This document summarizes a study that examined the association between serum inorganic phosphate (Pi) levels and cancer risk in over 397,000 Swedish adults. The study found:
1) Higher Pi levels were associated with increased cancer risk in men, but decreased risk in women.
2) Higher Pi levels were linked to increased risk of specific cancers like pancreas, lung, and bone cancer in men, and esophagus, lung, and skin cancer in women.
3) Conversely, higher Pi levels were associated with lower risk of breast, endometrial, and other endocrine cancers in both men and women.
This document summarizes a study on the prevalence of type 2 diabetes among hepatitis C virus seropositive subjects in Dutse, Nigeria. The study found that 16.1% of male and 19.4% of female HCV-infected subjects had fasting blood sugar levels above 7 mmol/L, indicating a higher risk of diabetes compared to the control group. Liver enzymes were significantly higher in the HCV group. While some metabolic syndrome parameters differed between groups, the differences were not statistically significant. The study concludes that there is a high prevalence of type 2 diabetes among HCV-infected individuals in Dutse, and factors like age, BMI, triglycerides, and HDL may contribute to the development of diabetes.
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
A comparative analysis of biochemical and hematological parameters in diabeti...amsjournal
This study evaluated the biochemical and the hematological parameters in diabetic and non- diabetic patients. The measured biochemical parameters were fasting blood sugar, serum alanine aminotransferase (SGPT/ALT), total cholesterol, urea, creatinine and hematological parameters were hemoglobin, total white blood cell, neutrophil, lymphocyte,monocyte, eosinophil and ESR. There were 403 diabetic and 320 non-diabetic subjects included in this study and the study was carried out in BIRDEM (Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital). It was observed that the mean values of SGPT/ALT (p<0.001),><0.001)><0.001)><0.001),><0.004),><0.001) of hematological parameters were significantly higher in diabetic patients than in the non-diabetic patients. In univariate analysis, all biochemical parameters and only four hematological parameters were found significantly associated with fasting blood sugar after adjusted with age and sex. The fasting blood sugar correlates highly with the other biochemical parameters but less or none with the hematological parameters. Our findings demonstrated that control of increased biochemical parameters and abnormal hematological levels in the early stage of diabetes mellitus may help the patients to raise quality of life.
Correlation between Blood group, Hypertension, Obesity, Diabetes, and combina...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Prevalence of Chronic Kidney disease in Patients with Metabolic Syndrome in S...asclepiuspdfs
Background and Objective: Chronic kidney disease (CKD) which is an increasingly important clinical and public health issue is associated with cardiovascular disease. Epidemiologic studies have also linked metabolic syndrome (MetS) with an increased risk of incident CKD. Therefore, the present study was designed retrospectively to find the prevalence and potential risk factors of CKD in patients with MetS in Saudi Arabia.
Study of Lipid Profile in Patients of Coronary Artery Disease among Rural Pop...iosrjce
India and other developing countries in South Asia are progressively facing alarming proportions of
morbidity and mortality caused by coronary artery disease. There are a number of studies on dyslipidemia in
coronary artery disease patients in Indian subcontinent, mostly in urban population in different geographical
territories of the country. There was no such community-based study in rural population of Bihar. Hence this
case control study was undertaken to study dyslipidemia among the rural patients admitted to hospital with
coronary artery disease. 100 consecutive cases diagnosed as coronary artery disease aged 30 to 90 years were
compared to 50 ages and sex matched healthy controls. Age, gender, blood pressure, history of smoking and
diabetes mellitus, waist-hip ratio and Body Mass Index were recorded in each subject. Blood samples for
investigations of lipid profile i.e. serum cholesterol (CHO), triglyceride (TG), high density lipoprotein–
cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were collected from cases. It was found
that high prevalence of dyslipidemia i.e. elevated serum cholesterol and TG and low HDL cholesterol were
significant in all the age groups above 40 years. Interestingly our study in rural population is not associated
with increased risk of coronary artery disease with LDL levels. In order to implement preventive approach to
CAD, our findings suggest that early detection of abnormal lipid profile and modification of lifestyles are important
Estimation of Dr. ihsan edan abdulkareem alsaimary PROFESSOR IN MEDICAL MICR...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Periodontal Disease Indices and Colorectal Cancer Risk in Greek Adults: A Cas...asclepiuspdfs
Introduction: The previous researches have recorded positive associations between periodontal disease (PD) and risk of cancer at various locations. The aim of the present case–control study was to investigate the possible associations between PD indices and the risk of colorectal cancer (CRC) development in a sample of Greek outpatients referred to a medical and dental private practice. Materials and Methods: A total of 342 individuals were interviewed and underwent an oral clinical examination, and 85 of them were suffered from CRC at various anatomic locations. The evaluation of the possible associations between CRC and PD indices was performed using a regression analysis model. Results: Clinical attachment loss (CAL) (P = 0.042, odds ratio [OR] = 1.78, 95% confidence interval [CI] = 1.02–3.11) was significantly associated with the risk of developing CRC. CRC family history (P = 0.002, OR = 2.33, 95% CI = 1.35–4.03) and smoking (P = 0.019, OR = 1.96, 95% CI = 1.12–3.45) were also significantly associated with the mentioned risk, whereas smoking was found to be nota confounder regarding the estimated association between moderate/severe CAL with the risk of developing CRC. Conclusion: CAL as an index for PD severity was statistically significantly associated with the risk of developing CRC.
This document summarizes a study on the prevalence of type 2 diabetes among hepatitis C virus seropositive subjects in Dutse, Nigeria. The study found that 16.1% of male and 19.4% of female HCV-infected subjects had fasting blood sugar levels above 7 mmol/L, indicating a higher risk of diabetes compared to the control group. Liver enzymes were significantly higher in the HCV group. While some metabolic syndrome parameters differed between groups, the differences were not statistically significant. The study concludes that there is a high prevalence of type 2 diabetes among HCV-infected individuals in Dutse, and factors like age, BMI, triglycerides, and HDL may contribute to the development of diabetes.
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
A comparative analysis of biochemical and hematological parameters in diabeti...amsjournal
This study evaluated the biochemical and the hematological parameters in diabetic and non- diabetic patients. The measured biochemical parameters were fasting blood sugar, serum alanine aminotransferase (SGPT/ALT), total cholesterol, urea, creatinine and hematological parameters were hemoglobin, total white blood cell, neutrophil, lymphocyte,monocyte, eosinophil and ESR. There were 403 diabetic and 320 non-diabetic subjects included in this study and the study was carried out in BIRDEM (Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital). It was observed that the mean values of SGPT/ALT (p<0.001),><0.001)><0.001)><0.001),><0.004),><0.001) of hematological parameters were significantly higher in diabetic patients than in the non-diabetic patients. In univariate analysis, all biochemical parameters and only four hematological parameters were found significantly associated with fasting blood sugar after adjusted with age and sex. The fasting blood sugar correlates highly with the other biochemical parameters but less or none with the hematological parameters. Our findings demonstrated that control of increased biochemical parameters and abnormal hematological levels in the early stage of diabetes mellitus may help the patients to raise quality of life.
Correlation between Blood group, Hypertension, Obesity, Diabetes, and combina...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Prevalence of Chronic Kidney disease in Patients with Metabolic Syndrome in S...asclepiuspdfs
Background and Objective: Chronic kidney disease (CKD) which is an increasingly important clinical and public health issue is associated with cardiovascular disease. Epidemiologic studies have also linked metabolic syndrome (MetS) with an increased risk of incident CKD. Therefore, the present study was designed retrospectively to find the prevalence and potential risk factors of CKD in patients with MetS in Saudi Arabia.
Study of Lipid Profile in Patients of Coronary Artery Disease among Rural Pop...iosrjce
India and other developing countries in South Asia are progressively facing alarming proportions of
morbidity and mortality caused by coronary artery disease. There are a number of studies on dyslipidemia in
coronary artery disease patients in Indian subcontinent, mostly in urban population in different geographical
territories of the country. There was no such community-based study in rural population of Bihar. Hence this
case control study was undertaken to study dyslipidemia among the rural patients admitted to hospital with
coronary artery disease. 100 consecutive cases diagnosed as coronary artery disease aged 30 to 90 years were
compared to 50 ages and sex matched healthy controls. Age, gender, blood pressure, history of smoking and
diabetes mellitus, waist-hip ratio and Body Mass Index were recorded in each subject. Blood samples for
investigations of lipid profile i.e. serum cholesterol (CHO), triglyceride (TG), high density lipoprotein–
cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were collected from cases. It was found
that high prevalence of dyslipidemia i.e. elevated serum cholesterol and TG and low HDL cholesterol were
significant in all the age groups above 40 years. Interestingly our study in rural population is not associated
with increased risk of coronary artery disease with LDL levels. In order to implement preventive approach to
CAD, our findings suggest that early detection of abnormal lipid profile and modification of lifestyles are important
Estimation of Dr. ihsan edan abdulkareem alsaimary PROFESSOR IN MEDICAL MICR...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Periodontal Disease Indices and Colorectal Cancer Risk in Greek Adults: A Cas...asclepiuspdfs
Introduction: The previous researches have recorded positive associations between periodontal disease (PD) and risk of cancer at various locations. The aim of the present case–control study was to investigate the possible associations between PD indices and the risk of colorectal cancer (CRC) development in a sample of Greek outpatients referred to a medical and dental private practice. Materials and Methods: A total of 342 individuals were interviewed and underwent an oral clinical examination, and 85 of them were suffered from CRC at various anatomic locations. The evaluation of the possible associations between CRC and PD indices was performed using a regression analysis model. Results: Clinical attachment loss (CAL) (P = 0.042, odds ratio [OR] = 1.78, 95% confidence interval [CI] = 1.02–3.11) was significantly associated with the risk of developing CRC. CRC family history (P = 0.002, OR = 2.33, 95% CI = 1.35–4.03) and smoking (P = 0.019, OR = 1.96, 95% CI = 1.12–3.45) were also significantly associated with the mentioned risk, whereas smoking was found to be nota confounder regarding the estimated association between moderate/severe CAL with the risk of developing CRC. Conclusion: CAL as an index for PD severity was statistically significantly associated with the risk of developing CRC.
Evaluation of the risk factors for the development of metabolic syndrome in b...Alexander Decker
This document summarizes a study that evaluated risk factors for metabolic syndrome in Babylon, Iraq in 2012. The study found that 31.1% of patients had a low risk, 50.8% had a moderate risk, and 18.1% had a high risk of metabolic syndrome. There was a significant association between risk of metabolic syndrome and age, as well as associations between risk levels and factors like hypertension, triglycerides, overweight/obesity, central obesity, diabetes, and low HDL cholesterol. The study concluded that the risk of metabolic syndrome in Babylon increased with the number of risk factors present and with advancing age.
