Objective To investigate the association between physical activity volume and medical care cost in elderly persons aged 70 years and over in Crane Valley, Sendal, Japan. Methods A total of 494 community-dwelling Japanese elderly persons living in residential area of Sendai City in northern Japan completed a self-administered questionnaire that included questions on physical activity. We ascertained total medical care costs through computerized linkage with claims lodged between November 2002 and December 2004 from the Miyagi National Health Insurance Association.Results After multivariate adjustment for potential confounders, the average monthly medical costs of hospitalization, hospital days, outpatient medical expenses, out-patient numbers and the total medical expenses in grade Ⅰ exercise volume group were (196.7±72.1) U.S. dollars, (0. 7±0.3) d, (308. 7±54.4) U.S. dollars, (6.2±1.1) times and (506. 95±94. 2) U.S. dollars; in grade Ⅱ exercise volume group were (139. 8±72.1) U.S. dollars, (0.5±0. 3) d, (295.3±54.6) U.S.dollars, (6.1±1.1) times and (437.8±94.5) U.S. dollars; in grade Ⅲ exercise volume group were (134.1±72.5) U.S. dollars, (0.4±0.3) d, (278.8±54.9) U.S. dollars, (5.8±1.1) times and (418. 1±95.0) U.S. dollars. With the increase in physical activity, there were significant differences between the medical costs of hospitalization and total medical expenses (F=5.85 and 8.11, both P=0.01). Conclusions This prospective study indicates that a higher volume of physical activity is associated with lower medical care costs among Japanese elderly persons.

Objective To evaluate whether serum complement C3 concentration was associated with the prevalence and incidence of prediabetes in an adult population. Methods A cross-sectional (n=10 539) and prospective cohort (n=3 064, followed up for-6 years, mean:2.8 y) study was performed on subjects recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin. Measurements of serum C3 concentration, blood fasting glucose and other potential confounding factors were assessed at baseline and per year during the follow-up period. Prediabetes was defined according to the criteria of American Diabetes Association. Adjusted Logistic and Cox proportional hazards regression models were used to assess the associations between C3 quintiles and prediabetes. Results The prevalence and incidence of prediabetes were 19.9% and 99.5 per 1 000 person-year, respectively. In cross-sectional analysis, after adjusted for potential confounders, the odds ratios (95% confidence interval) of prediabetes for increasing quintiles of C3 were 1.00 (reference), 1.18 (0.98-1.42), 1.11 (0.92-1.34), 1.38 (1.15-1.65) and 1.63 (1.36-1.95) (P for trend<0.000 1). In cohort analysis, in the final multivariate models, the hazard ratios (95% confidence interval) for prediabetes across C3 quintiles were 1.00 (reference), 1.20 (0.94-1.54), 1.48 (1.16-1.88), 1.38 (1.09-1.76) and 1.53 (1.21-1.95) (P for trend <0.001), respectively. Conclusion The study suggests that the elevated C3 level is significantly associated with the prevalence and incidence of prediabetes, which means that C3 can be used as a biomarker in early prevention of prediabetes and diabetes.

Objective To explore the association between complement C3 and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Methods A total of 2 799 health check-up participants were recruited from Tianjin Medical University General Hospital-Health Management Centre. Serum C3 levels were measured using immunoturbidimetry method and simple fatty liver disease and nonalcoholic steatohepatitis were diagnosed by liver ultrasonography and serum alanine aminotransferase concentration. Multiple logistic regression analysis was used to examine the association between quartiles of serum C3 levels and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Results After adjusting for covariates, the odds ratios (95% confidence interval) of simple fatty liver disease and nonalcoholic steatohepatitis for increasing quartiles of C3 were: 1.00 (reference), 2.15 (1.55, 3.01), 3.28 (2.35, 4.6) and 4.31 (3.11, 6.02); and 1.00 (reference), 4.54 (1.68, 15.91), 7.81 (3.02, 26.67) and 14.91 (5.94, 50.14) (both P for trend<0.000 1), respectively. Conclusions The study found that the elevated C3 levels were significantly associated with the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Further study is needed to clarify whether C3 has a predictive value for the occurrence of nonalcoholic fatty liver disease.

