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Neural decoding is useful to explore the timing and source location in which the brain encodes information. Higher classification accuracy means that an analysis is more likely to succeed in extracting useful information from noises. In this paper, we present the application of a nonlinear, nonstationary signal decomposition technique—the empirical mode decomposition (EMD), on MEG data. We discuss the fundamental concepts and importance of nonlinear methods when it comes to analyzing brainwave signals and demonstrate the procedure on a set of open-source MEG facial recognition task dataset. The improved clarity of data allowed further decoding analysis to capture distinguishing features between conditions that were formerly over-looked in the existing literature, while raising interesting questions concerning hemispheric dominance to the encoding process of facial and identity information.

This study aims to evaluate effects of word-internal variables on reading disyllabic Chinese words by manipulating (a) morphological complexity, defined as the number of morphemes and (b) structural complexity, defined as whether the two syllables relate to each other via the specifier-head-complement structure. In a visual lexical decision task, magnetoencephalography (MEG) was recorded during the reading of four types of Chinese disyllabic words: (1), disyllabic-monomorphemic (e.g., 蚯蚓 “qiu yin” earthworms), used as the control condition; (2) coordinative compounds (such as 花草 “hua cao” flower-grass: plants), which are double-headed, with meanings jointly derived from the two roots; (3) modifier-head compounds (such as 汽車 “qi che” gas-car: an automobile), which are right-headed, with the first root as the modifier; and (4) verb-object compounds (such as 開車 “kai che” operate-car: to drive a car), in which the first and second roots express an action and an object respectively. Our source analysis indicated that, at 200 m s, reading compounds revealed larger activity in left anterior temporal cortex than reading monomorphemic words, which might reflect composition of morphologically complex words during processing. From 300 to 400 m s, reading modifier-head compounds and verb-object compounds revealed larger activity in the left posterior temporal cortex than reading monomorphemic words, but there was no significant difference between reading coordinative compounds and reading monomorphemic words in this time window. These results indicate that morphological complexity and structural complexity substantially modulate activities in left temporal cortex during the reading of disyllabic words.

Background: Glypican-3 (GPC3) mRNA was more frequently overexpressed in women and patients with invasive HCC. We explore possible molecular mechanisms of the effect of GPC3 on growth factor receptor-bound protein 10 (Grb10) and insulin-like growth factor 1 receptor (IGF-1R) interaction of tumor invasion in women. Methods: For in vitro experiments, GPC3 and pertinent mutants were transfected, and Western blotting (HEK293T cells), confocal microscopy (HeLa and PLC-PRF-5 cells), luciferase assays for AP-1 reporter activities (NIH3T3 and HuH-7 cells), gelatin zymography (PLC-PRF-5 cells) and cell culture in 3D collagen I gels (NIH3T3 and R- cells) were performed. For in vivo experiments, GPC3 and IGF-1R coexpression was evaluated in hepatocellular carcinoma clinical samples. Results: We found that interaction of IGF-1R with Grb10 was hindered by GPC3, and GPC3 causes IGF-1R colocalization with Grb10 to a lesser extent after IGF-1 stimulation; moreover, it promoted IGF-1-stimulated AP-1 activation and matrix metalloproteinase -2 and 9 (MMP-2 and MMP-9) secretion in vitro, which seemingly play a role in tumor invasion or recurrence. Further, gender differences existed among patients with hepatocellular carcinoma in terms of GPC3 and IGF-1R coexpression in vivo.Conclusions: We believe that a more intensive surveillance of GPC3 expression in female patients with hepatocellular carcinoma should contribute to the prediction of recurrence, and this may highlight new strategies for treating hepatocellular carcinoma in women.

The ability to rapidly encode the direction of frequency contour contained in frequency-modulated (FM) sweeps is essential for speech processing, music appreciation, and conspecific communications. Psychophysical evidence points to a common temporal window threshold for human listeners in processing rapid changes in frequency glides. No neural evidence has been provided for the existence of a cortical temporal window threshold underlying the encoding of rapid transitions in frequency glides. The present magnetoencephalography study used the cortical mismatch negativity activity (MMNm) to investigate the minimum temporal window required for detecting different magnitudes of directional changes in frequency-modulated sweeps. A deviant oddball paradigm was used in which directional upward or downward frequency sweep serves as the standard and the same type of sweep with the opposite direction serves as its deviant. Stimuli consisted of unidirectional linear frequency-sweep complexes that swept across speech-relevant frequency bands in durations of 10, 20, 40, 80, 160, and 320 ms (with corresponding rates of 50, 25, 12.5, 6.2, 3.1, 1.5 oct/s). The data revealed significant magnetic mismatch field responses across all sweep durations, with slower-rate sweeps eliciting larger MMNm responses. A greater temporally related enhancement in MMNm response was obtained for rising but not falling frequency sweep contours. A hemispheric asymmetry in the MMNm response pattern was observed corresponding to the directionality of frequency sweeps. Contrary to psychophysical findings, we report a temporal window as short as 10 ms sufficient to elicit a robust MMNm response to a directional change in speech-relevant frequency contours. The results suggest that auditory cortex requires extremely brief temporal window to implicitly differentiate a dynamic change in frequency of linguistically relevant pitch contours. That the brain is extremely sensitive to fine spectral changes contained in speech-relevant glides provides cortical evidence for the ecological importance of FM sweeps in speech processing.

This study used the lexicality effects on N400 to investigate orthographic processing in children with developmental dyslexia. Participants performed a Go/No-Go semantic judgment task; three types of stimuli—real characters (RC), pseudocharacters (PC), and noncharacters (NC)—were embedded in No-Go trials. Two types of lexicality effects (RC vs. NC and PC vs. NC) were used to reflect the sensitivity to Chinese orthographic knowledge. In typical developing children, NC elicited a more negative N400 in frontal sites and a less negative N400 in bilateral posterior sites than RC and PC. The reversed lexicality effects in anterior and posterior sites support the dual-mechanism for lexical retrieval. Children with dyslexia revealed a more negative N400 for NC in frontal sites compared with RC, suggesting that they remained sensitive to orthographic familiarity. However, no difference between NC and PC was observed, suggesting a weakness in capturing Chinese orthographic knowledge in children with dyslexia.

Complete heart block (CHB) and acute renal infarction (ARI) are both uncommon diseases and seldom encountered in the clinical practice. We describe a rare case of pre-existing left bundle branch block, presenting simultaneously with CHB and ARI. The possible mechanism depends on prior presence of either CHB or ARI. If ARI occurs first, severe pain and embolism may enhance the vagal tone resulting in decrease in the heart rate and transient intraventricular conduction interruption, which subsequently causes CHB. The opposite scenario, CHB preceding ARI, is also possible. CHB can be physiologic and transient, with higher risk of development in the circumstance of pre-existing conduction system disturbances. Patients with CHB are predisposed to formation of thrombi and thromboemboli, giving rise to ARI. In conclusion, awareness and timely identification of the clinical manifestations of these two diseases may facilitate early diagnosis and prompt management.

