Biomedical subjects

Hsing-Yi Chang

Publications and source records attributed to Hsing-Yi Chang.

15 recordsLinked to original sources

PubMed2006

Relationship between components of leisure physical activity and mortality in Taiwanese older adults.

BACKGROUND: Whether the major components of leisure physical activity (number of types, intensity, frequency, and duration) have independent contribution to mortality reduction and there is a minimum amount of activity beneficial for the elderly remain unclear. METHODS: The prospective follow-up study aimed at examining the relationship between exercise components and total mortality in general elderly population. A total of 2113 persons aged 65 and older participating in 2001 Taiwan National Health Interview Survey were studied. Information regarding leisure physical activity, its energy parameters, other factors at baseline, and vital status at the end of 2003 was analyzed with Cox model. RESULTS: A total of 197 deaths occurred during a 2-year follow-up. Regular exercisers reduced 35% risk of death compared with sedentary individuals after adjustment for covariates. Moreover, exercisers with a weekly amount of energy exceeding 1000 kcal had significant benefit of risk reduction when energy expenditure is considered. There was a significant dose-response relationship between number of activity and the reduction in total mortality. The benefit on mortality reduction among the three components of total energy amount was only observed in intensity. CONCLUSIONS: For the amount of energy dedicated to leisure physical activity, older persons are recommended to expend at least 1000 kcal per week through regular exercise for mortality reduction. In addition to energy amount, protection of exercise against death also increases with the number of activities. Among the three components of total amount of energy, only intensity is significantly associated with mortality reduction.

Aged↗

PubMed2006

The regional differences in prevalence, medical expenditures and risk factors for injury in Taiwanese teenagers.

BACKGROUND: Injury is the leading cause of death in teenagers worldwide. In Taiwan, people in mountainous areas have a 4 to 8 years shorter life span than the general population. Injury among teenagers is likely a major cause. The objective of this study was to investigate the regional differences in the prevalence, the risk factors, and the medical expenditures for injury among Taiwanese teenagers. METHOD: An equal probability national sample was used. In addition, representative samples from mountainous areas and offshore islands were used. Only those who aged between 12 and 21 years, and signed the consent form permitting us to link their National Health Insurance (NHI) claim data were included in the analysis. Injury-related visits and expenditures in outpatient services were extracted from the NHI data. Logistic regression was used to examine the factors associated with injury. For those who had injury related outpatient visits, mixed model was used to examine the factors associated with medical expenditures accounting for multiple visits by the same individual. RESULTS: The prevalence of nonfatal injury was around 30% of teenagers in Taiwan. It was 10% higher in mountainous areas. Factors associated with injury were those who lived in mountainous areas (adjusted odds ratio [OR]: 1.7; 95%; confidence interval [CI]: 1.3-2.3), males (OR: 1.3; 95%; CI: 1.1-1.6), older teens (18-21 years old), and those with risk behavior were positively associated with injury. These factors were also associated with the number of injury-related outpatient visits. However, teenagers in mountainous areas did not spend more on medical care than those who lived in metropolitan Taiwan. CONCLUSION: Around 30% of the teenagers were injured in a year, not including the dead. Each of the injured spent at least 851.4NTD (approximately 27USD) for outpatient visits. The scope of the problem was not trivial. Hazardous environments and high-risk behaviors were the universal causes. In remote areas, lack of medical resources was another possibility. Empowering local people to design prevention programs according to their needs is recommended.

Adolescent↗

PubMed2006

Using endophenotypes for pathway clusters to map complex disease genes.

Nature determines the complexity of disease etiology and the likelihood of revealing disease genes. While culprit genes for many monogenic diseases have been successfully unraveled, efforts to map major complex disease genes have not been as productive as hoped. The conceptual framework currently adopted to deal with the heterogeneous nature of complex diseases focuses on using homogeneous internal features of the disease phenotype for mapping. However, phenotypic homogeneity does not equal genotypic homogeneity. In this report, we advocate working with well-measured phenotypes portrayed by amounts of transcripts and activities of gene products or their metabolites, which are pertinent to relatively small pathway clusters. Reliable and controlled measures for oligogenic traits resulting from proper dissection efforts may enhance statistical power. The large amounts of information obtained on gene and protein expression from technological advances can add to the power of gene finding, particularly for diseases with unclear etiology. Data-mining tools for dimension reduction can assist biologists to reveal novel molecular endophenotypes. However, there are still hurdles to overcome, including high cost, relatively poor reproducibility and comparability among platforms, the cross-sectional nature of the information, and the accessibility of human tissues. Concerted efforts are required to carry out large-scale prospective studies that are integrated at the levels of phenotype characterization, high throughput experimental techniques, data analyses, and beyond.

