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Ching-Chang Huang,
Ying-Hsien Chen,
Mao-Shin Lin,
Cheng-Hsin Lin,
Hung-Yuan Li,
Ming-Jang Chiu,
Chi-Chao Chao,
Yen-Wen Wu,
Ya-Fang Chen,
Jen-Kuang Lee,
Ming-Jiuh Wang, Ming-Fong Chen,
Hsien-Li Kao
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ABSTRACT: OBJECTIVES: To report the effect of carotid artery stenting (CS) on neurocognitive function (NCF) in patients with severe carotid artery occlusive disease depending on baseline brain perfusion status. BACKGROUND: The effect of CS on NCF was controversial. METHODS: We prospectively enrolled 61 patients with carotid artery diseases (22 with occlusion, 39with severe stenosis) in whom CS were attempted. Computed tomography perfusion (CTP) and NCF assessments including Mini-Mental State Examination (MMSE), Alzheimer Disease Assessment Scale-Cognitive Subtest (ADAS-Cog), verbal fluency, Color Trail Making A and B were applied prior to and 3 months after intervention. RESULTS: Successful recanalization was achieved in 14 of 22 occlusion patients (64%) and all 39 severe stenosis patients. 2 cases were excluded due to procedural cerebral complication. The patients were divided into 3 groups: group 1 (n=8) as patients with baseline ipsilateral abnormal cerebral perfusion in whom CS failed; group 2 (n=33) as patients with baseline ipsilateral abnormal cerebral perfusion in whom CS were successful; and group 3(n=19) as patients without baseline ipsilateral abnormal cerebral perfusion in whom CS were successful. The demographics and baseline NCF were similar among groups. Only in group 2, there were significant improvement in ADAS-Cog (pre 6(4~9) versus post 5.8±4.6, p=0.002), MMSE (pre 27(25~28) versus post 28(25~29), p=0.004) and Color Trail Making A (pre 100(78.5~136.5) seconds versus post 97(60~128.5) seconds, p=0.003) after CS. Significant difference in changes from baseline was observed only in the Color Trailing Making A among groups (group 1 vs 2 vs 3: 1.5(-14~11.5) vs -12.5(-36.5~0.5) vs -0.5(-11~27), P=0.0159). Significant correlation between the change of ipsilateral brain perfusion and MMSE (r=-0.33, P=0.01) was also identified. CONCLUSIONS: Successful CS for severe carotid stenosis/occlusion improves NCF, but only in patients with baseline objective abnormal cerebral perfusion.
Journal of the American College of Cardiology 04/2013; · 14.16 Impact Factor
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ABSTRACT: BACKGROUND: Little evidence is available for the validity of dietary fish and polyunsaturated fatty acid intake derived from interviewer-administered questionnaires and plasma docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) concentration. METHODS: We estimated the correlation of DHA and EPA intake from both questionnaires and biochemical measurements. Ethnic Chinese adults with a mean (+/- SD) age of 59.8 (+/-12.8) years (n = 297) (47% women) who completed a 38-item semi-quantitative food-frequency questionnaire and provided a plasma sample were enrolled. Plasma fatty acids were analyzed by capillary gas chromatography. RESULTS: The Spearmen rank correlation coefficients between the intake of various types of fish and marine n-3 fatty acids as well as plasma DHA were significant, ranging from 0.20 to 0.33 (P < 0.001). In addition, dietary EPA, C22:5 n-3 and DHA were significantly correlated with the levels of marine n-3 fatty acids and DHA, with the Spearman rank correlation coefficients ranging from 0.26 to 0.35 (P < 0.001). Moreover, compared with those in the lowest fish intake quintile, participants in the highest quintile had a significantly higher DHA level (adjusted mean difference, 0.99 +/- 0.10%, test for trend, P < 0.001). Similar patterns between dietary DHA intake and plasma DHA levels were found. However, the association between dietary fish intake and plasma EPA was not significant (test for trend, P = 0.69). CONCLUSIONS: The dietary intakes of fish and of long chain n-3 fatty acids, as determined by the food frequency questionnaire, were correlated with the percentages of these fatty acids in plasma, and in particular with plasma DHA. Plasma DHA levels were correlated to dietary intake of long-chain n-3 fatty acids.
