Prevalence and Symptomatic Correlation of Vitamin D Deficiency in Individuals Visiting for an Annual Health Check-up – A Cross-sectional Study

Vitamin D plays a crucial role in electrolytic reabsorption and calcium homeostasis, thereby maintaining skeletal and extra-skeletal integrity. In addition, the literature establishes its potency to prevent insulin-dependent diabetes, cardiovascular diseases, malignancies, and various autoimmune disorders. Therefore, determining vitamin D deficient states and its correlation with systemic factors plays a notable role in clinical medicine. The present cross-sectional study was conducted to determine the Prevalence and symptomatic correlation of vitamin D deficiency in individuals visiting an annual health check-up at a quaternary care hospital, Lucknow, Uttar Pradesh, India. The study stipulated the prevalence rate of serum vitamin D deficiency levels was 91 % among healthy individuals. The overall mean value of serum vitamin D was 17.54 ng/mL. With 91.2 % symptomatic individuals, the mean age of patients was 48.08 ± 10.33 years, with the majority of males (61.53 %). The mild, moderate, and severe grades of vitamin D deficiency were seen in 32.53 %, 53.01 %, and 14.45 % of study participants, respectively. On applying Pearson correlation, there is a strong negative correlation between the total symptom score (12.98) and serum vitamin D levels with an R-value of -0.788. The study reveals the higher prevalence rate of vitamin D deficiency among apparently healthy participants. The associated symptoms among moderate and severe vitamin D deficient study participants indicate the alarming stage in the country. The study concluded the need for comprehensive public health programs concerning the advantages of sun exposure and sufficient intake of fortified resources in the 21st-century lifestyle.

Metabolically healthy obesity was significantly associated with increased risk of gallstones

Objective The risk of gallstones among metabolically healthy obesity (MHO) individuals is largely unexplored. Therefore, the present study investigated the association between MHO and gallstones in a health check-up cohort of Chinese adults. Design A prospective cohort study. Methods Participants included 58,862 individuals from the MJ health check-up cohort aged ≥ 18 years without history of gallstones at baseline. Gallstones were diagnosed using abdominal B-type ultrasound. Metabolically healthy was defined as not having any one of the components of metabolic syndrome. Obesity was identified by body mass index (BMI) and waist circumference (WC). Participants were cross-classified at baseline by metabolic health and obesity. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of gallstones across BMI categories were estimated with Cox proportional hazard regression models. Results During a median follow-up of 3.0 (interquartile range, 1.6-6.1) years, 1,269 participants developed gallstones. Individuals with MHO (HR: 1.95, 95% CI: 1.23, 3.09 for BMI criteria; HR: 1.74, 95% CI: 1.37, 2.21 for WC criteria) had significantly higher risk of gallstones than those with metabolically healthy normal weight. In metabolically healthy individuals, BMI and WC both displayed linear dose-response relationships with gallstones (P for non-linearity > 0.05). The association between MHO and gallstones remained unchanged when using different criteria for metabolic health and obesity. Conclusions MHO was significantly associated with gallstones, suggesting that obesity can independently contribute to gallstones development, even among metabolically healthy individuals. These findings emphasize that metabolically healthy individuals may still benefit from maintaining normal body weight to prevent gallstones.

Remnant Lipoprotein Cholesterol as a Factor Related to Adult Fatty Liver Disease

Context Dyslipidemia is related to fatty liver disease (FLD), whose relationship with remnant lipoprotein cholesterol (RLP-C), a component of blood lipids, remains unclear. Objective To clarify the correlation between RLP-C and the occurrence and severity of FLD and establish an FLD discriminant model based on health check indicators. Methods Retrospective study of participants who underwent health check-up in the First Affiliated Hospital of China Medical University (Shenyang, China) between January and December 2019. We categorized participants according to liver ultrasound results and analyzed the correlation between RLP-C and occurrence of FLD (n = 38 885) through logistic regression, restricted cubic spline, and receiver operating characteristic curve. We categorized the severity of FLD according to the control attenuation parameter and analyzed the correlation between RLP-C and FLD severity through multiple logistic regression; only males were included (n = 564). Results The adjusted OR (aOR) per SD between RLP-C and FLD was 2.33 (95% CI 2.21-2.46, P < .001), indicating a dose–response relationship (P < .0001). The optimal cut-off value of RLP-C was 0.45 mmol/L and the area under the curve (AUC) was 0.79. The AUC of the 8-variable model was 0.89 in both the training and the validation sets. FLD severity was related to the level of RLP-C (aOR per SD = 1.29, 95% CI 1.07-1.55, P = .008). Conclusion RLP-C has a strong positive correlation with FLD occurrence and FLD severity. These results may help clinicians identify and implement interventions in individuals with high FLD risk and reduce FLD prevalence.