Chromosome Mapping↗

PubMed2006

High prevalence and low awareness of CKD in Taiwan: a study on the relationship between serum creatinine and awareness from a nationally representative survey.

BACKGROUND: The burden of chronic kidney disease (CKD) is a global challenge. Empirical evidence of low CKD awareness rates in developed countries speaks for an urgent need to strengthen strategies for CKD identification and prevention. The aim of this study is to estimate the awareness rate of CKD in Taiwan to promote early detection of CKD in this country. METHODS: Data from a nationally representative survey were used for analysis. The study included 6,001 subjects. The simplified Modification of Diet in Renal Disease equation was used to define glomerular filtration rate (GFR) and CKD stages according to criteria of the US National Kidney Foundation. Descriptive methods were used to analyze data. RESULTS: The prevalence of CKD stages 3 to 5 in Taiwan is 6.9% (95% confidence interval, 4.4 to 9.4). Awareness rates for CKD in Taiwan are low: 8.0% for individuals with stage 3, 25.0% for those with stage 4, and 71.4% for those with stage 5. Awareness rate is related closely to serum creatinine level: those with creatinine levels greater than 1.6 mg/dL (>141 micromol/L) are more likely to be informed of having a kidney disease. CONCLUSION: The high prevalence and low awareness of CKD in Taiwan explicitly show the need to advocate more strongly for CKD prevention and education for both physicians and the populace. Establishment of a mandated automatic GFR reporting system may be the first priority we need to accomplish in Taiwan to improve kidney well-being.

Adult↗

PubMed2006

Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men.

BACKGROUND: The beneficial effects of potassium-enriched salt on blood pressure have been reported in a few short-term trials. The long-term effects of potassium-enriched salt on cardiovascular mortality have not been carefully studied. OBJECTIVE: The objective was to examine the effects of potassium-enriched salt on cardiovascular disease (CVD) mortality and medical expenditures in elderly veterans. DESIGN: Five kitchens of a veteran retirement home were randomized into 2 groups (experimental or control) and veterans assigned to those kitchens were given either potassium-enriched salt (experimental group) or regular salt (control group) for approximately 31 mo. Information on death, health insurance claims, and dates that veterans moved in or out of the home was gathered. RESULTS: Altogether, 1981 veterans, 768 in the experimental [x (+/-SD) age: 74.8 +/- 7.1 y] and 1213 in the control (age: 74.9 +/- 6.7 y) groups, were included in the analysis. The experimental group had better CVD survivorship than did the control group. The incidence of CVD-related deaths was 13.1 per 1000 persons (27 deaths in 2057 person-years) and 20.5 per 1000 (66 deaths in 3218 person-years) for the experimental and control groups, respectively. A significant reduction in CVD mortality (age-adjusted hazard ratio: 0.59; 95% CI: 0.37, 0.95) was observed in the experimental group. Persons in the experimental group lived 0.3-0.90 y longer and spent significantly less (approximately US Dollars 426/y) in inpatient care for CVD than did the control group, after control for age and previous hospitalization expenditures. CONCLUSIONS: This study showed a long-term beneficial effect on CVD mortality and medical expenditure associated with a switch from regular salt to potassium-enriched salt in a group of elderly veterans. The effect was likely due to a major increase in potassium and a moderate reduction in sodium intakes.

Adult↗

PubMed2005

A population study of the self-care behaviors and their associated factors of diabetes in Taiwan: results from the 2001 National Health Interview Survey in Taiwan.

BACKGROUND: Diabetes has been the fifth leading cause of death in Taiwan since 1987, and the complications are a burden to the patients, their families, and society. PURPOSE: The purpose of this study was to examine the self-control behaviors of diabetics and associated factors. METHODS: Data for this study came from the 2001 National Health Interview Survey in Taiwan. Subjects with diabetes confirmed by medical professionals, aged 40 years or older, were included. Self-care behaviors included any of the following: taking medicine regularly, reducing weight, avoiding cigarettes or alcohol, exercising, practicing diet control, and maintaining a regular life style and avoiding late hours. The factors considered were demographic factors including age, sex, education, income, and health behavior factors including smoking, drinking alcohol, chewing betel nuts, and health conditions such as existence of other chronic diseases, limitation of activity of daily living (ADL), and self-perceived health. RESULTS: There were 764 subjects aged 40 years or older who were diagnosed with diabetes. Logistic regression showed that females, those with older age or chronic disease such as hypertension or dyslipidemia, and those with long duration of diabetes took medicine regularly. Old age group, middle school educated, and longer duration of the disease had a higher chance of using any self-care method than their counterparts. CONCLUSION: Attention should be given to the younger age group, shorter duration of the disease in practicing self-care of diabetes.

