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Objective To identify the risk factors of new-onset hypertriglyceridemia (HTG) in kidney transplant recipients. Methods Clinical data of 149 kidney transplant recipients were retrospectively analyzed. According to serum triglyceride (TG) level after operation, they were divided into the non-HTG group (TG≤1.7 mmol/L, n=60) and new-onset HTG group (TG>1.7 mmol/L, n=89). Baseline data of all recipients were compared between two groups. The risk factors of HTG in kidney transplant recipients were analyzed by generalized estimating equation (GEE), and validated by multiple regression equations. Results No significant differences were observed in baseline data between two groups (all P>0.05). Multivariate analysis showed that the incidence of HTG in the middle and high tacrolimus (Tac) concentration groups was higher than that in the low Tac concentration group [odds ratio (OR) 3.11, 95% confidence interval (CI) 1.22-7.93, P=0.018 in the middle Tac concentration group; OR 5.11, 95%CI 1.31-19.98, P=0.019 in the high Tac concentration group]. Compared with type-A blood recipients, the risk of new-onset HTG was significantly increased in type-O blood counterparts (OR 2.77, 95%CI 1.14-6.71, P=0.024). The risk of new-onset HTG was decreased along with the increase of preoperative globulin level (OR 0.93, 95%CI 0.87-0.99, P=0.043). At postoperative 3 months, Tac blood concentration in the new-onset HTG group was significantly higher compared with that in the non-HTG group, and significant difference was observed (P<0.05). Multiple regression equations confirmed that the risk of new-onset HTG in type-O blood kidney transplant recipients was higher than that in type-A blood counterparts, and the risk of new-onset HTG in the middle and high Tac concentration groups was higher than that in the low Tac concentration group (all P<0.05). Conclusions Type-O blood kidney transplant recipients are more prone to HTG. It is necessary to strengthen postoperative monitoring and control of blood lipids. The blood concentration of Tac probably affects the new-onset HTG in kidney transplant recipients. Maintaining an appropriate blood concentration of Tac may be beneficial to lowering the risk of HTG.
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@#Objective To explore the association between total cholesterol and type 2 diabetes ( T2DM) ． Methods Non－diabetic people who aged 20 to 90 years at the baseline and who had physical examination more than 2 times were screened． Comparisons of the baseline characteristics were conducted with Student－t test or Pearson chi－square test． Generalized estimating equation ( GEE) was used to analyze the effect of total cholesterol of quantiles groups ( 2．10－ mmol /L，4．16－ mmol /L，4．76－ mmol /L and 5．42 －13．29 mmol /L) to type 2 diabetes． Results The cohort with an average age of 3．53 years per person in- cluded 12 928 subjects and 45 626 person－years． During the follow－up，447 cases of new－onset diabetes occurred and the incidence density was 9. 80‰． The high incidence of type 2 diabetes increased with the increase of total cholesterol． After adjusting the factors including age，high density lipoprotein，hypertension and obesity，based on the 2. 10－ mmol /L group，the relative risk ( RR) of the 4. 16－ mmol /L，4. 76－ mmol/L and 5. 42－13. 29 mmol /L group were 1. 24( 95% CI: 0. 83－1. 86) ，1. 75 ( 95% CI: 1. 19－2. 56) and 3. 60( 95% CI: 2. 51－5. 17) ，respectively． Conclusions Total cholesterol is associated with type 2 diabetes，and as the total cholesterol increases，the risk of developing type 2 diabetes increases．
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In prospective cohort study, multi follow up is often necessary for study subjects, and the observed values are correlated with each other, usually resulting in time-dependent confounding. In this case, the data generally do not meet the application conditions of traditional multivariate regression analysis. Sequential conditional mean model (SCMM) is a new approach that can deal with time-dependent confounding. This paper mainly summarizes the basic theory, steps and characteristics of SCMM.
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In prospective cohort study, multi follow up is often necessary for study subjects, and the observed values are correlated with each other, usually resulting in time-dependent confounding. In this case, the data generally do not meet the application conditions of traditional multivariate regression analysis. Sequential conditional mean model (SCMM) is a new approach that can deal with time-dependent confounding. This paper mainly summarizes the basic theory, steps and characteristics of SCMM.
