year one to the final year, they tend to adopt a study plan that can help them obtain high grades and graduate with good result. Artificial Neural Network correctly classified 71.4% of satisfaction using only age as the only factor because, only age contributed significantly to the logistic regression model. Timely academic advising or mentorship is advocated especially for freshers.</p>


Author(s):  
Takashi Kunihara ◽  
Claudia Vukic ◽  
Fumihiro Sata ◽  
Hans-Jaochim Schäfers

Abstract Background Surgical thoracoabdominal aortic aneurysm (TAAA) repair remains challenging. Apart from mortality, spinal cord injury (SCI) is a dreaded complication. We analyzed our experience to identify predictors for SCI in a nonhigh-volume institution. Patients and Methods All patients who underwent TAAA repair between February 1996 and November 2016 (n = 182) were enrolled. Most were male (n = 121; 66.4%), median age was 68 years (range: 21–84). Elective operations were performed in 153 instances (84.1%). Our approach to minimize SCI includes distal aortic perfusion, mild hypothermia, identification of the Adamkiewicz artery, and sequential aortic clamping. Cerebrospinal fluid drainage was introduced in 2001 and liberal use of selective visceral perfusion in 2006. Results Early mortality was 12.1%; it was 8.5% after elective procedures. Reduced left ventricular function, nonelective setting, older age, and longer bypass time were identified as independent predictors for mortality in multivariable logistic regression model. Permanent SCI was observed in nine patients (4.9%), of whom seven (3.8%) developed paraplegia. In a multivariable logistic regression model for paraplegia, peripheral arterial disease (PAD), Crawford type II repair, smaller body surface area, and era before 2001 were identified as independent predictors, whereas only PAD was significant for SCI. The incidence of paraplegia was 13.8% in extensive repair out of the first 91 cases, whereas it was improved up to 2.7% thereafter. Conclusion Using an integrated approach, acceptable outcome of TAAA repair can be achieved, even in a nonhigh-volume center. PAD and extensive involvement of the aorta are strong independent predictors for spinal cord deficit after TAAA repair.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 572-572
Author(s):  
Nour Abuhadra ◽  
Kenneth R. Hess ◽  
Jennifer Keating Litton ◽  
Gaiane M Rauch ◽  
Alastair Mark Thompson ◽  
...  

572 Background: Increased TIL in TNBC is associated with higher rates of pCR. High TIL is also associated with improved disease free survival and overall survival. The aim of this study is to identify data cut-points of pre-treatment low, moderate and high TIL count based on pCR and to identify clinical and pathological predictors of pCR in patients with moderate TIL. Methods: We evaluated the relationship between pCR and TIL in 180 patients with stage I-III TNBC enrolled in the ARTEMIS trial (NCT02276443). Recursive portioning was used to identify cut-points. Clinical and pathological variables such as age at diagnosis, stage, race, histology as well as Ki-67, vimentin, and androgen receptor (AR) by immunohistochemistry, were evaluated in pts with moderate TIL. A multivariable logistic regression model identified variables independently, significantly associated with pCR. Results: Four TIL groups were identified with pCR rates of 23%, 31%, 48% and 78% respectively (p < 0.0001) (Table A). In the two combined moderate TIL groups, 90 (97%) pts were evaluable for the multivariate model. Stage I-II disease, high Ki-67 and low AR were associated with increased probability of pCR (Table B). The multivariable logistic regression model area under the ROC curve was 0.78 (95% CI=0.68-0.88; p<0.0001). A model of computed risk score [ Stage I-II (score 2)+Ki-67≥ 50% (score 1)+AR<10% (score 1)] predicted a probability of 67% for pCR when all three variables were favorable (Table). Conclusions: Four TIL groups were identified. In pts with moderate TIL levels, early stage disease, high Ki-67 and low AR were associated with increased probability of pCR with neoadjuvant therapy. [Table: see text]


2017 ◽  
Vol 29 (9) ◽  
pp. 1535-1541 ◽  
Author(s):  
Shih-Wei Lai ◽  
Cheng-Li Lin ◽  
Kuan-Fu Liao

