MJ Health Management Institution

Taipei, Taiwan

MJ Health Management Institution

Taipei, Taiwan
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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.


PubMed | MJ Health Management Institution, Academia Sinica, Taiwan, National Taiwan University, Taipei City Hospital and National Taiwan University Hospital
Type: | Journal: Scientific reports | Year: 2015

The association between mild renal dysfunction and bone mineral density (BMD) has not been fully explored. It is also unclear how menopausal status and the use of Chinese herb affect this association. This is a cross-sectional study that included a total of 1,419 women aged 40 to 55 years old who were recruited from the MJ Health Management Institution in Taiwan between 2009 and 2010. Spinal BMD was assessed by dual-energy X-ray absorptiometry. Renal function was assessed using estimated glomerular filtration rate (eGFR) and creatinine clearance rate (CCr). The multivariable logistic regression and general linear models were employed to assess the association between renal function and BMD. Stratification analyses were performed by menopausal status and use of Chinese herbs. Low CCr levels were significantly associated with low BMD [adjusted odds ratio (AOR) = 1.48, 95% confidence interval (CI) = 1.15-1.90]. This association was observed in premenopausal women (AOR = 1.43, 95% CI = 1.07-1.92) and in women not taking Chinese herbs (AOR = 1.48, 95% CI = 1.14-1.94). CCr is a better predictor for low BMD in middle-aged women. Menopausal status and the use of Chinese herbs also affected this association.


News Article | November 2, 2016
Site: www.eurekalert.org

Researchers at The University of Texas MD Anderson Cancer Center have developed a new personalized assessment tool that could better predict lung cancer risk in never, light and heavy smokers using a large Taiwanese prospective cohort study. By incorporating risk factors in addition to smoking history, this tool could better classify those in greatest need of lung cancer screening and reduce false positives. The study, published online today in Nature's Scientific Reports, is the first to develop a tool for personalized risk assessment in never smokers in a large prospective cohort design. The American Cancer Society estimates 224,390 people will be diagnosed with lung cancer this year in the United States and 158,080 will die from the disease. While the majority of these cases will be diagnosed in smokers, as many as 20 percent of lung cancers in the U.S. occur in those who do not smoke. "Currently, there are no criteria to select high-risk individuals for lung cancer in never smokers," says lead author Xifeng Wu, M.D., Ph.D., professor of Epidemiology. "Lung cancer screening criteria is based only on age and smoking information, but from this study we can differentiate risk in those who have never smoked in addition to light and heavy smokers." Based on the results of the National Lung Screening Trial (NLST), low-dose computed tomography (LDCT) lung cancer screening is recommended for individuals between the ages of 55 and 74 with a smoking history of 30 pack-years, which is defined as smoking one pack per day for 30 years. Thus, light and never smokers would not be candidates for lung cancer screening. However, according to Wu, roughly only one-quarter of lung cancers diagnosed in the U.S. meet the strict screening criteria from the NLST, indicating a need for better risk stratification across all smoking types. For this study, the researchers analyzed a prospective cohort of 395,875 participants in Taiwan, recruited by MJ Health Group to participate in a health-screening program across Taiwan. Mean age of the participants was 40.4 and 52 percent of the cohort was female. Heavy smokers were classified as those with a smoking history of 30 pack-years or greater, and light smokers had less than a 30 pack-year history The analyses were conducted after a median 7.3 years of follow-up. Among the participants, 1,117 cases of lung cancer were diagnosed at a mean age of 60.2. Forty-seven percent of the lung cancers were diagnosed in never-smokers, which constituted 71 percent of the participants, and 38 percent occurred in females. In addition to age, gender and smoking history, the researchers incorporated personal and family cancer history, body mass index, a lung function test, and four blood biomarkers to determine five- and 10-year risk probabilities for never, light and heavy smokers. In the current study, the five-year estimated risk of lung cancer ranged from 0.01 percent to 15.82 percent in never smokers, from 0 percent to 7.39 percent in light smokers, and from 0.02 percent to 7.48 percent in heavy smokers. The 10-year estimated risks ranged from 0.02 percent to 32.97 percent in never smokers, from 0.01 percent to 16.31 percent in light smokers, and 0.06 percent to 18.13 percent in heavy smokers. "Our model was able to stratify light and never smokers into groups with dramatically different probabilities of developing lung cancer over time. According to our results, a small number of never smokers have lung cancer risks as high as some heavy smokers," says Wu. The findings highlight varying degrees of risk across each type of smoker, underscoring the need to consider alternative factors when recommending LDCT screening for lung cancer, explains Wu. Through more accurate classification of lung cancer risk, the researchers hope to reduce unnecessary screening and false positives in lower-risk smokers and improve screening for high-risk non-smokers. Despite the large number of participants included in this study, the findings are limited by studying a distinct Taiwanese population. Additional validations in independent cohorts will be necessary to determine the true predictive ability of this model across non-Asian populations, says Wu, who is actively working with identify appropriate cohorts for future studies. Other MD Anderson authors on the study include: Yuanqing Ye, Ph.D, Xia Pu, Ph.D., Wong-Ho Chow, Ph.D., Chad Huff, Ph.D., Sonia Cunningham, Ph.D., Maosheng Huang, M.D., and Jian Gu, Ph.D., all of Epidemiology; Jack A. Roth, M.D., Thoracic and Cardiovascular Surgery Additional authors include: Chi Pang Wen, M.D., Dr.P.H., MinKwang Tsai, and Shuanbei Wu, all of National Health Research Institutes, Zhunan, Taiwan and China Medical University Hospital, Taichung, Taiwan; Christopher Wen, M.D., University of California at Irvine; Chwen Keng Tsao, MJ Health Management Institution, Taipei, Taiwan; and Scott M. Lippman, M.D., UC San Diego Moores Cancer Center. The work was supported by The University of Texas MD Anderson Cancer Center Research Trust, The Center for Translational and Public Health Genomics, Duncan Family Institute for Cancer Prevention and Risk Assessment, The University of Texas MD Anderson Cancer Center, and Taiwan Department of Health Clinical Trial and Research Center of Excellence (DOH101-TD-B-111-004).