Across languages and linguistic phenomena, rises in spoken pitch seem to occupy a privileged position compared to steady F0 or pitch lowering. Speakers are more likely to use sudden rises in pitch to arouse listener attention, rather than using falls; e.g., contrastive stress, questions seeking a response, beginnings of units of discourse, expressions of intense emotion, etc. The study evaluated whether there are brain responses that are more sensitive to stepwise raised vs. lowered spoken F0, and whether any such responses were also caused by pure tone stimuli. Three types of brain response were evaluated. Mismatch negativity (MMN), which reflects pre-attentive mechanisms, was only sensitive to degrees of F0 change, and not to direction. P300, which is an indicator of attention orientation, did not show sensitivity to F0 direction to non­speech stimuli, but showed greater sensitivity to raised F0 than to lowered F0 in speech. Time–frequency analysis of EEG data showed beta-band response in the right parietal area, when presented with spoken F0 elevation. Taken together, the P300 and beta band results suggest that attention modulation mechanisms are triggered when listeners are exposed to sudden rises in spoken F0. However, there was a lack of attention orientation response when non-speech F0 changes were presented, or when subjects were exposed to lowering of F0 in speech.

Metabolic syndrome (MetS) includes obesity, dyslipidemia, elevated blood pressure, and dysglycemia. Subjects with type 2 diabetes (T2D) exhibit features of MetS. The etiology of MetS is complex, involving both environmental and genetic factors. In this study, we examined the role of specific candidate genetic variants on the severity of MetS in T2D subjects. A total of 240 T2D subjects aged 35-64 years were recruited. Waist circumstance, plasma triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and blood pressure were measured to define MetS. Subjects were divided into 4 groups according to MetS components. Target genes involved in fibrotic and inflammatory processes, insulin and diabetes, cell growth and proliferation, and hypertension were genotyped. A total of 13 genes and 103 single-nucleotide polymorphisms (SNPs) were analyzed to evaluate their genetic association with MetS severity in T2D subjects. Univariate ordinal logistic regression using a dominant model (homozygous for the major allele vs carriers of the minor allele) revealed 6 SNP markers within 4 genes with genotypes associated with MetS risk. For the SNP genotypes of rs362551 (SNAP25), rs3818569 (RXRG), rs1479355, rs1570070 (IGF2R), and rs916829 (ABCC8), heterozygotes showed a lower risk of MetS compared with the reference group. In addition, the CC genotype was comparable to the TT genotype for rs3777411. There was no gender-specific effect. In conclusion, our results suggest that among the Han Chinese population, several SNPs increase the risk of severe MetS in T2D subjects. Further study in a large population should be conducted.

Spinocerebellar ataxia (SCA) is a hereditary disease characterized by central nervous system-related motor dysfunctions. Sleep disorders and frequent non-motor manifestations are commonly comorbid with SCA. To elucidate this relationship, we present three cases in a family that included multiple SCA type 2 patients with various sleep disorders. Complete physical examination, and genetic and imaging studies were performed. Anti-parkinsonism medications were prescribed after neurological examination. Clonazepam and/or quetiapine were administered for sleep disorders but failed to resolve insomnia and excessive daytime sleepiness (EDS). Based on DSM-5 criteria, all cases were diagnosed with depression. After treatment with serotonin-norepinephrine reuptake inhibitors and noradrenergic and specific serotonergic antidepressants, symptoms of insomnia and EDS, which are strongly associated with depression in SCA type 2 patients, improved significantly. It is crucial to recognize insomnia and EDS in neurodegenerative diseases, not only for earlier diagnosis, but also to improve quality of life.

Studies using functional magnetic resonance imaging have indicated that activities in the left inferior frontal cortex and left temporoparietal regions are associated with orthographic neighborhood size. To elucidate the temporal dynamics of reading-related cortical activities, we manipulated two types of neighborhood properties for Chinese phonograms, phonetic combinability and consistency. By using source analysis techniques in combination with magnetoencephalography, the results demonstrated a combinability effect in the right fusiform gyrus at ∼ 170 ms, which may reflect perceptual expertise in processing Chinese orthography. During 200 ms to 250 ms, the left anterior insula showed larger activity in reading small combinability characters than in reading large combinability characters, and the left inferior parietal cortex showed greater activity in reading low consistency characters than in reading high consistency characters. These results indicate that the left anterior insula cortex and left inferior parietal cortex may play important roles in the early stages of reading Chinese phonograms.

Background Although uric acid (UA) is not in the definition of metabolic syndrome (MetS), several studies had shown the positive correlation between UA and MetS. Due to the progress in the public health, the aging of the general population becomes a major issue. However, the aforementioned relationship between UA and MetS is not fully explored in elderly group. To fill up this deficient piece of knowledge, we enrolled Chinese elderly to shed light on the relationships between UA levels and MetS. Methods We randomly selected subjects aged 65 and older undergoing routine health checkups in Taiwan. After excluding subjects with taking medications known to affect components of MetS or UA, a total of 27,553 Chinese were eligible for analysis. All the participants were further divided into four groups according to the UA level. Results All the MetS components were significantly lower in the UA1 group. In simple correlation, all the MetS components were also correlated with UA. However, age and blood pressure became non-significant in multiple regressions. Compared to UA1, all the other 3 groups had higher odds ratio for MetS. Conclusion Higher UA level have higher rate of having MetS in Chinese elderly. UA could be regard as an ancillary tool for the awareness of MetS.

Decreased insulin sensitivity (IS) and impaired insulin secretion are major pathological features of type 2 diabetes (T2DM). The product of these factors is the disposition index (DI). We aimed to develop an equation for predicting DI. We enrolled 167 participants in our study. We randomly assigned 126 (75%) of the participants to the study group, whose data would be used to build the equation for estimating the DI. The remaining 41 participants comprised the external validation group. A frequently sampled intravenous glucose-tolerance test was performed for all participants, and the IS, the glucose sensitivity, the acute insulin response to the glucose load, and the DI were determined. Three factors were selected from multiple linear regression analysis, and we constructed the equation log (DI) = 2.449 - 0.113 × fasting plasma glucose + 0.046 × body mass index - 0.612 × high-density lipoprotein cholesterol. Using this equation, the calculated log (DI) significantly correlated with the measured log (DI) in the external validation group (r = 0.428, p = 0.007). By using the equation based on the demographic data and measurements of metabolic syndrome components, the DI could be predicted with acceptable accuracy (r = 0.428). Because of the relationships between the MetS and demographic parameters, this method of predicting DI may help further clinicians' understanding of the underlying pathological mechanisms in T2DM.