Trends of the Incidence and Prevalence of Metabolic Syndrome Among Participants of the Specific Health Check and Guidance System in Japan

A specific nationwide health check-up and guidance system (Tokutei-Kenshin) was initiated in April 2008 to detect metabolic syndrome (MetS) and if confirmed, to provide individual instruction to modify lifestyle and the necessary treatment. However, trends of the incidence and prevalence of MetS are not yet available. Data of the Tokutei-Kensin from 2008 to 2014 were used in this study. The total number of participants was 3,809,853. Among them, we identified 933,490 individuals who have screened at least twice during the study period. The mean number of visits was 3.4 times per person. Incidence of MetS was defined as those who were MetS (-) at the first screening and developed MetS next year. Persistent prevalence of MetS was defined as those who were MetS (+) at both the first and next year screening. We obtained five 1-year incidence and persistent prevalence of MetS during the study period. The average 1-year incidence of MetS was 5.7% (6.6%, 2.7%) and the average prevalence of MetS was 10.1% (16.1%, 6.2%) in the total (men, women) participants, respectively. The average persistent prevalence of MetS was 47.3% (49.6%, 43.3%) in the total (men, women) participants, respectively. Both incidence and prevalence of MetS were higher in men than that in women. Compared to those of age less than 65 years old, elderly participants had a higher incidence and prevalence of MetS. During the study period of 2008 to 2014, there were no apparent changes in the incidence, prevalence, and persistent prevalence of MetS.

Epidemiological estimates and early detection of polycystic kidney disease by ultrasonographic assessment in Japan

Aims: To estimate the prevalence of autosomal dominant polycystic kidney disease (ADPKD) and provide the evaluation of new ultrasonographic criteria and clinical indicators to help its early detection.Materials and methods: A total of 30750 individuals for health check-up with abdominal ultrasonography (US) were included, in which 231 suspects of ADPKD based on the number of renal cysts were extracted. They were divided into 4 groups by the grade of suspicion (definitive, a strongsuspect, a fair suspect and a weak suspect). Longitudinal data of US and renal function tests were compared between the groups.The estimated prevalence rate was 0.068% from the study subjects. The level of eGFR did not differ between the definitive and suspects, while the annual estimated glomerular filtration ratio (eGFR) decline was significantly larger in the former (p<0.001). The subjects with growing renal cysts showed a larger annual eGFR decline than those without growth (p=0.0324). The proposed cut-off set at the first quartile of the annualized eGFR change efficiently divided the subjects according to the presence of cyst growth (p= 0.027) and the grade of suspicion of ADPKD (p=0.028).Conclusion: The prevalence rate of ADPKD was higher than the corresponding rate previously reported in Japan (0.025%), suggesting that health check-ups maybe an efficient opportunity to pick up undiagnosed ADPKD. The large annual eGFR decline and the presence of growing cystsmay be feasible indicators to isolate ADPKD and should be introduced into US based screening to facilitate early detectionof ADPKD.

The Acceptance and Use of the e-Health Instrument ‘The Personal Health Check’ in Four Dutch Municipalities: Lessons Learned

This pilot study assessed the acceptance and use of the e-Health instrument “the Personal Health Check” (PHC) among clients and professionals in primary care settings. By filling in the online PHC instrument, participants were provided insights into their health and lifestyle. When results revealed an increased health risk, participants were advised to undertake additional lab tests measuring blood pressure and haemaglobin levels. Based on the online questionnaire and optional lab tests, participants then received a report that included individually-tailored feedback from the e-Health application about personal health risks and suggestions for health interventions. The PHC was implemented in 2016 in four Dutch municipalities that determined which neighbourhood(s) the PHC targeted and how participants were invited. The Unified Theory of Acceptance and Use of Technology was used as a theoretical framework to address our research questions. Methods used to assess acceptance were: PHC instrument data, data from additional questionnaires completed by PHC participants, focus groups with PHC participants and professionals in primary care, and telephone interviews with non-responders to the invitation to participate in the online PHC. Of the 21,735 invited, 12% participated. Our results showed that participants and professionals in this pilot were predominantly positive about the PHC. Participants reported that they made an effort to apply the PHC lifestyle advice they received. Almost all had the knowledge and resources needed to use the PHC online instrument. Invitations from general practitioners almost doubled participation relative to invitations from the sponsoring municipalities. The overall low response rate, however, suggests that the PHC is unsuitable as a foundation on which to develop local public health policy.