Retention in Community Health Screening among Taiwanese Adults: A 9-Year Prospective Cohort Study.

Largely conducted in Western developed nations, research on community health screening has mainly been of limited duration. This study aims to ascertain the predictors of retention in a community health screening program, involving multiple admission cohorts over a 9-year period in Taiwan. Retention is defined as the participation in subsequent waves of health screening after being recruited for an initial screening. Data came from a prospective cohort study, named "Landseed Integrated Outreaching Neighborhood Screening (LIONS)", in Taiwan. This research retrieved 5901 community-dwelling Taiwanese adults aged 30 and over from LIONS and examined their retention in three follow-ups during 2006-2014. Generalized estimating equations were employed to evaluate retention over time as a function of social determinants, health behaviors, and health conditions. Being middle-aged, higher education, and regular exercise were positively associated with retention. Conversely, smoking, betel-nut chewing, psychiatric disorder, hypertension, type 2 diabetes mellitus, stroke, and a longer time interval since enrollment were negatively associated with retention. Furthermore, retention rates varied substantially across admission cohorts with more recent cohorts having a lower rate of retention (aOR = 0.33-0.83). Greater attention needs to be directed to retention over time and variations across admission cohorts. Additionally, those who are in either younger or older age groups and have chronic diseases or unhealthy behaviors should be targeted with greater efforts.

Relationship Between Metabolic Syndrome Severity and Kidney Function as Related to Gender: A Population-Based Longitudinal Study.

The purpose of this study was to explore the relationship between the metabolic syndrome severity Z-score and kidney function by gender. We also examined the estimated glomerular filtration rate in relation to other known risk factors. The study used was a population-based prospective longitudinal research design. A total of 4,838 participants (2,683 females and 2,155 males) included individuals aged >30 years who were undergoing a health examination from 2006 to 2014 in Pingzhen City, Taiwan. In the initial generalized estimated equation model analysis, which included the covariates of age of first visit, period between the first and current visit, and metabolic syndrome severity Z-score, the results indicated that the interaction between age and metabolic syndrome severity Z-score is significantly related to the estimated glomerular filtration rate for males (p = .040). For females, the interaction between age and metabolic syndrome severity Z-score was not significant, but a higher metabolic syndrome severity Z-score was significantly associated with lower estimated glomerular filtration rate (p = .001). After controlling for the confounders, unhealthy behaviors, and comorbidities, the metabolic syndrome severity Z-score was still a negative predictor of estimated glomerular filtration rate in both the male (p = .005) and female (p = .023) models.

Gender Differences in the Effects of the Frequency of Physical Activity on the Incidence of Metabolic Syndrome: Results from a Middle-Aged Community Cohort in Taiwan.

BACKGROUND: Little is known about how the frequency of physical activity in adults influences the occurrence of metabolic syndrome (MetS), and whether there are gender differences within these effects. METHODS: In this study, 3368 residents from the established "Landseed Cohort" underwent three waves of health examinations, and those who did not have MetS at baseline were selected and analyzed using a multiple Poisson regression model. By calculating the adjusted relative risk (ARR), the linear and nonlinear relationships between the frequency of physical activity and risk of developing MetS were examined for male and female participants. RESULTS: The prevalence of MetS was fairly stable across the three waves (ranging from 16.24% to 16.82%), but the incidence dropped from 7.11% to 4.52%. The risk of MetS in women was 10 times higher than that in men (ARR = 10.06; 95% CI = 6.60-15.33), and frequent exercise was shown to help prevent it. The frequency of exercise had a linear dose-response effect in females and an exponential protective effect in males on the occurrence of MetS. Exercising more than four times a week for females and twice or more a week for males effectively reduced the risk of developing MetS. CONCLUSIONS: The frequency of physical activity in adults was negatively related to the risk of developing MetS, and this relationship differed based on gender. The protective effect of physical activity on MetS was linear in females and exponential in males.

Correlations between white blood cell count and metabolic syndrome in middle-age Taiwanese.

Metabolic syndrome was first proposed in 1988 and has been recognized as a powerful predictor for cardiovascular disease and diabetes. At the same time, white blood cell count (WBCC) was proposed to have significant correlation with metabolic syndrome (MS). In this study, we attempted to investigate the relationship between WBCC and components of metabolic syndrome in subjects in Taiwan with normal WBCC, no significant medical disease, and no medications known to affect the components of MS. We enrolled 1185 subjects with age > or = 40 years in 1997. These subjects participated in the annual health examination of the MJ Life Clinic. Subjects with abnormal WBCC (> 10x 10(9) cells/l), history of diabetes, hypertension or hyperlipidemia, or taking medications for these diseases or medications known to affect components of MS, were excluded. Because the menstrual cycle has an effect on the components of MS, we divided the subjects into three groups: male (M group, n = 576), old female (OF group, aged > or = 50 years, n = 307), and young female (YF group: aged < 50 years, n = 302). Each group was further divided into four quartiles according to WBCC (WBCC1 to WBCC4, from the lowest to highest WBCC). The body mass index (BMI) of YF was significantly lower than both M and OF. The diastolic blood pressure (DBP) and triglycerides (TG) were higher in M than YF. High-density lipoprotein cholesterol (HDLC) was lower in M compared to both YF and OF. When evaluating the metabolic components in different quartiles of WBCC in M, only WBCC1 had lower BMI and TG than WBCC4 after adjustment for age and BMI. For OF, the results were similar, the BMI of both WBCC1 and WBCC2 was lower than WBCC3 and TG of WBCC1 was lower than WBCC4. Finally, in YF, none of the BMI, blood pressure, FPG, HDLC, or TG was different in the four WBCC quartiles. The results of multiple regression between the WBCC and components of MS after adjustment for age and BMI were also evaluated. Significant correlations could only be noted in WBCC with BMI and TG in M and OF. In conclusion, in subjects with normal WBCC and no history of significant medical diseases, BMI and TG are significantly related to the levels of WBCC and are the two earliest components of MS to be noted, especially in males and post-menopausal females.

The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism.

OBJECTIVE: The study aims to evaluate the efficacy of combination therapy with propylthiouracil (PTU) and cholestyramine in the treatment of Graves' hyperthyroidism. BACKGROUND: Thyroxine (T4) is metabolized mainly in the liver by conjugation to glucuronides and sulphates that enter the enterohepatic circulation. Thyrotoxic patients have an abnormal increase in thyroid hormone in their enterohepatic circulation. Previous studies on combination therapy with methimazole and cholestyramine for Graves' hyperthyroidism have shown it to be an effective adjunctive treatment. In this study, we examined the efficacy of combination therapy with PTU and cholestyramine in the treatment of Graves' hyperthyroidism. METHODS: Thirty patients with newly diagnosed Graves' hyperthyroidism were randomly divided into two groups: group I (n = 15) received PTU 100 mg twice a day, propranolol 40 mg twice a day and cholestyramine 4 g twice a day for 4 weeks; group II (n = 15) received PTU 100 mg twice a day and propranolol 40 mg twice a day for 4 weeks. The therapeutic efficacy was determined by serum total triiodothyronine (TT3), free thyroxine (FT4) and TRAb levels at baseline, and at the end of 2 and 4 weeks during the study period. RESULTS: There was no significant difference in baseline thyroid function parameters. At the end of 2 and 4 weeks of the study period, serum TT3 and FT4 levels of group I were significantly lower than those of group II. No significant differences in the TRAb level were found between the two groups. CONCLUSION: Cholestyramine contributed to a more rapid and complete decline in thyroid hormone levels in patients with Graves' hyperthyroidism. It was thus proved to be an effective and well-tolerated adjunctive therapy.