The association between curry-rice consumption and hypertension,type 2 diabetes,and depression: The findings from KNHANES 2012–2016

Background and aimsWe aim to evaluate the association between curry-rice consumption, cardiovascular diseases (CVDs), type 2 diabetes (T2DB), arthritis, and depression.Methods17,625 participants aged ≥18 years were recruited to obtain data on sociodemographic characteristics, lifestyle, medical history, current medications, family history, and food consumption. The association between curry-rice consumption, CVDs, T2DB, arthritis, and depression was examined using multivariable-adjusted analyses.ResultsIn the logistic model, risks of elevated triglyceride (OR 0.89; 95% CI, 0.82–0.97, p = 0.006), elevated HbA1c (OR 0.81; 95% CI, 0.73–0.91, p < 0.001), and elevated glucose (OR 0.86; 95% CI, 0.79–0.94, p < 0.001) were significantly lower in the high curry-rice consumption group than in the low curry-rice consumption group. Risk of hypertension (OR 0.88; 95% CI, 0.78–0.98, p = 0.044), T2DB (OR, 0.82; 95% CI, 0.68–0.98, p < 0.001), and depression (OR 0.82; 95% CI, 0.70–0.97, p = 0.026) was significantly lower among the high curry-rice consumption group than in the low curry-rice consumption group. These findings were consistent with the results of the analysis when curry-rice consumption was treated as a continuous variable.ConclusionsThe potential health benefits resulting from the intake of curry-rice via an ordinary diet could protect the public from the burden of non-communicable diseases (NCDs) and mental health. These results highlight an ongoing need to understand the role of curry-rice in NCDs and mental health.     

Association between asthma and headache: Findings from the NHANES 2001–2004

Introduction

With the adjustment of sociodemographic factors, our study aimed to explore the association between asthma control and headache using a representative sample in the United States.

Methods

A total of participants aged >20 years from the National Health and Nutrition Examination Survey (NHANES) cycles 2001–2004 were included. The presence of asthma and headache was determined by questionnaires. Multivariate logistic regression was performed.

Results

Participants with asthma had higher odds of suffering headaches (odds ratio = 1.62, 95% confidence interval: 1.30–2.02, p < 0.001). Those who had an asthma attack in the past year had higher odds of experiencing headaches than those who did not (odds ratio = 1.94, 95% confidence interval: 1.11–3.39, p = 0.022). No statistically significant association was found between participants who had emergency care visit for asthma in the past year and those who had not.

Conclusion

Patients with asthma attack in the past year were more likely to have a headache than those who without.     

Non-alcoholic fatty liver disease and type 2 diabetes mellitus: The liver disease of our age?

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that might affect up to one-third of the adult population in industrialised countries. NAFLD incorporates histologically and clinically different non-alcoholic entities; fatty liver (NAFL, steatosis hepatis) and steatohepatitis (NASH-characterised by hepatocyte ballooning and lobular inflammation ± fibrosis) might progress to cirrhosis and rarely to hepatocellular cancer. NAFL increasingly affects children (paediatric prevalence is 4.2%-9.6%). Type 2 diabetes mellitus (T2DM), insulin resistance (IR), obesity, metabolic syndrome and NAFLD are particularly closely related. Increased hepatic lipid storage is an early abnormality in insulin resistant women with a history of gestational diabetes mellitus. The accumulation of triacylglycerols in hepatocytes is predominantly derived from the plasma nonesterified fatty acid pool supplied largely by the adipose tissue. A few NAFLD susceptibility gene variants are associated with progressive liver disease, IR, T2DM and a higher risk for hepatocellular carcinoma. Although not approved, pharmacological approaches might be considered in NASH patients.     

Is diabetes a causal agent for colorectal cancer？ Pathophysiological and molecular mechanisms

The possible relationship between diabetes mellitus (DM) and colorectal cancer (CRC), concerning pathophysiological and molecular mechanisms is highlighted in this review. The most recent and complete articles and developments in this particular field were thoroughly reviewed. Common risk factors, such as obesity, sedentary lifestyle, and Western diet between DM and CRC, led to the theory that DM might be a causal agent for CRC development. Various studies have connected type 2 DM and CRC, either proximal o...     

