• Title/Summary/Keyword: Risk Adjustment

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Association between the TP53BP1 rs2602141 A/C Polymorphism and Cancer Risk: A Systematic Review and Meta-Analysis

  • Liu, Lei;Zhang, Dong;Jiao, Jing-Hua;Wang, Yu;Wu, Jing-Yang;Huang, De-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2917-2922
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    • 2014
  • Background: The p53-binding protein 1 (TP53BP1) gene may be involved in the development of cancer through disrupting DNA repair. However, investigation of associations between TP53BP1 rs2602141 A/C polymorphism and cancer have yielded contradictory and inconclusive outcomes. We therefore performed a meta-analysis to evaluate the association between the TP53BP1 rs2602141 A/C polymorphism and cancer susceptibility. Materials and Methods: Published literature from PubMed, Medline, the Cochrane Library, EMbase, Web of Science, Google (scholar), CBMDisc, Chongqing VIP database, and CNKI database were retrieved. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed or random-effects models. Publication bias was estimated using funnel plots, Begg's and Egger's test. Results: A total of seven studies (3,018 cases and 5,548 controls) were included in the meta-analysis. Our results showed that the genotype distribution of TP53BP1 rs2602141 A/C was not associated with cancer risk overall. However, on subgroup analysis, we found that TP53BP1 rs2602141 A/C was associated with cancer risk within an allele model (A vs C, OR=1.14, 95%CI: 1.01-1.29) and a codominant model (AA vs CC, OR=1.36, 95%CI: 1.06-1.74) in Asians rather than in Caucasians. Subgroup analysis by cancer type, genotype, and with or without adjustment for controls showed no significant association. Conclusions: The findings suggested an association between rs2602141 A/C polymorphism in TP53BP1 gene and increased risk of cancer in Asians.

Regional disparities in the associations of cardiometabolic risk factors and healthy dietary factors in Korean adults

  • Ha, Kyungho;Song, YoonJu;Kim, Hye-Kyeong
    • Nutrition Research and Practice
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    • v.14 no.5
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    • pp.519-531
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    • 2020
  • BACKGROUND/OBJECTIVES: Regional disparities in dietary factors might be related to regional disparities in cardiometabolic health. Therefore, this study investigated the associations of cardiometabolic risk factors and dietary factors with regional types in Korean adults. SUBJECTS/METHODS: Based on data from the 2007-2017 Korea National Health and Nutrition Examination Survey, the study included 39,781 adults aged ≥ 19 years who completed the dietary survey and a health examination. Healthy and unhealthy dietary factors (fat, sodium, fruit, and vegetable intakes) were evaluated using 1-day 24-h dietary recall method, as well as the use of nutrition labels with a questionnaire. RESULTS: Of the participants, 48.7%, 36.0%, and 15.2% lived in metropolitan, urban, and rural areas, respectively. Adults living in urban and rural had higher odds ratios (ORs) for obesity (OR for urban, 1.07; 95% confidence interval (CI), 1.01-1.14; OR for rural, 1.14; 95% CI, 1.05-1.24) than adults living in metropolitan areas; these associations were significantly observed in middle-aged adults. Compared to metropolitan residents, rural residents had lower ORs for hypertension in middle-aged (OR, 0.86; 95% CI, 0.76-0.96) and metabolic syndrome in older adults (OR, 0.78; 95% CI, 0.67-0.91). Regarding urban residents, a lower OR for diabetes in middle-aged adults (OR, 0.85; 95% CI, 0.74-0.97) and a higher OR for hypertension in older adults (OR, 1.19; 95% CI, 1.02-1.39) were observed. Overall rural residents had higher ORs of excessive carbohydrate, low fruit, and high salted-vegetable intakes than metropolitan residents. Low fruit intake was positively associated with obesity, metabolic syndrome, and hypertension, after adjustment for regional type and other confounders in total participants. CONCLUSIONS: These findings indicate that cardiometabolic risk and unhealthy dietary factors differ among regional types and age groups within Korea. Nutritional policy and interventions should consider regional types for prevention and management of cardiometabolic risk factors.

