Job Stress, Gene Polymorphism of β_2-AR, and Prevalence of Hypertension

Objective To study the interactive effect of job stress and genetic susceptibility （or gene polymorphism） on hypertension. Methods A cross-sectional epidemiological study was conducted in 452 workers from a thermal power plant in China. Extrinsic effort, occupational reward, and over-commitment were measured. Hypertensive patients were defined by three phases of screening, reexamination, and final diagnosis. β2-AR genotypes and allele frequencies at amino acid positions 16 （β2-AR-16： Arg→Gly） and 27 （β2-AR-27： Gln→Glu） were identified by PCR-RFLE Results Job stress was related with the prevalence of hypertension in males （P〈0.05）, whereas no significant relationship was found in females （P〉0.05）. Differences in genotypes and allele frequencies of the β2-AR-16 were statistically significant between the hypertension and control groups （P〈0.05）, whereas those of β2-AR-27 were not （P〉0.05）. The prevalence of hypertension was higher in individuals carrying Gly16 allele than in those carrying Arg16 allele of the high job stress group （P〈0.01 or 0.05）. Conclusion High job stress and polymorphism of β2-AR-16 have an interactive effect on the prevalence of hypertension in male workers.

Effect of Physical Activity on Hospital Service Use and Expenditures of Patients with Coronary Heart Disease: Results from Dongfeng-Tongji Cohort Study in China

The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.

The Application of Surface Electromyography in the Assessment of Ergonomic Risk Factors Associated with Manual Lifting Tasks

Summary: The purpose of this study was to evaluate the ergonomic risk factors associated with manual lifting tasks using surface electromyography (EMG). 13 volunteers lifted loads of 6 and 13 kg at two speeds and at two horizontal distances in 3 different postures and three boxes of different sizes, from floor to knuckle height, performing 72 lifting tasks. For each lift, the surface electromyography signals from the erector spinae muscles, bilaterally at T_~10 and L_3, was recorded. The ergonomic risk factors associated with manual lifting tasks were evaluated by comparing the average amplitude of EMG signals from the erector spinae muscles. The EMG average amplitude for lifting the load of 13 kg was 14.3 % greater than that for lifting the load of 6 kg (t=-10.93, P<0.01). The EMG average amplitude at the site of L_3 was 10.3 % greater than that at the site of T_~10 (t=-7.98, P<0.01). The EMG average amplitude when performing “fast” lift was 5.9 %greater than the “slow” lift (t=-4.63, P<0.01). The posture of lifting affected the EMG average amplitude. It was lowest with semi-squat posture and greatest with squat posture (F=27.76, P<0.01). The result of multiple stepwise regression analysis showed that the loads of lifting, the size of box, horizontal distance, posture of lifting, the site of the spine subjected to force, lifting speed were the factors affecting the EMG average amplitude. The most significant factor was the loads of lifting, followed by the site of the spine subjected to force and the lifting speed in terms of risk. The ergonomic risk factors associated with manual lifting tasks includes the loads, posture, lifting speed, horizontal distance, the site of the spine subjected to force etc. The results of signal amplitude of EMG from the erector spinae muscles showed that semi-squat posture is the best posture for lifting tasks.

Studies of the Genotoxicity of Glycidyl Methacrylate (GMA)

The following experiments were conducted to evaluate the genotoxic effects of GMA (glycidyl methacrylale) on mammalian and human cells.(1) Using the absorption spectrum shift method in vitro, we observed that the maximums of calf thymus DNA and GMA were shifted toward longer wavelengths (a change of more than 15nm) and the absorbance decreased after incubation at room temperature for 15min or more.The result indicates that binding of DNA and GMA had occurred.The binding force is strong, not affected by the addition of concentrated sodium chloride solution, and only slightly decreased by the addition of 8 M urea solution.Therefore the bond between DNA and GMA might be covalent.(2) In cell cultures, unscheduled DNA synthesis (UDS) in human and/or rat lymphocyte was induced and DNA semiconserva-tive replication was inhibited by GMA at concentrations of less than 5.2 mM.(3) Sperm abnormality tests and assays of UDS in germ cells of male mice were conducted to study the in vivo genotoxicity of GMA.The results revealed that GMA could damage DNA, increase sperm abnormality frequency, and reduce the number of sperm cells, 1990 Academic Press.Inc.

