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Background/purpose: Lipid metabolism is involved in beta amyloid generation, which has been related with the progression of Alzheimer's disease (AD). No study has explored the association between polymorphisms of SAR1 homolog B (SAR1B) and the risk of dementia previously.Methods: This is a case-control study. A total of 279 AD and 117 vascular dementia (VaD) patients were recruited from neurology clinics at three teaching hospitals in Taiwan from 2007 to 2010. Controls (n = 466) were recruited from the elderly health checkup program and volunteers in the hospital during the same time interval. Three common (frequency ≥ 5%) haplotype-tagging single nucleotide polymorphisms were selected from the lipid metabolism gene SAR1B to assess its association with AD and VaD.Results: Homozygous variants of rs11948613 were associated with a decreased AD risk (CC vs. TT: adjusted odds ratio = 0.39, 95% confidence interval = 0.15-0.98) with a population attributable risk of 26.7%. This association decreased further in apolipoprotein E ε4 (ApoE ε4) noncarriers (adjusted odds ratio = 0.28, 95% confidence interval = 0.09-0.91). No association was found for VaD. Two common haplotypes (with a cumulative frequency of 95.7% in controls) were identified for SAR1B, and no association was found for AD or VaD. Simultaneous screening using rs11948613 and ApoE ε4 significantly improved the sensitivity of ApoE ε4 alone (from 0.40 to 0.75).Conclusion: SAR1B polymorphisms were associated with AD risk; results were not significant after correction for multiple tests. Simultaneous screening using SAR1B rs11948613 and ApoE ε4 status offered a better sensitivity for AD screening. [ABSTRACT FROM AUTHOR]

Background/purpose: Studies of the safety and efficacy of drug-eluting stent (DES) implantation to treat vertebral artery (VA) ostial stenosis are lacking in the Asian population. The aim of this study was to evaluate the feasibility and safety of DES implantation to treat VA ostial stenosis in Asians.Methods: We retrospectively analyzed the medical and radiologic records of patients receiving VA origin stenting with DES from October 2004 to September 2006 in the National Taiwan University Hospital.Results: Eleven symptomatic patients (9 male; mean age, 72 years) with 11 lesions treated with DES were included. There were eight lesions treated with paclitaxel-eluting stents and three lesions treated with sirolimus-eluting stents. The success rate for implantation of a DES was 100%. The percentage of stenosis was significantly reduced after stenting (86+/-5 to 2+/-4%; p<0.001). No peri-interventional neurologic, vascular, or other medical complications were noted. All patients were asymptomatic at the mean follow-up time of 18.7+/-8.6 months (range, 6-30 months). Two patients received repeat angiography at 4 or 8 months after stenting. No significant in-stent restenosis was found.Conclusion: Symptomatic VA origin stenosis can be treated safely and effectively with DES in Asians. [ABSTRACT FROM AUTHOR]

Background/purpose: Atherothrombosis is a generalized disease affecting different vascular beds, making it the leading cause of death worldwide. To evaluate the long-term risk of atherothrombotic risk factors and determine the predictors for atherothrombotic events, an international, prospective, observational study was initiated, in which Taiwan was involved.Methods: The REduction of Atherothrombosis for Continued Health (REACH) Registry recruited outpatients with either symptomatic atherothrombotic diseases or multiple risk factors. Baseline data were collected using a universal standard case report form. All subjects were followed to document future outcomes. In this paper, we analyzed the baseline data of the participants from Taiwan.Results: In the REACH Registry, a total of 67,888 subjects from 44 countries were recruited. Among the 1062 Taiwanese participants, 971 were symptomatic subjects and 91 subjects were with risk factors only (RFO). In comparison with the global participants, the Taiwan patients were younger, with a higher prevalence of males, lower prevalence of hypertension, obesity, hypercholesterolemia, former smokers, and a greater prevalence of non-smokers. The baseline prevalence rates were: hypertension, 46.5%; fasting hyperglycemia, 38.4%; hypercholesterolemia, 45.8%; and hypertriglyceridemia, 42.8%. All these prevalence were higher than the global data, indicating an undertreatment status for the Taiwanese patients. Only 29 (2.7%) peripheral arterial disease (PAD) subjects were recruited in Taiwan, suggesting under recognition of this disease. The RFO Taiwanese patients had fewer former smokers and more non-smokers than the symptomatic patients, suggesting that smoking may be an important factor contributing to atherothrombotic diseases.Conclusion: In Taiwan, atherothrombotic outpatients were generally undertreated and PAD was underdiagnosed. [ABSTRACT FROM AUTHOR]

• A link exists between NPC treated with RT and dementia development. • A 1.97-fold higher risk of dementia exists in NPC patients than in controls. • The occurrence of dementia seems earlier in NPC patients than in the controls. We evaluated the risk of dementia in patients with nasopharyngeal cancer (NPC) after undergoing radiation therapy (RT). Between January 1, 2000, and December 31, 2015, 594 patients newly diagnosed with NPC and treated with RT (NPC cohort) were identified from the Longitudinal Health Insurance Database (LHID) for this nationwide population-based matched cohort study. LHID is a subset of the National Health Insurance Research Database of Taiwan. We selected 2376 controls (non-NPC comparison cohort) using a four-fold propensity score-matched by sex, age, comorbidities, education level, tobacco abuse, and index date (the date when the patient received first RT). After adjusting for confounding factors, Fine and Gray's competing risk analysis compared dementia development between the NPC study cohort and non-NPC comparison cohort over the observation period from 2000 to 2015. Dementia development was 6.57% (39 of 594) and 4.42% (105 of 2376) in the NPC study cohort and non-NPC comparison cohort, respectively. Patients with NPC receiving RT were more likely to develop dementia than the comparison cohort, with a crude hazard ratio (HR) of 1.63 [95% confidence interval (CI) = 1.25–2.13, P < 0.001]. After adjusting for age, sex, education level, tobacco abuse, comorbidity, geographic area, urbanization level of the residence, and care level, the adjusted HR was 1.91 (95% CI = 1.42–2.51, P < 0.001). Patients with NPC receiving RT had a 1.91-fold higher risk of dementia than the non-NPC comparison controls. [ABSTRACT FROM AUTHOR]