Electromagnetic Field Exposure and Male Breast Cancer Risk: A Meta-analysis of 18 Studies

  • Sun, Jing-Wen;Li, Xiao-Rong;Gao, Hong-Yu;Yin, Jie-Yun;Qin, Qin;Nie, Shao-Fa;Wei, Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.523-528
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    • 2013
  • Background: The possibility that electromagnetic fields (EMF) exposure may increase male breast cancer risk has been discussed for a long time. However, arguments have been presented that studies limited by poor quality could have led to statistically significant results by chance or bias. Moreover, data fo the last 10 years have not been systematically summarized. Methods and Results: To confirm any possible association, a meta-analysis was performed by a systematic search strategy. Totals of 7 case-control and 11 cohort studies was identified and pooled ORs with 95% CIs were used as the principal outcome measures. Data from these studies were extracted with a standard meta-analysis procedure and grouped in relation to study design, cut-off point, exposure assessment method, adjustment and exposure model. A statistical significant increased risk of male breast cancer with EMF exposure was defined (pooled ORs = 1.32, 95% CI = 1.14-1.52, P < 0.001), and subgroup analyses also showed similar results. Conclusions: This meta-analysis suggests that EMF exposure may be associated with the increase risk of male breast cancer despite the arguments raised.

Severe periodontitis with tooth loss as a modifiable risk factor for the development of Alzheimer, vascular, and mixed dementia: National Health Insurance Service-National Health Screening Retrospective Cohort 2002-2015

  • Kim, Do-Hyung;Jeong, Seong-Nyum;Lee, Jae-Hong
    • Journal of Periodontal and Implant Science
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    • v.50 no.5
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    • pp.303-312
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    • 2020
  • Purpose: The purpose of this study was to evaluate severe periodontitis with tooth loss as a modifiable risk factor for Alzheimer dementia (AD), vascular dementia (VaD), and mixed dementia (MD) using the National Health Insurance Service-National Health Screening Retrospective Cohort database with long-term follow-up over 14 years. Methods: Multivariate Cox hazards regression analysis was applied to a longitudinal retrospective database, which was updated in 2018, to evaluate the association between severe periodontitis with few remaining teeth and dementia after adjusting for potential risk factors, including sociodemographic factors and comorbid diseases. Results: Among 514,866 individuals in South Korea, 237,940 (46.2%) participants satisfying the inclusion criteria were selected. A total of 10,115 age- and sex-matched participants with severe periodontitis and 10,115 periodontally healthy participants were randomly selected and evenly assigned. The results showed that the risks of AD (hazard ratio [HR], 1.08), VaD (HR, 1.24), and MD (HR, 1.16) were significantly higher in patients with severe periodontitis with 1-9 remaining teeth after adjustment for sociodemographic factors, anthropomorphic measurements, lifestyle factors, and comorbidities. Conclusions: Severe periodontitis with few remaining teeth (1-9) may be considered a modifiable risk factor for the development of AD, VaD, and MD in Korean adults.

The Trend of Risk-adjusted Hospital Mortality Rates of Coronary Artery Bypass Graft Patients from 2001 to 2003 (위험도가 보정된 의료기관 관상동맥우회로술 사망률의 3년간(2001년-2003년) 추세분석)