ABSTRACTBackground:The purpose of this paper was to examine whether glaucoma could be a non-memory manifestation of Alzheimer's disease in older people.Methods:We conducted a population-based, retrospective, case-control study to analyze the database of the Taiwan National Health Insurance Program. There were 1,351 subjects ≥65 years old with newly diagnosed Alzheimer's disease as the cases, and 5,329 subjects without any type of dementias as the controls during 2000–2011. The odds ratio (OR) and 95% confidence interval (CI) for the risk of Alzheimer's disease associated with glaucoma was estimated by the multivariable unconditional logistic regression model.Results:After controlling for confounders, the multivariable logistic regression model demonstrated that the adjusted OR of Alzheimer's disease was 1.50 in subjects with glaucoma (95% CI 1.19, 1.89), compared to subjects without glaucoma.Conclusions:Older people with glaucoma are associated with 1.5-fold increased odds of Alzheimer's disease in Taiwan. Glaucoma may be a non-memory manifestation of Alzheimer's disease in older people. Further research is needed to confirm this issue.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261772
Author(s):  
Mor Amital ◽  
Niv Ben-Shabat ◽  
Howard Amital ◽  
Dan Buskila ◽  
Arnon D. Cohen ◽  
...  

Objective To identify predicators of patients with fibromyalgia (FM) that are associated with a severe COVID-19 disease course. Methods We utilized the data base of the Clalit Health Services (CHS); the largest public organization in Israel, and extracted data concerning patients with FM. We matched two subjects without FM to each subject with FM by sex and age and geographic location. Baseline characteristics were evaluated by t-test for continuous variables and chi-square for categorical variables. Predictors of COVID-19 associated hospitalization were identified using univariable logistic regression model, significant variables were selected and analyzed by a multivariable logistic regression model. Results The initial cohort comprised 18,598 patients with FM and 36,985 matched controls. The mean age was 57.5± 14.5(SD), with a female dominance of 91%. Out of this cohort we extracted the study population, which included all patients contracted with COVID-19, and consisted of 571 patients with FM and 1008 controls. By multivariable analysis, the following variables were found to predict COVID-19 associated hospitalization in patients with FM: older age (OR, 1.25; CI, 1.13–1.39; p<0.001), male sex (OR, 2.63; CI, 1.18–5.88; p<0.05) and hypertension (OR, 1.75; CI, 1.04–2.95; p<0.05). Conclusion The current population-based study revealed that FM per se was not directly associated with COVID-19 hospitalization or related mortality. Yet classical risk factors endangering the general population were also relevant among patients with FM.


2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Lin Zhang ◽  
Liu Yang ◽  
Congzhi Wang ◽  
Ting Yuan ◽  
Dongmei Zhang ◽  
...  

