A single 24 h recall overestimates exclusive breastfeeding practices among infants aged less than six months in rural Ethiopia

Background

Exclusive breastfeeding (EBF) to six months is one of the World Health Organization’s (WHOs) infant and young child feeding (IYCF) core indicators. Single 24 h recall method is currently in use to measure exclusive breastfeeding practice among children of age less than six months. This approach overestimates the prevalence of EBF, especially among small population groups. This justifies the need to look for alternative measurement techniques to have a valid estimate regardless of population characteristics.

Method

The study involved 422 infants of age less than six months, living in Gurage zone, Southern Ethiopia. The study was conducted from January to February 2016. Child feeding practices were measured for seven consecutive days using 24 h recall method. Recall since birth, was used to measure breastfeeding practices from birth to the day of data collection. Data on EBF obtained by using single 24 h recall were compared with seven days repeated 24 h recall method. McNemar’s test was done to assess if a significant difference existed in rates of EBF between measurement methods.

Result

The mean age of infants in months was 3 (SD ?1.43). Exclusive breastfeeding prevalence was highest (76.7%; 95% CI 72.6, 80.8) when EBF was estimated using single 24 h recall. The prevalence of EBF based on seven repeated 24 h recall was 53.2% (95% CI: 48.3, 58.0). The estimated prevalence of EBF since birth based on retrospective data (recall since birth) was 50.2% (95% CI 45.4, 55.1). Compared to the EBF estimates obtained from seven repeated 24 h recall, single 24 h recall overestimated EBF magnitude by 23 percentage points (95% CI 19.2, 27.8). As the number of days of 24 h recall increased, a significant decrease in overestimation of EBF was observed.

Conclusion

A significant overestimation was observed when single 24 h recall was used to estimate prevalence of EBF compared to seven days of 24 h recall. By increasing the observation days we can significantly decrease the degree of overestimation. Recall since birth presented estimates of EBF that is close to seven repeated 24 h recall. This suggests that a week recall could be an alternative indicator to single 24 h recall.

     

Disordered eating attitude and associated factors among high school adolescents aged 12–19 years in Addis Ababa,Ethiopia: a cross-sectional study

Background

Eating disorders are very complex, frequently developed and have a public health impact on adolescents. Different studies revealed that eating disorders is a pressing public health problem among adolescents. Eating disorders may also lead to mortality due to their physiological sequelae. There is no previous study regarding disordered of eating attitude in Ethiopian adolescents. Therefore, this study aimed to assess prevalence of disordered eating attitude and its associated factors among adolescents in Addis Ababa high schools.

Methods

A school-based cross sectional study was conducted. Data were collected among 836 high school adolescents aged 12–19 years from May to June, 2015 in Addis Ababa city. The data were collected by self-administered questionnaire containing eating attitudes test-26 items (EAT-26) and socio-demographic factors. Binary logistic regression analysis was carried out to identify factors associated with disordered eating attitude. Both crude odds ratio and adjusted odds ratio were calculated to show the strength of association. In multivariable analysis, variables with a P value of <0.05 were considered statistically significant.

Results

The prevalence of disordered eating attitude among adolescents was 8.6% [95% CI 4.9, 12.3]. Being female [AOR = 1.75, 95% CI 1.03, 3.00], Mother’s educational status (Primary [AOR = 0.28, 95% CI 0.11, 0.78], Certificate/diploma [AOR = 0.22, 95% CI 0.07, 0.58] and first degree and above [AOR = 0.16, 95% CI 0.07, 0.40]) were found to be significantly associated with disordered eating attitude.

Conclusion

The finding of this study revealed that a significant number of adolescents were susceptible to developing disordered eating attitude. Being female and Mothers’ education status were significantly associated with disordered eating attitude among adolescents. Provision of screening test for eating disorders focusing on female adolescents is highly recommended.