  • Lee, Kwang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.1
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    • pp.29-35
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    • 2007
  • Objectives : To assess whether the risk-adjusted in-hospital mortality rates for non-emergent and isolated coronary artery bypass graft surgery (CABG) patients exhibited a consistent trend from 2001 to 2003. Methods : The data used in this study came from CABG claims that were submitted to a Korean Health Insurance Review Agency (HIRA) in 2001, 2002, and 2003. Study datasets included data from 17 tertiary hospitals, which had at least 25 claims each year over 3 years. The inter-hospital differences in patients' risk-factors were identified and controlled in the risk-adjustment model. Actual and predicted mortality rates for each hospital were calculated in 2001, 2002, 2003, and 2001+2002, and were then examined to identify consistent rate patterns over time. Kappa analysis was applied to assess the agreements between rates. Results : Hospitals with lower-than-expected inpatient mortality rates showed more consistent rates than those with higher-than-expected mortality rates. The mortality rates that were calculated based on data obtained over multiple years had less variation among hospitals than rates based on single year data. Based on the Kappa score, the highest agreement was found when the rates were compared between the 2-year combined data (2001+2002) and 2003. Conclusions : Consistent patterns over 3 years were most evident for hospitals which had lower-than expected mortality rates. Policy makers can use this information to identify the degree of outcomes in hospitals and help motivate or channel the behaviors of providers.

Dietary Phytochemical Index and the Risk of Breast Cancer: A Case Control Study in a Population of Iranian Women

  • Bahadoran, Zahra;Karimi, Zeinab;Houshiar-Rad, Anahita;Mirzayi, Hamid-Reza;Rashidkhani, Bahram
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2747-2751
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    • 2013
  • In this study we assessed the dietary phytochemical index in relation to the risk of breast cancer in women. This case-control study was conducted on 100 incident breast cancer cases and 175 healthy controls. Data regarding socio-demographic factors, medical history, medications, and anthropometric measurements were collected. Dietary data were obtained using a validated food frequency questionnaire and a energy-adjusted dietary phytochemical index (PI) was calculated. The odds ratios of breast cancer were assessed across energyadjusted PI quartile categories. The mean age of participants was $46.2{\pm}8.9$ and $45.9{\pm}9.4$ years in cases and controls, respectively. The mean PI across quartile categories was $13.9{\pm}2.6$, $21.1{\pm}1.8$, $26.7{\pm}2.1$, $41.6{\pm}10.2$ in the first, second, third and fourth quartiles, respectively. After adjustment for all potential confounders, the risk of breast cancer in the forth quartile of dietary PI was significantly decreased (OR=0.08, 95%CI=0.01-0.84). Higher intake of phytochemical-rich foods is associated with lower risk of breast cancer.

Association between Dietary Acid Load and Insulin Resistance: Tehran Lipid and Glucose Study

  • Moghadam, Sajjad Khalili;Bahadoran, Zahra;Mirmiran, Parvin;Tohidi, Maryam;Azizi, Fereidoun
    • Preventive Nutrition and Food Science
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    • v.21 no.2
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    • pp.104-109
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    • 2016
  • In the current study, we investigated the longitudinal association between dietary acid load and the risk of insulin resistance (IR) in the Tehranian adult population. This longitudinal study was conducted on 925 participants, aged 22~80 years old, in the framework of the third (2006~2008) and fourth (2009~2011) phases of the Tehran Lipid and Glucose Study. At baseline, the dietary intake of subjects was assessed using a validated semi-quantitative food frequency questionnaire, and the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated at baseline. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up; IR was defined according to optimal cut-off values. Multiple logistic regression models were used to estimate the risk of IR according to the PRAL and NEAP quartile categories. Mean age and body mass index of the participants were 40.3 years old of $26.4kg/m^2$, respectively. Mean PRAL and NEAP scores were -11.2 and 35.6 mEq/d, respectively. After adjustment for potential confounders, compared to the lowest quartile of PRAL and NEAP, the highest quartile was accompanied with increased risk of IR [odds ratio (OR)=2.81, 95% confidence interval (CI)=1.32~5.97 and OR=2.18, 95% CI=1.03~4.61, respectively]. Our findings suggest that higher acidic dietary acid-base load, defined by higher PRAL and NEAP scores, may be a risk factor for the development of IR and related metabolic disorders.

