Tsai-Chung Li

Introduction: This study investigated whether smoking, alcohol consumption, and physical inactivity mediate the associations between sex and Traditional Chinese Medicine body constitutions. Methods: We analyzed data from 35,456 adults aged >18 years enrolled in the Taiwan Biobank. Body constitutions (yang deficiency, yin deficiency, and phlegm-stasis) were assessed using the Body Constitution Questionnaire (BCQ). The BCQ consists of 44 items. Each item is rated on a five-point Likert scale ranging from 1 (“never”) to 5 (“always”), with higher scores indicating a greater tendency toward the corresponding body constitution. Lifestyle behaviors included smoking, alcohol consumption, and leisure-time physical inactivity. Multivariable logistic regression and mediation analyses were performed. Results: Female sex was independently associated with increased odds of yang deficiency [odds ratio (OR) = 2.52, 95% confidence interval (CI): 2.34–2.71], yin deficiency (OR = 2.09, 95% CI: 1.95–2.25), and phlegm-stasis (OR = 3.03, 95% CI: 2.79–3.30). Smoking showed significant negative indirect association, whereas alcohol consumption exhibited minimal mediation. Physical inactivity statistically accounted for approximately 6% of the observed associations between female sex and all three body constitution patterns. Discussion: Women were more likely than men to exhibit yang deficiency, yin deficiency, and phlegm-stasis constitutions. Lifestyle behaviors explained only a small proportion of these sex differences. Given the cross-sectional design, these findings should be interpreted as statistical associations rather than evidence of causal mediation.

This study aims to assess the associations between lifestyle behaviors – including smoking, alcohol consumption, tea consumption, and leisure-time physical activity – and traditional Chinese Medicine (TCM) body constitutions (BCs), Yin deficiency, Yang deficiency, and phlegm stasis, among Taiwanese adults participating in the Taiwan Biobank Study. A total of 15,665 participants from the Taiwan Biobank Study were included in the analysis. Comprehensive data were collected on lifestyle behaviors (including smoking, alcohol consumption, tea consumption, and leisure-time physical activity) and family medical history. TCM BC types – Yin deficiency, Yang deficiency, and phlegm stasis – were assessed using a well-validated BC questionnaire. Associations between lifestyle behaviors and BC types were examined using multivariate logistic regression models to estimate odds ratios (ORs). The average age was 46.55 years (standard deviation: 12.17), with 5611 males (35.82%). Compared with nonsmokers, current smokers had a significantly higher likelihood of having Yang deficiency (OR [95% confidence interval (CI)]: 1.62 [1.39–1.89]), Yin deficiency (1.64 [1.41–1.90]), and phlegm stasis (1.88 [1.59–2.22]) after multivariate adjustment. Compared with nondrinkers, current drinkers had a significantly higher likelihood of having Yin deficiency (1.21 [1.02–1.44]) and phlegm stasis (1.27 [1.04–1.56]) after multivariate adjustment. Tea consumption was significantly associated with phlegm stasis (1.18 [1.08–1.29]). Regarding leisure-time physical activity, this habit was negatively associated with Yang deficiency, Yin deficiency, and phlegm stasis with multivariate adjustment (0.71 [0.65–0.78], 0.74 [0.68–0.81], and 0.63 [0.58–0.70], respectively). This study demonstrates that lifestyle behaviors are associated with imbalanced TCM BCs, particularly Yin deficiency, Yang deficiency, and phlegm stasis.

