Biomedical subjects

Der-Min Wu

Publications and source records attributed to Der-Min Wu.

10 recordsLinked to original sources

PubMed2006

Aggregation of adverse behaviors and its affecting factors among young military conscripts in Taiwan.

The authors studied the prevalence of the aggregation in common lifestyle habits, namely, cigarette smoking, alcohol drinking, and betel-nut chewing and the demographic correlates of individual aggregation in these lifestyle behaviors among young military conscripts in Taiwan. Cross-sectional screening was conducted among conscripts in southern and eastern sections of Taiwan from Aug. 1st to Dec. 31st 2001. Totally, 3913 conscripts who had more than 1 month of service were included in this multistage sampling study. Information on smoking, drinking, and betel-nut chewing habits were ascertained as part of a self-administered questionnaire completed by examinees at the service unit. Aggregation in lifestyle habits was studied by comparing the observed and expected proportions (O/E ratio) with their 95% confidence intervals (CI) for zero, one, two, and three simultaneously occurring lifestyle habits. The study results showed a significant clustering of lifestyle habits studied; the number of subjects was greater than expected in groups with two (for cigarette smoking and betel-nut chewing, O/E ratio=1.17, 95%CI=1.06-1.28), and three (O/E ratio=5.63, 95%CI=5.06-6.20) lifestyle habits. Determinants for this clustering of lifestyle habits included lower educational levels and residential area in southern and eastern sections of Taiwan. There was a significant individual aggregation in lifestyle habits including cigarette smoking, alcohol drinking, and betel-nut chewing in the health survey among young military conscripts. In addition, young military conscripts with low educational levels and residential area in southern and eastern sections of Taiwan had an apparent tendency toward the aggregation in these lifestyle habits.

Adult↗

PubMed2006

Obesity, plasma high sensitivity C-reactive protein levels and insulin resistance status among school children in Taiwan.

OBJECTIVE: To evaluate the degree of obesity and plasma high sensitivity C-reactive protein (hs-CRP) levels in relation to insulin resistance status among school children in Taiwan. METHODS: After multistage sampling, we randomly selected 1438 children (701 boys and 737 girls) with the mean age of 13.4 years (from 12 to 16) in Taipei in 2003. Anthropometric measures and plasma biochemical variables (including lipid profiles, glucose and insulin) were measured using standard methods. Plasma hs-CRP levels were measured using nephelometric methods. We calculated insulin resistance (IR) index using HOMA methods and further calculated a gender-specific insulin resistance syndrome (IRS) summary score by adding the quartile ranks from the distribution of systolic blood pressure (SBP), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and insulin levels of each children. A high IRS summary score corresponds to higher levels of SBP, TG and insulin levels and lower levels of HDL-C. RESULTS: Boys were taller, heavier, had larger BMI, glucose, IRS summary score and hs-CRP than girls; however, there is no difference in plasma TG, insulin levels, and IR index between genders. Plasma hs-CRP levels were positively correlated with anthropometric measures, TG, insulin levels, IR index, and IRS summary score and negatively correlated with HDL-C. Anthropometric measures, plasma TG, insulin levels, IR index and IRS summary score were significantly higher in children with higher plasma hs-CRP levels (test for trend p<0.05). After adjustment for age, heart rate, smoking and drinking, hs-CRP continued to be positively associated with anthropometric variables (weight and BMI), insulin levels, and IR index and negatively correlated with HDL-C in both genders. Plasma hs-CRP levels were also positively associated with TG and IRS summary score in boys and glucose in girls. However, after further adjusting for BMI, the association of hs-CRP on TG, insulin levels, IR index and IRS summary score disappeared in boys and on body weight, HDL-C, insulin level and IR index disappeared in girls. CONCLUSION: Plasma hs-CRP levels are positively related to anthropometric variables, such as body weight and BMI, insulin levels, IR index and IRS summary score and negatively related to HDL-C in Taiwanese children. Moreover, the degree of body fat status (as measured by BMI) plays a more significantly role on insulin resistance status than hs-CRP levels among Taiwanese children.

Adolescent↗

PubMed2006

Prevalence of adverse behaviors among young military conscripts in Taiwan.