Significant Positive Correlation of Plasma BPDE-Albumin Adducts to Urinary 1-Hydroxypyrene in Coke Oven Workers

Objective To investigate the application of BPDE-albumin adducts as monitoring biomarkers for coke oven workers exposed to polycyclic aromatic hydrocarbons （PAHs） and to explore possible relationship between BPDE-albumin adducts and urinary 1-hydroxypyrene （1-OHP） levels in them. Methods Thirty-seven coke oven workers from a coke plant and 47 controls without the occupational exposure to PAHs were recruited in this study. The levels of plasma BPDE-albumin adducts and urinary 1-OHP were analyzed using high performance liquid chromatography. Results The median levels of BPDE-albumin adducts （42.10 fmol/mg albumin） and urinary 1-OHP （5.46 μmol/mol creatinine） were significantly higher in coke oven workers than in controls （14.16 fmol/mg albumin, 2.96μmol/mol creatinine, respectively; P〈0.01）. Multiple logistic regression analysis showed that coke oven workers were at higher risk of having BPDE-albumin adduct levels above 25.30 μmol/mg albumin （OR=1.79, P〈0.01） and urinary 1-OHP levels above 4.13 μmol/mol creatinine （OR=2.45, P〈0.05）. There was a positive correlation between the levels of BPDE-albumin adducts and urinary 1-OHP in all subjects （rs=0.349, P〈0.01）. Conclusion BPDE-albumin adduct is a useful biomarker for monitoring long-term exposure to PAHs, and plasma BPDE-albumin adducts level is significantly correlated to urinary 1-OHP levels in coke oven workers.

Short- and medium-term reproducibility of gastric emptying of a solid meal determined by a low dose of ^(13)C-octanoic acid and nondispersive isotope-selective infrared spectrometry

AIM： To evaluate the reproducibility of a modified 13^C breath test-based measurement of solid phase gastric emptying （GE） within the frames of a simple-repeated measure study protocol. METHODS： Twelve healthy subjects （6 females and 6 males, mean age 24.9＋0.7 years） were recruited to undergo three identical GE examinations. In six subjects the first two examinations were performed 2 d apart, and the third session was carried out at a median interval of 19.5 d （range 18 - 20 d） from the second one. In another six subjects the first two measurements were taken 20 d apart （median, range： 17-23 d）, whereas the third session took place 2 d after the second one. Probes of expiratory air collected before and during six hours after intake of a solid meal （378 kcal） labelled with 75 μL （68 mg） 13^C-octanoic acid, were measured for 13^CO2 enrichment with the nondispersive isotopeselective infrared spectrometry NDIRS apparatus. RESULTS： Taking coefficients of variation for paired examinations into account, the short-term reproducibility of the GE measurement was slightly but not significantly better than the medium-term one： 7.7% and 11.2% for the lag phase （T-Lag）, 7.3% and 10.9% for the gastric half emptying time （T1/2）. The least differences in GE parameters detectable at P= 0.05 level in the 12 paired examinations were 9.6 and 15.6 min for T-Lag, 11.6 and 19.7 min for T1/2 by a two-day or two to three-week time gap, respectively CONCLUSION： The low-cost modification of the breath test involving a lower dose of 13^C-octanoic acid and NDIRS, renders good short- and medium-term reproducibility, as well as sensitivity of the measurement of gastric emptying of solids.