     

Exclusive breastfeeding status of children aged between 6 and 24 months in the nomadic population of Hadaleala district,Afar Region,northeast Ethiopia

Background

Exclusive breastfeeding (EBF) during infancy is fundamental, however it is not fully practiced in the nomadic population of Ethiopia. In Ethiopia, there is still a lack of information on the implementation of the EBF, especially among the nomadic population. This study was conducted to assess the EBF status of children during their first 6 months of life, who are now aged between 6 and 24 months, in the nomadic population of Afar region. The study also aimed to identify factors affecting exclusive breastfeeding.

Methods

A community based cross-sectional study was conducted from April to May, 2015 to assess EBF of children aged between 6 and 24 months during the first 6 months of life. Exclusive breastfeeding is defined as consuming only breast milk (including expressed breast milk) during the first 6 months and no other liquids and solid foods except medications, and non exclusive breastfeeding is taking liquids and solid foods in addition to breast milk. The cluster sampling technique was used to select the study participants. Data were collected from 254 households using a structured questionnaire.

Results

One hundred eighty eight of the children were fed breast milk exclusively for the first 6 months of age; the rate of EBF in the study area was 74% (95% CI 70, 78%). One hundred fifty four (60.6%) of the children received breast milk within 1 h immediately after birth and 207 (81.5%) of the children maintained breastfeeding at the time of the survey. Exclusive breastfeeding was statistically associated with mothers aged above 35 years (AOR 8.3, 95% CI 1.7, 40.3), commencing to breastfeed in first hour (AOR 3.5, 95% CI 1.8, 6.9), and parents who didn’t migrate or move to a more comfortable area (AOR 4.6, 95% CI 1.5, 14.4).

Conclusion

Exclusive breastfeeding was not fully practiced in the study area. Therefore, promotion of infant and young children feeding (IYCF) is needed in the area to strengthen EBF practices. Moreover, child feeding practices should be integrated with the existing health system and attention should be given to the nomadic mothers.

     

Epidemiological study on chronotype among preschool children in Japan: Prevalence,sleep–wake patterns,and associated factors

Our current 24-h society and the weekday–weekend switch of our social clocks may affect young children’s sleep and circadian rhythms. However, such evidence is scarce. We conducted a nationwide epidemiological study of sleep and health in preschool children aged 3–5 years attending kindergarten or childcare centers in Japan, using stratified one-stage cluster sampling. The target population was 2 969 627 individuals (as of 1 April 2013). The Children’s ChronoType Questionnaire was used to measure chronotypes (morning (M)-type, neither (N)-type and evening (E)-type), and weekday and weekend sleep–wake parameters. Randomly sampled population estimates were obtained via respondents with a person-level weight, which accounted for survey responses and poststratification. Standard errors and 95% confidence intervals were adjusted for the complex survey design using jackknife estimation. A linear regression model of the correlation between chronotype and sleep–wake parameters and a multivariate logistic regression model for the links between chronotype and putative associated factors were used for statistical analyses. The estimated prevalence of M-, N- and E-types were 31.6%, 55.9% and 10.0%, respectively. The corresponding numbers of children were 937 910, 1 659 574 and 296 083. The remaining 2.5% was not specified. The proportions of children who woke up by themselves during the weekdays were 55.1%, 43.0% and 1.9% for M-, N- and E-types, respectively. Overall, bedtime, sleep onset time, wake-up time and get-up time during the weekdays were 21:04, 21:26, 6:55 and 6:59, respectively. Nocturnal sleep period, time in bed (TIB) and 24 h TIB (TIB and nap) during the weekdays were 9.49, 9.93 and 10.55 h, respectively. Sleep–wake timings were significantly and linearly delayed from M-, N-, to E-types (p < 0.001). The weekday 24 h TIB (10.47–10.66 h) and weekend nocturnal sleep period (9.58–9.76 h) did not differ significantly among chronotypes. For E-types, socially advanced weekdays rising times (approximately 1 h) caused nocturnal sleep deficit (0.57 h). Children’s socially scheduled times (e.g. start and finish times, mealtimes and daytime nap) and their parents’ diurnal preferences had significant adjusted odds ratios among E-types, while the significant unadjusted odds ratios for morning sunlight and multimedia exposure disappeared. These results suggest the importance of chronobiologically planned sleep discipline at home as well as assessment of socially scheduled times in children.     