Adult↗

PubMed2005

Elderly Nutrition and Health Survey in Taiwan (1999-2000): research design, methodology and content.

The purpose of the Elderly Nutrition and Health Survey in Taiwan (1999-2000) was to assess the diet, nutrition and health of persons aged 65 and above in Taiwan. A multi-staged, stratified, clustered probability sampling scheme was used in the survey. The survey population was stratified into a total of 13 strata. The four strata of "Hakka areas", "Mountain areas", " Eastern areas", and "PengHu islands" were unique in their ethnicity or geographic locations. The remaining areas of Taiwan were stratified into "Northern", "Central", and "Southern" parts with these 3 strata, then each subdivided into a further 3 strata based on population density. The household interview of the survey was arranged such that effect of seasonal variation was taken into account. A total of 1,937 persons completed the interview and 2,432 persons completed the health exam. The following data were collected: (1) Interview data : household information, basic demographics, 24 hour dietary recall, food frequency and habit, knowledge, attitudes and practice, medical history, 36-item Short Form for generic health status, and physical activity. (2) Health exam data: blood sample for measurement of nutritional biochemical indicators and complete clinical chemistry profile, urine sample for urinary electrolytes, anthropometric measurements, ECG, blood pressure, body temperature, pulmonary function, and an osteoporosis assessment. Data from the survey were analyzed using SUDAAN to adjust for the design effect and to obtain unbiased estimates of the mean, standard error and confidence intervals. Survey respondents were slightly younger compared to non-respondents; however, after weighting and adjustment with SUDAAN, the education levels and ethnicity of respondents and non-respondents were similar indicating lack of bias. We anticipate that the results of this survey will be of benefit in understanding the nutritional status of the elderly, the relationship between nutrition and health, and factors influencing elderly persons' nutritional status. Furthermore, this information could be used in the development of public health nutrition policy aimed at improving the nutrition and health of the elderly in Taiwan.

Aged↗

PubMed2005

High prevalence of hyperuricemia in elderly Taiwanese.

Serum urate status, the prevalence of hyperuricemia and their relationship to the metabolic syndrome in elderly Taiwanese were described using data from the Elderly Nutrition and Health Survey in Taiwan (1999-2000), in which a stratified multi-stage clustered sampling scheme was applied. Complete data from biochemical assays and anthropometric measures for 1225 males and 1167 females were included in the analysis. The mean urate level and 95% confidence interval was 411 (398, 424) microM for males and 357 (347, 367) microM for females. Males had significantly higher serum urate levels than females across all age groups (P<0.05). No significant difference in mean serum urate was found among the four age groups of males. On the other hand, females of 75-79 years had significantly higher serum urate levels (376 microM) than that of the 65-69 and>or=80 age groups. The overall prevalence of hyperuricemia (>or=416.7 microM (7.0 mg/dL) in the elderly was 36% (46% for males and 26% for females). Among the participants, 4.2% of males and 1.1% of females were taking medication to lower uric acid. The elderly (males 455 microM; females 416 microM) of the Mountain areas, mainly indigenes, had the highest mean serum urate overall, however, the highest prevalence of hyperuricemia in males was found in the PengHu islands (62%) and that for females in the Mountain areas (51%). The odds ratio (OR) for hyperuricemia was 2.84 for males in the PengHu islands and 4.33 for females in Mountain areas, compared with their counterparts in the third stratum in the northern areas. Adjusting for obesity, alcohol and other related covariates did not alter the relative rank of the ORs in the various strata. Elderly males (22%) had a significantly lower rate of metabolic syndrome (MS) than females (39%) (P<0.05). For both genders, those with MS had a significantly higher mean serum urate (males 436 microM vs. 405 microM; females 389 microM vs. 338 microM) and prevalence of hyperuricemia (males 56% vs. 43%; females 38% vs.19%) (P<0.05). The population attributable risk for MS from hyperuricemia was 18.8% in men and 15.5% in women. In conclusion, the mean serum urate and prevalence of hyperuricemia in the elderly in Taiwan were higher than those found in other populations and was significantly associated with MS. Gene-environmental interaction may play a key role since great geographical variation exists within various Han Chinese groups in Taiwan and between Han Chinese and Taiwanese indigenes.

Age Factors↗

PubMed2004

Risk factors for cardiovascular disease in the elderly in Taiwan.