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Generalized Estimating Equation (GEE) deals with such data that do not have normal distribution in case of repeated experiment and has better properties as compared to rANOVA. With the objective to describe the use of GEE in pharmacological study this endeavour started. GEE described hereby using rat data. Four correlation structured were taken in GEE. It was found Independent/Exchangeable structure best suited with data. The model fit on data was assessed graphically as well. The trend line of repeated data for all cases (rats) were fallen in 95 % bound of predicted model. The model gave the average weight of rat 226.51 gram with start of experiment and it increases 8.67gram per week after feeding high fat diet.
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OBJECTIVE: To investigate the prevalence of metabolic syndrome(MetS) and its related influencing factors among male workers in several industries in Guangzhou City.METHODS: A total of 2 987 male workers were selected by convenience sampling method and the occupational health physical exam data from 2012 to 2015 was collected.The MetS was diagnosed according to the diagnostic criteria proposed by the Chinese Medical Association Diabetes Association.The analysis of correlation factors was conducted by the generalized estimating equation method.RESULTS: The diastolic blood pressure of subjects increased year by year(P<0.01) and high-density lipoprotein cholesterol(HDL-C) decreased year by year(P<0.01) from 2012 to 2015,but the changes of body mass index,systolic blood pressure and levels of fasting plasma glucose,triglyceride didn't increase or decrease over time.The prevalence of high blood pressure,high glycemia,high TG,low HDL-C and MetS were found to increase year by year(P<0.01) from 2012 to 2015.The generalized estimating equation analysis results showed service length,family history(hypertension and/or diabetes),regular alcohol consumption,frequent smoking,oily diet and meat-rich diet were the risk factors of MetS(P<0.05) after adjusting the confounding factors of age.CONCLUSION: The incidence of MetS in male workers in Guangzhou City is increasing year by year.The service lengh,family history(hypertension and/or diabetes),regular alcohol consumption,regular smoking,oily diet and meat-rich diet are associated with the prevalence of MetS in this population.
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Objective To analysis the effects on the growth of rats by repeated restraint in dermal exposure test. Methods SD rats in the restraint group was bound for 6 hours per day for 91 days according the way by dermal exposure, while SD rats in the control group didn't receive the treatment. Clinical signs, body weight and food consumption changes were observed for 91 days. When the study was terminated, hematology, clinical biochemistry, urinalyses, gross necropsy, and histopathology were carried out. Statistical methods such as the generalized estimating equation were used to compare the differences between two groups. Results The statistical results of generalized estimating equation showed that there was an interaction between the group and test time for male and female rats in body weight changes (P<0.05), and the body weight of male rats in the restraint group was lower than the control group (P<0.05) . Further analysis showed that for male rats there was significant difference between groups since the forth week (P<0.05), and the interaction was found between groups and test time (P<0.05) . For female rats, the interaction was found since the eighth week between the group and test time (P <0.05) .There was no significant differences in other parameters between two groups (P>0.05) . Conclusion Repeated restraint during dermal exposure affected the body weight gain of rats, and the sensitivity of male rats was higher than that of female rats.
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Objective To investigate the association between serum direct bilirubin (DBIL) with metabolic syndrome (MS) and its components.Methods A dynamic health check-up cohort study was set up from 2006 to 2011.5 258 participants who satisfied the two basic rules:1) being free of MS at the 1st health check-up program;2) having at least two intact health checks were included in this study.With generalized estimating equation (GEE) model,after adjusting for items as age,gender,smoking,drinking,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,uric acid,blood urea nitrogen and white blood cells,the multivariable relative risks (RRs) of DBIL with MS and their components were analyzed.Results The RRs of DBIL for MS was 0.722 (95％ CI:0.654-0.797),which showing a dose-response.Serum DBIL was negatively associated with obesity and hyperlipidemia.Taking factors as gender and age into account,in the ＜45 years and 45-55 years groups,the RRs of DBIL for MS in females appeared as 0.516 (95％CI:0.349-0.761) and 0.435 (95％CI:0.256-0.740).And in males of ＜45 years and 45-55 years,the RRs of DBIL for MS were 0.738 (95％ CI:0.644-0.846) and 0.790 (95％ CI:0.667-0.937),respectively.Conclusions The elevated DBIL levels in serum appeared an early biomarker for MS and its components (obesity and hyperlipidemia).In particular,they may play a role in reducing the risk of MS in both females and males before 55 years of age.