BMC Medical Research Methodology 02/2013; 13(1):23. · 2.67 Impact Factor
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ABSTRACT: BACKGROUND: The HAS-BLED score is a validated bleeding risk model for predicting major bleeding events in anticoagulated individuals with atrial fibrillation (AF). It remains uncertain whether the HAS-BLED score could identify non-AF individuals at risk of developing intracranial haemorrhage (ICH), which is the most intractable and devastating major bleeding complication. METHODS: We assessed the predictive value of a modified HAS-BLED and other bleeding risk scoring models to predict the risk for ICH in the Chin-Shan Community Cohort, which followed 1899 women and 1703 men, aged >35years, for a median of 15.9years. ICH events (including haemorrhagic strokes) were ascertained according to questionnaires and the national register database. RESULTS: Of 3524 individuals without baseline AF, 54 ICH events occurred during follow-up. The risk for ICH was raised with increasing HAS-BLED scores, and was significantly associated with uncontrolled hypertension and older age (Odds Ratios [95% confidence interval (CI)], 4.2[2.3-7.6] and 1.9[1.1-3.4], respectively). Among the five bleeding risk scoring schemes tested, HAS-BLED had highest general discrimination performance (c-statistic [95% CI], 0.72 [0.67-0.78]), and better ability to discriminate between those who were at risk for ICH and who were not (NRI, net reclassification improvement, all p<0.05, compared to other four scoring schemes). CONCLUSION: The HAS-BLED score had the highest general discrimination performance and best ability to discriminate risk for ICH. This score may be of clinical use in predicting the risk for occurrence of ICH among non-AF individuals.
International journal of cardiology 01/2013; · 7.08 Impact Factor
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ABSTRACT: BACKGROUND: Evidence about whether white blood cell (WBC) or its subtypes can act as a biomarker to predict the ischemic stroke events in the general population is scanty, particularly in Asian populations. The aim of this study is to establish the predictive ability of total WBC count or subtypes for long-term ischemic stroke events in the cohort population in Taiwan. METHODS: The Chin-Shan Community Cohort Study began from 1990 to 2007 by recruiting 1782 men and 1814 women of Chinese ethnicity. Following a total of 3416 participants free from ischemic stroke events at baseline for a median of 15.9 years; we documented 187 new incident cases. RESULTS: The multivariate relative risk for the comparison of the participants in the fifth and first WBC count quintiles was 1.67 (95% confidence interval [CI], 1.02--2.73; P for trend=0.03), and the corresponding relative risk for neutrophil count was 1.93 (95% CI, 1.13--3.29; P for trend=0.02). The discriminative ability by WBC and neutrophil counts were similar (area under the receiver operating characteristic curve, 0.600 for adding WBC, 0.610 for adding neutrophils, 0.595 for traditional risk factor model). In addition, the net reclassification improvement (NRI) values between the neutrophil and white blood cell count models were not significant (NRI, =-2.60%, P=0.35), indicating the similar discrimination performance for both WBC and neutrophil counts. CONCLUSIONS: WBC and neutrophil count had a similar ability to predict the long-term ischemic stroke events among Taiwanese.
BMC Neurology 01/2013; 13(1):7. · 2.17 Impact Factor
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ABSTRACT: Telehealth based on advanced information technology is an emerging health care strategy for managing chronic diseases. However, the cost-effectiveness and clinical effect of synchronous telehealth services in older patients with cardiovascular diseases has not yet been studied. Since 2009, the Telehealth Center at the National Taiwan University Hospital has provided a range of telehealth services (led by a cardiologist and staffed by cardiovascular nursing specialists) for cardiovascular disease patients including (1) instant transmission of blood pressure, pulse rate, electrocardiography, oximetry, and glucometry for analysis, (2) mutual telephone communication and health promotion, and (3) continuous analytical and decision-making support.
To evaluate the impact of a synchronous telehealth service on older patients with cardiovascular diseases.
Between November 2009 and April 2010, patients with cardiovascular disease who received telehealth services at the National Taiwan University Hospital were recruited. We collected data on hospital visits and health expenditures for the 6-month period before and the 6-month period after the opening of the Telehealth Center to assess the clinical impact and cost-effectiveness of telehealth services on cardiovascular patients.