The major objective of the present study was to identify biologic and behavioral risk factors of cardiovascular disease (CVD) in the elderly population in Taiwan. It is hypothesized that the selected risk factors are significantly associated with the prevalence of CVD. Data came from a nationwide geriatric survey in 1991. Stratified proportional sampling was used to recruit 2,600 subjects. These were evaluated by family physicians working for the Departments of Family Medicine at four medical centers in four major cities in Taiwan. Univariate and multivariate logistic regression analyses were used to examine the associations between risk factors and the prevalence of CVD. The prevalence of CVD was 38.31%. Patients with CVD consistently had higher values for each selected risk factor except high-density lipoprotein-cholesterol (HDL-C) and glucose concentrations. The findings also indicated that hypertension, hypertriglyceridemia, low HDL-C concentration, ex-drinking status, and overweight were significantly associated with the prevalence of CVD among the elderly in Taiwan. The findings not only confirm the risk factors for CVD, but also invite more attention to be given to the importance of biologic and behavioral risk factors in CVD.

Aged↗

PubMed2004

Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians.

BACKGROUND: Recommendations based on scanty data have been made to lower the body mass index (BMI; in kg/m(2)) cutoff for obesity in Asians. OBJECTIVE: The goal was to compare relations between BMI and metabolic comorbidity among Asians and US whites and blacks. METHODS: We compared the prevalence rate, sensitivity, specificity, predictive values, and impact fraction of comorbidities at each BMI level and the BMI-comorbidity relations across ethnic groups by using data from the third National Health and Nutrition Examination Survey and the Nutrition and Health Survey in Taiwan (1993-1996). RESULTS: For most BMI values, the prevalences of hypertension, diabetes, and hyperuricemia were higher for Taiwanese than for US whites. In addition, increments of BMI corresponded to higher odds ratios in Taiwanese than in US whites for hypertriglyceridemia (P = 0.01) and hypertension (P = 0.075). BMI-comorbidity relations were stronger in Taiwanese than in US blacks for all comorbidities studied. BMIs of 22.5, 26, and 27.5 were the cutoffs with the highest sum of positive and negative predictive value for Taiwanese, US white, and US black men, respectively. The same order was observed for women. For BMIs >27, >85% of Taiwanese, 66% of whites, and 55% of blacks had at least one of the studied comorbidities. However, a cutoff close to the median of the studied population was often found by maximizing sensitivity and specificity. Reducing BMI from >25 to <25 in persons in the United States could eliminate 13% of the obesity comorbidity studied. The corresponding cutoff in Taiwan is slightly <24. CONCLUSION: These data suggest a possible need to set lower BMI cutoffs for Asians, but where to draw the line is a complex issue.

Adult↗

PubMed2003

A modified locally weighted method for developing reference standards for height, weight, and body mass index of boys and girls aged 4 to 18 in Taiwan.

The objectives of this study are to modify the locally weighted method to obtain reference values for height, weight, and body mass indices (BMI): to describe the median growth velocity of children aged 4 to 18 in Taiwan; and to compare those values with data from other countries. We modified the LOCAL method to generate empirical percentiles and used the locally weighed regression to smooth the percentiles. We examined the smoothed percentiles against original data to ensure that smoothed percentiles were within 1% of errors. We used numerical differentiation of the 50th percentiles of height and weight to obtain the velocity of growth in height and weight, respectively. We applied our method to the data of the Nutrition and Health Survey in Taiwan, 1993-1996, which was a multistaged stratified sample. The sample included 2351 boys and 2355 girls aged 4 to 18. Our results indicate that (a) the proposed method, which utilizes the original data, guarantees the percentiles within 1% errors; (b) before puberty, the height, weight, and BMI of Taiwanese children are not much different from those of their counterparts in Western countries; and (c) after puberty and at the stage of young adulthood, the height, weight, and BMI of Taiwanese youth are below the levels of those in Western young adults. Genetic makeup and dietary patterns may contribute to these phenomena.

Adolescent↗

PubMed2002

Prevalence of dyslipidemia and mean blood lipid values in Taiwan: results from the Nutrition and Health Survey in Taiwan (NAHSIT, 1993-1996).