Aims/Introduction How to measure insulin resistance (IR) accurately and conveniently is a critical issue for both clinical practice and research. In the present study, we tried to modify the β-cell function, insulin sensitivity, and glucose tolerance test (BIGTT) in patients with normal glucose tolerance (NGT) and abnormal glucose tolerance (AGT) by oral glucose tolerance test (OGTT) and metabolic syndrome (MetS) components. Materials and Methods There were 327 participants enrolled and divided into NGT or AGT. Data from 75% of the participants were used to build the models, and the remaining 25% were used for external validation. Steady-state plasma glucose (SSPG) concentration derived from the insulin suppression test was regarded as the standard measurement for IR. Five models were built from multiple regression: model 1 (MetS model with sex, age and MetS components); model 2 (simple OGTT model with sex, age, plasma glucose, and insulin concentrations at 0 and 120 min during OGTT); model 3 (full OGTT model with sex, age, and plasma glucose and insulin concentrations at 0, 30, 60, 90, 120, and 180 min during OGTT); model 4 (simple combined model): model 1 and model 2; and model 5 (full model): model 1 and 3. Results In general, our models had higher r2 compared with surrogates derived from OGTT, such as homeostasis model assessment-insulin resistance and quantitative insulin sensitivity check index. Among them, model 5 had the highest r2 (0.505 in NGT, 0.556 in AGT, respectively). Conclusions Our modified BIGTT models proved to be accurate and easy methods for estimating IR, and can be used in clinical practice and research.

The prevalence of cardiovascular disease (CVD) and metabolic syndrome (MetS) increases with increasing fasting plasma glucose (FPG) levels in an elderly population with pre-diabetes or diabetes. However, it remains unknown whether the relationship between elevated FPG and increased risks of MetS exists in older women with normoglycemia (FPG100mg/dL). Therefore, the present study was conducted to fill the lack of information in that area.We included 6505 apparently healthy women, aged 65years and older, with normoglycemia who participated in routine health checkups at health screening centers in Taiwan. Components of MetS (FPG, waist circumference (WC), high-density lipoprotein cholesterol (HDL-C), triglycerides, and systolic/diastolic blood pressure), body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and percentage body fat (PBF) were examined in all subjects.Subjects were sub-grouped by FPG levels (90mg/dL, 91-95mg/dL and95mg/dL for group 1, group 2 and group 3, respectively). Subjects in group 2 and group 3 were 1.22-fold (P=0.017) and 1.25-fold (P=0.007) more likely to have MetS compared with those in group 1. Age, WC, BMI, PBF, systolic and diastolic blood pressure, total cholesterol, triglycerides, and HDL-C were significantly correlated with FPG, whereas HDL-C was negatively correlated with FPG. In a multivariate stepwise regression analysis, PBF, LDL-C, triglycerides, and age were significantly and independently associated with FPG.Among older women, the risk of MetS was significantly associated with elevated FPG even for subjects with normal FPG. Lifestyle interventions for reducing PBF and controlling dyslipidemia could help reduce the risk of MetS in this population.

Aim Cardiovascular disease and diabetes are important causes for mortality in older people. Both hypertension and prehypertension are correlated with them. Recently, health promotion and disease prevention in postmenopausal women have become an essential issue of public health policy. The present study aimed to evaluate whether the harmful effects of blood pressure (BP) could still be found in normotensive postmenopausal women (below 120/80 mmHg). Methods A total of 4539 normotensive postmenopausal women aged 51 years or older, undergoing routine health examinations, were enrolled in the cross-sectional analyses. To mitigate the effect of age on BP, participants within the same age were divided into tertiles according to their systolic BP (SBP). Then, participants in the low-SBP tertile of each age stratum were pooled together to form a larger group (low-normal SBP group [LNSBP]). Similarly, the middle- and high-normal SBP were grouped accordingly (MNSBP and HNSBP). Metabolic syndrome (MetS) was considered to be a surrogate for future cardiovascular disease and diabetes. Results The study showed that HNSBP bore a higher likelihood of having abnormal MetS components, elevated low-density lipoprotein cholesterol levels and a higher odds ratio (1.46; 95% confidence interval 1.17–1.81) for having MetS than LNSBP. In contrast, age, body mass index, fasting plasma glucose and low-density lipoprotein cholesterol were significantly related to SBP in multiple regression analysis. Conclusions The risk of having MetS was significantly associated with higher SBP even within normotension. Primary prevention, such as lifestyle modification, and more strict control of BP should be stressed in postmenopausal women. Geriatr Gerontol Int 2014; 14: 293–300.

Impaired insulin sensitivity (SI) and β-cell function are the two main causes of type 2 diabetes (T2D) and are related to low-grade inflammation status. Trivalent chromium has shown to improve SI in our previous study. This might be due to the ability of decreasing interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) shown in animal studies. In the current study, we measured SI, β-cell function, and plasma levels of IL-6 and TNF-α after treatment of chromium chloride (GaCr) in T2D. Sixty-six patients were randomly assigned to the 20 g of GaCr milk powder studying group or the milk powder placebo group. Oral glucose tolerance test was performed before and after the treatment. The SI and the β-cell function were measured as well. The SI was significantly improved. At the same time, the static insulin responsivity index (Φs) was significantly higher after the treatment (p = 0.003). On the other hand, the dynamic insulin responsivity index (Φd) remained unchanged. Interestingly, a significant decrease in the IL-6 level after the treatment (p = 0.015) was noted. Although there was a trend of decreasing in TNF-α, it was not statistically significant. Finally, there was no significant correlation between the δ-IL-6, SI, and Φd after GaCr treatment. In conclusion, other than the improvement of SI, GaCr could also improve the second phase of insulin responsivity (Φs) and IL-6. However, δ-IL-6 was correlated with neither δ-SI nor δ-Φs which indicated that the improvement of SI and Φs might involve mechanisms other than lower inflammatory effect.