This study examined the relationship between apolipoprotein B (apo B) levels and diabetic retinopathy in 168 Egyptian patients with type 2 diabetes. The results showed a statistically significant increase in apo B levels in patients with retinopathy compared to those without. There was also a fair correlation between higher apo B levels and more severe grades of retinopathy. Additionally, patients with diabetic maculopathy had significantly higher apo B levels than those without maculopathy. The study concludes that elevated apo B is associated with retinopathy and macular edema in type 2 diabetes.
This document discusses a case-control study examining the relationship between sugar intake and pancreatic cancer risk in Lebanese adults aged 50-80 years. It provides background on pancreatic cancer statistics globally and in Lebanon. Previous studies have found associations between high glycemic load/index diets and pancreatic cancer risk, particularly for inactive/overweight individuals. Prospective cohort studies have also linked greater consumption of sugar-sweetened foods and beverages to higher pancreatic cancer risk. The proposed case-control study will examine pancreatic cancer patients' diets to determine if sugar intake is associated with disease development.
- The study involved 253 patients who were divided into two groups: diabetics (Group I) and healthy controls (Group II).
- Blood groups AB and B were less common in diabetics compared to controls, while blood group A was more common. Blood group O showed similar distribution between the two groups.
- A higher percentage of diabetics had Rh positive blood (97.3%) compared to controls (93.9%), while fewer diabetics had Rh negative blood (6.1% vs 2.7% of controls).
- However, statistical analysis found no significant association between ABO or Rh blood groups and diabetes mellitus.
Association between ABO Blood Group and Various Types of Cancer: A Case–Contr...asclepiuspdfs
This study investigated the association between ABO blood group and cancer risk in a Greek adult population. The study included 459 cancer patients and 918 non-cancer controls matched for age and gender. Multivariate analysis found that blood groups A and B were associated with significantly higher overall cancer risk compared to blood groups O and AB. Specifically, blood group A was associated with increased risk of gastric, colorectal, pancreatic, and lung cancer, while blood group B was associated with increased risk of esophageal cancer. The study provides evidence that ABO blood group is a risk factor for certain cancer types in Greek adults.
Journal of Cardiovascular Disorders is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts covering wide aspects of any related diseases that affect the cardiovascular system, primarily cardiac disease, vascular diseases of the vital organs such as brain and kidney, and peripheral arterial disease, understanding the spectrum of disease with applications in observational and analytic epidemiology, randomized clinical trials, screening, cause, risk factor's assessment, age factors, diagnosis and prognosis shimmering the entire spectrum of disease from the earliest emergence to the fatal stages.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Journal of Cardiovascular Disorders accepts original research articles, review articles, case reports, clinical images, mini reviews, rapid communication, opinions and editorials on all the related aspects of diseases that affect the cardiovascular system, primarily cardiac disease, vascular diseases of the vital organs such as brain and kidney, and peripheral arterial disease.
Prospective Cohort Study for Cardiovascular Intervention Medical research- Pu...Pubrica
Cohort studies are the analytical design of observational studies that are epidemiologically used to identify and quantify the relationship between exposure and outcome
This article will provide knowledge about Designing A Prospective Cohort Study For Cardiovascular Intervention
Learn More: https://bit.ly/2NOP5ZX
Contact us:
Web: https://pubrica.com/
Blog: https://pubrica.com/academy/
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United Kingdom : +44-1143520021
Obesity and Survival on Dialysis
In 3 sentences:
This article examines studies on the relationship between body mass and survival in patients undergoing dialysis therapy. Several recent large studies have found that overweight and obese dialysis patients have lower mortality rates than normal weight patients, in what is known as the "dialysis-risk paradox". However, some studies have contradicted these findings or found no survival advantage with higher body mass, suggesting the relationship may differ based on factors like race, population characteristics, and length of follow-up.
1. Cardiovascular diseases are the leading cause of death globally, accounting for 31% of all deaths in 2016. Accurately assessing CVD risk allows for early prevention efforts.
2. The original Framingham Risk Score from 1998 predicts 10-year risk of coronary heart disease based on age, sex, cholesterol, blood pressure, smoking, and diabetes. However, it does not include other outcomes like stroke and underestimates risk in other populations.
3. Several risk calculators have been developed to address limitations of the FRS. Models like SCORE and QRISK2 predict fatal cardiovascular risk and account for additional risk factors like ethnicity and deprivation level respectively.
This study evaluated the relationship between self-reported 3-day diets and cardiovascular markers in 92 young adult participants. Diet characteristics were analyzed using diet logs and correlated with blood pressure and body composition measurements. Sodium intake was positively correlated with BMI. Dietary fiber and iron intake were inversely correlated with systolic blood pressure, suggesting fiber and iron may help lower blood pressure. The results provide some insight into how specific nutrients in the diets of young adults may impact cardiovascular health markers.
Core Components of the Metabolic Syndrome in Nonalcohlic Fatty Liver DiseaseIOSR Journals
This study examined the association between nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) in Bangladeshi patients. The study included 67 patients diagnosed with NAFLD and 50 healthy controls matched for age and BMI. Results found that NAFLD patients had higher levels of insulin resistance, triglycerides, and central obesity compared to controls. However, no significant association was found between MetS and NAFLD when defined by common diagnostic criteria. Individual components of MetS like dyslipidemia, central obesity, and high postprandial glucose were significantly associated with NAFLD on logistic regression analysis. The study concludes that while various MetS components are linked to NAFLD in
Adiposity and incidence of heart failure hospitalization and m ortalityGabriel J Santos
This study examined the association between measures of adiposity (body mass index [BMI] and waist circumference [WC]) and the incidence of heart failure hospitalization and mortality in Swedish men and women. The results showed that higher BMI was associated with greater risk of heart failure, and this association declined with increasing age. Higher WC was also associated with increased risk, and among women the risk was increased at all levels of BMI. Both BMI and WC were independent predictors of heart failure risk in men.
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...Bladimir Viloria
This study used a Mendelian randomization approach to test whether elevated nonfasting glucose levels are causally associated with increased risk of ischemic heart disease (IHD) and myocardial infarction (MI). The study found that:
1) Risk of IHD and MI increased with higher nonfasting glucose levels.
2) Genetic variants associated with higher fasting glucose were also associated with higher nonfasting glucose levels.
3) These glucose-increasing genetic variants were associated with increased risk of IHD and MI.
4) Instrumental variable analysis estimated that a 1 mmol/L increase in nonfasting glucose due to genetic variants was associated with a 25% increased risk of IHD and 69% increased
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
Alterations of Hepcidin and Interleukin in Diabeticsasclepiuspdfs
Aim: This study was done to determine the levels of hepcidin and interleukin-6 (IL-6) in diabetics. Materials and Methods: The study involved 100 diabetics and 100 apparently normal subjects of the same age group 40–70. The levels of hepcidin and IL-6 were measured with an enzyme-linked immunosorbent assay method. Results: The level of hepcidin and IL-6 significantly increased in the diabetics when compared to the controls (P < 0.05). Conclusion: This study probably indicated a significant increase in serum IL-6 and hepcidin levels in patients with diabetics.
Dietary iron intake was assessed using a food frequency questionnaire in a cohort of 58,615 Japanese adults with no history of cardiovascular disease or cancer. During follow up, 2,690 deaths from cardiovascular disease occurred. In men, higher dietary iron intake was associated with increased risk of death from total stroke, ischemic stroke, and total cardiovascular disease. Each of these associations showed a dose-response relationship with increasing quintiles of iron intake. Dietary iron intake was not associated with cardiovascular mortality in women. The results provide some support for the hypothesis that iron intake increases cardiovascular risk, at least in Japanese men.
Statistical analysis of risk factors associated withanamjavaid13
Gallstones are crystal like collections that formed by merging of normal and abnormal gallbladder content. Usually there are two types of gallstones exist i.e. cholesterol stones & pigment stones. The current paper focuses on symptoms of the disease, major cause for the disease and on the treatments that majority of patients preferred. For this purpose, sample of size 170 data from different hospitals in Multan is collected by using convenience sampling. Main demographic factors involved in this study are Gender, Age group, marital status for patients of GSD. Frequency distribution has been formed for these different demographic and social factors and a bar chart is constructed for differentiating between gender as gender is also an important factor in GSD. For weight factor, paired t test is applied to see the difference between before and after weight after having treatment. Findings show that 67 percent people prefer govt. hospitals because of the people suffering from this disease were from backward areas or villages & their income not meet to pay the private hospitals expense.
Impaired mitochondrial beta-oxidation in patients with chronic hepatitis C: r...Enrique Moreno Gonzalez
Hepatic steatosis is often seen in patients with chronic hepatitis C (CH-C). It is still unclear whether these patients have an impaired mitochondrial β-oxidation. In this study we assessed mitochondrial β-oxidation in CH-C patients by investigating ketogenesis during fasting.
Interrogating differences in expression of targeted gene sets to predict brea...Enrique Moreno Gonzalez
Genomics provides opportunities to develop precise tests for diagnostics, therapy selection and monitoring. From analyses of our studies and those of published results, 32 candidate genes were identified, whose expression appears related to clinical outcome of breast cancer. Expression of these genes was validated by qPCR and correlated with clinical follow-up to identify a gene subset for development of a prognostic test.
Perceived benefits and barriers to exercise for recently treated patients wit...Enrique Moreno Gonzalez
Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM.
Optimal schedule of Bacillus Calmette-Guerin for non-muscle-invasive bladder ...Enrique Moreno Gonzalez
To explore the necessity of maintenance, efficacy of low-dose and superiority of various combination therapies of Bacillus Calmette-Guérin (BCG) in treatment of superficial bladder cancer (BCa).
Evaluation of the risk factors for the development of metabolic syndrome in b...Alexander Decker
This document summarizes a study that evaluated risk factors for metabolic syndrome in Babylon, Iraq in 2012. The study found that 31.1% of patients had a low risk, 50.8% had a moderate risk, and 18.1% had a high risk of metabolic syndrome. There was a significant association between risk of metabolic syndrome and age, as well as associations between risk levels and factors like hypertension, triglycerides, overweight/obesity, central obesity, diabetes, and low HDL cholesterol. The study concluded that the risk of metabolic syndrome in Babylon increased with the number of risk factors present and with advancing age.
This study examined the relationship between apolipoprotein B (apo B) levels and diabetic retinopathy in 168 Egyptian patients with type 2 diabetes. The results showed a statistically significant increase in apo B levels in patients with retinopathy compared to those without. There was also a fair correlation between higher apo B levels and more severe grades of retinopathy. Additionally, patients with diabetic maculopathy had significantly higher apo B levels than those without maculopathy. The study concludes that elevated apo B is associated with retinopathy and macular edema in type 2 diabetes.