OBJECTIVES: To evaluate cigarette smoking prevalence and to examine the clustering of adverse behaviors among young military conscripts in Taiwan. METHODS: Cross-sectional screening was conducted among conscripts in southern and eastern sections of Taiwan from August 1 to December 31, 2001. A total of 7,931 conscripts who had > 1 month of service were included in this multistage sampling study. RESULTS: Adjusted prevalence rates of cigarette smoking before and during military service were 49.2% and 51.9%, respectively. The prevalence of smoking slightly increased during military service, and this was statistically significant. Adjusted prevalence was highest in the Navy (53.8%) and lowest in the Air Force (48.4%). Less education and longer duration of service were associated with increased prevalence of smoking. Conscripts with high school educations or below and those in service > 18 months had higher adjusted prevalence rates (65.6% and 55.2%, respectively). During military service, the adjusted prevalence rates of smoking among conscripts were similar in different geographic areas. There was significant aggregation of adverse behaviors, such as cigarette smoking, alcohol consumption, and betel nut chewing, among these young military conscripts in Taiwan. CONCLUSIONS: The prevalence of cigarette smoking was slightly increased during military service. Furthermore, the prevalence of cigarette smoking was still higher among military conscripts, compared with the general population in Taiwan, which suggests that military service is a potential factor associated with cigarette smoking for adolescents and young adults. This finding and the aggregation of adverse behaviors among conscripts indicate that more surveillance and intervention studies are needed to evaluate the best way to control and to stop smoking among military conscripts in Taiwan.

Adult↗

PubMed2005

Dramatic and prolonged decrease of whole salivary secretion in nasopharyngeal carcinoma patients treated with radiotherapy.

OBJECTIVES: This study evaluates: (1) the change in whole salivary secretion rates of nasopharyngeal carcinoma patients before, during, and after radiotherapy, especially during the first week of irradiation; (2) the recovery capability of salivary glands up to 2 years postirradiation; and (3) the possible prognostic factors affecting salivary gland functions. STUDY DESIGN: Fifty patients who completed conventional radiotherapy using either once-per-day or hyperfractionated technique were included. Both unstimulated and stimulated whole salivary flow rates and ratios (flow rate compared with baseline) were measured before, during, 1, 3, and 6 months, and 1 and 2 years after radiotherapy. Multivariate analysis of potential prognostic factors affecting the salivary secretion ratio was made. RESULTS: Salivary glands were very radiosensitive and responded to radiation very early. After 720 cGy at the fourth day of the 8-week treatment, the unstimulated and stimulated salivary flow rates had decreased by 40%-50%. The nadir was reached in many patients after 3600 cGy (4 weeks). A second phase of decrease in salivary secretion was noted after completion of radiotherapy. CONCLUSIONS: Different mechanisms may be responsible for salivary response after low and high dose of radiation. This study shows no recovery of salivary secretion during the follow-up period, and the best strategy for managing radiation-induced salivary gland damage may be reduction of radiation dose to the glands.

Adolescent↗

PubMed2005

Relationship between plasma adiponectin levels and metabolic risk profiles in Taiwanese children.

OBJECTIVE: Adiponectin, a novel adipokine with antiinflammatory and insulin-sensitizing properties, has an important role in glucose metabolism and is negatively correlated with body fat amount in adults. The purpose of this study was to evaluate the association of plasma adiponectin level with metabolic risk profiles and insulin resistance status among Taiwanese children. RESEARCH METHODS AND PROCEDURES: We enrolled 1,248 children (608 boys and 640 girls) to ascertain their demographic, anthropometric, and cardiovascular risk factors distribution in Taipei. We measured plasma insulin, adiponectin, and leptin levels by radioimmunoassay (Linco Research Inc, St. Charles, MO). We calculated an insulin resistance index (IRI) using the Homeostasis Model Assessment model and also calculated an insulin resistance syndrome (IRS) summary score for each individual by adding the quartile ranks from the distribution of systolic blood pressure, serum triglyceride, high-density lipoprotein-cholesterol (HDL-C) (inverse), and insulin levels. RESULTS: In general, the boys had larger BMI, higher systolic blood pressure, serum total cholesterol, and triglyceride, and lower plasma leptin and adiponectin levels than girls. Plasma adiponectin levels were correlated negatively with BMI, leptin, insulin, IRI, and IRS summary score but positively correlated with HDL-C in both boys and girls. In multivariate regression analyses, adiponectin was negatively associated with insulin (girls only), IRI (girls only), and IRS score, and positively associated with HDL-C in both genders even after adjusting for age, BMI, plasma leptin level, and other potential confounders. DISCUSSION: These data suggest that plasma adiponectin levels were negatively associated with metabolic risk profiles that may have played a protective role in the development of insulin resistance among Taiwanese school children.