The major contributors to the pathogenesis of type 2 diabetes are impaired insulin action and insulin secretion, including second phase insulin secretion (2nd ISEC). This study aimed to compare surrogates derived from the mixed meal tolerance test (MTT) with 2nd ISEC derived from modified low-dose graded glucose infusion (M-LDGGI) in patients with type 2 diabetes. We were subsequently able to decide which surrogate would be performed easily and accurately. Twenty type 2 diabetes patients were enrolled. They received both MTT and M-LDGGI. The standardized MTT meals were provided at 8:00 A.M. and 12:00 P.M. The M-LDGGI was a simplified version of the Polonsky method; only two 80-min stages of glucose infusion (2 and 6 mg/kg/min) were given. The slopes of the insulin to glucose curve during the test were regarded as the 2nd ISEC. First, we used the area under the insulin curve (AUC(IN)) during MTT to quantify the 2nd ISEC. The best correlated AUC(IN) was from 60-240 min. Second, the slopes between any two time points of the plasma insulin to glucose level (SLOPE(I/G)) were also assessed. The time period best correlated with 2nd ISEC was from 0-120 min (SLOPE₀₋₁₂₀). Finally, the insulin-to-glucose ratio (IGr) of each time point was used to estimate the 2nd ISEC, and the best correlation was observed at 180 min. In conclusion, estimating 2nd ISEC surrogates derived from MTT proved to be possible. The most accurate surrogate is the SLOPE₀₋₁₂₀, while IG(r180) is another less precise but more convenient method.

Impaired insulin sensitivity and insulin secretion (ISEC) are major pathophysiologies of type 2 diabetes (T2DM). ISEC has two phases: the first and second phases (second ISEC). In this study, we derived equations to identify patients with second ISEC deficiency (ISEC-D).Data from 96 patients, namely 19 with a normal fasting plasma glucose (FPG) level, 21 with prediabetes, and 56 with T2DM, were enrolled. They underwent a modified low-dose graded glucose infusion test, which was originally proposed by Polonsky et al. The test results were interpreted as the slopes of the changes of plasma insulin against the glucose levels, which were considered second ISEC. Patients with the lowest quartile of the slopes were defined as having ISEC-D. We built three models: Model 0: FPG, Model 1: FPG + waist circumference, and Model 2: Model 1 + fasting plasma insulin. The area under the receiver operating characteristic (aROC) curve was used to determine the predictive power of these models.Among the metabolic syndrome components, FPG had the largest aROC curve (78.2%). Although aROC curves of Models 1 and 2 (85.2% and 91.5%, respectively) were higher than the aROC curve of FPG, no difference was observed between Models 1 and 0. By contrast, the aROC curve of Model 2 was higher compared with Model 1.FPG showed the largest aROC curve. Model 2 had the highest predictive power, which could identify patients with ISEC-D with a sensitivity and specificity of 94.3% and 82.6%, respectively. These two models could be conveniently used in daily practice.

Hypertension and prehypertension are correlated with future cardiovascular disease (CVD) and diabetes. Whether these harmful effects of the blood pressure (BP) could be found in normotensive is of interest.In this cross-sectional study, totally 2388 normotensive older men aged 65-80 years undergoing routine health examinations were enrolled. To eliminate the influence of age on BP, subjects were initially grouped in each age stratum. Then in each age-stratum, subjects were further grouped into low, middle and high-tertile systolic BP (SBP) subgroups. Finally, all the low-tertile subgroups in each age stratum were gathered to form Group-1. Similarly, Group-2 (middle-tertile) and Group-3 (high-tertile) were also created. Metabolic syndrome (MetS) was regarded as having risks for future CVD and diabetes.Age, waist circumstance (WC), fasting plasma glucose (FPG) and log triglyceride (TG) were independently and significantly correlated with SBP by multiple linear regression analysis. On the other hand, logistic regression showed that Group-3 had significant higher odds ratios (ORs) for having abnormal WC, FPG and TG. In addition, Group-3 presented a 1.55-fold OR (p0.001) for having MetS than Group-1.In normotensive older men, the risk for having MetS was significantly associated with higher SBP. Primary prevention of hypertension should be stressed.

Summary Background With the growing number of elderly population in Taiwan and many other countries, the role of metabolic syndrome (MetS) has become more important recently. Although had been reported in different age groups, the relationship between platelet and MetS in the geriatric population still remains unknown. Methods We included 1187 Taiwanese males who were older than 65 years. In this study, we excluded individuals with abnormal platelet counts to reveal a more clear relation between platelet counts and MetS. Platelet counts were analyzed among patients with and without MetS. We divided platelet counts into four groups according to quartiles arbitrary of platelet counts (lowest, PC1; highest, PC4). The number of MetS components was compared between platelet groups with analysis of variance. We also used simple correlation and multivariate linear regression to find the relationship between platelet counts and MetS components. Results We found that the platelet counts were higher in the group with MetS but not significantly different ( p = 0.675). The fasting plasma glucose (FPG), total cholesterol, low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), and Log-triglyceride (Log-TG) were all statistically different across the four platelet groups. These four components were also positively correlated to platelet count in simple correlation. Not surprisingly, FPG, LDL-C, TG, and Log-TG were positively correlated with platelet count in multivariate linear regression. Conclusion FPG, LDL-C, TG, and Log-TG were positively correlated with platelet count among the MetS components in geriatric Taiwanese males. The role of HDL-C and LDL-C in the definition of MetS should be re-evaluated.

We conducted this study to investigate whether subjects with high-normal systolic blood pressure (SBP) have an increased risk of cardiovascular disease (CVD) and/or diabetes compared to subjects with low-normal SBP, using metabolic syndrome (MetS) as a risk factor for future CVD/diabetes.The study included 6133 apparently healthy Taiwanese men aged 40-65 years. All subjects were normotensive, and none took medication for any abnormal MetS component. To avoid the effect of age on blood pressure, we stratified patients first by age then by SBP (that is, low, middle, and high SBP). We pooled all the low, middle, and high SBP groups from the different age strata to create 3 larger groups (Group 1, Group 2, and Group 3, respectively). The MetS components in subjects with the lowest SBP (Group 1) were compared with those in the other 2 groups. All of the MetS components, except for high-density lipoprotein cholesterol (HDL-C), were significantly lower in Group 1. Thus, it was not surprising that Group 2 and Group 3 had significantly higher odds ratios for abnormal body mass index, fasting plasma glucose, low-density lipoprotein-cholesterol (LDL-C), and triglycerides than Group 1 (but not for HDL-C). Specifically, Group 3 had a 1.7-fold higher odds ratio (p < 0.001) for having MetS than Group 1. Age, body mass index, fasting plasma glucose, LDL-C, and log triglycerides correlated significantly with SBP. In multivariate linear regression analysis, we found that only body mass index, fasting plasma glucose, and log triglycerides remained significantly related to SBP. Among them, body mass index had the highest β value.In conclusion, the level of SBP was highly correlated with body mass index, fasting plasma glucose, and triglycerides in subjects with normotension. Although there is not a cause-and-effect relationship, the risk of CVD and diabetes was significantly associated with an elevation of SBP, even when the SBP remained within the normal range. Further studies are needed to determine whether normotensive subjects would benefit from medical management.