This document discusses a case-control study examining the relationship between sugar intake and pancreatic cancer risk in Lebanese adults aged 50-80 years. It provides background on pancreatic cancer statistics globally and in Lebanon. Previous studies have found associations between high glycemic load/index diets and pancreatic cancer risk, particularly for inactive/overweight individuals. Prospective cohort studies have also linked greater consumption of sugar-sweetened foods and beverages to higher pancreatic cancer risk. The proposed case-control study will examine pancreatic cancer patients' diets to determine if sugar intake is associated with disease development.
- The study involved 253 patients who were divided into two groups: diabetics (Group I) and healthy controls (Group II).
- Blood groups AB and B were less common in diabetics compared to controls, while blood group A was more common. Blood group O showed similar distribution between the two groups.
- A higher percentage of diabetics had Rh positive blood (97.3%) compared to controls (93.9%), while fewer diabetics had Rh negative blood (6.1% vs 2.7% of controls).
- However, statistical analysis found no significant association between ABO or Rh blood groups and diabetes mellitus.
Association between ABO Blood Group and Various Types of Cancer: A Case–Contr...asclepiuspdfs
This study investigated the association between ABO blood group and cancer risk in a Greek adult population. The study included 459 cancer patients and 918 non-cancer controls matched for age and gender. Multivariate analysis found that blood groups A and B were associated with significantly higher overall cancer risk compared to blood groups O and AB. Specifically, blood group A was associated with increased risk of gastric, colorectal, pancreatic, and lung cancer, while blood group B was associated with increased risk of esophageal cancer. The study provides evidence that ABO blood group is a risk factor for certain cancer types in Greek adults.
Journal of Cardiovascular Disorders is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts covering wide aspects of any related diseases that affect the cardiovascular system, primarily cardiac disease, vascular diseases of the vital organs such as brain and kidney, and peripheral arterial disease, understanding the spectrum of disease with applications in observational and analytic epidemiology, randomized clinical trials, screening, cause, risk factor's assessment, age factors, diagnosis and prognosis shimmering the entire spectrum of disease from the earliest emergence to the fatal stages.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Journal of Cardiovascular Disorders accepts original research articles, review articles, case reports, clinical images, mini reviews, rapid communication, opinions and editorials on all the related aspects of diseases that affect the cardiovascular system, primarily cardiac disease, vascular diseases of the vital organs such as brain and kidney, and peripheral arterial disease.
Prospective Cohort Study for Cardiovascular Intervention Medical research- Pu...Pubrica
Cohort studies are the analytical design of observational studies that are epidemiologically used to identify and quantify the relationship between exposure and outcome
This article will provide knowledge about Designing A Prospective Cohort Study For Cardiovascular Intervention
Learn More: https://bit.ly/2NOP5ZX
Contact us:
Web: https://pubrica.com/
Blog: https://pubrica.com/academy/
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United Kingdom : +44-1143520021
Obesity and Survival on Dialysis
In 3 sentences:
This article examines studies on the relationship between body mass and survival in patients undergoing dialysis therapy. Several recent large studies have found that overweight and obese dialysis patients have lower mortality rates than normal weight patients, in what is known as the "dialysis-risk paradox". However, some studies have contradicted these findings or found no survival advantage with higher body mass, suggesting the relationship may differ based on factors like race, population characteristics, and length of follow-up.
1. Cardiovascular diseases are the leading cause of death globally, accounting for 31% of all deaths in 2016. Accurately assessing CVD risk allows for early prevention efforts.
2. The original Framingham Risk Score from 1998 predicts 10-year risk of coronary heart disease based on age, sex, cholesterol, blood pressure, smoking, and diabetes. However, it does not include other outcomes like stroke and underestimates risk in other populations.
3. Several risk calculators have been developed to address limitations of the FRS. Models like SCORE and QRISK2 predict fatal cardiovascular risk and account for additional risk factors like ethnicity and deprivation level respectively.
This study evaluated the relationship between self-reported 3-day diets and cardiovascular markers in 92 young adult participants. Diet characteristics were analyzed using diet logs and correlated with blood pressure and body composition measurements. Sodium intake was positively correlated with BMI. Dietary fiber and iron intake were inversely correlated with systolic blood pressure, suggesting fiber and iron may help lower blood pressure. The results provide some insight into how specific nutrients in the diets of young adults may impact cardiovascular health markers.
Core Components of the Metabolic Syndrome in Nonalcohlic Fatty Liver DiseaseIOSR Journals
This study examined the association between nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) in Bangladeshi patients. The study included 67 patients diagnosed with NAFLD and 50 healthy controls matched for age and BMI. Results found that NAFLD patients had higher levels of insulin resistance, triglycerides, and central obesity compared to controls. However, no significant association was found between MetS and NAFLD when defined by common diagnostic criteria. Individual components of MetS like dyslipidemia, central obesity, and high postprandial glucose were significantly associated with NAFLD on logistic regression analysis. The study concludes that while various MetS components are linked to NAFLD in
Adiposity and incidence of heart failure hospitalization and m ortalityGabriel J Santos
This study examined the association between measures of adiposity (body mass index [BMI] and waist circumference [WC]) and the incidence of heart failure hospitalization and mortality in Swedish men and women. The results showed that higher BMI was associated with greater risk of heart failure, and this association declined with increasing age. Higher WC was also associated with increased risk, and among women the risk was increased at all levels of BMI. Both BMI and WC were independent predictors of heart failure risk in men.
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...Bladimir Viloria
This study used a Mendelian randomization approach to test whether elevated nonfasting glucose levels are causally associated with increased risk of ischemic heart disease (IHD) and myocardial infarction (MI). The study found that:
1) Risk of IHD and MI increased with higher nonfasting glucose levels.
2) Genetic variants associated with higher fasting glucose were also associated with higher nonfasting glucose levels.
3) These glucose-increasing genetic variants were associated with increased risk of IHD and MI.
4) Instrumental variable analysis estimated that a 1 mmol/L increase in nonfasting glucose due to genetic variants was associated with a 25% increased risk of IHD and 69% increased
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
Alterations of Hepcidin and Interleukin in Diabeticsasclepiuspdfs
Aim: This study was done to determine the levels of hepcidin and interleukin-6 (IL-6) in diabetics. Materials and Methods: The study involved 100 diabetics and 100 apparently normal subjects of the same age group 40–70. The levels of hepcidin and IL-6 were measured with an enzyme-linked immunosorbent assay method. Results: The level of hepcidin and IL-6 significantly increased in the diabetics when compared to the controls (P < 0.05). Conclusion: This study probably indicated a significant increase in serum IL-6 and hepcidin levels in patients with diabetics.
Dietary iron intake was assessed using a food frequency questionnaire in a cohort of 58,615 Japanese adults with no history of cardiovascular disease or cancer. During follow up, 2,690 deaths from cardiovascular disease occurred. In men, higher dietary iron intake was associated with increased risk of death from total stroke, ischemic stroke, and total cardiovascular disease. Each of these associations showed a dose-response relationship with increasing quintiles of iron intake. Dietary iron intake was not associated with cardiovascular mortality in women. The results provide some support for the hypothesis that iron intake increases cardiovascular risk, at least in Japanese men.
Statistical analysis of risk factors associated withanamjavaid13
Gallstones are crystal like collections that formed by merging of normal and abnormal gallbladder content. Usually there are two types of gallstones exist i.e. cholesterol stones & pigment stones. The current paper focuses on symptoms of the disease, major cause for the disease and on the treatments that majority of patients preferred. For this purpose, sample of size 170 data from different hospitals in Multan is collected by using convenience sampling. Main demographic factors involved in this study are Gender, Age group, marital status for patients of GSD. Frequency distribution has been formed for these different demographic and social factors and a bar chart is constructed for differentiating between gender as gender is also an important factor in GSD. For weight factor, paired t test is applied to see the difference between before and after weight after having treatment. Findings show that 67 percent people prefer govt. hospitals because of the people suffering from this disease were from backward areas or villages & their income not meet to pay the private hospitals expense.
Impaired mitochondrial beta-oxidation in patients with chronic hepatitis C: r...Enrique Moreno Gonzalez
Hepatic steatosis is often seen in patients with chronic hepatitis C (CH-C). It is still unclear whether these patients have an impaired mitochondrial β-oxidation. In this study we assessed mitochondrial β-oxidation in CH-C patients by investigating ketogenesis during fasting.
Interrogating differences in expression of targeted gene sets to predict brea...Enrique Moreno Gonzalez
Genomics provides opportunities to develop precise tests for diagnostics, therapy selection and monitoring. From analyses of our studies and those of published results, 32 candidate genes were identified, whose expression appears related to clinical outcome of breast cancer. Expression of these genes was validated by qPCR and correlated with clinical follow-up to identify a gene subset for development of a prognostic test.
Perceived benefits and barriers to exercise for recently treated patients wit...Enrique Moreno Gonzalez
Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM.
Optimal schedule of Bacillus Calmette-Guerin for non-muscle-invasive bladder ...Enrique Moreno Gonzalez
To explore the necessity of maintenance, efficacy of low-dose and superiority of various combination therapies of Bacillus Calmette-Guérin (BCG) in treatment of superficial bladder cancer (BCa).
Abnormal expression of Pygopus 2 correlates with a malignant phenotype in hum...Enrique Moreno Gonzalez
Pygopus 2 (Pygo2) is a Pygo family member and an important component of the Wnt signaling transcriptional complex. Despite this data, no clinical studies investigating Pygo2 expression in lung cancer have yet been reported.
Sticky siRNAs targeting survivin and cyclin B1 exert an antitumoral effect on...Enrique Moreno Gonzalez
Melanoma represents one of the most aggressive and therapeutically challenging malignancies as it often gives rise to metastases and develops resistance to classical chemotherapeutic agents. Although diverse therapies have been generated, no major improvement of the patient prognosis has been noticed. One promising alternative to the conventional therapeutic approaches currently available is the inactivation of proteins essential for survival and/or progression of melanomas by means of RNA interference. Survivin and cyclin B1, both involved in cell survival and proliferation and frequently deregulated in human cancers, are good candidate target genes for siRNA mediated therapeutics.
Chemokine (C-X-C) ligand 1 (CXCL1) protein expression is increased in aggress...Enrique Moreno Gonzalez
This study examined CXCL1 protein expression in 152 bladder tissue samples, including 142 cancer samples and 10 benign samples, using immunohistochemical staining. The key findings were:
1) CXCL1 protein expression was present in cancerous bladder tissues but entirely absent in benign bladder tissues.
2) CXCL1 expression was significantly higher in high-grade and high-stage tumors compared to low-grade and low-stage tumors.
3) Increased CXCL1 expression was associated with reduced disease-specific survival and overall survival.
So in summary, this study found that CXCL1 protein expression is increased in more aggressive bladder cancers and associated with poorer survival outcomes. This suggests CXCL1 may play a
High intakes of thiamine, riboflavin, vitamin B6, and folate were associated with lower risk of breast cancer. Specifically, high riboflavin intake was linked to lower risk of estrogen receptor-positive and progesterone receptor-positive cancers, while high thiamine intake was associated with lower risk of estrogen receptor-negative and progesterone receptor-negative cancers. High riboflavin was also associated with lower risk of both HER2-positive and HER2-negative cancers, and high folate was linked to lower risk of HER2-negative disease.