Inflammatory bowel disease (IBD) has shown a steadily rising prevalence in Asian populations over recent decades, coinciding with rapid industrialization, Westernized dietary habits, and lifestyle changes. This study aimed to report the annual trends and sociodemographic-specific rates of the prevalence and incidence of diagnosed IBD in Taiwan from 2011 to 2021. A population-based study of all residents enrolled in the National Health Insurance (NHI) program, the Catastrophic Illness Patient Database, was conducted to identify patients diagnosed with IBD. The annual prevalence and incidence of diagnosed IBD were identified using International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM) diagnostic codes, stratified by age, sex, insurance premium, and degree of urbanization. Logistic regression analyses were performed to estimate odds ratios for associated risk factors; while Joinpoint regression analyses were used to assess temporal trends in age-standardized annual prevalence and incidence from 2011 to 2021. The age-standardized annual prevalence of IBD more than doubled from 9.56 per 100,000 persons in 2011 to 19.54 per 100,000 in 2021 (annual percent change [APC]: 7.35%), while incidence rates rose from 0.89 to 2.46 per 100,000 persons over the same period (APC: 11.04%). Males consistently showed higher prevalence and incidence rates than females throughout the study period. Prevalence was highest among individuals aged 50-60 years, those with high income levels, and residents of highly urbanized areas, whereas incidence peaked in the 40-50-year age group and was also elevated among individuals with high income. Nationwide NHI data showed a substantial increase in IBD prevalence and incidence in Taiwan from 2011 to 2021, with a disproportionately increased burden among men, middle-aged individuals, high-income groups, and residents of highly urbanized areas.

Aim: Cerebral white‐matter lesions serve as biomarkers for stroke, cardiovascular disease, and mortality. However, no genetic association studies on white‐matter hyperintensities (WMH) have focused specifically on the Han Chinese population. Despite previous studies on candidate genes, none have explored association with glucose regulation. This study aimed to investigate the association between a genetic risk score (GRS) derived from glucose‐related loci and cerebrovascular abnormality, cerebral WMH, and brain microstructure markers. Methods: This study is a community‐based family research conducted on 345 participants aged 65 years and over who provided brain magnetic resonance imaging (MRI) examinations and genome‐wide association studies data. The volume of white‐matter lesions was measured using brain MRI. Generalized linear models with generalized estimating equations were used to analyze the associations between GRSs and brain MRI parameters. Results: Based on the 194 glucose‐associated single‐nucleotide polymorphisms (SNPs), the GRSs for cerebrovascular abnormality, WMH volume, and fractional anisotropy (FA) and mean diffusivity (MD) for four brain regions, namely, the right and left corticospinal tracts and the cingulate gyri, were calculated based on 3, 3, 10, 5, 8, 6, 8, 8, 9, and 6 significant SNPs. After multivariable adjustment, unweighted and weighted GRS were both associated with cerebrovascular abnormality, WMH volume, FA, and MD of the four sites (right and left corticospinal tracts and cingulate gyri) except for the MD measured using the left cingulate gyrus. Conclusions: Our study indicated that glucose regulation‐associated loci are linked to MRI measures, which may provide novel insights into the presence and progression of brain injury.

Epidemiological studies have revealed that glucose variability (GV) is a predictor of stroke, cognitive impairment, and dementia in patients with type 2 diabetes mellitus (T2DM). However, evidence on the associations of GV with white matter hyperintensity (WMH) and cerebrovascular abnormalities remains scarce. This study aimed to explore the relationships of GV with WMH and cerebrovascular abnormalities using epidemiological and Mendelian randomization (MR) approaches. The MR approach was used to assess the effects of genetic proxies for GV on MRI outcomes. This cross-sectional study was conducted at a medical center where patients with T2DM were recruited. The measures for fasting plasma glucose (FPG) and HbA1c variability included the standard deviation, coefficient of variation, average real variability (ARV), and variability independent of the mean (VIM). Brain magnetic resonance images were analyzed to assess WMHs and cerebrovascular abnormalities. For MR, instrumental variables were used to assess the causal relationships between glycemic variability and outcome based on two-stage regression analysis. This study included 2,247 subjects, of whom 1,122 had WMH and 957 had cerebrovascular abnormalities. We found 80 independent single-nucleotide polymorphisms associated with GV but not with WMH or cerebrovascular abnormalities, which were subsequently used as genetic instruments. Genetically increased, unweighted FPG-VIM was linked with WMH (odds ratio 1.17 [95% CI 1.08, 1.27] per standard deviation). All genetically increased, unweighted and weighted GV measures were associated with cerebrovascular abnormalities, except FPG-ARV. Our study provided evidence that genetically predicted GV was associated with WMH and cerebrovascular abnormalities, supporting a potential causal link under MR assumptions.

