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Wen C.-P.,National Health Research Institute | Wen C.-P.,China Medical University at Taichung | Zhang F.,University of Houston | Liang D.,Texas Southern University | And 14 more authors.
Clinical Cancer Research | Year: 2015

Purpose: We aimed to identify serum metabolites as potential valuable biomarkers for lung cancer and to improve risk stratification in smokers. Experimental Design: We performed global metabolomic profiling followed by targeted validation of individual metabolites in a case-control design of 386 lung cancer cases and 193 matched controls. Wethen validated bilirubin, which consistently showed significant differential levels in cases and controls, as a risk marker for lung cancer incidence and mortality in a large prospective cohort composed of 425,660 participants. Results: Through global metabolomic profiling and following targeted validation, bilirubin levels consistently showed a statistically significant difference among healthy controls and lung cancer cases. In the prospective cohort, the inverse association was only seen in male smokers, regardless of smoking pack-years and intensity. Compared with male smokers in the highest bilirubin group (>1 mg/dL), those in the lowest bilirubin group (<0.75 mg/dL) had 55% and 66% increase in risks of lung cancer incidence and mortality, respectively. For every 0.1 mg/dL decrease of bilirubin, the risks for lung cancer incidence and mortality increased by 5% and 6% in male smokers, respectively (both P < 0.001). There was a significant interaction between low serum bilirubin level and smoking on lung cancer risk (Pinteraction = 0.001). Conclusion: Low levels of serum bilirubin are associated with higher risks of lung cancer incidence and mortality in male smokers and can be used to identify higher risk smokers for lung cancer. © 2014 AACR. Source

Sun W.,University of Houston | Sun W.,Tulane University | Wen C.-P.,National Health Research Institute | Wen C.-P.,China Medical University at Taichung | And 8 more authors.
Cancer Epidemiology | Year: 2015

Background: The associations of laboratory-based ABO phenotypes with cancer risks and mortality have not been systematically determined. Methods: The study subjects were 339,432 healthy individuals with laboratory-based blood types from a Taiwan cohort. Results: Compared to blood type O, blood type A was significantly associated with an elevated risk of stomach cancer incidence (Hazard Ratio [HR], 1.38 [95% CI, 1.11-1.72]) and mortality (HR, 1.38 [95% CI, 1.02-1.86]) compared with blood type O, after adjusting for age, sex, education, smoking, alcohol drinking, physical activity, and body mass index. Non-O blood types were associated with an elevated risk of pancreatic cancer, with blood type B reaching statistical significance for incidence (HR, 1.59 [95% CI, 1.02-2.48]) and mortality (HR, 1.63 [95% CI, 1.02-2.60]). In contrast, kidney cancer risk was inversely associated with blood type AB (HR, 0.41 [95% CI, 0.18-0.93]) compared to type O. Conclusion: Cancer risks vary in people with different ABO blood types, with elevated risks of stomach cancer associated with blood type A and pancreatic cancer associated with non-O blood types (A, B, and AB). © 2014 Elsevier Ltd. Source

Li C.-S.,National Kaohsiung First University of Science and Technology | Li C.-S.,Asia University | Liu C.-C.,Feng Chia University | Tsai M.-K.,National Health Research Institute | And 5 more authors.
Journal of Hypertension | Year: 2015