Use of wireless phones and serum β-trace protein in randomly recruited persons aged 18–65 years: a cross-sectional study

Background: There are studies suggesting effects on sleep from pulse-modulated radiofrequency fields used in mobile and cordless phones. So far, reports of adverse effects in observational studies are of limited value for risk assessment while effects from experimental studies seem to be more consistent but unclear as to their importance for health. The aim of this study was to investigate whether use of wireless phones is associated with lower concentrations of β-trace protein (lipocalin-type prostaglandin D synthase), a key enzyme in the synthesis of prostaglandin D₂, an endogenous sleep-promoting neurohormone.

Methods: Three hundred and fourteen people, aged 18–65 years and living in the municipality of Örebro, Sweden, were recruited randomly using the population registry. Total and age-specific linear regression analyses adjusted for known covariates were used to calculate associations between levels of β-trace protein and short- and long-term use of wireless phones.

Results: Overall, no statistically significant association between use of wireless phones and the serum concentration of β-trace protein was found, neither with respect to short-term nor long-term use. Age-specific analyses, however, yielded negative associations for long-term use (cumulative hours of use) and β-trace protein in the youngest age group (18–30 years). Conclusion: This study provided no overall evidence of an association between wireless phone use and serum concentrations of β-trace protein. While the findings in the 18–30 year age group indicating lower concentrations with more cumulative hours of use should be further investigated, no causal inferences can be made from the results of the present study.     

The polymorphisms of HLA class Ⅰ and Ⅱalleles were not associated with severe acute respiratory syndrome among recovered patients in Beijing: a case-control study

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a novel coronavirus (SARS-CoV), which emerged as a pandemic in 2003. The mechanism of the immune reaction initiated by SARS-CoV still remains unclear. Here we aimed to describe the genetic patterns of high-resolution HLA-A, -B, -C, -DRB1, and -DQB1, loci in recovered SARS patients from Beijing and examine the association between HLA genes and susceptibility or resistance to SARS. A total of 70 recovered Chinese Han SARS patients were recruited to donate convalescent plasma in 2003. HLA high-resolution typing was carried out using sequence based typing (SBT). Allele frequencies were calculated by direct counting, and were compared with the frequencies of HLA alleles of donors recruited by the China Marrow Donor Program between 2002 and 2015 using Fisher''s exact test. Significance of association was defined according to the Bonferroni method for multiple comparisons. We observed 20, 35, 21, 25, and 17 alleles respectively at HLA-A, -B, -C, -DRB1, and -DQB1 loci among the 70 recovered patients. We identified 12 alleles (HLA-A*02:10, -A*02:93, -A*03:02, -B*08:01, -B*15:152, -B*37:01, -DRB1*10:01, -DRB1*11:03, -DRB1*14:10, -DRB1*14:12, -DRB1*15:02, and -DQB1*05:10) showing a nominal association with SARS (P<0.05), but none remained significant after Bonferroni correction. The study suggests that high-resolution HLA alleles are unlikely to contribute significantly to the susceptibility or resistance to SARS-CoV infection in the northern Chinese population.     

ABO and Rhesus (D) blood group distribution among blood donors in rural south western Uganda: a retrospective study

Background

In Uganda, geographical distribution of blood groups and Rhesus (D) factor varies across the country. The aim of this study was to examine the distribution of these groups among voluntary blood donors in rural southwestern Uganda.

Results

Twenty-three thousand five hundred four (23,504) blood donors were included in the study. The donors had a mean age of 21 years (SD ± 5.7) and were mainly male (73%). The distribution of ABO blood group was; blood group O (50.3%); blood group A (24.6%); blood group B (20.7%) and blood group AB (4.5%). The proportions of Rhesus (D) positive and Rhesus (D) negative were 98 and 2% respectively. The proportion of non-adult donors (<18 years) was significantly higher among the female than the male donors (p value <0.001). A significantly higher proportion of males than females were Rhesus (D) negative (p-value <0.001). No significant relationship was found between age and blood group distribution.

