Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach

Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0-6-yr-old children accounted for 91% (79-107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0-3-yr-old children and 4-6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods.

Inverse association between body mass index and chronic kidney disease in older diabetic adults

PURPOSE

To identify associations among body mass index (BMI), diabetes, and chronic kidney disease (CKD) in older adults in Taiwan.

METHODS

This study enrolled 3334 participants aged 65 years and above who underwent an annual health screening at a medical center from January 2006 to December 2010. CKD was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m(2). A multiple logistic regression analysis was used to determine associations among BMI, diabetes, and CKD.

RESULTS

The prevalence rate of CKD was 19.7% and 10.5% in diabetic and nondiabetic subjects, respectively. A multivariate model indicated that age, diabetes, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, and hyperuricemia were associated with an increased risk of CKD. Furthermore, there was an inverse association between BMI and CKD in older diabetic patients, with odds ratios of 3.71, 2.32, 2.12, and 1.31 in underweight, normal, overweight, and obese subjects, respectively, compared with nondiabetic subjects of normal weight.

CONCLUSIONS

There was an inverse association between BMI and CKD in older diabetic patients but no such association was found in nondiabetic older adults. More attention should be given to older underweight diabetic patients because they have a higher risk of CKD.

Synergistic effect of gamma glutamyltransferase and obesity on metabolic syndrome, independent of hepatic steatosis

PURPOSE

Both obesity and gamma glutamyltransferase (GGT) are individually considered to be closely associated with metabolic syndrome (MetS). Whether the 2 factors synergistically associate with MetS is not yet confirmed. The purpose of this study was to investigate whether obesity and GGT are interactively associated with MetS.

METHODS

A cross-sectional study of 7390 adults (age 32-62 years old) was conducted from 2009 to 2010.

RESULTS

Our results showed that greater serum GGT quartiles were positively associated with all MetS components and fatty liver (P < .001). The odds ratio of MetS increased significantly along with quartiles of GGT and obesity. In comparison with subjects with normal body mass index and first quartile GGT, the odds ratio of MetS in obese groups with 1st, 2nd, 3rd, and 4th quartile GGT were 6.8, 14.5, 20.3, and 45.2, respectively, and it remained tenable after adjustment for fatty liver. The synergy index of GGT and obesity on MetS is 2.2 (95% confidence interval, 1.9-2.6).

CONCLUSIONS

Serum GGT level in combination with obesity can be a simple but useful tool for risk stratification of developing MetS. Obese individuals with high-normal GGT levels require close monitoring for high risk of MetS.