Pao-Ling Torng

Lipoprotein(a) [Lp(a)] is an established atherosclerotic cardiovascular risk factor, but its association with stroke is less consistent than that with coronary disease and appears to depend on stroke subtype and the degree of Lp(a) elevation. We examined whether baseline Lp(a) was associated with incident total stroke in 1113 Taiwanese women who met an amenorrhea-based definition of postmenopausal status in the Chin-Shan Community Cardiovascular Cohort. Because contemporary data suggest that Lp(a)-related stroke risk is most evident for ischemic stroke and at very high concentrations, cohort-specific 75th (20.05 mg/dL) and 90th (36.55 mg/dL) percentiles were treated as internal exposure rankings rather than clinical cutoffs. During a mean follow-up of 8.6 years, 55 total strokes and 25 coronary artery disease (CAD) events occurred. After adjustment for age, body mass index, hypertension, diabetes mellitus, smoking, LDL cholesterol, and triglycerides, Lp(a) ≥ 75th percentile was associated with total stroke (HR 1.81, 95% CI 1.02–3.21; p = 0.04), with a higher point estimate at ≥90th percentile (HR 2.45, 95% CI 1.26–4.76; p = 0.01). CAD estimates were imprecise and not statistically significant. These findings provide hypothesis-generating risk-marker evidence from an underrepresented East Asian population but do not establish ischemic-stroke specificity, a menopause-specific mechanism, a lower clinical Lp(a) threshold, or a stronger association with stroke than CAD.

Background/Objectives: Low-density lipoprotein cholesterol (LDL-C) remains central to atherosclerotic cardiovascular disease prevention, but in obesity it may not fully reflect atherogenic particle burden because cholesterol content per particle can vary. We examined whether central adiposity is more consistently associated with apolipoprotein B (ApoB)-related atherogenic phenotypes than with elevated LDL-C in Taiwanese adults. Methods: Cross-sectional analyses used data from the nationally representative Taiwan Survey on Hypertension, Hyperglycemia, and Hyperlipidemia. Waist circumference (WC) analyses included 6771 adults (3162 men and 3609 women), and 6061 of these participants (2975 men and 3086 women) had available body mass index (BMI) data for BMI-based analyses. Survey-weighted, sex-specific multivariable logistic regression was performed. High LDL-C and high ApoB were defined as ≥130 mg/dL, and dysapolipoproteinemia as an ApoB/ApoA-I ratio ≥ 75th percentile. Results: Increasing BMI and WC were associated with higher triglycerides, ApoB, and ApoB/ApoA-I ratios, whereas LDL-C gradients were less consistent. Among women, WC ≥ 90 cm was associated with high ApoB (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4–3.7) and dysapolipoproteinemia (OR, 1.6; 95% CI, 1.2–2.2), but not with high LDL-C. Among men, WC 90–100 cm and ≥100 cm were associated with dysapolipoproteinemia (OR, 1.6; 95% CI, 1.3–1.9; and OR, 2.0; 95% CI, 1.4–2.8, respectively), whereas associations with high LDL-C were not significant. Conclusions: In this cross-sectional dataset, central adiposity showed a pattern of more consistent associations with ApoB-related phenotypes than with high LDL-C, particularly for the ApoB/ApoA-I ratio; however, no formal statistical test directly compared effect sizes across lipid outcomes, and higher WC was not significantly associated with high ApoB in men. These findings are descriptive and hypothesis-generating and require confirmation in contemporary prospective cohorts before clinical implementation.

Endometriosis is a prevalent gynecologic disorder associated with infertility and increased cancer risk, necessitating the development of sensitive and reliable diagnostic methods. Circulating microRNAs (miRNAs) have emerged as promising noninvasive biomarkers for early disease detection. However, low abundance and sequence similarity among miRNA family members hinder accurate detection. Herein, we first conducted differential expression analysis of publicly available miRNA-sequencing data sets to identify potential diagnostic biomarkers for endometriosis, from which miR-199a-5p was selected as a representative target. Building on this selection, we subsequently developed a highly sensitive and specific fluorescent biosensing platform for miR-199a-5p detection by integrating poly(thymine) (polyT) DNA-templated copper nanoclusters (CuNCs) with a dual isothermal amplification strategy. The biosensing system utilizes a 3'-phosphorylated, biotinylated hairpin DNA probe immobilized on streptavidin-coated magnetic beads. Upon hybridization with the target miR-199a-5p, duplex-specific nuclease (DSN) mediates selective cleavage, enabling target recycling and simultaneously generating a 3'-hydroxyl terminus. This newly exposed terminus subsequently serves as a primer for terminal deoxynucleotidyl transferase (TdT)-catalyzed polyT elongation. The resulting polyT sequence functions as an effective scaffold for the in situ formation of copper nanoclusters (CuNCs), thus producing a label-free fluorescence signal within 2 h. In this design, magnetic beads not only facilitate efficient separation from serum matrices but also enhance reaction efficiency through surface-initiated enzymatic polymerization. As a result, the sensing platform exhibits excellent specificity, including reliable discrimination of single-base mismatches, and maintains robust performance in complex biological samples. This integrated platform, combining bioinformatic prescreening with a CuNCs-based sensing strategy, offers rapid, cost-effective, and label-free detection of miRNA, showing promise for early diagnosis and clinical monitoring of endometriosis.

MicroRNAs (miRNAs) have emerged as robust biomarkers for diagnosing and prognosing gynecological diseases due to their disease-specific expression and remarkable stability in body fluids. Despite the inherent instability of RNA molecules, circulating miRNAs remain well protected through encapsulation in extracellular vesicles (EVs) or binding to RNA-binding proteins and lipoproteins, enabling reliable clinical detection. This review summarizes circulating miRNAs’ biogenesis and clinical relevance, emphasizing their roles in both malignant (e.g., ovarian and endometrial cancers) and benign (e.g., endometriosis and preeclampsia) conditions. Several electrochemical, fluorescent, and colorimetric biosensing platforms have been developed for sensitive and specific miRNA detection. However, most research focuses on cancer-associated miRNAs, leaving those linked to non-malignant diseases largely overlooked. To bridge this gap, this review highlights the need for broader exploration of underrepresented miRNAs and the development of multiplexed biosensing strategies to enhance diagnostic precision. Integrating advanced detection technologies with comprehensive biomarker discovery could significantly improve diagnostic accuracy, expand clinical applications, and accelerate the adoption of miRNA biosensors in point-of-care testing (POCT). Graphical abstract Overview of gynecologic disease biomarkers and their corresponding biosensing detection strategies. The schematic depicts the interrelationship between gynecological diseases, circulating miRNA biomarkers, and biosensor-based detection modalities. The inner circle highlights four representative conditions—ovarian cancer, endometrial cancer, endometriosis, and preeclampsia—whose onset and progression are closely associated with dysregulated serum or plasma miRNAs.