Conclusion

The sequence of ABO distribution among the rural population in southwestern Uganda is; O > A > B > AB, with males as the predominant donors. The frequency of Rhesus (D) negative is very low in rural southwestern Ugandan and is mainly among males. The blood bank services in southwestern Uganda need to develop innovative strategies targeting female donors who are more likely to boost blood stocks in the region.

     

Dynamics of distribution and performance of ramets constructing genets: a demographic�Cgenetic study in a clonal plant, Convallaria keiskei

Background and Aims

In clonal plants producing vegetative offspring, performance at the genet level as well as at the ramet level should be investigated in order to understand the entire picture of the population dynamics and the life history characteristics. In this study, demography, including reproduction and survival, the growth patterns and the spatial distributions of ramets within genets of the clonal herb Convallaria keiskei were explored.

Methods

Vegetative growth, flowering and survival of shoots whose genets were identified using microsatellite markers were monitored in four study plots for 3 years (2003–2005). The size structures of ramets in genets and their temporal shifts were then analysed. Their spatial distributions were also examined.

Key Results

During the census, 274 and 149 ramets were mapped in two 1 × 2 m plots, and 83 and 94 ramets in two 2 × 2 m quadrats. Thirty-eight genotypes were identified from 580 samples. Each plot included 5–18 genets, and most ramets belonged to the predominant genet(s) in each plot. Shoots foliated yearly for several years, but flowering ramets did not have an inflorescence the next year. A considerable number of new clonal offspring persistently appeared, forming a bell-shaped curve of the size structure of ramets in each genet. Comparing the structures modelled by the normal distributions suggested variation among ramets belonging to a single genet and variation among genets. Furthermore, spatial analyses revealed clumped and distant distributions of ramet pairs in a genet, in which the distant patterns corresponded to the linearly elongating clonal growth pattern of this species.

Conclusion

Characteristics of ramet performances such as flowering and recruitment of clonal offspring, in addition to growth, played a large part in the regulation of genet dynamics and distribution, which were different among the studied genets. These might be characteristics particularly relevant to clonal life histories.Key words: Clonal plant, Convallaria keiskei, demography, genet, genetic identification, growth pattern, life history, ramet, spatial distribution     

Residents’ concerns about lake uses and environments: a comparative study of Lakes Kasumigaura,Suwa, and Biwa in Japan

Lakes are a common water resource. This study analyzed residents’ concerns regarding their lake environments to help solve lake environmental problems. The study area comprised three lakes in Japan—Kasumigaura, Suwa, and Biwa—which have different tendencies to change in water quality. A sample of 1200 respondents was evenly distributed among the three lake regions. A questionnaire survey asked about respondents’ proximity to the lake, their concerns about the lakes’ uses and environments, their evaluations of the lakes, and their opinions regarding environmental improvements. The number of options chosen in response to the multiple-answer questions was used to measure the extent of concern. The results found that knowledge of the water environment, general environmental concerns, the amount of travel time to the lake, and the visiting interval were significantly related to concerns about the lake environment. The results of logistic regression analysis found that high environmental concerns positively influenced attitudes toward lake use. Ways to increase concerns for lake environmental problems and the relationship between concerns and attitudes toward solving lake environmental problems are discussed.     

