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Background Obesity, metabolic syndrome ( MS) and chronic kidney disease ( CKD) are all becoming increasingly prevalent worldwide. Body mass index ( BMI) has traditionally been employed to identify overweight or obese individuals, yet multiple studies have yielded conflicting results when BMI was used to evaluate the association between obesity and CKD. Aims The purpose of this large, population-based, multicentre study was to evaluate the associations of BMI and waist-to-height ratio ( WHtR) with CKD. Methods A retrospective study of 41 600 subjects who had physical examinations from January 2010 to December 2011 was performed. Data such as life style and habits were collected by interviews, and systolic and diastolic blood pressure ( SBP and DBP), height, body weight, waist circumference, total cholesterol ( TC), high-density lipoproteins ( HDL), triglycerides ( TG), fasting blood glucose and creatinine levels were measured. The association of these factors with CKD was analysed by use of SPSS 15.0 software. Results The key findings of this study were that WHtR but not BMI was an independent predictor of CKD. Additionally, SBP was a predictor of CKD in males and females, and TG and TC were independent predictors of CKD in females. Such measures are components of MS, which may also be associated with the development of CKD. Conclusion WHtR appears to be a better measure of central obesity than BMI, and is an easy-to-use, noninvasive tool for identifying individuals at risk of developing obesity-related CKD, and potentially also MS-related CKD. [ABSTRACT FROM AUTHOR]

Objectives: To depict recent secular trend (2001-2005) in prevalence of depression among diabetic population in Taiwan, and to explore the influences of urbanization on the prevalence of depression. Study design: A descriptive correlation study design relating urbanization and prevalence of depression. Methods: Annual prevalence of depression was calculated as the ratio of number of individuals with depression (ICD-9-CM: 296, 309, or 311) to the size of diabetic population (ICD-9-CM: 250), which were ascertained from ambulatory care claim data of Taiwan's National Health Insurance between 2001 and 2005. Multivariate Poisson regression analysis was used to assess the secular trend in the prevalence of comorbid depression, and to appraise the influence of urbanization on prevalence of depression in diabetic patients. Results: The prevalence of depression among diabetic population increased annually from 22.6/10³ in 2001 to 27.0/10³ in 2005 with a significantly and linearly rising trend (β = 0.0461, p < 0.0001). Diabetic population living in urban areas showed the largest increase in prevalence (6.3/10³), followed by those from rural areas (5.6/10³). Compared to the diabetic patients residing in rural areas, those living in urban areas (RR = 1.28, 95% CI = 1.25--1.31) and those from satellite towns (RR = 1.22, 95% CI = 1.19-1.25) both had significantly increased adjusted RR. Conclusions: There is a significant increasing trend in prevalence of depression among diabetic population in recent years in Taiwan. Diabetic patients from urban areas not only had the greatest prevalence of depression but also showed the largest increase in prevalence during the study period, which highlights a need for managing depression in urban diabetes. [ABSTRACT FROM AUTHOR]

Background: Through data mining of a published transcriptomic database of urothelial carcinomas of the urinary bladder (GSE32894), colony stimulating factor 2 (CSF2) was identified as the most significant gene showing stepwise upregulation related to positive regulation of tyrosine phosphorylation of STAT5 (GO:0042523). We therefore analysed CSF2 transcript and protein expression and their association with clinicopathological factors and survival in our well-characterised cohort of urothelial carcinomas. Methods: Laser capture microdissection coupled with real-time qRT-PCR was used to detect CSF2 transcript level in 24 urothelial carcinomas of the urinary bladder and six non-tumour urothelium samples. Immunohistochemistry evaluated by using H-score was used to determine CSF2 protein expression in 296 urothelial carcinomas of the urinary bladder and 340 urothelial carcinomas of the upper urinary tract. Protein expression was correlated with clinicopathological features and disease-specific survival (DSS) and metastasis-free survival (MeFS). Findings: CSF2 transcripts were detected exclusively in tumour lesions (p=0.010) with stepwise upregulation. CSF2 protein overexpression was significantly associated with advanced pT status (urothelial carcinomas of the upper urinary tract, p=0.011; urothelial carcinomas of the urinary bladder, p<0.001), and perineural invasion (urothelial carcinomas of the upper urinary tract, p=0.002; urothelial carcinomas of the urinary bladder, p= 0.001) in both groups of urothelial carcinoma. CSF2 overexpression not only predicted worse DSS (urothelial carcinomas of the upper urinary tract, p=0.0001; urothelial carcinomas of the urinary bladder, p<0.0001) and MeFS (urothelial carcinomas of the upper urinary tract, p=0.0001; urothelial carcinomas of the urinary bladder, p=0.0002) at univariate analysis, but also inferior DSS (urothelial carcinomas of the upper urinary tract, p=0.015; urothelial carcinomas of the urinary bladder, p=0.004) and MeFS (urothelial carcinomas of the upper urinary tract, p=0.008; urothelial carcinomas of the urinary bladder, p=0.027) in multivariate analysis. Interpretation: CSF2 overexpression is associated with advanced clinical features for both patients with urothelial carcinomas of the upper urinary tract and urothelial carcinomas of the urinary bladder, suggesting it may serve as a potential prognostic and a novel therapeutic target of urothelial carcinoma. [ABSTRACT FROM AUTHOR]