Background: Elevated alanine aminotransferase (e-ALT) and abnormal liver echogenicity (ab-echo), as determined by sonography, have been linked to metabolic syndrome (MetS). However, which of these is more closely related to MetS, especially among older men, remains unknown. Methods: Data from 3065 men aged 65 years or older who were undergoing a routine health examination and who were not taking any medications for MetS were analyzed retrospectively. The patients were divided into 4 groups: group N (n = 1228; patients have normal ALT and liver echogenicity); group A (n = 110; patients have e-ALT but normal liver echogenicity); group E (n = 1381; patients have ab-echo but normal ALT); group AE (n = 346; patients have both e-ALT and ab-echo). Results: Among the 3065 subjects, 714 participants were found to have MetS (23.3%). It is not surprising that MetS components were highest in group AE. More interestingly, compared with group A, group E had higher levels of MetS components (except that high-density lipoprotein cholesterol levels were lower). Similar findings were confirmed by logistic regression. Group E had a significantly higher odds ratio of having MetS than group A (2.73; 95% CI, 1.565–4.763). Conclusions: Our data confirm that both e-ALT and ab-echo are related to a higher incidence of MetS among Taiwanese older men. Of these 2 abnormalities, ab-echo seems to be more closely related to MetS. Further studies are needed to elucidate the complex relationships between these factors in other age and ethnic groups.

Aim The present study evaluated the relative influence of body mass index (BMI) on insulin resistance (IR), first-phase insulin secretion (FPIS), second-phase insulin secretion (SPIS), and glucose effectiveness (GE) at a fixed fasting plasma glucose level in an older ethnic Chinese population. Methods In total, 265 individuals aged 60 years with a fasting plasma glucose level of 5.56 mmol/L were enrolled. Participants had BMIs of 20.0–34.2 kg/m2. IR, FPIS, SPIS, and GE were estimated using our previously developed equations. Pearson correlation analysis was conducted to assess the correlations between the four diabetogenesis factors and BMI. A general linear model was used to determine the differences in the percentage of change among the four factor slopes against BMI. Results Significant correlations were observed between BMI and FPIS, SPIS, IR, and GE in both women and men, which were higher than those reported previously. In men, BMI had the most profound effect on SPIS, followed by IR, FPIS, and GE, whereas in women, the order was slightly different: IR, followed by FPIS, SPIS, and GE. Significant differences were observed among all these slopes, except for the slopes between FPIS and SPIS in women (p = 0.856) and IR and FPIS in men (p = 0.258). Conclusions The contribution of obesity to all diabetes factors, except GE, was higher than that reported previously. BMI had the most profound effect on insulin secretion in men and on IR in women in this 60-year-old cohort, suggesting that lifestyle modifications for obesity reduction in women remain the most important method for improving glucose metabolism and preventing future type 2 diabetes mellitus.

Both decreased insulin sensitivity, and impaired insulin secretion are 2 major pathophyisologies for type 2 diabetes (T2DM). There are two phases of ISEC-the first (1st ISEC) and second phase (2nd ISEC). In this study, we tried to build an equation to predict 2nd ISEC. Totally, 82 subjects, including 15 with normal fasting glucose, 26 with pre-diabetes and 41 with T2DM were enrolled. They received a modified low dose graded glucose infusion (M-LDGGI). The M-LDGGI is a simplified version of Polonsky’s method. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. The slopes of these curves were regarded as the 2nd ISEC. If only metabolic syndrome (MetS) components were analyzed, the equation was built as the following: log (2nd ISEC) = -2.400- 0.088 • (fasting plasma glucose, FPG + 0.072 • (body mass index, BMI). After fasting plasma insulin (FPI) was added , the equation was shown as the following: log (2nd ISEC) = -2.316- 0.093˙FPG + 0.049 • BMI+ 0.434 • log(FPI). The second equation provided a greater accuracy to determine 2nd ISEC than first one in the external validation group (r2 = 0.545 vs r2 = 0.423). Using MetS components, 2nd ISEC could be predicted with good accuracy. After adding FPI into the equation, the predictive power further increases. These equations could be widely used in daily practice and clinical settings.

Background Mismatch negativity (MMN) is a component of event-related potentials (ERPs). Conventional approaches to measuring MMN include recording a large number of trials (e.g., 1000 trials per participant) and extracting signals within a low frequency band, e.g., between 2 Hz and 8 Hz. New Method Ensemble empirical mode decomposition (EEMD) is a method to decompose time series data into intrinsic mode functions (IMFs). Each IMF has a dominant frequency. Similar to ERP measurement, averaging IMFs across trials allows measurement of event-related modes (ERMs). This paper demonstrates a protocol that adopts EEMD and Hilbert spectral analyses and uses ERMs to extract MMN-related activity based on electroencephalography data recorded from 18 participants in an MMN paradigm. The effect of deviants was demonstrated by manipulating changes in lexical tones. Results The mean amplitudes of ERMs revealed a significant effect of lexical tone on MMN. Based on effect size statistics, a significant effect of lexical tone on MMN could be observed using ERM measurements over fewer trials (about 300 trials per participant) in a small sample size (five to six participants). Comparison with Existing Method(s) The EEMD method provided ERMs with remarkably high signal-to-noise ratios and yielded a strong effect size. Furthermore, the experimental requirements for recording MMN (i.e., the number of trials and the sample size) could be reduced while using the suggested analytic method. Conclusions ERMs may be useful for applying the MMN paradigm in clinical populations and children.

Inattention (IA) has been a major problem in children with attention deficit/hyperactivity disorder (ADHD), accounting for their behavioral and cognitive dysfunctions. However, there are at least three processing steps underlying attentional control for auditory change detection, namely pre-attentive change detection, involuntary attention orienting, and attention reorienting for further evaluation. This study aimed to examine whether children with ADHD would show deficits in any of these subcomponents by using mismatch negativity (MMN), P3a, and late discriminative negativity (LDN) as event-related potential (ERP) markers, under the passive auditory oddball paradigm. Two types of stimuli—pure tones and Mandarin lexical tones—were used to examine if the deficits were general across linguistic and non-linguistic domains. Participants included 15 native Mandarin-speaking children with ADHD and 16 age-matched controls (across groups, age ranged between 6 and 15 years). Two passive auditory oddball paradigms (lexical tones and pure tones) were applied. The pure tone oddball paradigm included a standard stimulus (1000 Hz, 80%) and two deviant stimuli (1015 and 1090 Hz, 10% each). The Mandarin lexical tone oddball paradigm’s standard stimulus was /yi3/ (80%) and two deviant stimuli were /yi1/ and /yi2/ (10% each). The results showed no MMN difference, but did show attenuated P3a and enhanced LDN to the large deviants for both pure and lexical tone changes in the ADHD group. Correlation analysis showed that children with higher ADHD tendency, as indexed by parents’ and teachers’ ratings on ADHD symptoms, showed less positive P3a amplitudes when responding to large lexical tone deviants. Thus, children with ADHD showed impaired auditory change detection for both pure tones and lexical tones in both involuntary attention switching, and attention reorienting for further evaluation. These ERP markers may therefore be used for the evaluation of anti-ADHD drugs that aim to alleviate these dysfunctions.