A total of 141 consecutive cardiovascular disease patients were recruited, including 93 aged ≥65 years (senior group) and 48 aged <65 years (nonsenior group). The telehealth intervention significantly reduced the all-cause admission rate per month per person in the nonsenior group (pretelehealth: median 0.09, IQR 0-0.14; posttelehealth: median 0, IQR 0-0; P=.002) and the duration (days per month per person) of all-cause hospital stay (pretelehealth: median 0.70, IQR 0-1.96; posttelehealth: median 0, IQR 0-0; P<.001) with increased all-cause outpatient visits per month per person (pretelehealth: median 0.77, IQR 0.20-1.64; posttelehealth: mean 1.60, IQR 1.06-2.57; P=.002). In the senior group, the telehealth intervention also significantly reduced the all-cause admission rate per month per person (pretelehealth: median 0.10, IQR 0-0.18; posttelehealth: median 0, IQR 0-0; P<.001) and the duration (days per month per person) of all-cause hospital stay (pretelehealth: median 0.59, IQR 0-2.24; posttelehealth: median 0, IQR 0-0; P<.001) with increased all-cause outpatient visits per month per person (pretelehealth: median 1.40, IQR 0.52-2.63; posttelehealth: median 1.76, IQR 1.12-2.75; P=.02). In addition, telehealth intervention reduced the inpatient cost in the nonsenior group from $814.93 (SD 1000.40) to US $217.39 (SD 771.01, P=.001) and the total cost per month from US $954.78 (SD 998.70) to US $485.06 (SD 952.47, P<.001). In the senior group, the inpatient cost per month was reduced from US $768.27 (SD 1148.20) to US $301.14 (SD 926.92, P<.001) and the total cost per month from US $928.20 (SD 1194.11) to US $494.87 (SD 1047.08, P<.001).
Synchronous telehealth intervention may reduce costs, decrease all-cause admission rates, and decrease durations of all-cause hospital stays in cardiovascular disease patients, regardless of age.
Journal of Medical Internet Research 01/2013; 15(4):e87. · 4.41 Impact Factor
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ABSTRACT: BACKGROUND: Evidence of the genetic association between CD36 candidate gene and the risk of metabolic syndrome and its components has been inconsistent. This case--control study assessed the haplotype-tagged SNPs from CD36 on the risk of metabolic syndrome and components.Methods and results: We recruited 1,000 cases and age, gender-matched controls were randomly selected from the participants with metabolic syndrome defined by International Diabetes Federation. Overall, the haplotype tagged SNPs of CD36 gene were not related to the risk of metabolic syndrome. For individuals with normal lipid levels, several SNPs were significantly associated with the triglycerides and HDL-cholesterol levels: Subjects with rs3211848 homozygote had a higher triglyceride level (99.16 +/- 2.61 mg/dL), compared with non-carriers (89.27 +/- 1.45 mg/dL, P = 0.001). In addition, compared with non-carriers, individuals with rs1054516 heterozygous and homozygous genotypes had a significantly lower HDL-cholesterol (46.6 +/- 0.46 mg/dL for non-carrier, 44.6 +/- 0.36 mg/dL for heterozygous, and 44.3 +/- 0.56 mg/dL for homozygous, P = 0.0008). CONCLUSION: The CD36 gene variants were significantly associated with triglycerides and HDL-cholesterol concentrations among ethnic Chinese in Taiwan.