Synergistic interaction of hypertension and diabetes on chronic kidney disease: Insights from the National Health and Nutrition Examination Survey 1999–2006

BackgroundHypertension and diabetes mellitus are 2 major risk factors for chronic kidney disease (CKD). However, whether hypertension and diabetes have a synergistic interaction towards greater renal damage remains unclear. Our study aimed to investigate whether hypertension and diabetes act synergistically towards CKD.Methods13,693 subjects from the cross-sectional National Health and Nutritional Examination Survey 1999–2006 were included in our analyses. The associations were investigated by multivariate logistic regression models. The interaction was evaluated on both additive and multiplicative scale.ResultsThe prevalence of CKD was 17.62%. After adjustment, subjects with both hypertension and diabetes had a 4.710 (3.652–6.073) times risk of CKD than non-hypertensive non-diabetic subjects, higher than that of subjects with only hypertension or diabetes (1.732, 95% CI: 1.502–1.997 and 2.407, 95% CI: 1.815–3.194, respectively). Furthermore, significant interaction was observed between hypertension and diabetes towards CKD in the additive scale (relative excess risk due to interaction: 1.570, 95% CI: 0.507–2.633; the attributable proportion due to interaction: 0.333, 95% CI: 0.168–0.499; Synergy index: 1.734, 95% CI: 1.239–2.426). Additionally, analyses of the associations with components of the primary endpoint demonstrated that the interaction was also applicable to those with reduced eGFR, albuminuria or normoalbuminuric CKD.ConclusionsThe joint effect of hypertension and diabetes was significantly larger than the sum of their independent impact on CKD. Our findings may provide intuitionistic and straightforward illustrations for the public to understand the danger of combined hypertension and diabetes on the renal injury.     

Resection of liver metastases from colorectal cancer: Are there any truly significant clinical prognosticators?

PURPOSE: This study was designed to evaluate the prognostic significance of various prognostic factors affecting recurrence after resection of colorectal hepatic metastases. PATIENTS AND METHODS: Records of 54 patients who had hepatic resection between 1986 and 1993 for metastatic liver tumor from colorectal cancer were reviewed. Factors analyzed were those reported to be of prognostic significance in other studies, including gender, primary tumor site, Dukes stage, diagnostic interval, grade, preoperative carcinoembryonic antigen (CEA) level, number of metastases, size of metastases, distribution of metastases, type of resection, resection margin, and estimated blood loss. RESULTS: Average follow-up of surviving patients was 28 (range, 12–89) months. Average survival time from date of hepatic resection was 26 months, with an estimated actuarial survival rate of 25.5 percent at five years. Using the multivariate analysis of factors, gender and preoperative CEA level were shown to be significantly related to overall survival (P=0.0455 and 0.054, respectively). Cancer of the right side colon had significant correlation with hepatic recurrence (P=0.0071). CONCLUSIONS: Female patients and those with preoperative CEA values higher than 20 ng/ml have a better chance of survival following hepatic resection. Cancer of the right colon has a greater tendency for hepatic recurrence than that of the left colon.     

Association between earlier age at natural menopause and risk of diabetes in middle-aged and older Chinese women: The Dongfeng–Tongji cohort study

AimAge at menopause is associated with cardiovascular disease, but little is known of its relationship with diabetes, and previous findings are controversial. The objective of this study was to evaluate the association between earlier menopause (at age ≤45 years) and the prevalence of diabetes in the Chinese population.MethodsA total of 16,299 postmenopausal women, aged 42.0–94.3 years, who completed the study questionnaires, underwent medical examinations and provided blood samples, were included in our analysis. Participants self-reported their age at menopause and were then divided into three age groups (≤45, 46–52, ≥53 years). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsOf the study participants, 2811 (17.2%) had diabetes. The average age at menopause was 49.5 ± 3.3 years. For each 1-year delay in menopausal age, the presence of diabetes was reduced by 2% (OR: 0.98, 95% CI: 0.97–0.99) after adjusting for potential confounding factors. Compared with those whose menopausal age was 46–52 years, the OR for diabetes was 1.20 (95% CI: 1.03–1.39) for those with an earlier menopausal age (≤45 years).ConclusionOur findings suggest that earlier menopause may be independently associated with an increased prevalence of diabetes. Future prospective studies are needed to verify this relationship.     