Background In Taiwan, persons over 65 years old have higher prevalence of hepatitis C. Among these patients, around 50% have non-alcoholic fatty liver disease (NAFLD). Since cardiovascular diseases and diabetes are main causes of death in this age group, in this cross-sectional study, we tried to evaluate the effects of NAFLD and hepatitis C on the risk of metabolic syndrome (MetS). Methods In total, 25 116 subjects over 65 years old who presented for routine health check-ups were enrolled. From the results of seropositivity for hepatitis C and abnormal echogenicity, they were classified into four groups: normal (N), subjects with only hepatitis C (C), subjects with only abnormal echogenicity (E) and subjects with both hepatitis C and abnormal echogenicity (CE). Results Subjects in both groups E and CE had higher abnormal MetS components than group C. Among all five components, triglyceride (TG) was the one having the highest odds ratio (OR) in determining the incidence of MetS in groups C and E. Finally, compared to group N, both groups E and CE had significantly higher OR for having MetS. However, after adjusting for confounding factors, only the significance between groups E and N remained. In other words, higher MetS was noted in group E compared to group N and there was no difference in incidence of MetS between group CE and group N. Conclusions Chronic hepatitis C is a protective factor against having MetS and this effect might be due to lower TG level in the elderly. Further studies are warranted for the underlying mechanisms.

Summary Introduction It is well known that higher fasting plasma glucose (FPG) is associated with metabolic syndrome (MetS). This relationship still exists even the FPG is within the normal range. However, most of these studies did not exclude subjects who were on medications which would affect the results of the studies. At the same time, there is no longitudinal study done to validate this correlation, especially in elderly. In this study, the relationships between normal FPG and MetS were evaluated. Method We randomly selected 57,517 subjects who were ≥ 60-years old from health screening centre. In the first part of study, subjects were enrolled in the cross-sectional study to find out the optimal cut-off value of FPG with higher chances to have MetS. In the second part of current study, subjects with MetS at baseline were excluded from the same study group, and performed a median 5.3-year longitudinal study. Results There were 18,287 subjects enrolled in this study. In the first part of study, the cross-sectional study, optimal cut-off values of FPG were determined by the ROC curve and the sensitivity for these cut-off values were 56.6% in men and 60.9% in women, respectively. The result showed that lower FPG is healthier than the higher (log-rank test, p

Background Metabolic syndrome (MetS) has an important implication from a preventive medicine perspective as early recognition and intervention will reduce associated mortality and morbidity. To better identify patients at risk for developing MetS and cardiovascular disease, we conduct a combined cross-sectional and longitudinal study to shed light on the elevated white blood cell (WBC) level in elderly. Methods A total of 10,463 subjects were eligible for analysis. In the first stage of study, subjects were enrolled in the cross-sectional study to find out not only the correlation between WBC and MetS but also the optimal cut-off value of WBC with higher chances to have MetS. In the second stage of current study, subjects with MetS at baseline were excluded from the same study group, and performed a median 6.8-year longitudinal study to validate the optimal cut-off value of WBC predicting MetS. Results WBC is significantly higher in the group with than without MetS in both genders. All MetS components were associated with WBC in multivariate analysis except diastolic blood pressure and fasting plasma glucose. In the longitudinal study, WBC showed to be a good predictor of MetS in both genders. Conclusion WBC is a good marker to identify the high risk subjects having MetS in the current status or in the future. Elderly with a higher WBC and without any underlying chronic diseases should receive more attention on the potential to develop MetS.

Aims. There are two phases of insulin secretion, the first (FPIS) and second phase (SPIS). In this study, we built equations to predict FPIS with metabolic syndrome (MetS) components and fasting plasma insulin (FPI).Methods. Totally, 186 participants were enrolled. 75% of participants were randomly selected as the study group to build equations. The remaining 25% of participants were selected as the external validation group. All participants received a frequently sampled intravenous glucose tolerance test, and acute insulin response after the glucose load (AIRg) was obtained. The AIRg was considered as FPIS.Results. When MetS components were only used, the following equation was built: log (FPIS) = 1.477 − 0.119 × fasting plasma glucose (FPG) + 0.079 × body mass index (BMI) − 0.523 × high-density lipoprotein cholesterol (HDL-C). After FPI was added, the second equation was formulated: log (FPIS) = 1.532 − 0.127 × FPG + 0.059 × BMI - 0.511 × HDL-C + 0.375 × log (FPI), which provided a better accuracy than the first one.Conclusions. Using MetS components, the FPIS could be estimated accurately. After adding FPI into the equation, the predictive power increased further. We hope that these equations could be widely used in daily practice.

Hypertension and prehypertension can increase the risk of developing cardiovascular disease (CVD) and diabetes. However, whether the harmful effects of high blood pressure (BP) are also seen with high normotension remains unknown. This 10-year longitudinal follow-up study aimed to investigat

Objective To compare four different blood pressure (BP) measurements—systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)—in predicting future metabolic syndrome (MetS) among the normotensive elderly population, and to estimate the optimal cutoff value of the best single measurement for clinical practice. Methods A total of 2782 non-medicated participants aged ≥ 60 years were enrolled in a standard health examination program in Taiwan from January 2004 to December 2013. Two thirds of the participants were randomly designated as the training group (n = 1855) and the other one third as the validation group (n = 927). The mean follow-up time was 3.60 years for both the training and validation groups. MAP and PP were calculated from SBP and DBP. Results SBP, DBP, and MAP were associated with future MetS, whereas PP was not. MAP had the largest hazard ratio in Cox regression (men 1.342 [95% CI 1.158–1.555] and women 1.348 [95% CI 1.185–1.534] in the training group; men 1.640 [95% CI 1.317–2.041] and women 1.485 [95% CI 1.230–1.794] in the validation group) and the largest area under the receiver operating characteristic curve (men 0.598 ± 0.021 and women 0.602 ± 0.021 in the training group). Multivariable Cox regression further indicated that a higher MAP level was independently associated with the future occurrence of MetS. Participants with MAP above the cutoff value (84.0 mm Hg for men, 83.3 mm Hg for women) had a higher cumulative incidence of MetS than did their counterparts after four years' follow-up in both the training and validation groups. The results derived from the training data could be replicated in the validation data, indicating that the results were generalizable across distinct samples. Conclusions MAP is more accurate than SBP, DBP, and PP in predicting future MetS among the normotensive geriatric population. Calculation of MAP is recommended when dealing with normotensive patients aged ≥ 60 years in clinical practice.