Background: Alpha-methylacyl CoA racemase (AMACR) is essential for catabolism of branched-chain fatty acids, allowing their subsequent β-oxidation to generate energy. However, its significance has not been assessed in urothelial carcinoma. We therefore analysed the clinicopathological and biological significance of AMACR expression in urothelial carcinoma. Methods: Laser capture microdissection coupled with real-time qRT-PCR was used to detect AMACR transcript level in 22 urothelial carcinomas of the urinary bladder. Immunohistochemistry evaluated by using H-score was used to determine AMACR protein expression in 295 urothelial carcinomas of the urinary bladder and 340 urothelial carcinomas of the upper urinary tract. mRNA and protein expression were correlated with clinicopathological features. AMACR protein expression was further evaluated for associations with disease-specific survival (DSS) and metastasis-free survival (MeFS). In vitro, AMACR overexpressing urothelial carcinoma cell lines (BFTC905 and RTCC-1) were evaluated for its biological function using RNA interference. Findings: Increments of AMACR transcript level was associated with higher pT status (p=0.017). AMACR protein overexpression was significantly associated with advanced pT status (both p<0.001), nodal metastasis (both p≼0.001), high histological grade (both p≼0.001), vascular invasion (urothelial carcinomas of the upper urinary tract, p<0.001; urothelial carcinomas of the urinary bladder, p=0.003), frequent mitoses (urothelial carcinomas of the upper urinary tract, p=0.007; urothelial carcinomas of the urinary bladder, p<0.001) in both groups of urothelial carcinomas. AMACR overexpression not only predicted worse DSS and MeFS at univariate analysis, but was also associated with inferior DSS (urothelial carcinomas of the upper urinary tract, p=0.025; urothelial carcinomas of the urinary bladder, p=0.001) and MeFS (urothelial carcinomas of the upper urinary tract, p=0.028; urothelial carcinomas of the urinary bladder, p=0.019) in multivariate analysis. In both urothelial carcinoma cell lines, stable AMACR knockdown resulted in impaired cell proliferation, as well as migration/invasion capabilities. Interpretation: AMACR overexpression is associated with advanced clinical features for patients with urothelial carcinoma and may serve as a potential prognostic biomarker and a novel therapeutic target. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a worldwide health issue with heavy economic burden. Chronic hepatitis C virus (HCV) infection is a common cause of CKD, which can significantly impact the progression and mortality among patients with CKD. The prevalence of both illnesses is high in Taiwan. A multicentre and population-based cross-sectional study including 24 642 subjects was conducted to explore the association of HCV infection with the prevalence and severity of CKD. The measurements of metabolic parameters, eGFR and CKD stages were compared between subjects with HCV seropositivity and seronegativity. The analyses of association between HCV infection with CKD stages and evaluation of potential risk factors of CKD were performed by gender and age (≤ and >45 years). HCV-seropositive subjects accounted for 6.9% and had a significantly older age. The prevalence of CKD increased in those with HCV seropositivity (16.5%). Significantly higher prevalence of CKD stages ≥3 in HCV-seropositive subjects was noticed (7.8%). Age (>45 year), male gender, alcohol drinking, hypertension, creatinine and HCV infection were the significant factors associated with the presence of CKD. HCV seropositivity was an independent risk factor of developing CKD and associated with an increased risk of having CKD of all stages. The higher prevalence of earlier stage of CKD warrants longitudinal studies with frequent testing on renal function and sufficient duration to determine the changes of eGFR over time. Implementation of effective treatment intervention is also required for these subjects to prevent the progression of CKD to late stages., (© 2013 John Wiley & Sons Ltd.)

Background: This study was conducted to evaluate the risks of adverse birth outcomes including low birthweight, preterm and small-for-gestational age among teen mothers., Methods: Data were collected from the Taiwan Birth Registry between 1985 and 1997. Among a total of 1,185,597 live births born to mothers aged 24 years or less, 151,259 (12.8%) were born to teen mothers aged 19 years or less. Crude odds ratios (ORs), adjusted ORs (AORs), their 95% confidence intervals and test for linear trend of maternal age-specific AOR were estimated using logistic regression analysis., Results: After controlling for certain birth characteristics and socio-economic factors, the age-specific analysis showed significantly gradient variations in increased risks of adverse birth outcomes among births of teen mothers, where the elevated risk was lessened in older teen mothers. Teen mothers aged 16 years or less were observed to experience particularly high AORs for all adverse birth outcomes of interest., Conclusions: Not all teen mothers experienced the same magnitude of increased risk of adverse birth outcomes in Taiwan. Considering all teen mothers as the same group may have overlooked the particularly high risks of adverse birth outcomes among very young teen mothers (16 years or less), who are especially vulnerable to such elevated risks.

Arsenic is a well-documented human carcinogen. Bowen's disease, squamous cell carcinoma, and basal cell carcinoma are the most common skin cancers found in patients exposed to arsenic over the long term. Merkel cell carcinoma has been documented in Taiwanese patients who resided in an endemic area of black foot disease, another condition found in patients with chronic arsenicism. We collected all cases of Merkel cell carcinoma diagnosed at two medical centers in Taiwan (N = 11) to find a possible association between chronic arsenicism and Merkel cell carcinoma. In our study 6 of the 11 patients were residents of the endemic areas for chronic arsenicism.

A family in Taiwan is reported to have Mal de Meleda with possibly autosomal recessive inheritance among 5 of its members. The glove- and sock-like erythrokeratosis and the hyperkeratotic plaques of the knees and elbows are the common features. Erythema of the nose, cheeks, and the perioral area in 4 affected members, actinic elastosis in 2 severely affected members, and partially impaired cell-mediated immunity in vitro in both affected and unaffected members are notable findings. Tigason (etretinate) treatment was beneficial in regard to hyperkeratinization, but not to erythema.