The polymorphisms of HLA class Ⅰ and Ⅱalleles were not associated with severe acute respiratory syndrome among recovered patients in Beijing: a case-control study

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a novel coronavirus (SARS-CoV), which emerged as a pandemic in 2003. The mechanism of the immune reaction initiated by SARS-CoV still remains unclear. Here we aimed to describe the genetic patterns of high-resolution HLA-A, -B, -C, -DRB1, and -DQB1, loci in recovered SARS patients from Beijing and examine the association between HLA genes and susceptibility or resistance to SARS. A total of 70 recovered Chinese Han SARS patients were recruited to donate convalescent plasma in 2003. HLA high-resolution typing was carried out using sequence based typing (SBT). Allele frequencies were calculated by direct counting, and were compared with the frequencies of HLA alleles of donors recruited by the China Marrow Donor Program between 2002 and 2015 using Fisher's exact test. Significance of association was defined according to the Bonferroni method for multiple comparisons. We observed 20, 35, 21, 25, and 17 alleles respectively at HLA-A, -B, -C, -DRB1, and -DQB1 loci among the 70 recovered patients. We identified 12 alleles (HLA-A*02:10, -A*02:93, -A*03:02, -B*08:01, -B*15:152, -B*37:01, -DRB1*10:01, -DRB1*11:03, -DRB1*14:10, -DRB1*14:12, -DRB1*15:02, and -DQB1*05:10) showing a nominal association with SARS (P<0.05), but none remained significant after Bonferroni correction. The study suggests that high-resolution HLA alleles are unlikely to contribute significantly to the susceptibility or resistance to SARS-CoV infection in the northern Chinese population.     

A putative urinary biosignature for diagnosis and follow-up of tuberculous meningitis in children: outcome of a metabolomics study disclosing host–pathogen responses

Introduction

Tuberculous meningitis (TBM) is a severe manifestation of tuberculosis, presenting with high morbidity and mortality in children. Existing diagnostic methods for TBM are invasive and time-consuming and the need for highly sensitive and selective diagnosis remains high on the TBM agenda.

Objective

Our aim was to exploit metabolomics as an approach to identify metabolites as potential diagnostic predictors for children with TBM through a non-invasive means.

Methods

Urine samples selected for this study were from three paediatric groups: patients with confirmed TBM (n = 12), patients clinically suspected with TBM but later confirmed to be negative (n = 19) and age-matched controls (n = 29). Metabolomics data were generated through gas chromatography–mass spectrometry analysis and important metabolites were identified according to standard statistical procedures used for metabolomics data.

Results

A global metabolite profile that characterized TBM was developed from the data, reflecting the host and microbial responses. Nine different logistic regression models were fitted to selected metabolites for the best combination as predictors for TBM. Four metabolites—methylcitric, 2-ketoglutaric, quinolinic and 4-hydroxyhippuric acids—showed excellent diagnostic ability and provided prognostic insight into our TBM patients.

Conclusions

This study is the first to illustrate holistically the metabolic complexity of TBM and provided proof-of-concept that a biosignature of urinary metabolites can be defined for non-invasive diagnosis and prognosis of paediatric TBM patients. The biosignature should be developed and validated through future prospective studies to generate a medical algorithm for diagnosis in the initial stages of the disease and for monitoring of treatment strategies.

     

Declining snake population—why and how: a case study in the Mangrove Swamps of Sundarban, India

Species diversity of reptiles is much higher in Sundarban than in other mangrove ecosystems in India. Presently snakes are declining in Sundarban due to habitat loss caused by tremendous population pressure. Besides, irresponsible killing to avoid snakebite both from poisonous and nonpoisonous varieties is another reason for the gradual declining snake population. According to an intensive household survey in 35 villages in Sundarban, about 22 species (five poisonous and 17 non-poisonous) of snakes have been identified and there appears to have been a general decline in densities. On the contrary, a large number of people are bitten and die from snakebite every year with 0.57 and 0.34 vulnerability and mortality rate per 10,000 people, respectively. The two most commonly observed poisonous species are the common krait, Bungarus caeruleus (51 %) and common cobra, Naja naja (40 %), and that of non-poisonous varieties are the Ptyas mucosus (41 %), Typhlina bramina (34 %), Xenochrophis piscator (12 %), and Amphiesma stolata (10 %). Apart from killing of snakes out of fear; habitat loss, unscientific handling of snakes by snake catchers and charmers, and netting by fisherman contributes to snake mortality to a large extent; 72 % killed snakes are of poisonous varieties, 60 % of which are B. caeruleus, the most venomous snake in Sundarban. This paper is an attempt to highlight some of the important conservation efforts like the introduction of snake firms, alternative employment channels for the snake charmers and catchers, and mass awareness campaign through panchayet (village level governing body) and local NGOs.     

