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Background Allergic asthma occurs worldwide and is particularly prevalent in westernized countries characterized by chronic airway inflammation resulting in airway hyperresponsiveness. The house dust mites (HDM) including Dermatophagoides pteronyssinus are major sources of sensitization and triggering allergic symptoms in asthmatic patients. The Der p 2 is a major allergen and the predominant source of causative respiratory disorders which induce airway inflammation and bronchial constriction in mite-allergic patients. Few studies evaluate the ameliorating effects of modified Liu-Wei-Di-Huang-Wan (modified LWDHW) on allergic asthma. Methods This study aimed to investigate the immunological mechanisms of modified LWDHW on the inhibitory effects of airway inflammation, signal transduction, inflammatory cytokine production, Th2 cell proliferation, and bronchial obstruction in Der p 2-induced asthmatic mice. Results At least ten active ingredients were contained in the formula of modified LWDHW- 1217A and 1217B. Results showed that the immunoglobulin generations (Der p 2 specific- IgE and IgG1), inflammatory cytokine productions (IL-5 and IL-13) in the Sera and BALF could be down-regulated, and the Th1-cytokine productions (IL-12 and IFN-γ) be increased after immunotherapy with modified LWDHW of 1217A or 1217B. The inflammatory cell infiltrations (macrophages, eosinophils, and neutrophils) in the airway and the expressions of TH2-related genes (IL4, IL5, and IL13), TH2-related transcription factor (GATA-3), and neutrophil chemotactic chemokine (IL8) in the lung tissue of asthmatic mice were significantly decreased after the immunotherapy. The Th1/Th2 polarization had been identified that the IL-4+/CD4+ T cells were downregulated and IFN-γ+/CD4+ T cells were increased. The airway hyperresponsiveness to methacholine inhalation of Penh values was significantly decreased in the treated groups. There were significant improvements in the bronchus histopathology after immunotherapy with 1217A or 1217B which were evaluated by tracheal thickness, inflammatory cell count, and tracheal rupture of mouse lung. Conclusions It revealed that 1217A or 1217B could regulate the immune responses and improve pulmonary function. Data suggests that modified LWDHW of 1217A or 1217B have the potential for use as a therapeutic modality for the treatment of mite allergen Der p 2-induced allergic asthma.

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.

Studies have suggested that visually presented words are obligatorily decomposed into constituents that could be mapped to language representations. The present study aims to elucidate how orthographic processing of one constituent affects the other and vice versa during a word recognition task. Chinese orthographic system has characters representing syllables and meanings instead of suffixation roles, and the majority of Chinese characters are phonograms that can be further decomposed into phonetic radical and semantic radical. We propose that semantic radical combinability indexed by semantic radicals and the effect of phonological consistency indexed by phonetic radicals would interact with each other during the reading of Chinese phonograms. Twenty-six right-handed native Chinese speakers were recruited to the study. Participants were presented with phonograms divided into four conditions following their semantic radical combinability (large vs. small) and phonological consistency (high vs. low). EEG signals were recorded throughout the covert naming task. Our results show that there is an interaction effect between phonological consistency and semantic radical combinability on the right hemisphere N170 activity while reading phonograms. Semantic radical combinability influenced the right hemisphere N170 during the process of low-consistency character reading but not high-consistency character reading. On the other hand, the left hemisphere N170 revealed a more significant activity during reading high-consistency characters and was not affected by radical combinability. In addition, while low-consistency characters revealed a larger P200 than high-consistency characters, the semantic radical combinability effect on P200 was only significant when participants were reading high-consistency characters but not low-consistency characters. These results provide new information about how ERPs are involved in word recognition within the context of interaction among orthographic and phonological dimensions.

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.

Brain neuroplasticity refers to anatomical changes and functional reorganization in the brain as the results of daily experience and new learning, and thus, should have profound implications for the changes in brain processing during and after bilingual learning. By using a MEG experiment of magnetic mismatch negativity (MMN)/magnetic mismatch field (MMNm) paradigm, the present study examined the brain wave patterns of beginning learners of learning Chinese as a second language (CSL), who enrolled in a short term digital learning program, and were found to have improved sensitivity in discrimination for lexical tones by developing a left lateralized dominance for processing Chinese lexical tones, just like native Mandarin speakers. In the experiment, the measurements of MMNm, with the contrast between large deviant T3/T1 and between small deviant T3/T2, were computed to index the changed patterns of brain processing before and after learning. Results of the MMNm data indicated that activation for large deviant contrast T3/T1 elicited earlier and significantly larger MMN than that of the small deviant contrast T3/T2, which is in line with previous studies done on native Chinese speakers. More importantly, in the comparison of pre-test and post-test time course, the amplitude of MMNm showed a significant increase in the left hemisphere after learning. The evidence indicated clearly a learning effect in the perception of linguistic features and a left lateralized neural network of processing Mandarin lexical tones. Moreover, in the source analysis, the left lateralized patterns of prefrontal generator (i.e., insula) and generator of auditory cortex (i.e., Heschl's Gyrus) changed after learning, which is also consistent with the native Mandarin speaker's response patterns. In sum, the present study provides neural evidence for a functional reorganization in the brains of second language learners, transforming the CSL learners to behave like native speakers in the perception of lexical tones even after just a short-term and non-specific training program.

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.

In this study, we aimed to provide a large-scale set of psycholinguistic norms for 3,314 traditional Chinese characters, along with their naming reaction times (RTs), collected from 140 Chinese speakers. The lexical and semantic variables in the database include frequency, regularity, familiarity, consistency, number of strokes, homophone density, semantic ambiguity rating, phonetic combinability, semantic combinability, and the number of disyllabic compound words formed by a character. Multiple regression analyses were conducted to examine the predictive powers of these variables for the naming RTs. The results demonstrated that these variables could account for a significant portion of variance (55.8 %) in the naming RTs. An additional multiple regression analysis was conducted to demonstrate the effects of consistency and character frequency. Overall, the regression results were consistent with the findings of previous studies on Chinese character naming. This database should be useful for research into Chinese language processing, Chinese education, or cross-linguistic comparisons. The database can be accessed via an online inquiry system (http://ball.ling.sinica.edu.tw/namingdatabase/index.html).

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.

This study aimed to understand how reading ability shapes the lexicality effects on N400. Fifth-three typical developing children from 2nd to 6th grades were asked to perform the pronounceability judgment task on a set of Chinese real characters, pseudocharacters and noncharacters, as ERPs were recorded. The cluster-based permutation analysis revealed that children with low- to medium-reading ability showed greater negativity to noncharacters than to real characters and pseudocharacters in frontal sites from 300 to 450 ms, while children with high ability group showed a greater positivity to noncharacters than both real character and pseudocharacters at central to posterior sites. Furthermore, the linear mixed model (LMM) analysis was applied to investigate the relationship between lexicality effects on N400 and reading-related behavioral assessments on a set of standardized tests (including character recognition, vocabulary size, phonological awareness, and working memory). The results found that in children with lower reading ability, the N400 elicited by noncharacters becomes more negative in the frontal sites. For children with higher reading ability, the N400 elicited by noncharacters became more positive than that elicited by real characters or pseudocharacters in the posterior sites. These findings demonstrate the developmental changes in the lexicality effects on N400 as children become more advanced readers and suggest the lexicality effects on N400 can serve as neural markers for the evaluation of orthographic proficiency in reading development.

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.