Lipids in Health and Disease 12/2012; 11(1):174. · 2.17 Impact Factor
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ABSTRACT: BACKGROUND: Apolipoprotein (Apo) levels are considered more reliable than plasma lipoprotein levels for predicting coronary artery disease (CAD). However, a unanimous Apo marker for CAD has not been identified. In the Chin-Shan Community Cardiovascular Cohort (CCCC), we sought to identify a common Apo marker for predicting CAD in the general population. METHODS: We examined the cross-sectional association between Apo markers and CAD in the CCCC from 1990 to 2001. Among 3,602 subjects, 90 had angiographically proven CAD (>50% stenosis in >=1 vessel), and 200 did not have CAD. These subjects were divided into the following 4 groups for analysis: normolipidemic (total cholesterol [TC] <200 mg/dL, triglyceride [TG] <150 mg/dL), hypertriglyceridemic (TC <200 mg/dL, TG >=150 mg/dL), hypercholesterolemic (TC >=200 mg/dL, TG <150 mg/dL), and hyperlipidemic (TC >=200 mg/dL, TG >=150 mg/dL). RESULTS: Compatible with findings in other populations, our results showed that CAD patients in the CCCC had higher ApoB and lower high-density lipoprotein (HDL) cholesterol and ApoAI concentrations than non-CAD subjects, but the differences were not significant in all groups. Plasma concentrations of ApoE and lipoprotein (a) were not consistently correlated with CAD. In contrast, the ratio of HDL-ApoCIII to very-low-density lipoprotein (VLDL)-ApoCIII was the only universal determinant for CAD in the normolipidemic group (P=0.0018), the hypertriglyceridemic group (P=0.0001), the hypercholesterolemic group (P=0.0001), and the hyperlipidemic group (P=0.0001). Overall, a high HDL-ApoCIII/VLDL-ApoCIII ratio was observed in all CAD patients, including those with a normal lipid profile. In multivariate analyses, the HDL-ApoCIII/VLDL-ApoCIII ratio was the strongest predictor for CAD among all lipid factors investigated (odds ratio, 2.04; 95% confidence interval, 1.46--2.84; P<0.0001). CONCLUSIONS: A high HDL-ApoCIII to VLDL-ApoCIII ratio is a better marker for predicting CAD than are the conventional lipid markers or ApoAI and ApoB. High HDL-ApoCIII and low VLDL-ApoCIII values in CAD, irrespective of lipid variations, suggest that ApoCIII is markedly transported from VLDL to HDL in this disease. Measurement of plasma ApoCIII may improve CAD prediction in the general population.
Lipids in Health and Disease 11/2012; 11(1):162. · 2.17 Impact Factor
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ABSTRACT: BACKGROUND: This study aimed to investigate whether the body mass index (BMI) in combination with genetic variations in APOE and APOA5_'T' alleles modulates the risk of sHTG. METHODS: There were 255 moderate HTG (TG ≥2.26 and <5.65mmol/L) and 176 sHTG (TG ≥5.65mmol/L) and 304 controls (TG <2.26mmol/L) were recruited. APOE epsilon alleles were genotyped using sequence-specific primers; the APOA5_'T' allele (c.553G>T, rs2075291) was identified using a restriction site polymorphism. Overweight/obesity was defined as BMI ≥25kg/m(2) and non-overweight as BMI <25kg/m(2). RESULTS: Multivariate logistic regression analysis showed, in addition to APOA5_'T' allele, a significant interaction between BMI ≥25kg/m(2) and APOE4 carriers on the risk of sHTG. Subjects with diagnosis of diabetes, current smoking, hypertension, levels of non-high density lipoprotein, and BMI ≥25kg/m(2) were significant determinants of sHTG. The odds ratio (95% confidence intervals) of overweight/obese APOE4 carriers for sHTG was 13.56 (4.89-37.59) more than those of non-overweight non-APOE4 carriers, while the odds ratio for sHTG in overweight/obese patients with the APOA5_'T' allele was 15.83 (7.77-32.26) higher than those of non-overweight non-APOA5 carriers. CONCLUSIONS: Overweight/obesity may potentiate the genetic variants of the APOE4 and APOA5_'T' alleles on the risk of sHTG.
