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Item Association of erythrocyte n-3 polyunsaturated fatty acids with incident type 2 diabetes in a Chinese population(Elsevier, 2018-09-26) Zheng, Ju-Sheng; Lin, Jie-sheng; Dong, Hong-li; Zeng, Fang-fang; Li, Duo; Song, Yiqing; Chen, Yu-ming; Epidemiology, School of Public HealthSummary Background & aims The association between circulating n-3 polyunsaturated fatty acid (PUFA) biomarkers and incident type 2 diabetes in Asian populations remains unclear. We aimed to examine the association of erythrocyte n-3 PUFA with incident type 2 diabetes in a Chinese population. Methods A total of 2671 participants, aged 40–75 y, free of type 2 diabetes at baseline, were included in the present analysis. Incident type 2 diabetes cases (n = 213) were ascertained during median follow-up of 5.6 years. Baseline erythrocyte fatty acids were measured by gas chromatography. We used multivariable Cox regression models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of type 2 diabetes across quartiles of erythrocyte n-3 PUFA. Results After adjustment for potential confounders, HRs (95% CIs) of type 2 diabetes were 0.68 (0.47, 1.00), 0.77 (0.52, 1.15), and 0.63 (0.41, 0.95) in quartiles 2–4 of docosapentaenoic acid (C22:5n-3) (P-trend = 0.07), compared with quartile 1; and 1.08 (0.74, 1.60), 1.03 (0.70, 1.51), and 0.57 (0.38, 0.86) for eicosapentaenoic acid (C20:5n-3) (P-trend = 0.007). No association was found for docosahexaenoic acid (C22:6n-3) or alpha-linolenic acid (C18:3n-3). Conclusions Erythrocyte n-3 PUFA from marine sources (C22:5n-3 and C20:5n-3), as biomarkers of dietary marine n-3 PUFA, were inversely associated with incident type 2 diabetes in this Chinese population. Future prospective investigations in other Asian populations are necessary to confirm our findings.Item Associations of Metabolic syndrome and C-reactive protein with Mortality from total cancer, obesity-linked cancers and Breast Cancer among Women in NHANES III(Wiley, 2018-08) Gathirua-Mwangi, Wambui G.; Song, Yiqing; Monahan, Patrick; Champion, Victoria L.; Zollinger, Terrell; Biostatistics, School of Public HealthAlthough metabolic syndrome (MetS) is a prognostic factor for cancer occurrence, the association of MetS and cancer mortality remains unclear. The purpose of this study was to evaluate whether MetS, components of MetS and C-reactive protein (CRP) are associated with cancer mortality in women. A total of 400 cancer deaths, with 140 deaths from obesity-linked-cancers (OLCas), [breast (BCa), colorectal, pancreatic and endometrial], linked through the National Death Index, were identified from 10,104 eligible subjects aged ≥18 years. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) for cancer mortality. MetS was associated with increased deaths for total cancer [HR = 1.33, 95% confidence interval (CI) 1.04-1.70] and BCa [HR = 2.1, 95% CI, 1.09-4.11]. The risk of total cancer [HR = 1.7, 95% CI, 1.12-2.68], OLCas [HR = 2.1, 95% CI, 1.00-4.37] and BCa [HR = 3.8, 95% CI, 1.34-10.91] mortality was highest for women with all MetS components abnormal, compared to those without MetS. Linear associations of blood-pressure [HR = 2.5, 1.02-6.12, Quartile (Q) 4 vs Q1, p trend = 0.004] and blood-glucose [HR = 2.2, 1.04-4.60, Q4 vs. Q1, p trend = 0.04] with total-OLCas mortality were observed. A threefold increased risk of BCa mortality was observed for women with enlarged waist circumference, ≥100.9 cm, [HR = 3.5, 1.14-10.51, p trend = 0.008] and in those with increased blood glucose, ≥101 mg/dL, [HR = 3.2, 1.11-9.20, p trend = 0.03] compared to those in Q1. None of the components of MetS were associated with total-cancer mortality. CRP was not associated with cancer mortality. In conclusion, MetS is associated with total-cancer and breast-cancer mortality, with waist circumference, blood pressure and blood glucose as independent predictors of OLCas and BCa mortality.Item Does an Apple (or Many) Each Day, Keep Mortality Away?(American Society of Nephrology, 2019-02-07) Moorthi, Ranjani N.; Medicine, School of MedicineItem Influence of Temperament As a Risk Indicator for Early Childhood Caries(Ingenta, 2020-11-15) Quinonez, Rocio B.; Santos, Robert G.; Eckert, George J.; Keels, Martha Ann; Levy, Steven; Levy, Barcey T.; Jackson, Richard; Fontana, Margherita; Biostatistics, School of Public HealthPurpose: To evaluate the association between temperament and caries. Methods: A total of 408 primary caregiver-child pairs were followed for 36 months; they completed the Early Childhood Behavior Questionnaire Very Short-Form (ECBQ-VSF) at age four years. Demographic, behavioral, and clinical data were obtained at ages one, two-and-a-half, and four years, with caries experience assessed each time using the International Caries Detection and Assessment System (ICDAS). The ECBQ-VSF (36 items) was used to measure three child temperament domains: (1) surgency; (2) negative affect; and (3) effortful control. The associations between cavitated carious lesion experience by age four years (decayed, missing, and filled primary surfaces [dmfs] score greater than zero; d equals ICDAS score greater than or equal to three) and the three ECBQ-VSF temperament domains were analyzed using generalized estimating equation models. Results: Temperament domains predicted the number of carious surfaces (dmfs). After adjusting for covariates, every one-point increase in surgency and one-point increase in negative affect were associated with 77 percent and 31 percent increases in dmfs, respectively (P<0.05), and every one-point increase in effortful control was associated with a 39 percent decrease in dmfs (P<0.05). Conclusions: By age four years, children with higher levels of surgency and negative affect have a higher caries experience, whereas children with greater effortful control have a lower caries experience.Item Low Incidence of Aerodigestive Cancers in Patients With Negative Results From Colonoscopies, Regardless of Findings From Multitarget Stool DNA Tests(Elsevier, 2020) Berger, Barry M.; Kisiel, John B.; Imperiale, Thomas F.; Geenen, Daniel J.; Heigh, Russell I.; Mahoney, Douglas W.; Hilsden, Robert J.; Medicine, School of MedicineBackground & aims: We aimed to compare the incidence of aerodigestive cancers in persons with negative results from colonoscopies and positive vs negative results from multitarget stool DNA tests for colorectal cancer and vs expected incidence. Methods: We performed a retrospective cohort study of 1216 subjects with comprehensive patient records and/or cancer registry data from 3 medical centers in North America. Subjects had no neoplasia or only nonadvanced adenomas, based on screening colonoscopy, and either negative results (concordant with colonoscopy, n = 1011) or positive results (discordant colonoscopy, n = 205) from the multitarget stool DNA test. Outcomes included aerodigestive cancers in discordant vs concordant groups and comparison of observed aerodigestive cancer incidence between the groups and compared with expected incidence for the population, based on the Surveillance, Epidemiology, and End Results (SEER) data. Results: Median follow-up times were comparable between subjects in the discordant (5.3 y; interquartile range, 3.5-5.8 y) and concordant (5.4 y; interquartile range, 3.7-5.8 y) groups. Aerodigestive cancers developed in 5 subjects in the discordant group vs 11 subjects in the concordant group (crude risk ratio, 2.3; 95% CI, 0.8-6.6; adjusted risk ratio, 2.2; 95% CI, 0.8-6.2; P = .151). The incidence of aerodigestive cancer was lower in the concordant group than the expected incidence based on SEER data (risk ratio, 0.4; 95% CI, 0.2-0.6; P = .0008). The incidence of aerodigestive cancer was not significantly greater in the population in the discordant group than the expected incidence based on SEER data (risk ratio, 0.8; 95% CI, 0.3-1.9; P = .599). Conclusions: In a retrospective study with a median follow-up time of 5.4 years, incident aerodigestive cancers were uncommon among subjects with negative findings from colonoscopies, regardless of discordant or concordant results from multitarget stool DNA tests. Patients with negative results from high-quality colonoscopies therefore should not undergo further testing.Item Metabolic syndrome and total cancer mortality in the Third National Health and Nutrition Examination Survey(Springer, 2017-02) Gathirua-Mwangi, Wambui G.; Monahan, Patrick O.; Murage, Mwangi J.; Zhang, Jianjun; Epidemiology, School of Public HealthPURPOSE: Although metabolic syndrome incidence has substantially increased during the last few decades, it largely remains unclear whether this metabolic disorder is associated with total cancer mortality. The present study was carried out to investigate this important question. METHODS: A total of 687 cancer deaths were identified from 14,916 participants in the third National Health and Nutrition Examination Survey by linking them to the National Death Index database through December 31, 2006. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for total cancer mortality in relation to metabolic syndrome and its individual components. RESULTS: After adjustment for confounders, a diagnosis of metabolic syndrome was associated with 33% elevated total cancer mortality. Compared with individuals without metabolic syndrome, those with 3, 4 and 5 abnormal components had HRs (95% CIs) of 1.28 (1.03-1.59), 1.24 (0.96-1.60), and 1.87 (1.34-2.63), respectively (p-trend = 0.0003). Systolic blood pressure and serum glucose were associated with an increased risk of death from total cancer [HR (95% CI) for highest vs. lowest quartiles: 1.67 (1.19-2.33), p-trend = 0.002 and 1.34 (1.04-1.74), p-trend = 0.003, respectively]. Overall null results were obtained for lung cancer mortality. The effects of metabolic syndrome and its components on non-lung cancer mortality were generally similar to, but somewhat larger than, those for total cancer mortality. CONCLUSION: Our study is among the first to reveal that metabolic syndrome is associated with increased total cancer mortality.