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<p><b>OBJECTIVE</b>This study explored the correlation of longitudinal changes in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels with the incidence of metabolic syndrome (Mets) based on a dynamic health examination cohort.</p><p><b>METHODS</b>A Mets-free dynamic cohort involving 4541 participants who underwent at least three health examinations from 2006 to 2011 was included in the study. Mets was defined according to the Chinese Medical Association Diabetes Branch definition that included hypertension, obesity, hyperlipidemia, and hyperglycemia. Generalized estimating equation (GEE) model was used to analyze multivariate relative risk (RR) of repeated observations of ALT and AST in quartiles for Mets or its components according to gender.</p><p><b>RESULTS</b>In all, 826 Mets cases were reported. Adjustment of relevant parameters indicated that time-varying changes in ALT and AST levels were positively associated with the incidence of Mets in a dose-response manner. Positive association between high ALT levels and fatty liver was much stronger than that between high AST levels and fatty liver, particularly in male participants. These associations were consistently observed in the following subgroups: participants with ALT and AST levels of <40 U/L, participants with of <25 kg/m2, and participants with non-fatty liver. Furthermore, participants with 2 Mets components at baseline showed lower multivariate adjusted RRs of ALT and AST for Mets than participants with 0-1 Mets component.</p><p><b>CONCLUSION</b>These results suggested that elevated serum ALT and AST levels were early biomarkers of Mets or its components.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Alanine Transaminase , Blood , Aspartate Aminotransferases , Blood , Biomarkers , Blood , China , Epidemiology , Cohort Studies , Hepatitis , Epidemiology , Incidence , Liver , Metabolic Syndrome , Diagnosis , EpidemiologyABSTRACT
Objective To evaluate the effect of child obesity intervention comprehensive program on the improvement of overweight,obese control and knowledge-attitude-practice.Methods The study design was under cluster-randomized controlled trial,with 965 children in the intervention and 895 children in the control groups.Repeated measurement data on child obesity was analyzed through Generalized Estimating Equation models.Results The risk of becoming overweight or obesity in the intervention group was 0.824 times more than children in the control group,showing a reduction of 17.6％ the risk of being overweight or obese (P=0.031).In addition,the possibility of increasing one unit of correct rate on obesity related knowledge,children in the intervention group children was 1.044 times (P=0.001) than in the control group.On the mean obesity related correct attitude rate,it was 1.023 times (P=0.001) in the intervention group of the control group.Regarding the possibility of increasing one unit om the mean obesity related behavior score,children in the intervention group was 1.522 times (P=0.001) than those in the control group (P=0.046).Conclusion The comprehensive child obesity intervention program could effectively reduce the risk of developing overweight or obeseity and improving the obesity related knowledge,attitude and behavior in children.
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To explore the appropriate method in estimating relative risk (RR)/prevalence ratio (PR) related to non-independent datasets.The simulation datasets generated by computer and case study were analyzed by two generalized estimating equation (GEE) models to investigate and compare the related applicability.Both convergence effects of log-binomial-GEE model and Robust Poisson-GEE model were almost 100％.The estimation results of the two GEE models were both closer to the true value.95％CI coverage of the two GEE models increased along with the reduction of class aggregation or the increase of the number of categories.Robust-Poisson-GEE model seemed to be more stable and steady than the log-binomial-GEE.The two GEE models could correctly evaluate the effects of exposure on the outcome in the case study.Rarely,there appeared problems on convergence of Robust Poisson or log-binomial-GEE model,and the accuracy was high.Both models could be used to estimate the RR/PR on non-independent epidemiological data.
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the mood of anger, sadness agitation, having some kind of infection were related to IVT. Case-crossover design seemed to be able to identify the risk factors of IVT and its intensity.