Clinica chimica acta; international journal of clinical chemistry 11/2012; · 2.54 Impact Factor
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ABSTRACT: BACKGROUND: In patients at high risk of stroke, such as atrial fibrillation (AF), there has been great interest in developing stroke risk prediction schemes for identifying those at high risk of stroke. Stroke risk prediction schemes have also been developed in non-AF populations, but are limited by lack of simplicity, which is more evident in schemes used in AF populations. We hypothesized that contemporary stroke risk stratification schemes used in assessing AF patients could predict stroke and thromboembolism in a non-AF community population, comparably to that seen in AF populations. METHODS: We tested the CHADS(2) and CHA(2)DS(2)-VASc schemes, as well as the AF stroke risk stratification schemes from the Framingham study, Rietbrock et al., 2006 ACC/AHA/ESC guidelines, the 8th American College of Cardiology (ACCP) guidelines and NICE, for predicting stroke in a large community cohort of non-AF subjects, the Chin-Shan Community Cohort Study. RESULTS: The tested schemes had variable classification into low, moderate and high risk strata, with the proportion classified as low risk ranging from 5.4% (Rietbrock et al. to 59.0% (CHADS(2) classical). Rates of stroke also varied in those classified as 'low risk' ranging from 1.1% (Rietbrock et al. to 3.5% (Framingham). All common risk schemes had broadly similar c-statistics, ranging from 0.658 (Framingham) to 0.728 (CHADS(2) classical) when assessed as a continuous risk variable for predicting stroke in this population, with clear overlap between the 95% CIs. In an exploratory analysis amongst AF subjects in our population, the c-statistics were broadly similar to those seen in non-AF subjects. CONCLUSION: Contemporary stroke risk stratification schema used for AF can also be applied to non-AF populations with a similar (modest) predictive value. Given their simplicity (e.g. CHADS(2) score), these scores could potentially be used for a 'quick' evaluation of stroke risk in non-AF populations, in a similar manner to AF populations.
International journal of cardiology 10/2012; · 7.08 Impact Factor
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Ying-Hsien Chen,
Yen-Wen Wu,
Wei-Shiung Yang,
Shoei-Shen Wang,
Chi-Ming Lee,
Nai-Kuan Chou,
Ron-Bin Hsu,
Yen-Hung Lin,
Mao-Shin Lin,
Yi-Lwun Ho, Ming-Fong Chen
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ABSTRACT: Purpose
Heart failure (HF) had been reported with increased risk of hip fractures. However, the relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF remained unclear.
Methods
This is a cross-sectional study which recruited stable chronic HF from registry of the Heart Failure Center of National Taiwan University Hospital. Patients underwent dual-energy x-ray absorptiometry (DEXA) measurements at hip and lumbar spines and biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin and osteoprotegerin (OPG).
Results
A total of 115 stable chronic HF individuals with left ventricular ejection fraction (EF)
PLoS ONE 08/2012; 7(8). · 4.09 Impact Factor
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ABSTRACT: The effects of baseline and changes in blood pressure and low density lipoprotein (LDL) cholesterol on the carotid intima media thickness (IMT) have not been well documented.
A total of 2572 adults (mean age 53.8 years, 54.6% women) in a Taiwanese community undertook three blood pressure and LDL cholesterol examinations over 6 years. Latent growth curve modeling was used to investigate the effects of baseline and change in blood pressure and LDL cholesterol on IMT.
Greater baseline LDL and blood pressure were associated with an increase in IMT (0.005 ± 0.002 mm per 1 mg/dL [p = 0.006] and 0.041 ± 0.004 mm mmHg [p <0.0001], respectively. Change in blood pressure was associated with a significant increase in IMT (0.047±0.016, P = 0.004), whilst the association between change in LDL and change in IMT was not statistically significant (0.008±0.006, P = 0.20).
Carotid IMT was associated with baseline blood pressure and LDL cholesterol, yet only changes of blood pressure, not LDL cholesterol, were related to carotid IMT during the 6-year observation.
BMC Cardiovascular Disorders 08/2012; 12:66. · 1.52 Impact Factor
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ABSTRACT: Aim: Few population-based studies have assessed the risk factors of and gender differences in intima-media thickness (IMT) at the common carotid artery (CCA) for different age groups. Objective: Factors determining age and gender differences in IMT were studied in ethnic Chinese participants of the Chin-Shan Community Cardiovascular Cohort in Taiwan.Methods: From July 1994 through August 1996, the CCA-IMT of 1203 men and 1487 women aged 35 years or more was measured using high-resolution B-mode carotid ultrasound. Cardiovascular risk factors were recorded for each subject.Results: The CCA-IMT consistently increased with age and was more in men than in women. For participants aged 55 years or more, women showed a more rapid increase in systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL) than men. The gender difference in CCA-IMT became insignificant after 75 years of age. The major determinants of CCA-IMT in addition to age and gender were body mass index at 35-44 years of age, LDL in both genders and SBP in women at 45-54 years old, SBP at 55-64 and 65-74 years old, and women with left ventricular hypertrophy, hypertension with medication, and high LDL levels at 65-74 years old after multivariate linear regression analysis. For those aged over 75 years, SBP was an important determinant of CCA-IMT.Conclusions: The CCA-IMT increases with age and its determinants are associated with age and gender. The rapid increase in cardiovascular risk factors in women after 55 years of age attenuates the female advantage in CCA-IMT.