Lack of validation of genetic variants associated with anti–tumor necrosis factor therapy response in rheumatoid arthritis: a genome-wide association study replication and meta-analysis

Introduction

In this study, our aim was to elucidate the role of four polymorphisms identified in a prior large genome-wide association study (GWAS) in which the investigators analyzed the responses of patients with rheumatoid arthritis (RA) to treatment with tumor necrosis factor inhibitors (TNFi). The authors of that study reported that the four genetic variants were significantly associated. However, none of the associations reached GWAS significance, and two subsequent studies failed to replicate these associations.

Methods

The four polymorphisms (rs12081765, rs1532269, rs17301249 and rs7305646) were genotyped in a total of 634 TNFi-treated RA patients of Spanish Caucasian origin. Four outcomes were evaluated: changes in the Disease Activity Score in 28 joints (DAS28) after 6 and 12 months of treatment and classification according to the European League Against Rheumatism (EULAR) response criteria at the same time points. Association with DAS28 changes was assessed by linear regression using an additive genetic model. Contingency tables of genotype and allele frequencies between EULAR responder and nonresponder patients were compared. In addition, we combined our data with those of previously reported studies in a meta-analysis including 2,998 RA patients.

Results

None of the four genetic variants showed an association with response to TNFi in any of the four outcomes analyzed in our Spanish patients. In addition, only rs1532269 yielded a suggestive association (P = 0.0033) with the response to TNFi when available data from previous studies were combined in the meta-analysis.

Conclusion

Our data suggest that the rs12081765, rs1532269, rs17301249 and rs7305646 genetic variants do not have a role as genetic predictors of TNFi treatment outcomes.     

Promoter hypermethylation of tumour suppressor genes (p14/ARF and p16/INK4a): case–control study in North Indian population

The epigenetic modifications have been reported to be key factors in breast carcinogenesis. In the current study, it has been tried to determine the methylation status of two tumour suppressor genes p14/ARF and p16/INK4a in 150 breast cancer patients as well as 150 controls by using MSP-PCR. There was, highly significant difference in methylation of p14/ARF and p16/INK4a (P = 0.000) between patients and controls. Methylation of both the genes together significantly increased the risk of breast cancer by 12.31 folds. The present study concludes that hypermethylation of p14/ARF and p16/INK4a promoters demonstrate significant association with the risk of breast cancer, hence indicating these as important tumour suppressor genes involved in the pathogenesis of breast cancer in North Indian population (i.e. Punjab, Haryana, Uttar Pradesh, Himachal Pradesh as well as Union Territory of Chandigarh).     

The combined effect of waterlogging,extractable P and soil pH on α-diversity: a case study on mesotrophic grasslands in the UK

Developing a strategy for evidence-based conservation is often problematic where a given habitat is found on relatively few small sites. Here, we investigate the important environmental variables that control species α-diversity in wet mesotrophic grasslands in lowland England. We analysed data on species richness and three soils variables from 10 mesotrophic grasslands to test the following hypothesis: is species diversity related to these soil factors, and if so, which is the most important? Generalised linear modelling was used to derive minimum adequate models of these relationships. The analysis identified degree of waterlogging and its interaction with both soil available phosphorus and soil pH as significant. Species diversity decreased with increasing waterlogging and available phosphorus. If species richness is to be conserved in these mesotrophic grasslands, it would be best done by maintaining low levels of waterlogging (0–1 m weeks), and low available phosphorus concentrations (<10 μg P g^?1). However, this approach may predicate against specialist wetland species. Our results will help develop sound conservation strategies for these mesotrophic grasslands, and points the way for further investigative research.     