Objective The aim of this study was to investigate the relationship between serum C-reactive protein (CRP) and muscle strength, physical performance in the elderly. Methods A cross-sectional study was conducted in Hangu district of Tianjin from April to June in 2013. Totally 1 131 subjects aged 60 years or older completed the survey. Every subject filled out a standard questionnaire and underwent grip strength test, timed up and go test (TUGT). Serum CRP concentrations were determined using chemiluminescent immunoassay kits. Multivariate analysis was performed to determine the relationship between CRP and muscle strength, physical performance. Results After adjustment for potential confounding factors including age, BMI, smoking status, drinking status, hypertension, diabetes, cardiovascular disease, anemia, cancer and physical activity, the multiple linear regression analysis suggested that CRP levels were inversely related to handgrip strength (β'=-0.11, P<0.01), and the logistic regression analysis showed that compared with subjects in the lowest quintile, the odds ratios and 95%confidence interval of higher quintile of CRP were 1.09 (0.50, 2.39) and 2.70 (1.34, 5.66) (Ptrend<0.05) in males. However, the relationship between CRP and muscle strength, physical performance was not statistically significant in females. Conclusions In males, higher serum CRP levels were independently correlated with lower muscle strength and poor physical performance in older adults. These results suggested that inflammation-signaling pathways may play an important role in the progression of sarcopenia.

Objective To explore the association between the infection rate of Helicobacter pylori (Hp) and intake frequency of capsicum in dietary pattern. Methods A total of 914 health check-up participants were recruited from Tianjin Medical University General Hospital (male: 510,female:404). All participants were asked about the intake frequency of capsicum. Diagnostic criteria of the Hp infection included positive C13 breath test. Results The intake frequency of capsicum was ≥2 times/week, 1 time/week and <1 time/week. The infection rate of Hp was 56.08%, 49.04% and 48.29%. After adjusting for covariates, compared with the≥2 times/week, the odds ratios(95%confidence interval)of intake frequency of capsicum 1 time/week and <1 time/week: the frequency of capsicum intake ≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 0.57(0.33-0.97) and the frequency of capsicum intake<1 time/week was 0.69(0.42-1.14) in men;the frequency of capsicum intake≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 1.01(0.54-1.88), and the frequency of capsicum intake<1 time/week was 0.71(0.41-1.23) in women. Conclusions This study found that food intake frequency of capsicum≥2 times/week was associated with the infection rate of Hp in men. But similar relationship was not observed in women.

@@

Objective To understand the relationship between dietary patterns and breast cancer and to provide a possible scientific basis for breast cancer prevention,we performed a meta-analysis in order to evaluate the current relevant literature.Method Meta-analysis was used to pool the effect of vegetable,fruit,fish and soybean dietary patterns on the risk of breast cancer.The breast cancer risk of the highest categories compared to the lowest categories of such dietary patterns was combined using fixed effect model.Searching the database (Chinese databases included CQVIP,WANFANG medicine online,CNKI and SinoMED,and English databases included PubMed,Embase,Cochrane database,Medline and Google Scholar) for articles published between January 1997 and June 2014.All statistical analyses were performed using the Stata 11.0.Result Twelve cohort studies involving 623 536 participants and 19 707 patients with brcast cancer were found to be eligible.Our results indicate that a reasonably healthy dietary pattern (which is characterized by a high consumption of vegetables,fruit,fish and soybean) is beneficial for the prevention of breast cancer.Compared to the lowest categories of such dietary patterns,relative risk (RR) of the highest categories is 0.86 (95％ CI 0.80-0.92).Conclusion A reasonably healthy dietary pattern (which is characterized by a high consumption of vegetables,fruit,fish and soybean) is beneficial for the prevention of breast cancer.