Adiponectin↗

PubMed2004

Prevalence and factors associated with the consumption of betel-nut among military conscripts in Taiwan.

OBJECTIVE: This study evaluates the prevalence of betel-nut chewing among military personnel stationed on Taiwan's offshore islands. Furthermore, this study examines variables to identify which may predict a greater predilection toward betel-nut chewing among the conscript population studied. METHODS: A cross-sectional mass screening was conducted of compulsory military service personnel stationed on Taiwan's offshore islands between August 1 and December 31, 2001. A total of 7574 military employees were included in this survey. Information regarding betel-nut chewing habits were ascertained using a standard structured questionnaire, which including the level and duration of betel-nut chewing as well as respondents' knowledge, attitude and practices with regard to consumption of this product. RESULTS: Conscripts were found to be less likely to chew betel-nut regularly while performing military service. There are 1535 (20.3%) of respondents reporting to habitually chew betel-nut prior to active duty shrank to 1048 (13.8%) after going on active-duty. The most reasons to chew betel-nut among the recruits after military services are curiosity (33.3%) and as a stimulant (29.8%). About 46% of military employees who currently chew betel-nut report an interest to quit in the future. The risk factors for betel-nut chewing include individual factors (e.g., age, education, knowledge, and attitude toward betel-nut chewing), lifestyle habits (e.g., cigarette smoking), and familial factors (e.g., consumption of betel-nut by parents). More interesting, the recruits had the habit of cigarette smoking associated with increase risk for betel-nut chewing (OR: 7.18; 95% CI: 5.66-9.20). CONCLUSIONS: Although the military has made considerable progress in reducing betel-nut chewing on military campuses, the prevalence of betel-nut chewing is still relatively high and, in 2001, affected about one quarter of all military personnel stationed on the abovementioned offshore islands. In future efforts to lower betel-nut consumption among high risk groups, targeting the group of conscripted military personnel described in this study should be considered.

Adult↗

PubMed2003

Incidence and cofactors of hepatitis C virus-related hepatocellular carcinoma: a prospective study of 12,008 men in Taiwan.

In a community-based prospective study, the authors examined the independent and interactive effects of hepatitis C virus (HCV) infection and cofactors, including hepatitis B virus (HBV) infection and lifestyle habits, on the incidence of hepatocellular carcinoma (HCC) in Taiwan. At baseline recruitment, subjects were evaluated with regard to second-generation HCV antibody (anti-HCV), hepatitis B surface antigen, and serum alanine aminotransferase, as well as cigarette smoking, alcohol drinking, and betel quid chewing habits. A total of 12,008 male residents aged 30-64 years without a history of HCC were included in the study. Between July 1990 and June 2001, 112 incident cases of HCC were identified among the subjects and included in the analysis. Persons with anti-HCV positivity alone had a 20-fold increased risk of developing HCC in comparison with those who were negative for anti-HCV. In statistical assessment of additive interaction, HCV and HBV tended to act independently in the pathogenesis of HCC. The results of this study suggest that HCV plays a significant role in hepatocarcinogenesis in an area endemic for chronic HBV infection.

Adult↗

PubMed2003

Insulin, proinsulin and insulin resistance status in relation to lipid profiles among school children in Taiwan-The Taipei Children Heart Study.

PURPOSE: Evidence suggests that there may be a metabolic syndrome characterized by hyperinsulinemia or insulin resistance associated with increased cardiovascular disease risk. The purpose of this study is to evaluate insulin, proinsulin or insulin resistance to determine which is the best parameter to predict lipid profiles among children in Taiwan. METHODS: After multi-stage sampling, we randomly included 852 school children (415 boys and 437 girls) with a mean age of 13 yr in this study. We measured insulin and intact proinsulin levels by RIA (<0.2% cross-reactivity) and estimated insulin resistance index (IRI) using the homeostatic model assessment (HOMA) method. We used standard methods to measure atherosclerotic lipid profiles including total cholesterol (CHOL), triglyceride (TG), HDL-C, apolipoprotein A (ApoA), apolipoprotein B (ApoB), and lipoprotein[a] and calculated LDL-C and TCHR (total cholesterol to HDL-C ratio) levels. RESULTS: Girls had higher CHOL, LDL-C, ApoA and ApoB levels than boys (p < 0.001). There was no significant difference in insulin, proinsulin and IRI status between boys and girls. Among boys, insulin, proinsulin and IRI were positively correlated with TG, ApoB and TCHR and negatively related to HDL-C. Among girls, these associations were attenuated and became insignificantly for TCHR and HDL-C. After adjusting for potential confounders, IRI and insulin were still positively associated with TG and ApoB levels and negatively associated with HDL-C in boys. However, in girls, proinsulin and insulin were positively associated with TG only. Finally, in the stepwise regression analyses, IRI was a better predictor of TG, HDL-C, and ApoB than insulin or proinsulin in boys. However, in girls, proinsulin was a stronger predictor than insulin or IRI for TG and TCHR. CONCLUSION: From this study, we found that IRI (in boys) and proinsulin (in girls) levels are generally more significant and stronger parameters than insulin for predicting lipid profiles among children in Taiwan.