The metabolic syndrome (MetS) is proposed to predict future occurrence of cardiovascular diseases and diabetes. There are some other "non-traditional" risk factors such as hematogram components that are also related to the same endpoints as MetS. In this four-year longitudinal study, we used hematogram components to build models for predicting future occurrence of MetS in older men and women separately.Subjects above 65 years without MetS and related diseases were enrolled. All subjects were followed up until they developed MetS or until up to four years from the day of entry, whichever was earlier.Among the 4539 study participants, 1327 developed MetS. Models were built for men and women separately and the areas under the receiver operation curves were significant. The Kaplan-Meier plot showed that the models could predict future MetS. Finally, Cox regression analysis showed that the hematogram model was correlated to future MetS with hazard ratios of 1.567 and 1.738 in men and women, respectively.Our hematogram models could significantly predict future MetS in elderly and might be more practical and convenient for daily clinical practice.

The white blood cell (WBC) count was one of the first inflammatory markers associated with metabolic syndrome (MetS). Recently, two longitudinal studies have demonstrated a cause and effect relationship between MetS and WBC counts among middle-aged adults. However, no study has used WBC cutoff values to predict MetS in the elderly.Subjects who underwent routine health checkups, and were above 60 years of age, were enrolled. All subjects were followed-up until they developed MetS or until 4 years from the date of entry, whichever came earlier. Of the 4539 subjects eligible for enrollment, 3428 subjects comprised the study group and 1111 subjects comprised the validation group.WBC counts were significantly different between subjects with and without MetS in both genders. Using the ROC curve, WBC cutoff values of 5.7 × 10(3)/µl in males and 5.0 × 10(3)/µl in females were associated with the increased risk of developing MetS (all p values0.001). Using these WBC cutoff values, the hazard ratio (HR) for females was significant in both the study group and validation group. However, the HR for males failed significance in the validation group. Kaplan-Meier plots and κ coefficients confirmed that the WBC cutoff value could predict development of MetS in women but not in men.The association between WBC count and MetS was gender specific. A WBC cutoff value greater than 5.0 10(3)/µl may predict the development of MetS in elderly women.

The present magnetoencephalography study used the cortically constrained minimumnorm estimates of human brain activity to elucidate functional roles of neural generators for detecting different magnitudes of lexical tones changes. A multiple-deviant oddball paradigm was used in which the syllable “yi” with a low-dipping tone (T3) was the common standard sound and the same syllable with a high-level tone (T1) or a high-rising tone (T2) were the large and small deviant sounds, respectively. The data revealed a larger magnetic mismatch field (MMNm) for large deviant in the left hemisphere. The source analysis also confirmed that the MMNm to lexical tone changes was generated in bilateral superior temporal gyri and only the large deviant revealed left lateralization. A set of frontal generators was activated at a later time and revealed differential sensitivities to the degree of deviance. The left anterior insula, the right anterior cingulate cortex, and the right ventral orbital frontal cortex were activated when detecting a large deviant, whereas the right frontal-opercular region was sensitive to the small deviant. These frontal generators were thought to be associated with various top-down mechanisms for attentional modulation. The time frequency (TF) analysis showed that large deviants yielded large theta band (5–7 Hz) activity over the left anterior scalp and the left central scalp, while small deviants yielded large alpha band activity (9–11 Hz) over the posterior scalp. The results of TF analyses implied that mechanisms of working memory and functional inhibition involved in the processes of acoustic change detection.

The relationship between metabolic syndrome (MetS) and uric acid (UA) has been explored in many studies, but there is paucity of information on hypo-uricemia and MetS. The current study aimed to elucidate the relationship between the lower end of UA and MetS in elderly. Subjects aged ≥60 years who underwent routine health checkups were enrolled, and 10,579 were eligible for analysis. A cross-sectional study was first performed to determine the correlation between MetS and UA. The subjects were divided into two groups according to the lowest male MetS prevalence in each UA level (UA ≤5 and >5 mg/dl). A longitudinal study then excluded subjects with MetS at baseline to validate the UA level of those with the lowest incidence of MetS. In the prevalence of MetS in different UA levels, there was a J-shaped curve in males but a linear relationship in females. In males, waist circumference, systolic blood pressure, high-density lipoprotein, and triglyceride were correlated with UA in univariate analysis, but high-density lipoprotein became insignificant in multivariate analysis in UA >5 mg/dl (UA-high). Only fasting plasma glucose (FPG) was significantly related to UA ≤5 mg/dl (UA-low). The UA level of 4.5–5 mg/dl had the lowest risk of having MetS in odds ratio, log-rank test, and hazard ratio. A J-shaped phenomenon exists between UA and MetS in elderly men but not in elderly women and FPG seem to be the key factor in this. Lower UA does not provide benefits in elderly men. The new UA control strategy for the elderly warrants further investigation.

Obesity is a major public health problem, and measuring adiposity accurately and predicting its future comorbidities are important issues. Therefore, we hypothesized that 4 adiposity measurements, body mass index (BMI), waist circumference (WC), waist-to-height ratio, and body fat percentage, have different physiological meanings and distinct associations with adverse health consequences. This study aimed to investigate the relationship of these 4 measurements with metabolic syndrome (MetS) components and identify the most associated factor for MetS occurrence in older, non-medicated men. Cross-sectional data from 3004 men, all 65 years of age and older, were analyzed. The correlation and association between adiposity measurements and MetS components were evaluated by Pearson correlation and multiple linear regression. Based on multivariate logistic regression, BMI and WC were significantly associated with MetS and were selected to build a combined model of receiver operating characteristic curves to increase the diagnosis accuracy for MetS. The results show that BMI is independently associated with systolic and diastolic blood pressure; WC and body fat percentage are associated with fasting plasma glucose and log transformation of triglyceride; BMI and WC are negatively associated with high-density lipoprotein cholesterol (HDL-C); and WC is a better discriminate for MetS than BMI, although the combined model (WC + BMI) is not significantly better than WC alone. Based on these results, we conclude that the 4 adiposity measurements have different clinical implications. Thus, in older men, BMI is an important determinant for blood pressure and HDL-C. Waist circumference is associated with the risk of fasting plasma glucose, HDL-C, triglyceride, and MetS occurrence. The combined model did not increase the diagnosis accuracy.