Objective Neutrophil/lymphocyte ratio (NLR) is an easy-to-analyze inflammation biomarker but few studies have assessed the relationship between NLR and type 2 diabetes. In order to evaluate how NLR is related to type 2 diabetes, we designed a large scale cross?sectional study in an adult population. Method A cross?sectional study (including 49 861 men and 40 376 women) was conducted on participants recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin, China. Measurements of neutrophil and lymphocyte counts, fasting blood glucose and other potential confounding factors were performed. Type 2 diabetes was defined according to the criteria of American Diabetes Association. Adjusted logistic regression models were used to assess relationships between NLR quintiles and type 2 diabetes. Result In the final multivariate models, the odds ratios (95% confidence interval) for T2D across NLR quintiles were 1.00 (Reference), 1.19 (1.05, 1.35), 1.33 (1.17, 1.50), 1.28 (1.13, 1.44) and 1.34 (1.19, 1.51) (P for trend<0.000 1), in men. Similar relationships were also observed in women. Conclusion This study demonstrated that NLR was related to the prevalence of type 2 diabetes in men and women, and suggesting that NLR may be an efficient and accurate prognostic biomarker for type 2 diabetes.

Objective To evaluate whether the serum uric acid (SUA) levels are related to development of prediabetes. Methods This was a 6-year cohort study, subjects were recruited from Tianjin Medical University General Hospital Health Management Center. A prospective assessment (n=30 910) was performed. Subjects without a history of prediabetes were followed up for 6 years (with a median follow-up of 2.7 person-years). All relevant variables including SUA concentrations, and fasting plasma glucose were assessed at baseline and yearly during the follow-up. Prediabetes was defined in accordance with the American Diabetes Association criteria of 2014. Multivariate-adjusted Cox proportional hazards regression models were fitted to assess relationships between the quintiles of baseline SUA and the incidence of prediabetes. Results The incidence of prediabetes was 55 per 1 000 person-years. In comparison with subjects in the lowest quintile, the odds ratios and hazard ratio (95%confidence interval) of higher quintile of SUA were 1.04 (0.93, 1.15), 1.07 (0.95, 1.19), 1.13 (1.01, 1.28) and 1.15 (1.02, 1.30) (P for trend=0.01), respectively, after adjusting for potential confounders. Conclusion SUA levels predicted an increased risk of prediabetes in adults.

Objective To investigate the relationships between different dietary patterns and serum uric acid in Tianjin residents. Method By cross-sectional study design, 11282 subjects were studied via lifestyle questionnaires (including a valid food frequency questionnaire), physical examination and laboratory tests. Using factor analysis method to establish the dietary patterns, and relationships between different dietary patterns and serum uric acid were analyzed. Results Factor analysis showed 3 kinds of dietary patterns, including eastern dietary pattern, vegetable diets and Tianjin dietary pattern. There were more males in hyperuricemic population, who have a higher BMI, waist circumference, blood lipids, blood pressure and blood sugar levels, and also higher proportion of metabolic syndrome, smokers and alcohol drinkers. In addition, hyperuricemia patients had a higher level of social status and income. After adjustments for age, sex, BMI, smoking habits, alcohol consumption, hypertension, hyperlipidemia, education level, occupational status, energy intake, physical activity and metabolic syndrome, logistic regression analysis showed the odds ratio (95%confidence interval) for hyperuricemia across the quartiles of 3 dietary patterns as follows: 1.00, 1.07 (0.91, 1.25), 0.96 (0.82, 1.14), 1.12 (0.94, 1.33);1.00, 1.03 (0.88, 1.21), 1.04 (0.88, 1.23), 1.00 (0.84, 1.19); 1.00, 1.28 (1.08, 1.52), 1.40 (1.22, 1.71), 1.37 (1.15, 1.63), respectively. Significantly positive correlation was shown between Tianjin dietary pattern and hyperuricemia. Conclusion Tianjin residents' Tianjin dietary pattern is closely related to serum uric acid levels. Tianjin dietary patterns have characteristics of high calorie, high fat, high protein. Healthy eating habits have significant importance to prevent occurrence of hyperuricemia.