How Work Organization Affects the Prevalence of WMSDs: A Case-control Study

Objective In this study, we aimed at exploring the association between work-related musculoskeletal disorders（WMSDs） and work organization based on a case-control study. Methods A total of 1938 workers who claimed to suffer from WMSDs were selected from Beijing, Henan, Hubei, and the Guangdong province. The control group consisted of 2009 workers employed in similar industries without severe disease or musculoskeletal discomforts. We used a modified version of the questionnaire developed by the NMQ and the DMQ to investigate individual and work-related factors. Results A total of 13 variables（P〈0.1） were selected by the chi-square test and finally, 7 variables entered into the equation, with 6 variables reaching statistical significance（P〈0.05）. The odds ratios（OR） of ＇work changing with season＇ and ＇sufficient rest time＇ did not reach 1（0.749 and 0.441, respectively）. In addition, ＇sufficient rest time＇ seemed to be the stronger protective factor according to its higher standardized coefficient. And ＇repetitive work every minute＇, ＇constantly repetitive work＇（every day）, ＇shortage of site personnel＇, and ＇often switching shifts with others＇ seemed to be the risk factors. Conclusion Work organization may have comprehensive effects on the occurrence of WMSDs. This pattern of associations suggests that further investigation into the mechanism of how work organization affects the prevalence of WMSDs is required.

Comparison of dimension reduction-based logistic regression models for case-control genome-wide association study:principal components analysis vs.partial least squares

With recent advances in biotechnology, genome-wide association study （GWAS） has been widely used to identify genetic variants that underlie human complex diseases and traits. In case-control GWAS, typical statistical strategy is traditional logistical regression （LR） based on single-locus analysis. However, such a single-locus analysis leads to the well-known multiplicity problem, with a risk of inflating type I error and reducing power. Dimension reduction-based techniques, such as principal component-based logistic regression （PC-LR）, partial least squares-based logistic regression （PLS-LR）, have recently gained much attention in the analysis of high dimensional genomic data. However, the perfor- mance of these methods is still not clear, especially in GWAS. We conducted simulations and real data application to compare the type I error and power of PC-LR, PLS-LR and LR applicable to GWAS within a defined single nucleotide polymorphism （SNP） set region. We found that PC-LR and PLS can reasonably control type I error under null hypothesis. On contrast, LR, which is corrected by Bonferroni method, was more conserved in all simulation settings. In particular, we found that PC-LR and PLS-LR had comparable power and they both outperformed LR, especially when the causal SNP was in high linkage disequilibrium with genotyped ones and with a small effective size in simulation. Based on SNP set analysis, we applied all three methods to analyze non-small cell lung cancer GWAS data.

Analysis of the Phenotype and the Restriction Enzyme Mapping Level of Mutations Induced by the New Mutagen Glycidyl Methacrylate

Glycidyl methaerylate (GMA) is a recently recognized chemical mutagen. In order to explore the mutagenicity and mutagenic process of GMA, plasmid pBR322 was used for in vitro binding, mutant screening, and restriction enzyme mapping. The binding between GMA and DNA in vitro has been verified by means of a spectrophotometric method. When pBR322 and GMAbound pBR322 were used to transform Eschenchia coli HB101, the following results were obtained: (1) The transformation efficiency of GMA-bound pBR322 was much lower than that of pBR322 alone. (2) GMA-bound pBR322 induced phenotype changes in competent cells (i.e., tetracycline-resistance inactivation or ampicillin-resistance inactivation). There were two mutants of pBR322, Ap~RTc~S and Ap~STc~R, in the transformants and a deductive mutant Ap~STc~S in the nontranstormants. (3) All of the selected mutants were stable and heritable. (4) When restriction enzyme maps were used to analyze the mutant Ap~RTc~S, four of seven maps were changed. some sites were shifted to other resistant gene regions, for example, sites of Bgll, EcoRl, Ilindlll. Hinclll, etc., and there was a new recognition site for Hindi (252). We did not observe any DNA fragment insertion or deletion on any maps. Our results suggest that when GMA is covalently linked to the plasmid DNA, it gives rise to a premutagenic lesion of DNA that is converted in vivo into a point mutation. (C)1990 Academic Press, Inc.