Journal of atherosclerosis and thrombosis 08/2012; 19(9):872-80. · 2.69 Impact Factor
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Xue-Ming Wu,
Yen-Hung Lin,
Aaron Chen,
Tse-Pin Hsu,
Yen-Wen Wu,
Hung-Ju Lin,
Ron-Bin Hsu,
Chi-Ming Lee,
Shoei-Shen Wang,
Men-Tzung Lo,
Yi-Lwun Ho, Ming-Fong Chen
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ABSTRACT: Eur J Clin Invest 2012; 42 (10): 1079-1086 ABSTRACT: Objectives The goal of this study was designed to assess prognostic values of simultaneous measurement of adipocytokines in systolic heart failure (HF) patients. Methods Patients with HF manifestations and left ventricular ejection fraction (LVEF) ≤ 50% were selected in this study. Gender, age, medications and serum biochemical data were recorded upon admissions. Adipocytokines including adiponectin, leptin, resistin, visfatin and retinol binding protein-4 were measured. Results A total of 108 (83 males and 25 females) patients were enroled. The age was 62 ± 15 years and mean LVEF was 35%. Twenty patients died during 776 ± 323 days follow-up. In univariate analysis, mortality was found to be associated with the log-transformed values of serum resistin (β = 5·616, P = 0·04), log-transformed values of serum adiponectin (β = 4·377, P = 0·038), age (β = 1·071, P < 0·001), NTHA functional status (β = 3·752, P = 0·001) and body mass index (β = 0·858, P = 0·012). Patients with higher level of serum resistin were associated with higher mortality (P = 0·012). In multivariate analysis, mortality is associated with log-transformed values of serum resistin (β = 3·666, P = 0·045), age (β = 1·044, P = 0·017) and NTHA functional status (β = 2·541, P = 0·025). Conclusions Serum resistin level was associated with higher mortality in systolic HF patients even after adjusting clinical parameters. Resistin may be an informative risk marker for systolic HF patients.
European Journal of Clinical Investigation 05/2012; 42(10):1079-1086. · 3.02 Impact Factor
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International journal of cardiology 04/2012; 157(2):263-8. · 7.08 Impact Factor
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ABSTRACT: Transplant arteriosclerosis (TA) remains the major limitation of long-term graft survival in heart transplantation despite the advances in immunosuppressants. Mesenchymal stem cells (MSCs) have been demonstrated to suppress allogeneic immune responses by numerous in vitro studies. However, the immunomodulatory effects of MSCs in vivo are controversial and the underlying molecular mechanisms are not conclusive. In this study, we investigated the therapeutic potential of autologous bone marrow-derived MSCs on TA in a porcine model of femoral artery transplantation. MSCs or saline were injected into the soft tissue surrounding the arterial grafts immediately postanastomosis. Four weeks after transplantation, neointimal formation increased significantly in untreated allografts compared with the MSC-treated grafts as assessed by intravascular ultrasound (maximum luminal area stenosis: 40 ± 12% vs. 18 ± 6%, p < 0.001). Grafts harvested at 4 weeks showed dense perivascular lymphocyte infiltration accompanied by significant intimal hyperplasia in the untreated but not in the MSC-treated allografts. Serial angiographic examination showed that all of the untreated allografts became occluded at the 8th week whereas the majority of the MSC-treated grafts remained patent at the 12th week posttransplantation (n = 12 each group, p < 0.001). Quantitative PCR analysis revealed that Foxp3 expression was comparable between the untreated and the MSC-treated groups. However, expression of interleukin-10 (IL-10), interferon-γ (IFN-γ), and indoleamine 2,3-dioxygenase (IDO) was increased significantly in the MSC-treated allografts compared with that in the allograft controls (p = 0.021 for IL-10, p = 0.003 for IFN-γ, and p = 0.008 for IDO). In conclusion, local delivery of autologous MSCs alleviates TA by inducing allograft tolerance via enhanced expression of IL-10, IFN-γ, and IDO but not Foxp3-positive cells in the vessel wall. These results suggest that MSCs induce immune tolerance by activating the type 1 regulatory T-like cells.