Austin Journal of Cancer and Clinical Research is an open access, peer reviewed, scholarly journal dedicated to publish articles in all areas of cancer research and oncology. The aim of the journal is to provide a forum for oncologists, researchers, physicians, and other health professionals to find most recent advances in the areas of cancer research.
Austin Journal of Cancer and Clinical Research accepts original research articles, review articles, case reports, clinical images and rapid communication on all the aspects of diagnosis and treatment of cancer.
Austin Journal of Cancer and Clinical Research strongly supports the scientific upgradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Post-diagnosis hemoglobin change associates with overall survival of multiple...Enrique Moreno Gonzalez
Anemia refers to low hemoglobin (Hb) level and is a risk factor of cancer patient survival. The National Comprehensive Cancer Network recently suggested that post-diagnosis Hb change, regardless of baseline Hb level, indicates the potential presence of anemia. However, there is no epidemiological study evaluating whether Hb change has direct prognostic values for cancer patients at the population level.
Secular trends of salted fish consumption and nasopharyngeal carcinoma: a mul...Enrique Moreno Gonzalez
This document summarizes a study that examined the relationship between salted fish consumption and nasopharyngeal carcinoma (NPC) incidence and mortality rates in 8 regions over several decades. The study found decreasing NPC rates in Hong Kong correlated with decreasing salted fish consumption. However, these correlations were no longer significant after adjusting for changes in tobacco use and vegetable consumption. Additionally, no consistent relationships were observed between NPC rates and salted fish intake in the 7 other regions studied. The results do not strongly support the role of salted fish in explaining global NPC rate trends.
Association between variations in the fat mass and obesity-associated gene an...Enrique Moreno Gonzalez
It is clear that genetic variations in the fat mass and obesity-associated (FTO) gene affect body mass index and the risk of obesity. Given the mounting evidence showing a positive association between obesity and pancreatic cancer, this study aimed to investigate the relation between variants in the FTO gene, obesity and pancreatic cancer risk.
WCRF International Continuous Update Project (CUP). Presentation given by Giota Mitrou PhD MSc, Head of Research Funding and Science Activities, World Cancer Research Fund International (WCRF International).
This study examined the association between the ratio of serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) and risk of cardiovascular disease in a Japanese population. Over 5 years of follow up, 127 participants experienced cardiovascular events. The risk of cardiovascular disease was higher among those with a lower EPA/AA ratio and higher levels of high-sensitivity C-reactive protein (hs-CRP), a marker of inflammation. A lower EPA/AA ratio was associated with a 52% increased risk of cardiovascular disease per 0.20 decrease in those with hs-CRP over 1.0 mg/L. The results suggest that a lower EPA/AA ratio may be linked to greater risk of
Polycyclic aromatic hydrocarbons: Determinants of urinary 1-hydroxypyrene glu...Enrique Moreno Gonzalez
Associations between polycyclic aromatic hydrocarbons (PAHs) and colorectal cancer have been reported previously but few studies have characterized PAH exposure using biological measurements. We evaluated colorectal cancer risk in relation to urinary concentration of 1-hydroxypyrene glucuronide (1-OHPG), a polycyclic aromatic hydrocarbon (PAH) metabolite, and assessed determinants of PAH exposure among controls in the Shanghai Women’s Health Study (SWHS).
Epidemiological studies are applicable to communicable and non-com.docxSALU18
Epidemiological studies are applicable to communicable and non-communicable diseases. Childhood obesity is an area that is receiving more attention in public health due to the multiple morbidities that emerge as a result of this condition. Below are links to a cross-sectional study and a case-control study. Imagine that you are interested in conducting a case-control or cross-sectional study proposal of childhood obesity vs. birth weight (prenatal and early life influences). Both articles below address prenatal influences on childhood obesity and birth weight using different approaches.
Article 1 -attached
Article 2-attached
Using the information in the articles, answer the following questions using AMA format.
1. How would you select cases and controls for this study and how would you define exposure and outcome variables for a case-control study design? What other factors would you control for?
2. How would you design a proposal measuring the effect of birthweight on childhood obesity for a cross-sectional study design? What other factors would you control for?
BioMed CentralBMC Public Health
ss
Open AcceStudy protocol
Cross sectional study of childhood obesity and prevalence of risk
factors for cardiovascular disease and diabetes in children aged 11–
13
Anwen Rees*1, Non Thomas1, Sinead Brophy2, Gareth Knox1 and
Rhys Williams2
Address: 1Cardiff School of Sport, University of Wales Institute Cardiff, Wales, UK and 2School of Medicine, Swansea University, Wales, UK
Email: Anwen Rees* - [email protected]; Non Thomas - [email protected]; Sinead Brophy - [email protected];
Gareth Knox - [email protected]; Rhys Williams - [email protected]
* Corresponding author
Abstract
Background: Childhood obesity levels are rising with estimates suggesting that around one in
three children in Western countries are overweight. People from lower socioeconomic status and
ethnic minority backgrounds are at higher risk of obesity and subsequent CVD and diabetes.
Within this study we examine the prevalence of risk factors for CVD and diabetes (obesity,
hypercholesterolemia, hypertension) and examine factors associated with the presence of these
risk factors in school children aged 11–13.
Methods and design: Participants will be recruited from schools across South Wales. Schools
will be selected based on catchment area, recruiting those with high ethnic minority or deprived
catchment areas. Data collection will take place during the PE lessons and on school premises. Data
will include: anthropometrical variables (height, weight, waist, hip and neck circumferences, skinfold
thickness at 4 sites), physiological variables (blood pressure and aerobic fitness (20 metre multi
stage fitness test (20 MSFT)), diet (self-reported seven-day food diary), physical activity (Physical
Activity Questionnire for Adolescents (PAQ-A), accelerometery) and blood tests (fasting glucose,
insulin, lipids, fibrinogen (Fg), adiponectin (high molecular weight), C-react ...
The role of genetic factors in Hypertension among Iraqi citizensAI Publications
This document summarizes a study examining the role of genetic factors in hypertension among Iraqi citizens. The study included 140 patients divided into a case group of 120 hypertensive patients and a control group of 30 normotensive patients. Data on demographics, family history, blood pressure, and other medical variables were collected and analyzed. Statistical analysis found a significant relationship between genetic factors and hypertension, with a p-value of 0.001. Patients with a positive family history of hypertension in a first-degree relative had 3.98 times higher odds of having hypertension themselves. The study concluded that genetics play an important role in hypertension risk among Iraqi citizens.
Antibiotic exposure and the development of coeliac disease: a nationwide case...Enrique Moreno Gonzalez
The intestinal microbiota has been proposed to play a pathogenic role in coeliac disease (CD). Although antibiotics are common environmental factors with a profound impact on intestinal microbiota, data on antibiotic use as a risk factor for subsequent CD development are scarce.
This study examined the association between blood group antigens, CD4 cell count, and hemoglobin patterns in HIV-infected patients. 240 newly diagnosed HIV-positive patients and 120 healthy controls were analyzed. There was no significant association found between ABO/Rh blood groups or hemoglobin genotypes between the two groups. However, a significant association was observed between CD4 cell count and ABO blood group, with blood groups A and AB having higher average CD4 counts. The study suggests blood group A may confer some immunity against HIV infection.
What is the current evidence between alcohol and cancer?
Presentation given by Giota Mitrou PhD MSc, Head of Research Funding and Science Activities, World Cancer Research Fund International (WCRF International).
This document summarizes a study that examined the relationship between cigarette smoking and cardiovascular disease risk factors in over 17,000 US adults. The study found higher levels of homocysteine, fibrinogen, and C-reactive protein in current smokers compared to former smokers and never smokers. Cigarette smoking was associated with increased levels of these risk factors, even after controlling for other cardiovascular risk factors. The results provide evidence that cigarette smoking increases cardiovascular disease risk in part by raising levels of homocysteine, fibrinogen, and inflammation.
Serum Total Bilirubin levels in Diabetic Retinopathy - A case control studyiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Similar to Inorganic phosphate and the risk of cancer in the Swedish AMORIS study (20)
Incidence of pneumonia and risk factors among patients with head and neck can...Enrique Moreno Gonzalez
This study investigated the incidence and patient- and treatment-related risk factors related to pneumonia acquired during radiotherapy (PNRT) in head and neck cancer (HNC) patients.
Gene expression analysis of a Helicobacter pyloriinfected and high-salt diet-...Enrique Moreno Gonzalez
Helicobacter pylori (H. pylori) infection and excessive salt intake are known as important risk factors for stomach cancer in humans. However, interactions of these two factors with gene expression profiles during gastric carcinogenesis remain unclear. In the present study, we investigated the global gene expression associated with stomach carcinogenesis and prognosis of human gastric cancer using a mouse model.
Acute myeloid leukemia (AML) is a hematopoietic malignancy with a dismal outcome in the majority of cases. A detailed understanding of the genetic alterations and gene expression changes that contribute to its pathogenesis is important to improve prognostication, disease monitoring, and therapy. In this context, leukemia-associated misexpression of microRNAs (miRNAs) has been studied, but no coherent picture has emerged yet, thus warranting further investigations.
Recently, a phase II clinical trial in hepatocellular carcinoma (HCC) has suggested that the combination of sorafenib and 5-fluorouracil (5-FU) is feasible and side effects are manageable. However, preclinical experimental data explaining the interaction mechanism(s) are lacking. Our objective is to investigate the anticancer efficacy and mechanism of combined sorafenib and 5-FU therapy in vitro in HCC cell lines MHCC97H and SMMC-7721.
Differences in microRNA expression during tumor development in the transition...Enrique Moreno Gonzalez
The prostate is divided into three glandular zones, the peripheral zone (PZ), the transition zone (TZ), and the central zone. Most prostate tumors arise in the peripheral zone (70-75%) and in the transition zone (20-25%) while only 10% arise in the central zone. The aim of this study was to investigate if differences in miRNA expression could be a possible explanation for the difference in propensity of tumors in the zones of the prostate.
Multicentric and multifocal versus unifocal breast cancer: differences in the...Enrique Moreno Gonzalez
This study compared the expression of E-cadherin, β-catenin, and MUC1 in multicentric/multifocal breast cancers versus unifocal breast cancers of identical tumor size and grade. The study found significantly downregulated expression of E-cadherin in multicentric/multifocal cancers compared to unifocal cancers. In contrast, no significant differences were seen in β-catenin expression between the two groups. Within the unifocal group, E-cadherin and β-catenin expression were positively correlated, but this was not seen in the multicentric/multifocal group. The results suggest multicentric/multifocal and unifocal breast cancers differ in E-
The life in sight application study (LISA): design of a randomized controlled...Enrique Moreno Gonzalez
It is widely recognized that spiritual care plays an important role in physical and psychosocial well-being of cancer patients, but there is little evidence based research on the effects of spiritual care. We will conduct a randomized controlled trial on spiritual care using a brief structured interview scheme supported by an e-application. The aim is to examine whether an assisted reflection on life events and ultimate life goals can improve quality of life of cancer patients.