Objectives. Undernutrition early in life may increase the incidence of adverse effects on adult health. The relations between undernutrition and obesity parameters (body mass index (BMI) and WC (waist circle)) and hypertension were often contradictory. Our study is aimed at identifying the combined effects of famine exposure and obesity parameters on hypertension in middle-aged and older Chinese. Design. A population-based cross-sectional study. Setting. Data were selected from the China Health and Retirement Longitudinal Study Wave2011 (CHARLS Wave2011). Participants. The sample included 12945 individuals aged 45 to 96. Main Outcome Measurements. The study analyzed data from 12945 middle-aged and older Chinese selected from CHARLS Wave2011. Differences between baseline characteristics and famine exposure/BMI levels/WC levels were evaluated using the t -, Chi-square- ( χ 2 -), and F -test. Then, the difference in the prevalence of hypertension between baseline characteristics was estimated by the t - and χ 2 -test. Finally, multivariable-adjusted logistic regression models were used to explore the associations of famine exposure and obesity parameters with odds of prevalence of hypertension. Results. Among the 12945 participants, 1548 (11.96%) participants had been exposed to the Chinese famine during the fetal group, whereas 5101 (39.41%) participants and 4362 (33.70%) participants had been exposed to the famine during childhood and adolescence/adult group, respectively. Regarding the participants with BMI levels, 3746 (28.94%) were overweight, and 1465 (11.32%) were obese, whereas 5345 (41.29%) of the participants with WC levels were obese, respectively. Furthermore, 1920 (31.17%) had hypertension in males and 2233 (32.91%) in females. In multivariable-adjusted models, famine exposure and obesity parameters were related with prevalence of hypertension independently in total populations ((1) model threec, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.27; 95% CI 1.08, 1.49); childhood-exposed vs. no-exposed group (OR1.64; 95% CI 1.44, 1.87); the adolescence/adult-exposed vs. no-exposed group (OR3.06; 95% CI 2.68, 3.50); P for trend < 0.001 ; (2) model threee, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.25; 95% CI 1.06, 1.47); childhood-exposed vs. no-exposed group (OR1.52; 95% CI 1.34, 1.73); the adolescence/adult-exposed vs. no-exposed group (OR2.66; 95% CI 2.33, 3.03); P for trend < 0.001 ; (3) model threeg, BMI levels with prevalence of hypertension: overweight vs. normal (OR1.75; 95% CI 1.60, 1.91); obesity vs. normal (OR2.79; 95% CI 2.48, 3.15); P for trend < 0.001 ; (4) WC levels with prevalence of hypertension: overweight vs. normal (OR1.42; 95% CI 1.36, 1.48)). When stratified by sex, results in both males and females were mostly similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal BMI/WC levels and no-exposed famine group, all groups trended towards higher odds of prevalence of hypertension (the greatest increase in odds, adolescence/adult-exposed group with obesity in BMI levels: (OR8.13; 95% CI 6.18, 10.71); adolescence/adult-exposed group with obesity in WC levels: (OR6.36; 95% CI 5.22, 7.75); P for interaction < 0.001 ). When stratified by sex, the results in both males and females were also similar to those in the total population. Conclusion. Our data support a strongly positive combined effect of famine exposure and obesity parameters on hypertension in middle-aged and elderly Chinese.


2018 ◽  
Vol 87 (5) ◽  
pp. 255-262 ◽  
Author(s):  
A. Dufourni ◽  
A. Decloedt ◽  
L. Lefère ◽  
D. De Clercq ◽  
P. Deprez ◽  
...  

While mature coastal bermudagrass hay is strongly associated with ileal impaction in the Southeastern United States, stabling on flax bedding has anecdotally been associated with this condition in Europe. The aim of this retrospective study was to investigate the association between ileal impaction and the use of flax shives compared to straw as bedding in horses with colic. Medical records of 2336 referral cases evaluated for abdominal pain between January 2008 and May 2017 at the Department of Large Animal Internal Medicine, Ghent University were reviewed. Diagnosis, date of admission, age, breed, gender, body weight and stable bedding were recorded. Conditional logistic regression analysis was used to assess the association between ileal impaction and each individual variable. Odds ratios (OR) and 95% confidence intervals (CI) were determined. Predictors with a value of P < 0.2 were included in a multivariable Cox regression model and Wald’s test was used to assess parameter estimate significance. Further, the association between survival to discharge and type of bedding or type of treatment (medical versus surgical) was analyzed for horses with ileal impactions. The proportion of colic cases stabled on flax bedding at home was 11.3%. The overall prevalence of ileal impaction was 4.2%. In the flax group, the prevalence of ileal impaction was 9.4% as opposed to 3.6% within the straw group. The OR of 2.8 (95% CI 1.7-4.7; P < 0.001) in the multivariable logistic regression model indicated that horses stabled on flax shives were approximately three times more likely to have ileal impactions than horses stabled on straw. There was no significant association found between ileal impaction and the period of admission, age, gender or body weight in a multivariable logistic regression model. The odds for having ileal impaction is approximately six times (OR 6.3; 95% CI 2.4-16.4; P < 0.001) higher in draft horses than in warmbloods in the multivariable logistic regression model. No significant association was found between survival to discharge and type of bedding or treatment. These results suggest that horses with colic that were housed on flax bedding are more likely to present ileal impactions than horses housed on straw.


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