Adolescent↗

PubMed2003

Plasma C-reactive protein levels and their relationship to anthropometric and lipid characteristics among children.

C-reactive protein (CRP), a nonspecific marker of inflammatory status, is associated with cardiovascular disease (CVD) risk factors and the late occurrence of heart disease in adults. However, few studies assess the plasma CRP levels in healthy children. The purpose of this study is to evaluate the relationship between plasma CRP levels and anthropometric and lipid characteristics among children in Taiwan. After a multi-stage sampling of 85 junior high schools in Taipei, we randomly selected 835 children (410 boys and 425 girls) aged 12 to 16 years. Anthropometric and lipid profiles, including total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), and lipoprotein (a) were measured. We also calculated low-density lipoprotein cholesterol levels and the total cholesterol-to-HDL-C ratio as shown on the atherosclerotic index. In both genders, plasma CRP levels were significantly positively correlated with anthropometrics measures and inversely correlated with HDL-C levels. After adjusting for age, cigarette smoking, alcohol consumption, heart rate, and puberty development, children in the fourth quartile CRP subgroups were heavier and had significantly higher body mass index (BMI) and lower HDL-C levels than children with nondetected CRP. In multivariate regression models, CRP was significantly negatively associated with HDL-C levels even after adjusting for BMI in both genders. In this study, anthropometrics measures, especially BMI, were positively associated with plasma CRP levels. Furthermore, elevated CRP levels were associated with adverse lipids profiles. These data suggest that elevated plasma CRP levels might be associated with CVD risk factors that may be related to the late development of CVD in some Taiwanese children.

Adolescent↗

PubMed2002

Plasma homocyst(e)ine, folate and vitamin B(12) levels among school children in Taiwan: The Taipei Children Heart Study.

OBJECTIVE: The purpose of this study is to examine the association of plasma Hcy, folate and vitamin B(12) levels on CVD risk factors among children in Taiwan. METHODS: After multistage sampling, we selected randomly 1,235 children (609 boys and 626 girls) aged 12 to 15 yr. Plasma Hcy levels was measured using ABBOTT Imx analyzer, while plasma folate and vitamin B(12) were measured using ACS: 180 automated chemiluminescence analyzer. Anthropometric, blood pressure (BP) and other biochemical CVD risk factors including serum total cholesterol (CHOL), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 (apoA1) and B (apoB) and lipoprotein(a) [Lp(a)]were measured using standard methods. We also calculated low density lipoprotein-cholesterol (LDL-C) and TCHR (total cholesterol to HDL-C ratio) as atherogenic indices. RESULTS: Boys were taller and heavier, having higher body mass index (BMI), systolic blood pressure (SBP) and plasma glucose levels but lower diastolic blood pressure (DBP), heart rate (HR), cholesterol, TG, HDL-C, LDL-C, TCHR, and Lp(a) levels than girls. Boys also had higher plasma Hcy and lower folate, vitamin B(12), levels than girls (for plasma Hcy, mean +/- SD, 10.50 +/- 4.13 vs. 8.95 +/- 2.61 micromol/L for boys vs. girls, respectively). Plasma Hcy levels were significantly correlated positively with body height, body weight, SBP and DBP in both genders. Body height, body weight, BMI and SBP levels were found to increase with trend among different quintile plasma Hcy subgroups on boys but not on girls. Plasma folate and vitamin B(12) were decreased significantly along with the higher quintile plasma Hcy subgroup in both genders. CONCLUSIONS: Boys had higher plasma Hcy levels than girls after adjusting for age. Furthermore, plasma Hcy levels were significantly associated with anthropometric parameters, such as body height and weight and blood pressure, but not related with lipid profiles among children in Taiwan.

Adolescent↗