Association of G+1688A Polymorphism of Platelet Endothelial Cell Adhesion Molecule-1 Gene with Myocardial Infarction in the Chinese Han Population

In order to investigate the association of G＋1688A （Ser563Asn） polymorphism of platelet endothelial cell adhesion molecule-1 （PECAM-1） gene with myocardial infarction （MI） in the Chinese Han population, the G＋1688A polymorphism in PECAM-1 gene was detected by polymerase chain reaction-restriction fragment-length polymorphism （PCR-RFLP） method among 502 subjects, including 218 patients with MI and 284 controls. The results showed that there was significant difference in AA frequencies of genotype G＋1688A polymorphism between case and control groups （39% vs 24%, P〈0.001）. A similar trend was observed on the allele frequencies （A/G： 62% vs 49%, P〈0.001）. Among the subjects with high serum total cholesterol level or high systolic blood pressure level, the variant AA genotype was associated with high risk of MI （adjusted OR, 2.13; 95% CI, 1.08 -4.41 and adjusted OR, 2.53; 95%CI, 1.63-3.63）. The single nucleotide polymorphism （SNP） at position ＋1688 in the exon 8 of PECAM-1 gene was associated with MI and the allele A might be a risk factor for MI in the Chinese Han population.

Expression of Extracellular Signal-regulated Kinase and Angiotensin-converting Enzyme in Human Atria during Atrial Fibrillation

In order to investigate the changes in the expression of extracellular signal regulated kinase (ERK1/ERK2) and angiotensin converting enzyme (ACE) in the patients with atrial fibrillation (AF), 52 patients with rheumatic heart diseases were examined. Nineteen patients had chronic persistent AF (AF≥6 months, CAF), 12 patients had paroxymal AF (PAF) and 21 patients had no history of AF. The ERK expression was detected at the mRNA level by reverse transcription polymerase chain reaction, at the protein level by Western blotting and at atrial tissue level by immunohistochemistry. ERK activating kinases (MEK1/2) and ACE were determined by Western blotting techniques. The expression of ERK2 mRNA was increased in the patients with CAF (74±19 U vs sinus rhythm: 32±24 U, P <0.05). Activated ERK1/ERK2 and MEK1/2 were increased to more than 150 % in the patients with AF compared to those with sinus rhythm. No significant difference between CAF and PAF was found. The expression of ACE was three fold increased in the patients with CAF compared to those with sinus rhythm. Patients with AF showed an increased expression of ERK1/ERK2 in atrial interstitial cells and marked atrial fibrosis. An ACE dependent increase in the amounts of activated ERK1/ERK2 in atrial interstitial cells may be one of molecular mechanisms for the development of atrial fibrosis in the patients with AF. These findings may have important impact on the treatment of AF.

Alterations of mtDNA copy number and 4977 bp deletion induced by ionizing radiation in human peripheral blood

Alterations of mitochondria DNA(mtDNA)4977 bp common deletion(CD)and mtDNA copy number induced by ionizing radiation were observed in human different cell lines and total body irradiation patients.However,only few experiments have evaluated the levels of the CD and mtDNA copy number in human peripheral blood exposed to ionizing radiation till now.The aim of this study is to analyze the mtDNA alterations in irradiated human peripheral blood from healthy donors as well as to explore their feasibility as biomarkers for constructing new biodosimeter.Peripheral blood samples were collected from six healthy donors,and exposed to 60Co gamma ray with the doses of 0 Gy,1 Gy,2 Gy,3 Gy,4 Gy and 5 Gy.Levels of the CD and mtDNA copy number in irradiated samples after 2h or 24h incubation were detected using TaqMan real-time PCR,and the CD ratio was calculated.The results showed that the mean of the CD ratio and the CD copy number exhibited a dose-dependent increase 2 h in the dose range from 0–5 Gy,and of the mtDNA copy number significantly increased 24 h in irradiated groups compared with 0 Gy group after irradiation.It indicates that the parameters in human peripheral blood may be considered as molecular biomarkers to applying construction of new biodosimeter.