Survival after a diagnosis of testicular germ cell cancers in Germany and the United States, 2002–2006: A high resolution study by histology and age

Introduction: The aim of this study was to provide detailed age-specific (5-year age groups) and histology-specific (histologic subtypes of seminoma and nonseminoma) relative survival estimates of testicular germ cell cancer patients in Germany and the United States (U.S.) for the years 2002–2006 and to compare these estimates between countries. Methods: We pooled data from 11 cancer registries of Germany and used data from the U.S. (SEER-13 database) including 11,508 and 10,774 newly diagnosed cases (1997–2006) in Germany and the U.S., respectively. We estimated 5-year relative survival (5-year-RS) by histology and age based on period analysis. Results: 5-year-RS for testicular germ cell tumors was 96.7% and 96.3% in Germany and the U.S., respectively. 5-Year-RS for spermatocytic seminoma was close to 100% in both countries. 5-Year-RS for nonseminoma was lower than for classical seminoma in Germany (93.3% versus 97.6%) and the U.S. (91.0% versus 98.2%). Among nonseminomas, choriocarcinomas provided the lowest 5-year-RS in both countries (Germany 80.1%, U.S. 79.6%). Age-specific 5-year-RS for seminoma showed only little variation by age. 5-Year-RS for nonseminomas tended to be lower at higher ages, especially for malignant teratoma. Discussion: This is the first study that provides up-to-date survival estimates for testicular cancer by histology and age in Germany and the U.S. Survival after a diagnosis of testicular cancer is very comparable between Germany and the U.S. 5-Year-RS for spermatocytic seminoma was close to 100% and the lowest 5-year-RS occurred among choriocarcinoma. Higher age at diagnosis is associated with a poorer prognosis among nonseminoma patients.     

Changes in body mass index and smoking habits have a different impact on hemoglobin concentration in men and women: A longitudinal follow-up of the tromsø study, 1994–2002

Background: Body mass index (BMI) and smoking have been positively associated with hemoglobin concentration, and both are risk factors for cardiovascular disease.Objective: The aim of this study was to assess whether there were sex differences in how changes in BMI and smoking habits influenced hemoglobin concentration.Methods: In 1994–95 and 2001–02, a longitudinal, population-based study was conducted in the municipality of Tromsø, in northern Norway. Inhabitants aged ≥25 years were invited to participate. Participants replied to a questionnaire regarding health, physical activity, coffee and alcohol consumption, and smoking habits. Blood samples were drawn to analyze hemoglobin concentration.All analyses were performed separately for each sex. Differences between 1994–95 and 2001–02 were examined with t or χ² (McNemar) tests for paired data. Cross-sectional comparisons were made using 2-sample t tests. Different models of univariate and multiple linear regression analyses were used to investigate the impact of the various variables on hemoglobin change.Results: Data from a total of 2105 men and 2945 women were examined. At baseline, mean age was 58.9 years for men (range, 25–78 years) and 57.8 years for women (range, 25–82 years); mean BMI was 26.1 kg/m² for men and 25.8 kg/m² for women. In men, hemoglobin decreased with age, on average from 147.5 to 145.1 g/L. In women, hemoglobin decreased from 135.6 to 134.7 g/L, but increased with increasing age up to 54 years, and thereafter decreased gradually. Mean BMI increased 0.8 kg/m² in men and 1.2 kg/m² in women. In total, 394 of 2057 men (19%) and 499 of 2889 women (17%) stopped smoking or smoked fewer cigarettes per day. In a univariate regression model, an increase of 1 kg/m² in BMI was associated with an increase in hemoglobin of 1.1 g/L (95% CI, 0.84 to 1.27) in men and 0.4 g/L (95% CI, 0.30 to 0.56) in women. In another univariate model, smoking cessation was associated with a decrease in hemoglobin of 1.9 g/L (95% CI, ?3.32 to ?0.56) in men and 1.7 g/L (95% CI, ?2.93 to ?0.56) in women. In men who smoked less and had a BMI increase of >2.5 kg/m², hemoglobin decreased 0.3 g/L. In contrast, hemoglobin decreased 3.4 g/L in men who smoked less and lost weight (P for trend, < 0.001 by changing BMI). Women who smoked less had a decrease in hemoglobin independent of BMI changes.Conclusions: The positive association between an increase in BMI and hemoglobin was stronger in men than in women. The effect of smoking reduction on hemoglobin was attenuated with increasing BMI in men, but not in women.     