This paper reports the blood lipid status of people aged 4 years and older in Taiwan. The data is based on the Nutrition and Health Survey in Taiwan (NAHSIT: 1993-1996), which adopted a multi-stage, stratified clustering sampling scheme. Altogether, 5097 subjects (2451 males and 2646 females) had data on triglyceride and 5643 subjects (2736 males and 2907 females) had data on cholesterol. We found that (a) cholesterol levels of males were lower than females in mid-to old age group (> or = 45 years old); (b) triglyceride values of females were lower than males in young adulthood (19-44 years), but higher than males after the age of 45 years, and (c) adult females had higher HDL-C value and lower ratio of total cholesterol to HDL-C than males. The prevalence of hypercholesterolemia was 10.2% in adult males and 12.6% in mid-to-old aged men, and that in females was 11.2% and 24.4%, respectively. The prevalence of hypertriglyceridemia was 13.4% and 6.1% in adult males and females (> or = 19 years as a whole), respectively. It was 12.3% in mid-to-old aged men (> or = 45 years), and 11.9% in women. The mean cholesterol values were similar to values of several previous surveys in different areas of Taiwan. But it was higher than those in some areas of Mainland China, and lower than those of western countries. People in metropolitan cities had a higher level of blood cholesterol than other areas. The average triglyceride values of males and females were higher than those of previous studies in Taiwan and of people in Mainland China. Mountainous stratum with predominantly aboriginal residents had higher level of triglycerides and body mass index (BMI) than other strata. The associations between dietary intakes of men and women and blood lipids were examined controlling for age and BMI. Result showed that Keys score, which was derived from saturated fat, polyunsaturated fat and dietary cholesterol of a 24-hour recall, was positively related to blood cholesterol and LDL-C in men, but not in women. Average alcohol intakes per day were related to HDL-C positively, but LDL-C negatively in men and women. The regional differences in blood lipid profiles in Taiwan are consistent with the dietary and life-style variations island-wide.

Adolescent↗

PubMed2002

Factors associated with amalgam restorations in Taiwan.

OBJECTIVE: This study investigated the prevalence of and factors associated with amalgam restorations of posterior teeth in Taiwan. METHOD: The authors analyzed the dental data regarding direct restorations of posterior teeth from the National Health Insurance Research Database of 1997, which was the first nationwide data available. The chi-square test and analysis of variance was used to compare the characteristics of the teeth, patients, dentists, and dental treatment settings between amalgam and composite restorations. The multivariate analysis was applied to obtain the Generalized Estimating Equation estimation for associations of multiple factors with amalgam restorations, taking into account the intra-individual correlation of teeth restored. RESULTS: Amalgam was used in 53.3% of the direct restorations of posterior teeth. When all the important factors were assessed simultaneously, characteristics significantly associated with more amalgam restorations were: dentists aged 43 years and above, patients aged 1-22 years, primary molars, two- or three-surface cavity, regions with higher number of population served per dentist, and dental clinic. CONCLUSION: Doctors' age, patients' age, type of dental treatment settings, population served per dentist, type of tooth, and number of surfaces restored were significantly associated with amalgam restorations in Taiwan.

Adolescent↗

PubMed2002

Do the elderly benefit from annual physical examination? An example from Kaohsiung City, Taiwan.

BACKGROUND: This study evaluates the impact of free annual health examinations on survival of elderly (> or =65 years of age) residents in Kaohsiung City, Taiwan. METHODS: A stratified random sample scheme was used in each of the 11 districts of Kaohsiung City. A total of 1,193 elderly people were selected and interviewed in 1993; deaths and results of health check-ups were recorded through 1998. RESULTS: While over 50% of the subjects received at least one health examination between 1993 and 1998, only 18% received three or more. Most (60%) subjects who received examinations in a given year also received examinations the subsequent year; most (over 70%) who did not receive examinations in a given year did not receive check-ups the following year. Cox proportional hazards model showed that those who utilized the examination service had better survival probability than those who did not, given the same age, sex, education, marital status, living arrangements, and number of chronic diseases at baseline: The relative risk (RR) of mortality for those who ever utilized the health examination service was 0.50 (P < 0.0001). CONCLUSIONS: Elderly subjects who received annual health examinations had lower mortality than those who did not. This finding should be interpreted cautiously, however, as the difference in survival may reflect better general health behaviors among those who participated in the program.

Age Distribution↗

PubMedDate not supplied

Quantitative vibration perception thresholds in normal and diabetic chinese: influence of age, height and body mass index.

In this study, we established normality data of vibration perception thresholds (VPT) in a Chinese population. Over 1,400 healthy subjects were recruited to create age-related centile charts of VPT after pretesting for reliability. Another 273 diabetic (DM) patients were recruited to assess the impact of age, height and body mass index (BMI) on VPT values in DM and non-DM subjects. The present study is the first one which reports normality data of VPT from a large Chinese population. The VPT values were higher in male and female DM patients than in the non-DM counterparts. Age significantly contributed to the variance of VPT in both DM and non-DM subjects. Height was positively associated with VPT in men, so was BMI in non-DM subjects with much smaller magnitudes of effect than for age.

Adult↗