Expression of HSP70 in Peripheral Lymphocytes of the Patients with Allergic Rhinitis

The expression levels of heat shock protein 70 (HSP70) from peripheral lymphocytes of the patients with allergic rhinitis (AR) and the clinical implication were investigated In the morning, 3 ml of fasting venous blood was taken out The lymphocytes were isolated by using Ficoll-Hypaque and the expression of HSP70 in the lymphocytes was detected by using Western blot In the AR patients the HSP70 level (41 49±15 77 integrated optical density, IOD) were significantly higher than that in the control group (23 89±10 13 IOD, P< 0 05) Western blot demonstrated that HSP70 bands in AR patients were more intensive than those in the control group It was concluded that the elevated HSP70 level in peripheral lymphocytes of the AR patients might contribute to the development of AR

Mutagenicity of Urine From Individuals Exposed to LPG Combustion Products

The mutngenicity of urine from individua1s exposed to the combustion products of liquefied petroleum gas (LPG) was detected with Salmonella typhimurium TA98 and its newly developed derivatives YG1021 (nitroreductase overproducing) and YG1024 (O-acetyltransferase overproducing). The detection showed significantly increased mutagenicity for the two YG strains and increased positive rates for all three stralns in the presence of both rat liver S9 and β-glucuronidase. Further analysis demonstrated that urine samples taken from smoking and non-smoking exposed individuals exhibited significantly higher mutagenic potency (revertants/10 μl urine concentrate) than their corresponding controls. These results indicate that the increased urine mutagenicity is caused by the exposure to LPG combustion products or smoking. The mutagenic potency of urine samples of all exposed individuals tested with YG1024 was found to be about 7 times higher than with TA98. The difference in mutagenic potency was smaller for the sarne samples when comparison was made between YG1021 and TA98. This suggests that the mutagenic compounds present in the urine samples contaln mainly arotnatic compounds as glucuronide conugates. our results demonstrate that YG1024 is more sensitive than TA98 in detecting the mutagenicity of these samples. In addition, no significant difference in the mutagenic poency between the' pure' exposed (non-srnokers') and the ' pure' smokers' (unexpeed) samples was found in all three tester strains. This might mean that the exopure extent Of mutagens/carcinogens in LPG combustion products for exmped individuals roughly corresponds to the smoking level of smokers who smoke 20-40 cigarettes per day. Furthermore, the results also suggest that sguergism might exist in the mutagenic effects of exposure to LPG combustion products and cigarette smoking.

Modifiable determinants of attitude towards dengue vaccination among healthy inhabitants of Aceh,Indonesia:Findings from a community-based survey

Objective:To explore and understand the attitude towards dengue vaccination and its modifiable determinants among inhabitants of Aceh(northern Sumatra Island,Indonesia),the region that was most severely affected by the earthquake and tsunami of 26 December 2004.Methods:A communitybased,cross-sectional study was conducted among 535 healthy inhabitants in nine regencies(Kabupaten or Kotamadya) of Aceh that were selected randomly from November 2014 to March 2015.A set of validated,pre-tested,structured questionnaires was used to guide the interviews.The questionnaires covered a range of explanatory variables and one outcome variable(attitude to dengue vaccination).Multi-step logistic regression analysis and Spearman's rank correlation were used to test the role of explanatory variables for the outcome variable.Results:More than 70%of the participants had a poor attitude towards dengue vaccination.Modifiablc determinants associated with poor attitude to dengue vaccination were low education level,working as farmers and traditional market traders,low socioeconomic status and poor knowledge,attitude and practice regarding dengue fever(P<0.05).The KAP domain scores were correlated strongly with attitude to dengue vaccination,r_s=0.25,r_S=0.67 and r_s=0.20,respectively(P<0.001).Multivariate analysis found that independent predictors associated with attitude towards dengue vaccination among study participants were only sex and attitude towards dengue fever(P<0.001).Conclusions:This study reveals that low KAP regarding dengue fever,low education level and low socioeconomic status are associated with a poor attitude towards dengue vaccination.Therefore,inhabitants of suburbs who are working as larmers or traditional market traders with low socioeconomic status are the most appropriate target group for a dengue vaccine introduction program.