High expression levels of pyrimidine metabolic rate–limiting enzymes are adverse prognostic factors in lung adenocarcinoma: a study based on The Cancer Genome Atlas and Gene Expression Omnibus datasets

Reprogramming of metabolism is described in many types of cancer and is associated with the clinical outcomes. However, the prognostic significance of pyrimidine metabolism signaling pathway in lung adenocarcinoma (LUAD) is unclear. Using the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) datasets, we found that the pyrimidine metabolism signaling pathway was significantly enriched in LUAD. Compared with normal lung tissues, the pyrimidine metabolic rate–limiting enzymes were highly expressed in lung tumor tissues. The high expression levels of pyrimidine metabolic–rate limiting enzymes were associated with unfavorable prognosis. However, purinergic receptors P2RX1, P2RX7, P2RY12, P2RY13, and P2RY14 were relatively downregulated in lung cancer tissues and were associated with favorable prognosis. Moreover, we found that hypo-DNA methylation, DNA amplification, and TP53 mutation were contributing to the high expression levels of pyrimidine metabolic rate–limiting enzymes in lung cancer cells. Furthermore, combined pyrimidine metabolic rate–limiting enzymes had significant prognostic effects in LUAD. Comprehensively, the pyrimidine metabolic rate–limiting enzymes were highly expressed in bladder cancer, breast cancer, colon cancer, liver cancer, and stomach cancer. And the high expression levels of pyrimidine metabolic rate–limiting enzymes were associated with unfavorable prognosis in liver cancer. Overall, our results suggested the mRNA levels of pyrimidine metabolic rate–limiting enzymes CAD, DTYMK, RRM1, RRM2, TK1, TYMS, UCK2, NR5C2, and TK2 were predictive of lung cancer as well as other cancers.

     

The Association of IL-6, TNFα and CRP Gene Polymorphisms with Coronary Artery Disease in a Tunisian Population: A Case–Control study

Coronary artery disease is an inflammatory disease. Systemic markers of inflammation such as Interleukin-6, Tumor Necrosis Factor alpha and C-reactive protein have previously been shown to be associated with increased risk of cardiovascular events. The aim of the present study is to assess the role of variants in the IL-6 (??174 G/C), TNFα (??308 A/G) and CRP (+?1059G/C) genes as susceptibility markers for CAD in a Tunisian population. The investigation was conducted as a case–control study involving 204 patients and 400 age-gender matched controls. Genotyping was performed using polymerase chain reaction and restriction fragment length polymorphism analysis. There are significant differences between CAD patients and the control group with regard to BMI (p?<?10^–3) and family history of CAD (p?<?10^–3). The CAD patients are more likely to have a history of smoking (p?<?10^–3), have a higher value of TC (p?=?0.003), LDLc (p?=?0.016), hs-CRP (p?=?0.01), IL6 (p?<?10^–3) and TNFα (p?=?0.038). Our analysis showed significant differences between cases and controls in genotypic distribution of IL6-174CC (p?=?0.003; OR?=?7.71 CI (1.58–37.56)), TNFα ??308 AA (p?=?0.004; OR?=?2.95 (1.57–5.51)) and CRP?+?1059 CC (p?<?10^–3; OR?=?5.40 (2.30–12.68)). However, we failed to find an association between the different genotypes and the inflammatory markers levels. Our results suggest that the presence of IL-6 (??174 G/C), TNFα (-308 A/G) and CRP (+?1059G/C) polymorphisms, may be considered to be a risk factor for CAD in Tunisian population.