Chen J.-H.,China Medical University at Taichung | Wen C.P.,China Medical University at Taichung | Wen C.P.,National Health Research Institute | Wu S.B.,National Health Research Institute | And 11 more authors.
Annals of the Rheumatic Diseases | Year: 2014

Background High serum uric acid (sUA) has been associated with increased mortality risks, but its clinical treatment varied with potential side effects. The role of physical activity has received limited attention. Methods A cohort, consisting of 467 976 adults, who went through a standard health screening programme, with questionnaire and fasting blood samples, was successively recruited between 1996 and 2008. High sUA is defined as uric acid above 7.0 mg/dL. Leisure time physical activity level was self-reported, with fully active defined as those with 30 min per day for at least 5 days a week. National death file identified 12 228 deaths with a median follow-up of 8.5 years. Cox proportional model was used to analyse HRs, and 12 variables were controlled, including medical history, life style and risk factors. Findings High sUA constituted one quarter of the cohort (25.6%). Their all-cause mortality was significantly increased [HR: 1.22 (1.15-1.29)], with much of the increase contributed to by the inactive (HR: 1.27 (1.17-1.37)), relative to the reference group with sUA level of 5-6 mg/dL. When they were fully active, mortality risks did not increase, but decreased by 11% (HR: 0.89 (0.82-0.97)), reflecting the benefits of being active was able to overcome the adverse effects of high sUA. Given the same high sUA, a 4-6 years difference in life expectancy was found between the active and the inactive. Conclusions Physical activity is a valuable alternative to pharmacotherapy in its ability to reduce the increases in mortality risks from high sUA. By being fully active, exercise can extend life span by 4-6 years, a level greater than the 1-4 years of life-shortening effect from high sUA. © 2014 BMJ Publishing Group Ltd & European League Against Rheumatism.


Gunnell D.,University of Bristol | Chang S.-S.,University of Bristol | Chang S.-S.,University of Hong Kong | Chang S.-S.,Ju Shan Hospital | And 5 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.


Chen J.-H.,China Medical University at Taichung | Wen C.P.,China Medical University at Taichung | Wen C.P.,National Health Research Institute | Wu S.B.,National Health Research Institute | And 11 more authors.
Annals of the Rheumatic Diseases | Year: 2015

Background: High serum uric acid (sUA) has been associated with increased mortality risks, but its clinical treatment varied with potential side effects. The role of physical activity has received limited attention. Methods: A cohort, consisting of 467 976 adults, who went through a standard health screening programme, with questionnaire and fasting blood samples, was successively recruited between 1996 and 2008. High sUA is defined as uric acid above 7.0 mg/dL. Leisure time physical activity level was self-reported, with fully active defined as those with 30 min per day for at least 5days a week.National death file identified 12 228 deaths with a median follow-up of 8.5 years.Cox proportional model was used to analyse HRs, and 12 variables were controlled, including medical history, life style and risk factors. Findings High sUA constituted one quarter of the cohort (25.6%). Their all-cause mortality was significantly increased [HR: 1.22 (1.15-1.29)], with much of the increase contributed to by the inactive (HR: 1.27 (1.17-1.37)), relative to the reference group with sUA level of 5-6 mg/dL. When they were fully active, mortality risks did not increase, but decreased by 11% (HR: 0.89 (0.82-0.97)), reflecting the benefits of being active was able to overcome the adverse effects of high sUA. Given the same high sUA, a 4-6 years difference in life expectancy was found between the active and the inactive. Conclusions: Physical activity is a valuable alternative to pharmacotherapy in its ability to reduce the increases in mortality risks from high sUA. By being fully active, exercise can extend life span by 4-6 years, a level greater than the 1-4 years of life-shortening effect from high sUA.