X-ray-induced Expression Changes of TNFSF4 Gene in Human Peripheral Blood

This study examined ionizing radiation-induced tumor necrosis factor （ligand） superfamily, member 4 （TNFSF4） mRNA expression changes in human peripheral blood cells and their distribution in a normal population. The results showed that expression level of TNFSF4 mRNA exhibited a dose- dependent response after different irradiation doses, but that was independent of incubation time post-irradiation. Moreover, it was not affected by age and gender in 51 healthy donors. Our studies indicate that TNFSF4 can be considered as a candidate gene to develop a new biodosimeter.

Risk of anemia in morbidly obese patients after bariatric surgery in Taiwan

BACKGROUND Bariatric surgery is one of most effective long-term treatments for morbid obesity.However,post-bariatric surgery anemia is identified as a common adverse effect and remains a challenge nowadays.AIM To estimate the risk of post-bariatric surgery anemia and to stratify the association between age,gender,and types of surgery.METHODS This study is a population-based cohort study.We conducted this nationwide study using claims data from National Health Insurance Research Database in Taiwan.There were 4373 morbidly obese patients in this study cohort.RESULTS Among patients who were diagnosed with morbid obesity,2864 received bariatric surgery.All obesity-associated comorbidities decreased in the surgical group.Increasing risk of post-bariatric surgery anemia among obese patients was found by Cox proportional hazards regression[adjusted hazard ratio(HR):2.36].Also,we found significantly increasing cumulative incidence rate of anemia among patients receiving bariatric surgery by log-rank test.After adjusting for age and gender,the increasing incidence of post-bariatric surgery anemia was found among women(adjusted HR:2.48),patients in the 20–29-year-old group(adjusted HR:3.83),and patients in the 30-64-year-old group(adjusted HR:2.37).Moreover,malabsorptive and restrictive procedures had significantly higher adjusted HRs,3.18 and 1.55,respectively.CONCLUSION Bariatric surgery give rise to anemia risk among obese patients,specifically in women,young-and middle-aged patients,and patients undergoing malabsorptive procedures in our population-based cohort study in Taiwan.

Peroxisome Proliferator-activated Receptor-γ2 Pro12Ala and C-689T Polymorphisms and Haplotypes Affect the Profiles of Coronary Heart Disease in Diabetic Chinese People

Objectives Peroxisome proliferator-activated receptor-γ2（PPARγ2） variant Pro12Ala was demonstrated with risk of coronary heart disease （CHD） and type 2 diabetes mellitus （T2DM）. Another variant C-689T in the promoter was reported with lower receptor activity but lack of reports on association between C-689T and CHD or T2DM. Methods A total of 351 subjects without CHD and T2DM （controls） and 125 patients with CHD and T2DM （cases） were enrolled in our case-control study. Polymerase chain reaction-restricted fragments length polymorphism （PCR-RFLP） was used to detect Pro12Ala and C-689T polymorphisms. And effects on CHD merged with T2DM of the two polymorphisms were analyzed in individual and haplotype analyses. Results In the study, Pro12Pro, Pro12Ala and Ala12Ala genotype frequencies were 92.9%, 6.8% and 0.3% in controls; 92.8%, 7.2% and 0.0% in cases respectively whilst CC, CT and TT genotype frequencies were 93.4%, 6.3% and 0.3% in controls; 92.8%, 7.2% and 0.0% in cases respectively. Pro12Ala and C-689T polymorphisms were in strong linkage disequilibrium （D＇=0.81, P=0.000） and the observed haplotype frequency of Pro-C, Pro-T, Ala-C and Ala-T was 0.957, 0.006, 0.008 and 0.028 respectively. No significant associations were detected between the two polymorphisms and CHD merged with T2DM in either individual or haplotype analyses. In subjects with obesity [body mass index （BMI）≥25 kg/m^2], we found that both Pro12Ala and C-689T polymorphisms were associated with BMI. In haplotype analyses, we found that Pro12Ala and C-689T haplotypes had associations with systolic blood pressure in total population, with BMI, waist circle and total cholesterol（TC） in obesity subgroup and with fasting blood glucose and TC in males. Conclusions PPARγ2 Pro12Ala and C-689T polymorphisms and haplotypes affect the profiles of CHD merged with T2DM in Chinese Han people.