Cell Transplantation 03/2012; 21(5):971-84. · 5.13 Impact Factor
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ABSTRACT: The evidence for a relationship between dietary patterns and uric acid concentrations is scanty. Here, we used a validated food frequency questionnaire for an ethnic Chinese population in Taiwan to investigate the relationship between dietary patterns and uric acid concentrations. A cross-sectional study on 266 adults, who were interviewed with a 38-item food frequency questionnaire, was conducted and serum uric acid levels were measured. Three dietary patterns were derived from the questionnaire by exploratory factor analysis. Participants in the higher vegetable and fruit pattern quartiles were more likely to have a lower uric acid concentration (6.5 for the first, 5.7 for the second, 6.0 for the third, and 6.0 mg/dL for the fourth quartile, p = 0.030). For uric acid-prone patterns, as the quartiles increased, the adjusted mean uric acid concentrations increased significantly (5.88, 5.93, 5.99 and 6.38 mg/dL for each quartile, respectively, p = 0.04). However, the significance level was attenuated after adjusting for additional confounding factors. In conclusion, three dietary patterns were identified for ethnic Chinese in Taiwan, and the relationship between these dietary patterns and uric acid was not significant after adjustment.
Asia Pacific Journal of Clinical Nutrition 01/2012; 21(2):263-70. · 1.13 Impact Factor
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Ying-Hsien Chen,
Yen-Wen Wu,
Wei-Shiung Yang,
Shoei-Shen Wang,
Chi-Ming Lee,
Nai-Kuan Chou,
Ron-Bin Hsu,
Yen-Hung Lin,
Mao-Shin Lin,
Yi-Lwun Ho, Ming-Fong Chen
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ABSTRACT: Heart failure (HF) had been reported with increased risk of hip fractures. However, the relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF remained unclear.
This is a cross-sectional study which recruited stable chronic HF from registry of the Heart Failure Center of National Taiwan University Hospital. Patients underwent dual-energy x-ray absorptiometry (DEXA) measurements at hip and lumbar spines and biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin and osteoprotegerin (OPG).
A total of 115 stable chronic HF individuals with left ventricular ejection fraction (EF) <45% (74% of male, mean age at 59) were recruited with 24 patients in NYHA class I, 73 patients in NYHA class II and 18 patients in NYHA class III. Results of BMD showed that Z scores of hip in NYHA III group (-0.12±1.15) was significantly lower than who were NYHA II (0.58±1.04). Serum OPG was significantly higher in subjects of NYHA III (9.3±4.6 pmol/l) than NYHA II (7.4±2.8 pmol/l) or NYHA I (6.8±3.6 pmol/l) groups. There's a significant negative association between log transformed serum OPG and trochanteric BMD (R = -0.299, P = 0.001), which remained significant after multivariate analysis.
Our study demonstrated an inverse association between serum OPG and trochanteric BMD in patients with HF. OPG may be a predictor of BMD and an alternative to DEXA for identifying at risk HF patients for osteoporosis.
PLoS ONE 01/2012; 7(8):e44242. · 4.09 Impact Factor
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Yen-Wen Wu,
Hsian-Li Kao,
Chi-Lun Huang, Ming-Fong Chen,
Lian-Yu Lin,
Yi-Chih Wang,
Yen-Hung Lin,
Hung-Ju Lin,
Kai-Yuan Tzen,
Ruoh-Fang Yen,
Yu-Chiao Chi,
Por-Jau Huang,
Wei-Shiung Yang
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ABSTRACT: (18)F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has the potential to track vascular inflammation and monitor therapeutic response. The purpose of this study was to determine the association between arterial inflammation, calcification and serological biomarkers in subjects with atherosclerosis, and to assess their therapeutic response to 12-week atorvastatin treatment.