Clinical and experimental studies regarding the expression and diagnostic val...Enrique Moreno Gonzalez
Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is a multifunctional Ig-like cell adhesion molecule that has a wide range of biological functions. According to previous reports, serum CEACAM1 is dysregulated in different malignant tumours and associated with tumour progression. However, the serum CEACAM1 expression in nonsmall-cell lung carcinomas (NSCLC) is unclear. The different expression ratio of CEACAM1-S and CEACAM1-L isoform has seldom been investigated in NSCLC. This research is intended to study the serum CEACAM1 and the ratio of CEACAM1-S/L isoforms in NSCLC.
Assessment of preoperative exercise capacity in hepatocellular carcinoma pati...Enrique Moreno Gonzalez
Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma (HCC) patients with chronic liver injury who underwent hepatectomy.
Overexpression of YAP 1 contributes to progressive features and poor prognosi...Enrique Moreno Gonzalez
Yes-associated protein 1 (YAP 1), the nuclear effector of the Hippo pathway, is a key regulator of organ size and a candidate human oncogene in multiple tumors. However, the expression dynamics of YAP 1 in urothelial carcinoma of the bladder (UCB) and its clinical/prognostic significance are unclear.
CXCR7 is induced by hypoxia and mediates glioma cell migration towards SDF-1a...Enrique Moreno Gonzalez
Glioblastomas, the most common and malignant brain tumors of the central nervous system, exhibit high invasive capacity, which hinders effective therapy. Therefore, intense efforts aimed at improved therapeutics are ongoing to delineate the molecular mechanisms governing glioma cell migration and invasion.
Differentiation of irradiation and cetuximab induced skin reactions in patien...Enrique Moreno Gonzalez
In order to improve the clinical outcome of patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN) not being capable to receive platinum-based chemoradiation, radiotherapy can be intensified by addition of cetuximab, a monoclonal antibody that blocks the epidermal growth factor receptor (EGFR). The radioimmunotherapy with cetuximab is a feasible treatment option showing a favourable toxicity profile. The most frequent side effect of radiotherapy is radiation dermatitis, the most common side effect of treatment with cetuximab is acneiform rash. Incidence and severity of these frequent, often overlapping and sometimes limiting skin reactions, however, are not well explored. A clinical and molecular differentiation between radiogenic skin reactions and skin reactions caused by cetuximab which may correlate with outcome, have never been described before.
Cholestasis induces reversible accumulation of periplakin in mouse liverEnrique Moreno Gonzalez
Periplakin (PPL) is a rod-shaped cytolinker protein thought to connect cellular adhesion junctional complexes to cytoskeletal filaments. PPL serves as a structural component of the cornified envelope in the skin and interacts with various types of proteins in cultured cells; its level decreases dramatically during tumorigenic progression in human epithelial tissues. Despite these intriguing observations, the physiological roles of PPL, especially in noncutaneous tissues, are still largely unknown. Because we observed a marked fluctuation of PPL expression in mouse liver in association with the bile acid receptor farnesoid X receptor (FXR) and cholestasis, we sought to characterize the role of PPL in the liver and determine its contributions to the etiology and pathogenesis of cholestasis.
Functional p53 is required for rapid restoration of daunorubicin-induced lesi...Enrique Moreno Gonzalez
This document summarizes a research article that studied the role of p53 in daunorubicin (DNR)-induced lesions in the spleen. The key findings were:
1) DNR treatment caused more rapid cell death and weight loss in the spleens of wild type mice compared to p53-null mice.
2) While wild type mouse spleens recovered normal morphology 8 days after DNR treatment, p53-null mouse spleens still had large necrotic lesions.
3) DNR treatment increased p21 levels in wild type mice but not p53-null mice, indicating p53 is required for p21 induction.
4) The results suggest p53
Cost-effectiveness of MRI for breast cancer screening in BRCA1/2 mutation car...Enrique Moreno Gonzalez
Women with mutations in BRCA1 or BRCA2 are at high risk of developing breast cancer and, in British Columbia, Canada, are offered screening with both magnetic resonance imaging (MRI) and mammography to facilitate early detection. MRI is more sensitive than mammography but is more costly and produces more false positive results. The purpose of this study was to calculate the cost-effectiveness of MRI screening for breast cancer in BRCA1/2 mutation carriers in a Canadian setting.
Intraepithelial lymphocyte distribution differs between the bulb and the seco...Enrique Moreno Gonzalez
Evaluation of intraepithelial duodenal lymphocytosis (IDL) is important in celiac disease (CD). There is no established cut-off value for increased number of IELs in the bulb. We therefore investigated the relation between IEL counts in the bulb and duodenal specimens in non-celiac subjects.
The cysteinyl leukotriene 2 receptor contributes to all-trans retinoic acid-i...Enrique Moreno Gonzalez
Cysteinyl leukotrienes (CysLTs) are potent pro-inflammatory mediators that are increased in samples from patients with inflammatory bowel diseases (IBDs). Individuals with IBDs have enhanced susceptibility to colon carcinogenesis. In colorectal cancer, the balance between the pro-mitogenic cysteinyl leukotriene 1 receptor (CysLT1R) and the differentiation-promoting cysteinyl leukotriene 2 receptor (CysLT2R) is lost. Further, our previous data indicate that patients with high CysLT1R and low CysLT2R expression have a poor prognosis. In this study, we examined whether the balance between CysLT1R and CysLT2R could be restored by treatment with the cancer chemopreventive agent all-trans retinoic acid (ATRA).
Clinical features and outcome of cryptogenic hepatocellular carcinoma compare...Enrique Moreno Gonzalez
Cryptogenic hepatocellular carcinoma (HCC) is thought to arise due to non-alcoholic fatty liver disease (NAFLD). This study investigated the prevalence, clinical features, and outcomes of cryptogenic HCC and compared them with those of HCC related to hepatitis B virus infection (HBV-HCC), hepatitis C virus infection (HCV-HCC), and alcohol (ALCHCC) in Korea.
Fatty liver index correlates with non-alcoholic fatty liver disease, but not ...Enrique Moreno Gonzalez
Fatty liver index (FLI) was recently established to predict non-alcoholic fatty liver disease (NAFLD) in general population, which is known to be associated with coronary artery atherosclerotic disease (CAD).
This study aims to investigate whether FLI correlates with NAFLD and with newly diagnosed CAD in a special Chinese population who underwent coronary angiography.
Este documento presenta la laudatio del Dr. Enrique Moreno González, quien recibe el grado de Doctor Honoris Causa de la Universidad de Málaga. Resalta la trayectoria académica y profesional del Dr. Moreno, incluyendo sus logros en cirugía hepática y de trasplantes, sus cargos y distinciones, y su dedicación a la enseñanza. El orador destaca al Dr. Moreno como pionero quirúrgico, maestro, y persona comprometida con mejorar la atención médica a través
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Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
2. Inorganic phosphate and the risk of cancer in the
Swedish AMORIS study
Wahyu Wulaningsih1
Email: wahyu.wulaningsih@kcl.ac.uk
Karl Michaelsson2
Email: karl.michaelsson@surgsci.uu.se
Hans Garmo1,3
Email: hans.garmo@kcl.ac.uk
Niklas Hammar4,5
Email: niklas.hammar@ki.se
Ingmar Jungner6
Email: ingmar.jungner@ki.se
Göran Walldius4
Email: goran.walldius@ki.se
Lars Holmberg1,3
Email: lars.holmberg@kcl.ac.uk
Mieke Van Hemelrijck1,7,*
Email: mieke.vanhemelrijck@kcl.ac.uk
1
King’s College London, School of Medicine, Division of Cancer Studies,
Cancer Epidemiology Unit, London, UK
2
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
3
Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden
4
Department of Epidemiology, Insitute of Environmental Medicine, Karolinska
Institutet, Stockholm, Sweden
5
AstraZeneca Sverige, Södertalje, Sweden
6
Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet
and CALAB Research, Stockholm, Sweden
7
King’s College London, School of Medicine, Division of Cancer Studies,
Cancer Epidemiology Unit, Research Oncology, 3rd Floor, Bermondsey Wing,
Guy’s Hospital, London SE1 9RT, UK
3. *
Corresponding author. King’s College London, School of Medicine, Division of
Cancer Studies, Cancer Epidemiology Unit, Research Oncology, 3rd Floor,
Bermondsey Wing, Guy’s Hospital, London SE1 9RT, UK
Abstract
Background
Both dietary and serum levels of inorganic phosphate (Pi) have been linked to development
of cancer in experimental studies. This is the first population-based study investigating the
relation between serum Pi and risk of cancer in humans.
Methods
From the Swedish Apolipoprotein Mortality Risk (AMORIS) study, we selected all
participants (> 20 years old) with baseline measurements of serum Pi, calcium, alkaline
phosphatase, glucose, and creatinine (n = 397,292). Multivariable Cox proportional hazards
regression analyses were used to assess serum Pi in relation to overall cancer risk. Similar
analyses were performed for specific cancer sites.
Results
We found a higher overall cancer risk with increasing Pi levels in men ( HR: 1.02 (95% CI:
1.00-1.04) for every SD increase in Pi), and a negative association in women (HR: 0.97 (95%
CI: 0.96-0.99) for every SD increase in Pi). Further analyses for specific cancer sites showed
a positive link between Pi quartiles and the risk of cancer of the pancreas, lung, thyroid gland
and bone in men, and cancer of the oesophagus, lung, and nonmelanoma skin cancer in
women. Conversely, the risks for developing breast and endometrial cancer as well as other
endocrine cancer in both men and women were lower in those with higher Pi levels.
Conclusions
Abnormal Pi levels are related to development of cancer. Furthermore, the inverse association
between Pi levels and risk of breast, endometrial and other endocrine cancers may indicate
the role of hormonal factors in the relation between Pi metabolism and cancer.
Keywords
Cancer, Inorganic phosphate, Prospective cohort study
Background
Dietary patterns are suggested to be an important environmental risk factor for cancer [1].
Inorganic phosphate (Pi) is a dietary constituent well-known for its role in skeletal
mineralization, and normal levels of Pi are essential to maintain normal cellular function [2].
Recent experimental studies in rodents indicated that Pi may act as an active regulator of
growth rather than a merely compulsory element in cellular homeostasis. Elevated levels of
4. serum Pi were found to modify gene expression as well as protein translation and affect the
rate of cell proliferation in vitro [3,4]. Moreover, a high Pi diet has been reported to result in
a significantly increased development of lung and skin cancers, as well as perturbed normal
brain growth in animal studies [5-7], which denoted the potential link between Pi and
carcinogenesis in humans. However, to our knowledge there are no observational studies
describing the association between Pi and cancer risk in humans.