Sonographic fatty liver and hepatitis B virus carrier status: Synergistic effect on liver damage in Taiwan Residents adults

AIM: To examine the epidemiology of hepatitis B virus carrier status (HBVC) and sonographic fatty liver (SFL) in Taiwan Residents adults, and to evaluate their possible interaction in inducing liver damage (LD). From an epidemiological viewpoint, we analyzed previous studies which indicated that fatty liver sensitizes host immune response to HBV infection and enhances liver damage.METHODS: A cross-sectional retrospective analysis of health records including medical history, physical examination, abdominal sonogram, blood biochemistry and hepatic virological tests. We utilized the Student's t-test, chi-square, multivariate logistic regression and synergy index to assess risks for LD.RESULTS: Among a total of 5406 Taiwan Residents adults (mean age 46.2 years, 51.5% males), the prevalence of LD, HBVC and SFL were 12.3%, 15.1% and 33.4%, respectively; 5.1% of participants had SFL plus HBVC. Multivariate logistic regression analysis demonstrated that male gender (odds ratio (OR) = 2.8, 95% confidence interval (CI): 2.3-3.5), overweight state (OR = 1.6, 95% CI: 1.3-2.0), HBVC (OR = 2.5, 95% CI: 2.0-3.1) and SFL (OR = 4.2, 95% CI: 2.2-5.3) were independently associated with LD. Synergism analysis showed that the adjusted OR for LD in adults with HBVC-alone was 3.3 (95% CI: 2.4-4.6), SFL-alone, 4.7 (95% CI: 3.7-6.1) and combined HBVC and SFL, 9.5 (95% CI: 6.8-13.3); the synergy index was 1.4 (95% CI: 1.001-2.0).CONCLUSION: In Taiwan Residents adults, SFL plus HBVC have a significant synergistic association with LD.

Shift work aggravates metabolic syndrome development among early-middle-aged males with elevated ALT

AIM: To examine whether shift work accelerates metabolic syndrome (MetS) development among early middle-aged males with elevated alanine aminotransferase (e-ALT).METHODS: A retrospective, observational followup study on MetS development at a 5-year interval was conducted using health examination data. Nine hundred and ninety six male employees not fulfi lling MetS criteria at screening were enrolled. Age, MetScomponents, liver enzymes, serological markers for viral hepatitis, abdominal ultrasound, insulin resistance status, lifestyles, and workplace factors were analyzed.RESULTS: The prevalence of elevated serum ALT (> 40 U/L, e-ALT) at baseline was 19.1%. There were 381 (38.3%) workers with long-term exposures to day-night rotating shift work (RSW). 14.2% of subjects developed MetS during follow-up. After 5 years, the workers with e-ALT had significantly unfavorable changes in MetS-components, and higher rates of MetS development, vs subjects with normal baseline ALT levels. Workers with both baseline e-ALT and 5-year persistent RSW (pRSW) exposure had the highest rate of MetS development. Also, e-ALT-plus-pRSW workers had a significant increase in MetS-components atfollow-up, compared with the other subgroups. After controlling for potential confounders, e-ALT-plus-pRSW workers posed a signifi cant risk for MetS development (odds ratio, 2.7; 95% confi dence interval, 1.4-5.3, vs workers without baseline e-ALT nor pRSW). CONCLUSION: We suggest that all early middle-aged male employees with e-ALT should be evaluated and managed for MetS. Particularly in terms of job arrangements, impacts of long-term RSW on MetS development should be assessed for all male employees having baseline e-ALT.