Type 1 diabetes mellitus: an imbalance between effector and regulatory T cells?

Abundant evidence now exists that autoimmunity plays a critical role in the pathogenesis of type 1 (insulin-dependent) diabetes mellitus. The non-obese diabetic (NOD) mouse is an extensively studied animal model of this T-cell-mediated autoimmune disease. Our laboratory has focused on isolating diabetogenic T cell clones from NOD mice as a means of elucidating the pathogenesis of type 1 diabetes. This experimental approach presupposes that type 1 diabetes in NOD mice results from the action of islet-reactive T cells that are not present in other mouse strains; the diabetogenic T cells would therefore represent forbidden clones which exist in NOD mice as a result of a failure of clonal deletion. While the inappropriate presence of diabetogenic T cells probably play a central role in murine diabetes, it cannot explain all aspects of the disease. Type 1 diabetes is a chronic disorder with a lengthy preclinical stage; if the diabetogenic T cells acted in an unopposed fashion, one might expect to see a much more fulminant clinical course. This observation suggests that regulatory influences are likely to exist in this disease —a possibility supported by recent experimental data. If these regulatory influences could be identified and enhanced, specific immunotherapy for type 1 diabetes could be achieved.     

Associations between calf,thigh, and arm circumference and cardiovascular and all-cause mortality in NHANES 1999–2004

Background and aimsPrior studies have described an association between calf circumference and cardiovascular disorders. We evaluated the associations between calf, thigh, and arm circumference and cardiovascular and all-cause mortality.Methods and resultsWe performed a retrospective cohort study of 11,871 patients in the 1999–2004 National Health and Nutrition Examination Survey (NHANES) to determine the association between calf circumference and cardiovascular and all-cause mortality using univariate and multivariate Cox proportional hazards. We additionally examined the association between thigh and arm circumference and mortality. In the multivariable Cox regression for the female stratum, each centimeter increase in calf circumference was associated with a hazard ratio of 0.88 (95% CI 0.84–0.92), and a hazard ratio of 0.90 (95% CI 0.85–0.95) for cardiovascular death. In the model with males, the hazard ratio for higher calf circumference was 0.92 (95% CI 0.88–0.96) for all-cause mortality and 0.94 (95% CI 0.89–0.99) for cardiovascular death. There was a statistically significant association between higher thigh circumference and lower risk of all-cause and cardiovascular mortality. Arm circumference was not similarly associated with mortality in the multivariate model.ConclusionCalf and thigh circumference may provide important prognostic information regarding cardiovascular and all-cause mortality. Future prospective studies should examine the role of extremity circumference and cardiovascular events.     

Association between klotho and non-alcoholic fatty liver disease and liver fibrosis based on the NHANES 2007–2016