Forty-three statin-naïve subjects with atherosclerosis received atorvastatin (40 mg/day) for 12 weeks and underwent (18)F-FDG PET/CT, coronary calcification and abdominal adipose tissue volume measurements. A panel of serological biomarkers was analysed. Arterial inflammation was measured at seven arterial segments and normalized to venous FDG activity to produce target to background ratios (TBR). Thirty-four subjects without cardiovascular disease who repeated PET 1-4 years apart for routine health check-ups were retrospectively evaluated for comparison.
The baseline mean TBR values in atherosclerotic patients were positively correlated with age (R = 0.36), body mass index (R = 0.54), abdominal visceral adipose tissue volume (R = 0.65), coronary calcification score (R = 0.40), levels of low-density lipoprotein cholesterol (R = 0.54), matrix metalloproteinase (MMP)-9 (R = 0.46) and fatty acid binding protein 4 (FABP4) (R = 0.67, all p < 0.05). The TBR as well as high-sensitivity C-reactive protein (hsCRP), E-selectin, MMP-9, monocyte chemotactic protein 1, FABP4 and follistatin values were reduced significantly after the 12-week atorvastatin treatment. The TBR reduction marginally correlated with changes in MMP-9 levels (R = 0.56, p = 0.05). The control group, whose median age was younger, by comparison had lower hsCRP and arterial TBR than the subjects with atherosclerosis (all p < 0.05), and moreover had a slight but insignificant increase in mean TBR at their 2.5±0.8 year follow-up.
The medium dose of atorvastatin over a 12-week period resulted in a significant reduction of arterial inflammation as well as various circulating biomarkers.
European Journal of Nuclear Medicine 11/2011; 39(3):399-407. · 4.53 Impact Factor
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ABSTRACT: We investigated relationship of low levels of high density lipoprotein cholesterol (HDL-C), high levels of triglycerides, and renal function for the odds, prognosis and survival following acute coronary events among patients with a first event and normal low density lipoprotein cholesterol levels.
A case-control study based on 557 patients and 1086 matched control subjects was conducted. Case patients were followed up for survival with a median of 1.9 years. Participants in the higher quintiles of HDL-C had lower odds to develop acute coronary events (the adjusted odds ratios were 0.24 for the second, 0.24 for the third, 0.10 for the fourth and 0.05 for the fifth quintile). Patients with normal glomerular filtration rate were at a lower risk for all-cause death. However, a reverse association between triglycerides and death risk was found: patients with higher triglycerides were at a lower risk for all-cause death (adjusted relative risk, 0.38 for triglycerides ranging from 82 to 132.9 mg/dL, and 0.14 for triglycerides > = 133 mg/dL).
Low HDL-C was significantly associated with acute coronary events, and triglyceride levels as well as renal function were inversely related to all-cause deaths after the coronary event.
Lipids in Health and Disease 11/2011; 10:215. · 2.17 Impact Factor
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ABSTRACT: Evidence on the relationship between left atrial dimension and cardiovascular events is inconclusive. We explored the association between left atrial dimension and stroke and all-cause death in an ethnic Chinese population.
We recruited 1,937 subjects undertaking echocardiographic examination without prior atrial fibrillation/stroke in the Chin-Shan Community Cardiovascular Cohort study. Left atrial dimension indexed by body mass index was used as left atrial dimension index (LADI) for analysis. The end points were stroke and all-cause death. A multivariate Cox regression analysis was used to estimate the relative risks between participants stratified by tertile of LADI within each gender.
During a median follow-up of 11.9 years, 21,733 person-years were accrued and 114 subjects with stroke and 364 all-cause deaths were identified. The adjusted relative risk of stroke was 2.44 (95% CI, 1.11 to 5.36, P for trend = 0.029) among women in the upper tertile of LADI compared with women in the lower tertile of LADI. Further adjusting for left ventricular mass index attenuated the relationship of LADI to stroke (adjusted relative risk 2.11, 95% CI, 0.88 to 5.02, P for trend = 0.09). In men, tertile of LADI was not associated with stroke. LADI was not associated with risk of all-cause death in both genders.
We found an association between increased LADI and incident stroke in women but not in men in this ethnic Chinese population. LADI was not associated with all-cause death in both genders.
Echocardiography 11/2011; 28(10):1054-60. · 1.24 Impact Factor