Besides being naturally present in raw food including meats, fish, eggs, dairy products and
vegetables, Pi is also found as an additive in processed food such as hamburgers and pizza,
and as phosphoric acid in soda beverages [8]. Mostly, this Pi content is not listed as an
ingredient per se, and it was reported that this ‘hidden’ Pi content of food with Pi-containing
additives is nearly 70% higher than in food without additives [9]. In the human body Pi is
known to be mainly regulated by a set of hormonal and metabolic factors which tightly
control calcium homeostasis, i.e. vitamin D and parathyroid hormone (PTH), and a recently
identified Pi-regulating hormone, fibroblast growth factor 23 (FGF-23). However, intestinal
absorption of Pi is efficient and minimally regulated [2,10], so that high Pi supplementation
results in markedly elevated levels of serum Pi [11,12]. Additionally, abnormal Pi levels are
also a common feature of various metabolic diseases including diabetes and rickets [13,14].
Considering the emerging experimental evidence linking Pi and cancer, it is of interest to
explore this relation in an observational population-based setting.
Methods
Study population and data collection
The Swedish Apolipoprotein Mortality Risk (AMORIS) database has been described in detail
elsewhere [15-17]. Briefly, this database is based on the linkage of the Central Automation
Laboratory (CALAB) database (1985–1996) to various Swedish national registries, including
the National Cancer Register. The CALAB database includes data from 351,487 male and
338,101 female individuals having clinical laboratory testing as part of a general health
check-up or outpatients referred for laboratory testing. No individuals were inpatients at the
time their blood samples were taken. This study complied with the Declaration of Helsinki,
and the ethics review board of the Karolinska Institutet approved the study (diary number:
2010/1047-31/1).
We selected all participants aged 20 or older with baseline measurements of serum Pi,
calcium (mmol/L), alkaline phosphatase (mmol/L), glucose (mmol/L) and creatinine
(µmol/L) (n = 397,292). All participants were free from cancer at time of entry and none were
diagnosed with cancer or died within three months after study entry. Follow-up time was
defined as the time from measurement until date of cancer diagnosis, emigration, death, or
study closing date (31st
of December 2002), whichever occurred first. The CALAB database
also contained information on age, season at time of measurement, and fasting status.
Diagnosis of cancer were obtained from the National Cancer Register and classified based on
the International Classification of Diseases, seventh revision (ICD-7; codes for specific
cancer sites are presented in tables). Socioeconomic status (SES) was taken from the
consecutive Swedish censuses during 1970–1990 and is based on occupational groups and
classifies gainfully employed subjects into manual workers and non-manual employees,
below designated as blue-collar and white-collar workers [18]. History of hospitalization for
diabetes (ICD-7: 260) and lung disease (ICD-7: 470–527; mostly include upper and lower
5. respiratory tract infections and did not include asthma) was obtained from the National
Patient Register.
Serum inorganic phosphate was measured via formation of the phosphomolybdic acid
complex (coefficient of variation ≤4%) [19]. To assess the effect of small changes in serum
Pi levels, we calculated standardized values of Pi using its standard deviation (SD) as a unit.
Calcium and alkaline phosphatase were measured by colorimetric method [20,21], while
glucose was measured enzymatically with a glucose-oxidase/peroxidase method [22]. Serum
creatinine was measured with the Jaffé method (kinetic) [23]. All laboratory examinations
were performed using described methods above with automated and calibrated instruments in
the same laboratory [24].
Data analysis
Multivariate Cox proportional hazards models were used to investigate quartiles and
standardized values of serum Pi as a continuous variable in relation to overall incident cancer.
All models were adjusted for age, gender and SES. We also took into account serum glucose,
fasting status and history of diabetes based on hospital discharge diagnosis since diabetes is
known to modify the risk of cancer and Pi metabolism is abnormal in diabetic persons
[13,25]. The levels of Pi as well as other metabolic markers potentially related to cancer are
also altered in metabolic bone disease [26-28], so that additional adjustment for alkaline
phosphatase, a marker of bone turnover, was performed. Our database did not have
information regarding phosphate regulators, i.e. vitamin D, FGF23 and parathyroid hormone
(PTH) [2,29], but we used season at time of baseline measurement as a proxy for vitamin D
[30]. Kidney function is also a potential confounder as renal reabsorption of Pi is a major
component in maintaining physiological Pi levels, and kidney disease is a risk factor of
cancer [31,32]. Thus, serum creatinine was used in the multivariable models. Further
adjustment was done for history of lung disease as a proxy for smoking as the latter has been
strongly linked to an increased risk of respiratory tract infection [33] To assess reverse
causation [34], we performed a sensitivity analysis in which those with follow-up <3 years
were excluded (n = 10,360). Finally, we conducted sex-stratified analyses of Pi and risk of
specific cancer sites using quartiles and standardized values of Pi. All analyses were
conducted with Statistical Analysis Systems (SAS) release 9.1.3 (SAS Institute, Cary, NC).
Results
A total of 31,482 persons developed cancer during mean follow-of 12.75 years. Most
measurements were taken as part of health examinations done at company health check-ups,
so that the majority of the study population (84%) was gainfully employed (Table 1). The age
of the participants, serum glucose, alkaline phosphatase and creatinine were higher in the
population with cancer than those without cancer. Pi levels were slightly higher in the group
without cancer, while no marked difference in calcium levels was noted between the two
groups.
6. Table 1 Baseline characteristics of study population
N (%)
No Cancer (N=365,810) Cancer (N=31,482)
Age (years) - Mean (SD) 44.00 (14.00) 55.71 (11.93)
Sex
Male 193769 (52.97) 16903 (53.69)
Female 172041 (47.03) 14579 (46.31)
SES
White Collar 132733 (36.28) 12064 (38.32)
Blue Collar 174385 (47.67) 14009 (44.50)
Not gainfully employed or Missing 58692 (16.04) 5409 (17.18)
Fasting status
Fasting 208923 (57.11) 19547 (62.09)
Non-fasting 113613 (31.06) 8153 (25.90)
Missing 43274 (11.83) 3782 (12.01)
Follow-up time (years) - Mean (SD) 13.12 (3.89) 8.39 (4.68)
Pi1
(mmol/L) Mean (SD) 1.06 (0.17) 1.04 (0.16)
Calcium (mmol/L) Mean (SD) 2.39 (0.10) 2.39 (0.10)
Alkaline phosphatase (mmol/) Mean (SD) 2.64 (0.96) 2.78 (1.02)
Glucose (mmol/L) - Mean (SD) 4.97 (1.29) 5.19 (1.48)
Creatinine (µmol/L) - Mean (SD) 81.70 (15.22) 83.77 (16.76)
Season
Winter 93580 (25.58) 8328 (26.45)
Spring 99572 (27.22) 8747 (27.78)
Summer 55799 (15.25) 4601 (14.61)
Fall 116859 (31.95) 9806 (31.15)
History of diabetes (ICD-7 260) 1905 (0.52) 201 (0.64)
History of lung disease (ICD-7 470–527) 23709 (6.48) 1791 (5.69)
1
Pi inorganic phosphate.
ICD-7, International Classification of Diseases, seventh revision.
Multivariable Cox proportional hazards ratios for quartiles of Pi showed a lower risk of
overall cancer for those in the 3rd
and 4th
quartiles of Pi for both men and women. This
pattern of risk was also observed for women, but in men higher quartiles were associated with
an increased risk of cancer. When we excluded persons with follow-up <3 years, the positive
association between Pi quartiles and overall cancer risk for men weakened slightly (Table 2).
When using standardized Pi instead of quartiles, there was a negative association with risk of
overall cancer (HR per SD: 0.97 (95% CI: 0.96-0.99), P-value < 0.0001). Excluding the first
three years of follow-up did not change the results.
7. Table 2 Hazard ratios and 95% confidence intervals for the risk of overall cancer for
quartiles and standardized values of serum Pi levels
Overall cancer Overall cancer1
Hazard Ratio (95%CI) Hazard Ratio (95%CI)
Men and Women combined
Standardized Pi (SD = 0.17) 0.97 (0.96 – 0.99) 0.98 (0.96 – 0.99)
Quartiles of Pi (mmol/L)
< 0.95 1.00 (Ref) 1.00 (Ref)
0.95 – 1.05 0.98 (0.96 – 1.02) 1.00 (0.97 – 1.03)
1.05 – 1.16 0.94 (0.91 – 0.97) 0.95 (0.91 – 0.98)
≥ 1.16 0.94 (0.91 – 0.97) 0.95 (0.92 – 0.98)
P-value for trend < 0.0001 < 0.0001
Men2
Standardized Pi (SD = 0.17) 1.02 (1.00 – 1.04) 1.02 (1.00 – 1.04)
Quartiles of Pi (mmol/L)
< 0.92 1.00 (Ref) 1.00 (Ref)
0.92 – 1.03 1.06 (1.02 – 1.10) 1.05 (1.01 – 1.09)
1.03 – 1.14 1.04 (1.00 – 1.08) 1.03 (0.98 – 1.08)
≥ 1.14 1.07 (1.03 – 1.12) 1.06 (1.01 – 1.12)
P-value for trend 0.01 0.05
Women2
Standardized Pi (SD = 0.16) 0.97 (0.96 – 0.99) 0.97 (0.95 – 0.99)
Quartiles of Pi (mmol/L)
< 0.99 1.00 (Ref) 1.00 (Ref)
0.99 – 1.09 0.95 (0.91 – 0.99) 0.98 (0.93 – 1.04)
1.09 – 1.19 0.93 (0.89 – 0.97) 0.93 (0.89 – 0.99)
≥ 1.19 0.91 (0.87 – 0.96) 0.93 (0.88 – 0.98)
P-value for trend < 0.0001 0.001
All models were adjusted for age, sex, SES, fasting status, calcium, alkaline phosphatase, glucose, creatinine, season, history
of diabetes and lung diseases.
1
A sensitivity analysis excluding the first three years of follow-up (n = 386,683).
2
Not adjusted for sex.
When investigating the relation between quartiles of Pi and risk of different types of cancer in
men, we found a statistically significant increase in the risk of pancreatic, lung, thyroid,bone
and other cancer in those with higher Pi quartiles (Table 3). Additionally, a higher risk of
developing cancer of the liver and gallbladder was found in men in the highest Pi quartile
(HR: 1.38 (95% CI: 1.00-1.91) for the fourth quartile of Pi compared to the first). Using
standardized Pi, a positive association was also observed between increasing standardized Pi
and the risk of non-Hodgkin’s lymphoma in men, but no linear association was observed
using quartiles of Pi. However, there was an inverse association between Pi levels and risk of
endocrine cancer other than the thyroid gland, prostate, and testis (e.g. HR 0.87 (95% CI:
0.76-1.00) per SD increase of Pi, P-value < 0.0001), although the trend over the quartiles was
not linear. There was also a borderline inverse association between standardized Pi and risk
of colorectal cancer, but this was not confirmed by Pi quartiles. Excluding other endocrine
cancer resulted in a stronger association between Pi and overall cancer in men (e.g. HR: 1.10
(95% CI: 1.03-1.18) per SD increase in Pi, P-value 0.003, results not shown in tables).