Introduction and ObjectivesThis study aims to explore the association between Klotho and Non-Alcoholic Fatty Liver Disease (NAFLD), a condition affecting millions worldwide. Klotho may have a protective effect against NAFLD mechanisms like inflammation, oxidative stress, and fibrosis. The study will use FLI and FIB-4 score to diagnose NAFLD in a large population for investigating the link between Klotho and NAFLD.Materials and MethodsThe study aimed to explore the association between Klotho and NAFLD by measuring the α-Klotho protein levels in the participants' blood using ELISA. Patients with underlying chronic liver diseases were excluded. The severity of NAFLD was evaluated using FLI and FIB-4, and logistic regression models were used to analyze the data obtained from NHANES. Subgroup analyses were conducted to study Klotho's effect on hepatic steatosis and fibrosis in diverse subpopulations.ResultsThe study found that low levels of α-Klotho were associated with NAFLD, with ORs ranging from 0.72 to 0.83. However, high levels of α-Klotho were associated with NAFLD-related fibrosis. The Q4 group showed significant results in individuals aged 51 years or younger and in females. Non-Hispanic White ethnicity, education level of high school or above, non-smoking, non-hypertension, and non-diabetic groups showed negative correlations.ConclusionsOur study suggests a potential correlation between α-Klotho levels in the blood and NAFLD in adult patients, especially among younger individuals, females and Non-Hispanic Whites. Elevated α-Klotho levels may have therapeutic benefits in treating NAFLD. Further research is required to validate these findings, but they provide new insights for managing this condition.     

Cardiovascular profile and events of US adults 20–49 years with HIV: Results from the NHANES 1999–2008

The incidence of vascular events in HIV-infected individuals is increasing. We investigated whether there is a higher prevalence of vascular risk factors in the adult US population with HIV compared to uninfected controls that could explain some of the increased vascular events. We obtained prevalence estimates of vascular risk factors, stratified by the HIV status, in sampled adults aged 20–49 years from the 1999 to 2008 National Health and Nutrition Examination Survey. Estimates were weighted to account for oversampling and nonresponse. Logistic regression models with adjustment for demographic and socioeconomic status were created to adjust for confounders. The analysis included 12,339 US adults, 76 with HIV infection. The weighted seroprevalence of HIV was 0.48% (95% CI 0.33–0.65). In univariate analysis, HIV infection was more prevalent in non-Hispanic blacks (odds ratio [OR] 7.4, 95% CI 3.6–15.2), men (OR 2.6, 95% CI 1.42–4.89), the physically inactive (OR 1.8, 95% CI 1.0–3.0), and current smokers (OR 2.4, 95% CI 1.3–4.4). Increased waist circumference (OR 0.5, 95% CI 0.3–1.0) was less common in HIV-infected individuals, although controlling for sex and ethnicity differences, this difference became nonsignificant (OR 0.6, 95% CI 0.3–1.2). Further controlling for differences in income and education rendered the associations with smoking and physical inactivity nonsignificant, but revealed associations of HIV infection with hypertension (OR 2.4, 95% CI 1.0–6.0) and diabetes (OR 4.1, 95% CI 1.1–16.1). These results underscore the need to further investigate the role of cardiovascular risk factors in the growing HIV population.     

The cost burden of diabetes mellitus: the evidence from Germany—the CoDiM Study

Aims/hypothesis The aim of this study was to identify the health care costs of diabetic patients in Germany in 2001, focusing on the influence of age, sex, and type of treatment.Subjects and methods Annual direct costs of medical care and indirect costs of inability to work and early retirement in diabetic subjects were compared with costs of age- and sex-matched non-diabetic control subjects. The analysis was based on routine health care data from a random sample (18.75%) taken from a database of 1.9 million insured persons. Incremental differences in medical and national expenditure between subjects with and without diabetes were calculated.Results Annual direct mean costs per diabetic patient were €5,262, and indirect costs were €5,019. In the control group, mean direct and indirect costs were €2,755 and €3,691, respectively. Analysis of cost components revealed that the high costs associated with the care of diabetic patients could be largely attributed to inpatient care and overall medication costs. Hypoglycaemic drugs amounted to only one-quarter of the medication costs. The total health care costs were correlated with the type of treatment. Direct excess costs increased with increasing age in insulin-treated patients, but were unaffected by age in patients receiving other types of treatment.Conclusions/interpretation The Costs of Diabetes Mellitus (CoDiM) study is the first comprehensive study to provide estimates of costs associated with diabetes care in Germany. Direct costs of diabetic patients account for 14.2% of total health care costs, which includes the proportion that specifically accounts for diabetes-related costs (6.8%).Electronic Supplementary Material Supplementary material is available for this article at