Objective: Even with the 2008 physical activity guidelines for Americans and the strong epidemiological evidence, physicians are not routinely emphasizing the importance of exercise. We try to explore an innovative way to communicate the benefits of physical activity in a term familiar to patients. Methods and results: A cohort of 470 163 adults from a medical screening program in Taiwan were recruited between 1994 and 2008. Their vital status was followed up by matching with the National Death File. Individuals were classified as 'inactive', 'low active', or 'fully active', with 'fully active' meeting the current exercise recommendation of 150 min per week or more. Cox proportional model was used to calculate the hazard ratio. More than one-half of the cohort was inactive (54%), with one-quarter fully active (24%). One in seven was hypertensive (14%), defined as SBP at least 140 mmHg. Among the hypertensive individuals, mortality risks were increased by 37% for the inactive. Inactive individuals had higher all-cause mortality than active ones across all blood pressure (BP) levels. At 110-119 mmHg, the inactive had a risk as high as the risk at 155 mmHg, an increased mortality risk equivalent to a risk of BP increase of 41.2 mmHg. Conclusion: The mortality risk of being inactive was equivalent to an increase of around 40 mmHg in SBP or 20 mmHg in DBP, a number relevant to hypertensive patients. Appreciating this relationship may convince the inactive to start exercising, a behavior as important as controlling BP. © 2015 Wolters Kluwer Health, Inc. Source

Gunnell D.,University of Bristol | Chang S.-S.,University of Bristol | Chang S.-S.,University of Hong Kong | Tsai M.K.,China Medical University at Taichung | And 4 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2013

Background: Sleep problems may lead to, or be symptomatic of, depression and other mental illnesses yet few studies have investigated their association with suicide risk. Design: Prospective cohort study. Setting: Taiwan. Participants: 393,983 men and women aged 20 or above participating in the MJ health check-up programme. Results: There were 335 suicides over a mean of 7.4 years follow-up. There was a reverse J-shaped association between sleep duration and suicide risk. When compared with those sleeping 6-8 h per night the adjusted hazard ratios (95 % confidence intervals) for suicide associated with 0-4, 4-6 and >8 h sleep were 3.5 (2.0-6.1), 1.5 (1.1-1.9) and 1.5 (1.1-2.0), respectively. People requiring sleeping pills to get to sleep (1.2 % participants) were at over 11-fold increased risk; difficulty falling asleep (11.5 % participants), frequent dreaming (16.7 %) and being easily awoken (30.6 %) were associated with a 2.0-, 1.6- and 1.3-fold increased risk of suicide, respectively. Conclusions: Less than 6 h sleep duration, sleep disturbances and reported use of sleep medicines are markers of suicide risk. Sleep problems should be assessed when evaluating suicide risk. © 2013 Springer-Verlag Berlin Heidelberg. Source

You Y.-S.,National Taiwan University | Lin C.-Y.,National Taiwan University | Liang H.-J.,National Taiwan University | Lee S.-H.,National Taiwan University | And 7 more authors.
Journal of Bone and Mineral Research | Year: 2014

Osteoporosis is related to the alteration of specific circulating metabolites. However, previous studies on only a few metabolites inadequately explain the pathogenesis of this complex syndrome. To date, no study has related the metabolome to bone mineral density (BMD), which would provide an overview of metabolism status and may be useful in clinical practice. This cross-sectional study involved 601 healthy Taiwanese women aged 40 to 55 years recruited from MJ Health Management Institution between 2009 and 2010. Participants were classified according to high (2nd tertile plus 3rd tertile) and low (1st tertile) BMD groups. The plasma metabolome was evaluated by proton nuclear magnetic resonance spectroscopy (1H NMR). Principal components analysis (PCA), partial least-squares discriminant analysis (PLS-DA), and logistic regression analysis were used to assess the association between the metabolome and BMD. The high and low BMD groups could be differentiated by PLS-DA but not PCA in postmenopausal women (Q2 = 0.05, p permutation = 0.04). Among postmenopausal women, elevated glutamine was significantly associated with low BMD (adjusted odds ratio [AOR] = 5.10); meanwhile, elevated lactate (AOR = 0.55), acetone (AOR = 0.51), lipids (AOR = 0.04), and very low-density lipoprotein (AOR = 0.49) protected against low BMD. To the best of our knowledge, this study is the first to identify a group of metabolites for characterizing low BMD in postmenopausal women using a 1H NMR-based metabolomic approach. The metabolic profile may be useful for predicting the risk of osteoporosis in postmenopausal women at an early age. © 2014 American Society for Bone and Mineral Research. Source

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