8. Table 3 Hazard ratios and 95% confidence intervals for the risk of site-specific cancer
for quartiles of serum Pi in men
Cancer site (ICD-7) n cases Quartiles of Pi (mmol/L), HR (95% CI) P-value
for trend
Standardized Pi,
HR (95% CI)< 0.92 0.92 – 1.03 1.03 – 1.14 ≥ 1.14
Lip, oral cavity, pharynx (140–149) 135 1.00 (Ref) 1.12 (0.71 – 1.77) 1.15 (0.71 – 1.86) 1.28 (0.77 – 2.12) 0.31 1.10 (0.93 – 1.30)
Oesophagus (150) 196 1.00 (Ref) 1.23 (0.84 – 1.80) 1.26 (0.84 – 1.89) 1.43 (0.94 – 2.18) 0.17 1.12 (0.98 – 1.28)
Stomach (151) 400 1.00 (Ref) 1.10 (0.87 – 1.41) 0.80 (0.60 – 1.07) 1.07 (0.80 – 1.44) 0.49 0.98 (0.88 – 1.09)
Colorectal (153, 154) 1929 1.00 (Ref) 1.06 (0.94 – 1.18) 0.95 (0.84 – 1.08) 0.91 (0.79 – 1.05) 0.07 0.95 (0.91 – 1.00)
Liver, gallbladder (155) 319 1.00 (Ref) 1.15 (0.86 – 1.54) 1.07 (0.78 – 1.47) 1.38 (1.00 – 1.91) 0.14 1.09 (0.98 – 1.22)
Pancreas (157) 427 1.00 (Ref) 1.32 (1.03 – 1.71) 1.27 (0.97 – 1.68) 1.41 (1.05 – 1.88) 0.02 1.11 (1.02 – 1.22)
Larynx (161) 143 1.00 (Ref) 1.13 (0.72 – 1.77) 1.33 (0.84 – 2.10) 1.28 (0.78 – 2.10) 0.24 1.11 (0.95 – 1.29)
Lung (162) 1396 1.00 (Ref) 1.24 (1.07 – 1.42) 1.22 (1.05 – 1.42) 1.35 (1.15 – 1.58) 0.002 1.10 (1.04 – 1.15)
Prostate (177) 5075 1.00 (Ref) 1.01 (0.94 – 1.08) 1.02 (0.94 – 1.10) 0.98 (0.90 – 1.07) 0.72 0.98 (0.95 – 1.01)
Testis (178) 159 1.00 (Ref) 0.98 (0.60 – 1.58) 0.97 (0.60 – 1.57) 1.11 (0.70 – 1.75) 0.62 1.02 (0.88 – 1.19)
Kidney (180) 525 1.00 (Ref) 1.05 (0.84 – 1.32) 1.14 (0.90 – 1.44) 0.87 (0.66 – 1.15) 0.49 1.03 (0.94 – 1.13)
Bladder (181) 1181 1.00 (Ref) 0.99 (0.85 – 1.15) 1.04 (0.89 – 1.21) 1.02 (0.86 – 1.21) 0.76 1.02 (0.96 – 1.08)
Melanoma of skin (190) 765 1.00 (Ref) 1.02 (0.85 – 1.24) 1.08 (0.89 – 1.32) 1.01 (0.89 – 1.25) 0.66 1.01 (0.94 – 1.09)
Nonmelanoma of skin (191) 772 1.00 (Ref) 0.95 (0.80 – 1.14) 0.90 (0.74 – 1.10) 1.13 (0.91 – 1.39) 0.46 0.98 (0.91 – 1.06)
Brain/central nervous system (193) 527 1.00 (Ref) 1.03 (0.82 – 1.31) 1.08 (0.84 – 1.37) 1.06 (0.82 – 1.37) 0.74 1.01 (0.92 – 1.10)
Thyroid gland (194) 69 1.00 (Ref) 0.94 (0.45 – 1.98) 1.76 (0.90 – 3.43) 1.69 (0.85 – 3.38) 0.04 1.15 (0.93 – 1.41)
Other endocrine organ (195) 215 1.00 (Ref) 0.46 (0.31 – 0.66) 0.44 (0.29 – 0.65) 0.67 (0.47 – 0.96) 0.03 0.87 (0.76 – 1.00)
Bone (196) 1690 1.00 (Ref) 1.15 (1.02 – 1.31) 1.15 (1.01 – 1.32) 1.25 (1.08 – 1.10) 0.002 1.06 (1.01 – 1.11)
Soft tissues (197) 126 1.00 (Ref) 1.48 (0.93 – 2.37) 1.13 (0.67 – 1.92) 1.42 (0.83 – 2.42) 0.32 1.11 (0.95 – 1.30)
Non-Hodgkin’s lymphoma (200, 202) 613 1.00 (Ref) 1.24 (1.00 – 1.52) 1.06 (0.84 – 1.33) 1.22 (0.96 – 1.55) 0.25 1.08 (1.00 – 1.17)
Hodgkin’s lymphoma (201) 62 1.00 (Ref) 0.98 (0.82 – 1.18) 1.01 (0.99 – 1.02) 1.45 (0.95 – 2.22) 0.51 0.92 (0.71 – 1.20)
Multiple myeloma (203) 259 1.00 (Ref) 1.31 (0.96 – 1.77) 0.84 (0.57 – 1.21) 1.20 (0.83 – 1.74) 0.82 1.02 (0.90 – 1.16)
Leukemia (204–207) 398 1.00 (Ref) 0.88 (0.68 – 1.13) 0.79 (0.59 – 1.04) 0.85 (0.63 – 1.14) 0.12 0.98 (0.89 – 1.09)
Other cancer1
865 1.00 (Ref) 1.15 (0.96 – 1.38) 1.23 (1.02 – 1.49) 1.38 (1.13 – 1.68) 0.003 1.10 (1.03 – 1.18)
All models were adjusted for age, SES, fasting status, calcium, alkaline phosphatase, glucose, creatinine, season, history of
diabetes and lung diseases.
1
Other cancer than the separately presented sites.
ICD-7, International Classification of Diseases, seventh revision; ref, referent group.
In women, higher Pi quartiles were related with an increased risk of oesophageal, lung, and
nonmelanoma skin cancer (Table 4). The test for trend also showed a borderline positive
association with risk of laryngeal cancer, but the limited number of cases resulted in low
statistical power. Increased risks of stomach and bone cancer were also observed for women
in higher quartiles of Pi compared to the first. In contrast, an inverse association was
observed between Pi quartiles and risk of breast, endometrial and other endocrine cancers.
Furthermore, there was an increased risk of colorectal cancer risk with every SD increase in
Pi, although this was not confirmed with Pi quartiles. When cancer of the breast,
endometrium, and other endocrine organs were excluded from the analysis, the inverse
association between Pi and overall cancer risk in women disappeared (e.g. HR: 1.06 (95% CI:
0.98-1.15) for every SD increase in Pi, P-value 0.13, results not shown in tables).
9. Table 4 Hazard ratios and 95% confidence intervals for the risk of site-specific cancer
for quartiles of serum Pi in women
Cancer site (ICD-7) n cases Quartiles of Pi (mmol/L), HR (95% CI) P-value
for
trend
Standardized Pi, HR
(95% CI)< 0.99 0.99 – 1.09 1.09 – 1.19 ≥ 1.19
Lip, oral cavity, pharynx (140–149) 66 1.00 (Ref) 0.62 (0.30 – 1.29) 0.93 (0.48 – 1.81) 1.05 (0.55 – 2.00) 0.67 1.04 (0.80 – 1.35)
Oesophagus (150) 75 1.00 (Ref) 0.57 (0.25 – 1.30) 1.56 (0.81 – 2.99) 1.95 (1.04 – 3.67) 0.004 1.34 (1.10 – 1.65)
Stomach (151) 251 1.00 (Ref) 1.71 (1.18 – 2.47) 1.48 (1.01 – 2.18) 1.52 (1.03 – 2.25) 0.10 1.13 (0.98 – 1.29)
Colorectal (153, 154) 1410 1.00 (Ref) 1.06 (0.91 – 1.23) 1.04 (0.89 – 1.21) 1.11 (0.96 – 1.30) 0.22 1.06 (1.00 – 1.12)
Liver, gallbladder (155) 260 1.00 (Ref) 1.08 (0.75 – 1.55) 1.38 (0.97 – 1.95) 1.26 (0.88 – 1.81) 0.11 1.09 (0.95 – 1.25)
Pancreas (157) 335 1.00 (Ref) 1.08 (0.80 – 1.46) 0.93 (0.67 – 1.28) 1.24 (0.92 – 1.68) 0.28 1.04 (0.93 – 1.18)
Larynx (161) 16 1.00 (Ref) 2.86 (0.30 – 27.58) 7.31 (0.90 – 59.67) 5.72 (0.66 – 49.37) 0.05 1.36 (0.85 – 2.17)
Lung (162) 887 1.00 (Ref) 1.21 (0.98 – 1.48) 1.51 (1.24 – 1.84) 1.66 (1.37 – 2.02) < 0.0001 1.20 (1.12 – 1.29)
Breast (170) 4925 1.00 (Ref) 0.94 (0.87 – 1.01) 0.89 (0.82 – 0.96) 0.81 (0.75 – 0.88) < 0.0001 0.93 (0.90 – 0.96)
Cervix uteri (171) 318 1.00 (Ref) 1.12 (0.82 – 1.53) 1.09 (0.80 – 1.51) 1.12 (0.82 – 1.54) 0.52 1.03 (0.91 – 1.16)
Endometrium (172) 900 1.00 (Ref) 0.83 (0.70 – 0.99) 0.72 (0.60 – 0.87) 0.72 (0.60 – 0.87) 0.0002 0.84 (0.78 – 0.91)
Ovary (175) 637 1.00 (Ref) 1.00 (0.81 – 1.24) 0.97 (0.78 – 1.20) 0.90 (0.72 – 1.13) 0.31 0.98 (0.90 – 1.07)
Other parts of uterus (174, 176) 67 1.00 (Ref) 0.81 (0.39 – 1.71) 1.37 (0.71 – 2.67) 1.15 (0.58 – 2.29) 0.39 1.07 (0.83 – 1.38)
Kidney (180) 262 1.00 (Ref) 1.19 (0.85 – 1.68) 1.24 (0.88 – 1.75) 1.04 (0.72 – 1.49) 0.81 1.02 (0.89 – 1.16)
Bladder (181) 325 1.00 (Ref) 1.05 (0.77 – 1.43) 1.11 (0.82 – 1.52) 1.02 (0.74 – 1.40) 0.79 1.02 (0.91 – 1.16)
Melanoma of skin (190) 532 1.00 (Ref) 1.02 (0.80 – 1.29) 1.09 (0.86 – 1.39) 0.99 (0.77 – 1.27) 0.93 1.05 (0.95 – 1.15)
Nonmelanoma of skin (191) 442 1.00 (Ref) 1.47 (1.12 – 1.94) 1.33 (1.00 – 1.77) 1.53 (1.16 – 2.04) 0.01 1.12 (1.01 – 1.24)
Brain/central nervous system (193) 456 1.00 (Ref) 0.90 (0.70 – 1.17) 1.00 (0.78 – 1.30) 0.95 (0.73 – 1.24) 0.88 1.00 (0.90 – 1.11)
Thyroid gland (194) 121 1.00 (Ref) 0.77 (0.45 – 1.30) 1.14 (0.70 – 1.85) 0.99 (0.60 – 1.63) 0.65 1.06 (0.88 – 1.27)
Other endocrine organ (195) 407 1.00 (Ref) 0.33 (0.25 – 0.43) 0.15 (0.11 – 0.43) 0.19 (0.14 – 0.26) < 0.0001 0.45 (0.41 – 0.51)
Bone (196) 1080 1.00 (Ref) 1.21 (1.02 – 1.44) 1.20 (1.01 – 1.43) 1.19 (1.00 – 1.42) 0.06 1.08 (1.02 – 1.16)
Soft tissues (197) 93 1.00 (Ref) 0.84 (0.48 – 1.47) 0.79 (0.44 – 1.41) 1.02 (0.58 – 1.78) 0.96 1.02 (0.82 – 1.29)
Non-Hodgkin’s lymphoma (200, 202) 419 1.00 (Ref) 0.96 (0.74 – 1.24) 0.95 (0.72 – 1.24) 0.88 (0.67 – 1.16) 0.38 1.00 (0.90 – 1.11)
Hodgkin’s lymphoma (201) 39 1.00 (Ref) 1.23 (0.62 – 2.43) 1.38 (0.70 – 2.75) 0.63 (0.27 – 1.48) 0.94 1.18 (0.86 – 1.62)
Multiple myeloma (203) 140 1.00 (Ref) 1.31 (0.82 – 2.10) 1.26 (0.78 – 2.04) 1.14 (0.69 – 1.88) 0.70 1.02 (0.84 – 1.22)
Leukemia (204–207) 265 1.00 (Ref) 0.74 (0.51 – 1.06) 0.94 (0.67 – 1.32) 1.26 (0.91 – 1.74) 0.07 1.09 (0.95 – 1.24)
Other cancer1
720 1.00 (Ref) 1.14 (0.92 – 1.40) 1.05 (0.84 – 1.30) 1.20 (0.97 – 1.49) 0.17 1.08 (0.99 – 1.17)
All models were adjusted for age, SES, fasting status, calcium, alkaline phosphatase, glucose, creatinine, season, history of
diabetes and lung diseases.