Low-grade inflammatory status was thought to be a major underlying mechanism in MetS. White blood cell (WBC) count was one of the inflammatory markers identified to be associated with MetS. Moreover, not only WBC but also hemoglobin (Hb) and platelet (PLT) were all associated with MetS.In this study, we tried to build models by the hematogram components. In this way, we can not only predict the occurrence of MetS with a relatively low-cost and routine lab test, but also can understand more about the relationships between low grade inflammation and MetS.We randomly collected subjects over 65 years old from MJ Health Screening Center's database between 1999 and 2008. After excluding subjects with medications for hypertension, hyperlipidemia and/or diabetes, 13,132 female were eligible for analysis.All the MetS components, hematogram parameters and age were higher in group with MetS. In the correlation matrix, all these three hematogram parameters (WBC, Hb and PLT) were correlated with MetS components except for the correlation between Hb and HDL-C. The ROC curves showed that the model 3 (PLT + Hb + WBC) had greatest area under the curve of 0.631 with the sensitivity of 58.1% and specificity of 61.4%.Our findings have shown that all the three hematogram parameters are related to MetS. The results not only shed light on the complex relationships, but also demonstrate a common and easy model to aid clinicians to be more aware of the occurrence of MetS.

Summary Objective Type-2 diabetes is mainly the metabolic defect involving multiple organs. To conclude their intricate relationships, the term ‘ominous octet’ had been proposed to denote this phenomenon. In this study, we enrolled older men without any medications for MetS components to further elucidate the relationships between normoglycaemic state and MetS. Methods We enrolled male subjects with FPG less than 100 mg/dl and aged 65 and older undergoing routine health check-ups in Taiwan. After excluding subjects taking medications that might affect the components of MetS, a total of 6679 men were eligible for the analysis. Study subjects were further grouped into FPG tertiles ( 95 mg/dl for tertil 1, tertil 2 and tertil 3, respectively). Results There was a significant trend between the FPG and percentages of subjects having MetS (p = 0.009). The relationships between the MetS components were higher in FPG 2 and FPG 3 than FPG 1. In simple correlation, all of the MetS and LDL-C were positively correlated with FPG level and multiple regression further confirmed the same result except for HDL-C that became non-significant. Subjects in FPG3 had significantly higher ORs (ORs = 1.19) for having MetS than those in FPG1. Conclusions In conclusion, higher FPG still had higher risk of having MetS in normoglycaemic range in elderly male. More strict FPG level control may be valuable in CVD prevention and warrants further investigations.

Aims The aim of this study was to evaluate the relative importance of insulin sensitivity ( S I ), and the first (1st ISEC) and second phase insulin secretion (2nd ISEC) in the development of type 2 diabetes (T2D) in Chinese subjects. Methods A total of 96 subjects, including 19 with normal fasting glucose, 21 with pre-diabetes, and 56 with T2D were enrolled. Subjects underwent a modified low dose graded glucose infusion (M-LDGGI; a simplified version of Polonsky's method) and frequently sampled intravenous glucose tolerance test. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. By observing the respective percentage reduction, the deterioration rate of each parameter was compared. Results As fasting plasma glucose (FPG) levels increased, S I decreased mildly and non-significantly, while the 1st and 2nd ISECs decreased more dramatically and significantly. More importantly, the decrease of the 1st ISEC from baseline was greater than that of the 2nd ISEC. Conclusions Since the 1st ISEC decreased the most with increasing FPG levels, it is concluded that the 1st ISEC is the key trigger of T2D development. On the contrary, the 2nd ISEC remained more stable across increasing FPG levels. This latter finding may explain the effectiveness of insulin secretagogues during the early stage of T2D. The results of this study can be helpful in the development of interventions aimed at stopping the progression and/or treating T2D in Chinese populations.

We employ a linear mixed-effects model to estimate the effects of visual form and the linguistic properties of Chinese characters on M100 and M170 MEG responses from single-trial data of Chinese and English speakers in a Chinese lexical decision task. Cortically constrained minimum-norm estimation is used to compute the activation of M100 and M170 responses in functionally defined regions of interest. Both Chinese and English participants’ M100 responses tend to increase in response to characters with a high numbers of strokes. English participants’ M170 responses show a posterior distribution and only reflect the effect of the visual complexity of characters. On the other hand, the Chinese participants’ left hemisphere M170 is increased when reading characters with high number of strokes, and their right hemisphere M170 is increased when reading characters with small combinability of semantic radicals. Our results suggest that expertise with words and the decomposition of word forms underlies processing in the left and right occipitotemporal regions in the reading of Chinese characters by Chinese speakers.

Objective To evaluate the cause-effect relationships between serum levels of uric acid (UA) and metabolic syndrome (MetS) in an adolescent-male cohort that was followed for 2.7 years. Study design We enrolled male adolescents aged between 10 and 15 years at the baseline. A total of 613 subjects were divided into quartiles according to their UA levels, from UA-1 (the lowest) to UA-4 (the highest). Results After the mean follow-up period of 2.7 ± 0.97 years, 19 (3.1%) subjects developed MetS. Waist circumference (WC), systolic blood pressure, high density lipoprotein cholesterol (HDL-C), and log triglyceride levels were significantly related to baseline UA levels. Compared with the UA-1 group, subjects in the UA-4 group had significantly higher OR for abnormal WC, blood pressure, and HDL-C at the end of follow-up and had a 6.39-fold higher OR (95% CI 1.41-29.08; P 7.6 mg/dL had a 4.32 (95% CI 1.57-11.93) higher risk of developing MetS. Conclusions In this longitudinal study, we found that serum UA is correlated with future WC, systolic blood pressure, triglyceride, and HDL-C and is a risk factor for developing MetS. UA might be valuable in predicting adolescent MetS.

Objectives: Insulin resistance is one of the important underlying abnormalities of type 2 diabetes. The effect of thiazolidinedione on liver functions has been controversial in different studies. In this study, we evaluated the effect of rosiglitazone on liver enzymes in subjects with type 2 diabetes with and without abnormal liver function. Materials and Methods: Seventy-three patients with type 2 diabetes taking rosiglitazone 4 mg daily were enrolled in this 3-month study. Forty-two of them had normal liver function (NLF), and 31 had abnormal liver function (ABLF). Blood biochemistries were collected monthly during the treatment period. Results: At baseline, other than age and liver enzymes, there were no differences in body mass index, fasting plasma glucose, hemoglobin A1c (HbA1c), and lipid profiles between the NLF and ABLF groups. At the end of the treatment, HbA1c was lowered in both groups, but only significantly in the ABLF group ( P = 0.027). More importantly, serum concentrations of both aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the ABLF group decreased significantly (AST: 57.8 ± 26.5 to 47.5 ± 20.2 U/L, P = 0.006; ALT 66.6 ± 35.0 to 51.9 ± 23.5 UL, P = 0.004), while in the NLF group, a similar change was not found. Conclusion: After 3-month rosiglitazone treatment in subjects with type 2 diabetes with mildly elevated liver enzymes, significant improvement in AST and ALT were observed. Our study provides some hints that rosiglitazone might not be contraindicated in subjects with diabetes with abnormal liver function as previously thought, but further well-designed studies are necessary to clarify this issue.