Role of Information and Communication Technology and Women's Empowerment in Contraceptive Discontinuation in Indonesia

  • Samosir, Omas Bulan;Kiting, Ayke Soraya;Aninditya, Flora
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.2
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    • pp.117-125
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    • 2020
  • Objectives: This study investigated the role of information and communication technology and women's empowerment in contraceptive discontinuation in Indonesia. Methods: The study used data from the 2017 Indonesia Demographic and Health Survey and monthly contraceptive calendar data. A Gompertz proportional hazards model was used for analysis. Results: The 12-month contraceptive discontinuation rate was higher among women who had used the Internet in the past year, women who were mobile phone owners, and women who reported having fully participated in household decision-making than among their counterparts. These factors significantly impacted the risk of contraceptive discontinuation in Indonesia, even after controlling for contraceptive method, age, parity, contraceptive intent, education, work status, place of residence, and wealth status. Conclusions: After adjustment for the control variables, a higher risk of contraceptive discontinuation was associated with having used the Internet in the past year, owning a mobile phone, and not participating in household decision-making. Higher contraceptive discontinuation risk was also associated with using contraceptive pills, older age, lower parity, intent of spacing births, more education, current unemployment, and rural residence, and the risk was also significantly higher for those in the lowest household wealth quintile than for those in the fourth household wealth quintile. The association of contraceptive discontinuation with the use of modern information and communication technology and relatively disempowerment in household decision-making may imply that information regarding family planning and contraception should be conveyed via social media as part of setting up an eHealth system. This must include a strong communication strategy to empower and educate women in contraceptive decision-making.

Prostatectomy Provides Better Symptom-Free Survival Than Radiotherapy Among Patients With High-Risk or Locally Advanced Prostate Cancer After Neoadjuvant Hormonal Therapy

  • Kim, Sung Han;Song, Mi Kyung;Park, Weon Seo;Joung, Jae Young;Seo, Ho Kyung;Chung, Jinsoo;Lee, Kang Hyun
    • The Korean Journal of Urological Oncology
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    • v.16 no.3
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    • pp.126-134
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    • 2018
  • Purpose: The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT). Materials and Methods: This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003-2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test. Results: Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p<0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p>0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013). Conclusions: Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.

Urinary Incontinences Are Related with Fall and Fragility Fractures in Elderly Population: Nationwide Cohort Study

  • Kim, Hye-Jin;Kim, Jin-Woo;Jang, Soong-Nang;Kim, Kyung Do;Yoo, Jun-Il;Ha, Yong-Chan
    • Journal of Bone Metabolism
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    • v.25 no.4
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    • pp.267-274
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    • 2018
  • Background: This prospective cohort study used nationwide claims data to investigate the incidence of fall and fragility fractures in association with urinary incontinence (UI) in the elderly, and to compare mortality after fragility fractures in elderly patients with or without incontinence. Methods: A total of 39,854 Korean adults (age, 66-80 years) who participated in health examinations between 2007 and 2012 and were followed up until 2015 were analyzed. Patient and comparison groups were classified according to the presence or absence of UI. The cumulative incidence of osteoporotic fragility fractures and falls in the 2 groups was assessed and compared. Hazard ratios for fragility fractures were calculated for the risk of UI in association with falls using a Cox proportional hazards model. Results: Of 39,854 elderly participants, 5,703 were classified in the UI group, while 34,151 were placed in the comparison group. Fall rates were significantly higher (20.8%) in the incontinence group than in the comparison group (4.7%) (P<0.001). Women in the incontinence group (13.9%) showed a significantly higher incidence of all types of fragility fractures than those in the comparison group (11.8%) (P=0.005). After adjustment for confounders, UI was not a significant risk factor for fragility fractures in men (P=0.878) or women (P=0.324). Conclusions: This study demonstrated that elderly women with UI have a significantly higher incidence of osteoporotic fragility fractures. In addition, elderly women are at higher risk for falls.