1
Other cancer than the separately presented sites.
ICD-7, International Classification of Diseases, seventh revision; ref, referent group.
Discussion
This is the first study evaluating the association between Pi and risk of cancer in a
population-based observational setting. We found a positive association between serum Pi
and risk of overall cancer in men, but an inverse association for women using data from a
large prospective Swedish cohort study. Higher Pi quartiles in men was related to pancreatic,
lung, thyroid, bone and other cancers. In women, a positive trend was observed between Pi
quartiles and risk of oesophageal, lung, and nonmelanoma skin cancer, while a negative
association was seen in breast, endometrial, and other endocrine cancer.
The role of Pi in development of cancer has recently been suggested. Elevated levels of
serum Pi were found to enhance gene expression as well as protein translation regulating cell
proliferation in vitro [3,4]. Furthermore, a high phosphate diet has been reported to promote
colonic cell hyperplasia and hyperproliferation in mice, indicating a role of Pi in
carcinogenesis [35]. Elevated Pi has been suggested to promote development of cancer via
amplifying Akt signaling activities and enhancing cap-dependent translation, eventually
resulting in increased cell proliferation [6,36]. On the other hand, also mice treated with low
dietary phosphate have been shown to develop increased tumourigenesis and enhanced
activities of similar signaling pathways [37]. All these pre-clinical findings suggest that both
high and low Pi may influence carcinogenesis.
10. The present study demonstrated that lower Pi was related to an increased risk of overall
cancer in women, while higher Pi levels were linked to increased overall cancer risk in men.
These associations remained clear after excluding first three years of follow-up, thus no
reverse causation was indicated. Reverse causation between Pi and cancer is plausible since
low Pi levels may be caused by increased Pi excretion. The latter is often reported in cancer
patients and is suggested to occur through renal proximal tubular dysfunction due to
administration of cytotoxic drugs or cancer progression [38]. This was unlikely to be the case
in the current study.
In the current study, higher Pi levels were associated with an increased risk of male pancreas,
lung, thyroid and bone cancer and female oesophagus, lung, and nomelanoma skin cancer.
The consistent positive association between Pi levels and lung cancer corroborated prior
biological findings linking high dietary Pi to a significantly increased tumor formation in
mouse models of lung cancer [36]. Additionally, elevated serum Pi levels have also been
reported to enhance the growth and proliferation of nontumourigenic human bronchial
epithelial (NHBE) cells, and this process was linked to increased activation of PI3K/Akt as
well as Raf/MEK/ERK pathways which play an important role in carcinogenesis [4].
Nevertheless, when higher Pi doses were administered in similar experiments, a steep
decrease in cell growth was observed, indicating the existence of a Pi threshold beyond
normal range over which cytotoxicity occurs. Further investigation is necessary to define the
acceptable range of Pi levels to maintain physiologic control of cell growth and function.
The observed relation between Pi and nonmelanoma skin cancer in women is also in line with
previous experimental findings. In a study by Camalier and colleagues, female mouse models
of skin tumorigenesis treated with high dietary Pi showed a 50% increase of tumor formation
upon 7,12-dimethylbenz[a]anthracene/12-O-tetradecanolyphorbol-13-acetate (DMBA/TPA)
treatment compared to those treated with low Pi diet [5]. It was suggested that Pi affects the
formation of skin tumours partly through increased activation of N-ras and its downstream
targets [5]. For cancer of the brain/central nervous system, we observed no clear association
with Pi levels, despite the reported effects of Pi on brain growth in animal studies. Jin et al.
suggested that high dietary Pi reduces brain cell proliferation through suppression of cyclin
D1 and PCNA, two marker proteins related to cell cycle [12]. Nevertheless, the same authors
also reported increased apoptosis and related disruptions of cell cycle in normal brain cells of
mice treated with low dietary Pi [7]. Both low and high levels of Pi are thus likely to impede
normal proliferation of brain cells and may also play a role in carcinogenesis. However there
is lack of observational studies linking Pi and brain cancer. For colorectal cancer, results in
women corroborated the positive link with Pi as shown in experimental findings in mice, but
opposing results were found in men [35].
We found a clear inverse association between Pi levels with risks of female breast and
endometrial cancers as well as “other endocrine cancers”, which drove the inverse relation
with overall cancer risk in women. Breast and endometrial cancers are well-known to be
affected by hormonal factors, especially estrogen [39,40]. Increased levels of estrogen are
known to negatively regulate circulating Pi, both directly and via modulation of PTH levels
[41]. Therefore, it is possible that the inverse association between Pi levels and gynecological
cancer risk in women reflects the underlying estrogen levels. Correspondingly, it is suggested
that hormonal and metabolic factors regulating Pi, i.e. vitamin D, FGF-23 and PTH, are
related to cancer incidence [42-44], and thus their abnormal levels may be responsible for the
association between Pi and cancer risks. Finally, the klotho gene encoding the obligate co-
11. receptor for FGF-23 is also a putative tumour suppressor gene [45], further implying the link
between Pi regulation and carcinogenesis.
The major strength of this study is the large number of subjects with baseline measurements
of serum Pi, all measured in the same laboratory. The use of national registers provided
detailed follow-up information on diagnosis of cancer, time of death, and emigration for all
subjects. The AMORIS population was mainly selected based on the availability of blood
samples from health check-ups in non-hospitalized individuals. However, this healthy cohort
effect would not affect the internal validity of the current study and is likely to be minor since
it has been shown that the AMORIS cohort is similar to the general working population of
Stockholm County in terms of SES and ethnicity [46]. A limitation of this study is that there
was no available data on dietary Pi intake or Pi regulators such as FGF23, PTH, and vitamin
D [29]. There was no information on other possible confounders such as smoking status and
alcohol consumption. History of lung disease was used as a proxy for smoking, however
some confounding effect of smoking may remain. For the current study we did not have
repeated measurements of phosphate to assess its fluctuations over time. Nonetheless, as
alteration in phosphate levels is likely to occur in specific conditions, i.e. kidney disease,
ricketts and diabetes, we adjusted the models for these diseases using serum creatinine,
alkaline phosphatase, glucose and history of diabetes in order to more accurately reflect
phosphate levels. Furthermore, a single measurement of phosphate has been used in many
published studies to measure the relation between phosphate metabolism and other diseases
[47,48]
Conclusion
Our findings provide novel epidemiological evidence revealing a decreased cancer risk in
women with high Pi and increased risk in men with high Pi. However, women with high Pi
displayed a higher risk for developing some specific cancers including oesophageal, lung, and
nonmelanoma skin cancer. The persistent negative link between Pi levels and the risk of
breast, endometrial and other endocrine cancers which drove the inverse relation between Pi
and overall cancer risk in women may imply that Pi rather serves as a proxy for underlying
hormonal or metabolic factors instigating carcinogenesis. Further studies in this field should
take into account these hormonal and metabolic factors involved in Pi metabolism and also
the role of dietary Pi, while also addressing the impacts of other cancer-related effect
modifiers beyond the coverage of the current study.
Competing interest
None declared. Niklas Hammar is employed by the AstraZeneca Sverige, Södertalje, Sweden
and the views of the present study are his own and not necessarily any official views of the
AstraZeneca Sverige.
Authors’ contributions
WW designed the study, analyzed the data, interpreted analysis results, and wrote the paper.
KM interpreted analysis results and edited the manuscript. HG NH IJ GW LH contributed to
the analysis tools and database used in this study and edited the manuscript. MVH conceived
12. and designed the study, interpreted analysis results, and edited the manuscript. All authors
read and approved the final manuscript.
Acknowledgements
This research was also supported by the Experimental Cancer Medicine Centre at King's
College London and also by the National Institute for Health Research (NIHR) Biomedical
Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College
London. The views expressed are those of the author(s) and not necessarily those of the NHS,
the NIHR or the Department of Health.
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