PubMed | China Medical University at Taichung, University of Bristol, MJ Health Management Institution, University of Hong Kong and 3 more.
Type: Journal Article | Journal: Acta psychiatrica Scandinavica | Year: 2016

To investigate the association of resting heart rate with suicide in two large cohorts.The MJ cohort (Taiwan) included 532 932 adults from a health check-up programme (1994-2008). The HUNT cohort (Norway) included 74 977 adults in the Nord-Trndelag County study (1984-1986), followed up to 2004. In both cohorts heart rate was measured at baseline, and suicide was ascertained through linkage to cause-of-death registers. Risk of suicide was estimated using Cox proportional hazards models.There were 569 and 188 suicides (average follow-up period of 8.1 and 16.9 years) in the MJ and HUNT cohorts respectively. Sex- and age-adjusted hazard ratio for every 10 beat increase in heart rate per minute was 1.08 (95% Confidence Interval 1.00-1.16) and 1.24 (1.12-1.38) in the MJ and HUNT cohorts, respectively. In the MJ cohort this association was confined to individuals with a history of heart diseases vs. those without such a history (P for interaction = 0.008). In the HUNT cohort the association did not differ by history of heart diseases and was robust to adjustment for health-related life style, medication use, and symptoms of anxiety and depression.Elevated resting heart rate may be a marker of increased suicide risk.


PubMed | National Health Research Institute, University of California at Irvine, MJ Health Management Institution, University of Houston and University of California at San Diego
Type: | Journal: Scientific reports | Year: 2016

The objective of this study was to develop markedly improved risk prediction models for lung cancer using a prospective cohort of 395,875 participants in Taiwan. Discriminatory accuracy was measured by generation of receiver operator curves and estimation of area under the curve (AUC). In multivariate Cox regression analysis, age, gender, smoking pack-years, family history of lung cancer, personal cancer history, BMI, lung function test, and serum biomarkers such as carcinoembryonic antigen (CEA), bilirubin, alpha fetoprotein (AFP), and c-reactive protein (CRP) were identified and included in an integrative risk prediction model. The AUC in overall population was 0.851 (95% CI=0.840-0.862), with never smokers 0.806 (95% CI=0.790-0.819), light smokers 0.847 (95% CI=0.824-0.871), and heavy smokers 0.732 (95% CI=0.708-0.752). By integrating risk factors such as family history of lung cancer, CEA and AFP for light smokers, and lung function test (Maximum Mid-Expiratory Flow, MMEF


Wen C.P.,National Health Research Institute | Wen C.P.,China Medical University at Taichung | Wai J.P.M.,National Taiwan Sport University | Tsai M.K.,National Health Research Institute | And 9 more authors.
The Lancet | Year: 2011

The health benefits of leisure-time physical activity are well known, but whether less exercise than the recommended 150 min a week can have life expectancy benefits is unclear. We assessed the health benefits of a range of volumes of physical activity in a Taiwanese population. In this prospective cohort study, 416 175 individuals (199 265 men and 216 910 women) participated in a standard medical screening programme in Taiwan between 1996 and 2008, with an average follow-up of 8·05 years (SD 4·21). On the basis of the amount of weekly exercise indicated in a self-administered questionnaire, participants were placed into one of five categories of exercise volumes: inactive, or low, medium, high, or very high activity. We calculated hazard ratios (HR) for mortality risks for every group compared with the inactive group, and calculated life expectancy for every group. Compared with individuals in the inactive group, those in the low-volume activity group, who exercised for an average of 92 min per week (95 CI 71-112) or 15 min a day (SD 1·8), had a 14 reduced risk of all-cause mortality (0·86, 0·81-0·91), and had a 3 year longer life expectancy. Every additional 15 min of daily exercise beyond the minimum amount of 15 min a day further reduced all-cause mortality by 4 (95 CI 2·5-7·0) and all-cancer mortality by 1 (0·3-4·5). These benefits were applicable to all age groups and both sexes, and to those with cardiovascular disease risks. Individuals who were inactive had a 17 (HR 1·17, 95 CI 1·10-1·24) increased risk of mortality compared with individuals in the low-volume group. 15 min a day or 90 min a week of moderate-intensity exercise might be of benefit, even for individuals at risk of cardiovascular disease. Taiwan Department of Health Clinical Trial and Research Center of Excellence and National Health Research Institutes. © 2011 Elsevier Ltd.


PubMed | University of California at Irvine, University of Houston, China Medical University at Taichung, Texas Southern University and 4 more.
Type: Journal Article | Journal: Clinical cancer research : an official journal of the American Association for Cancer Research | Year: 2015

We aimed to identify serum metabolites as potential valuable biomarkers for lung cancer and to improve risk stratification in smokers.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. We then 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.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).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.

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