This study aimed to identify three-year trajectories of body mass index (BMI), a body shape index (ABSI), waist circumference (WC), waist-to-hip ratio (WHR

Depression is linked to a high risk of mortality from any causes in older adults. However, the role of frailty or quality of life (QOL) as a mediator in th

Glycemic variability (GV) is an emerging biomarker of glycemic control and may be a predictor for lung function impairment in persons with type 2 diabetes mellitus (T2DM). However, the associations between GV and lung function variables and lung function impairment have not been fully evaluated. The objective of this study was to assess the associations of glycemic variability (GV) with lung function impairment in persons with T2DM. A follow-up study was conducted on the data of 3,108 subjects collected from 2001 to 2020 using the diabetes care management program database in Taiwan. GV in fasting plasma glucose (FPG) was calculated using standard deviation (SD), average real variability (ARV), coefficient of variation (CV), variability independent of the mean (VIM), and slope of 1-year repeated measurements. A ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) less than 0.70 was used to define lung function impairment. Multivariable linear and logistic regression models were applied to explore the relationships of GV with lung function variables and lung function impairment. A total of 359 (11.6%) subjects were defined as having lung function impairment. After multivariable adjustment, FPG‐SD, FPG-CV, FPG-AVR, FPG-VIM and were found to be negatively linked with FEV1, % predicted FEV1, and FVC but not FEV1/FVC. Relative to those for the first tertile, the odds ratios (ORs) of lung function impairment for the second and third tertiles were 1.37 (95% confidence interval [CI]: 1.01, 1.87) and 1.51 (1.10, 2.08) for FPG-CV, respectively; 1.59 (1.16, 2.17) and 1.73 (1.24, 2.40) for FPG‐SD, respectively; and 1.57 (1.15, 2.13) and 1.69 (1.22, 2.33) for FPG-AVR, respectively. GV, measured by CV, SD, VIM, and VIM, is linked with lung function impairment and all lung function variables, except for FEV1/FVC ratio. GV may serve as a useful biomarker for assessing lung function impairment in persons with T2DM.

This study aimed to explore the relationship between glucose variability (GV) and echocardiographic parameters and to investigate the mediating effect of echocardiographic parameters in the association of GV with all-cause and cardiovascular mortality. In this retrospective cohort study, we acquired data from the electronic health records of individuals with type 2 diabetes mellitus (T2DM) who visited a medical center during 2001–2020 (Jan to Oct) with follow-up until December 31, 2021. Cox proportional hazards models were conducted to explore the relationship of GV and echocardiographic parameters and mortality. We employed mediation analysis to assess the role of echocardiographic parameters in linking GV to mortality. There were 3,996 patients with T2DM. Both variability in HbA1c and fasting plasma glucose (FPG) were significantly linked with mortality. FPG variability was correlated with left ventricular mass index (LVMI), left ventricular mass (LVM), e’, and tricuspid regurgitation (TR) velocity according to multivariable regression analyses. At a mean follow-up of 5.2 years, FPG variability, LVM, LVMI, s’, and TR velocity were independently linked with all-cause and expanded cardiovascular disease (CVD) mortality. LVM, LVMI, s’, and TR velocity mediated 3.04%, 3.75%, 2.19%, and 2.71% of the association between FPG variability and mortality from any cause, respectively; and s’ and TR velocity mediated 4.33% and 2.72% of the effect of FPG variability on expanded CVD mortality, respectively. All the tested echocardiographic parameters were not significant mediators of the relationship of HbA1c-CV with mortality from any causes and expanded CVD. Our study found a weak mediating effect of the echocardiographic parameters of cardiac structure and function in the association between FPG variability and mortality, but not in the association between HbA1c variability and mortality.