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Abstract
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Study objective: This study analysis the spatial and temporal variations of different tumor types of lung cancer incidence rate in Taiwan from 1981-2005, and to explore the relation between soil heavy metals concentration and different tumor types of lung cancer incidence for both gender.
Material and methods: Data on cancer registry system from 1981-2005 and two periods (1982-1986 and 1992-1999) of soil heavy metal concentrations survey data, included soil Arsenic, Cadmium, Chromium, Copper, Lead, Mercury, Nickel, Zinc concentrations was collected from DOH and EAP respectively. To estimate the period effects of different tumor types of lung cancer incidence by APC-Model. Poisson regression model was used to develop relative risks (RRs) of lung adenocarcinoma (lung AC) and lung squamous-cell carcinoma (lung SCC) from 2001-2005 when exposure to different soil heavy metals levels from 1982-1986. In order to prevent the misclassification of exposure, the exposure groups divide into [low-low], [median-median], [high-high] levels according to two periods of soil heavy metals concentrations, and estimate the RRs from 2001-2005 and trends of age standardized incidence rate of lung cancer from 1986-2005 for these exposure groups.
Results: Both male and female, lung AC and lung SCC trends are rising from 1981-2005. The period effect of male lung AC log(RR) increased from -0.78 (1981-1985) to 0.93 (2001-2005), female lung AC log(RR) increased from -1.17 to 1.21, male lung SCC log(RR) increased from -0.59 to 0.55, female lung SCC log(RR) increased from -0.38 to 0.22. Lung cancer RRs of exposure levels by quartile township soil heavy metals concentrations show that soil Copper was related with both male and female lung AC (P value for trend was significant), soil Chromium, Nickel and Zinc was related with both male and female lung SCC (P value for trend was significant). When exposure levels was [high-high] level of two periods soil heavy metals concentrations compares with [low-low] level, there are highest male lung SCC RRs for [high-high] level of soil Chromium (RR=1.59, 95%C.I.=1.37-1.83) and Nickel (RR=1.33, 95%C.I.=1.17-1.83) respectively (P values for trend were also significant for soil Chromium and Nickel). But male lung AC and female lung AC and lung SCC didn’t find any association with soil heavy metals.
Conclusion: This study finds that period effect of lung AC and lung SCC are increased for both male and female from 1981-2005 in Taiwan, and There were spatial variations for lung AC and lung SCC age standardized incidence rate. Township soil Chromium and Nickel concentrations were association with Township male lung SCC incidence.
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Abstract
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Objective: This study is relating to the obesity index which are able to predict HDL is under 46mg/dL.
Methods: The data were collected from Nutrition and Health Survey in Taiwan,NAHSIT,1993-1996，1999-2000，2005-2008. Using three index, including the body mass index (BMI), waist-hip ratio (WHR), and BMI weighted WHR correlate to HDL. The cut-point of the obesity index was able to predict HDL is under 46mg/dL via logistic regression and ROC curve.
Results: The three odd ratios received from BMI, WHR and BMI_WHR were calculated through the logistic regression. The risk of HDL＜46 mg/dL would be increased due to the higher odd ratios. This positive proportion also conform the dose response relationship. The cut-point of the obesity index was able to predict HDL is under 46mg/dL via ROC curve. The cut point of WHR is increasing by period no matter which ages they are. For males, ages between 19 to 44 years old in 1993 to 1996 is 0.83(Sen=0.68；Spe=0.55) and then go to 0.87(Sen=0.73；Spe=0.72) in 2005-2008. Same positive trend from 0.88(Sen=0.62；Spe=0.57) to 0.92(Sen=0.58；Spe=0.59) for ages between 45 to 64 years old. For females, ages between 19 to 44 years old in 1993 to 1996 is 0.76(Sen=0.67；Spe=0.66) and then go to 0.81(Sen=0.85；Spe=0.77) in 2005-2008. Same positive trend from 0.80( Sen=0.72；Spe=0.59) to 0.87(Sen=0.54；Spe=0.73) for ages between 45 to 64 years old. The cut-point of BMI for males is ages between 19 to 44 years old in 1993 to 1996 is 23.56(Sen=0.61；Spe=0.68) and then go to 25.29(Sen=0.55；Spe=0.78) in 2005-2008. Same positive trend from 25.15(Sen=0.49；Spe=0.72) to 24.85(Sen=0.59；Spe=0.64) for ages between 45 to 64 years old. For females, ages between 19 to 44 years old in 1993 to 1996 is 24.27(Sen=0.56；Spe=0.75) and then go to 23.47 (Sen=0.73；Spe=0.74)in 2005-2008. Same positive trend from 25.12(Sen=0.61；Spe=0.58) to 25.88 (Sen=0.56；Spe=0.71)for ages between 45 to 64 years old. The BMI is rising up by period as the age is 19-44, but decays as the age is between 45 and 64 for males. Nevertheless, this trend is tend to opposite for females. The cut-point of BMI_WHR for males is ages between 19 to 44 years old in 1993 to 1996 is 20.26(Sen=0.57；Spe=0.73) and then go to 20.84(Sen=0.71；Spe=0.65) in 2005-2008. Same positive trend from 21.67 (Sen=0.59；Spe=0.61)to 22.36(Sen=0.65；Spe=0.61) for ages between 45 to 64 years old. For females, ages between 19 to 44 years old in 1993 to 1996 is 17.52(Sen=0.63；Spe=0.67) and then go to 18.79(Sen=0.79；Spe=0.72) in 2005-2008. Same positive trend from 20.48(Sen=0.64Spe=0.59) to 21.40(Sen=0.73；Spe=0.63) for ages between 45 to 64 years old.
The cut-point of WHR for males is increase from 0.88(Sen=0.63；Spe=0.63) to 0.92 (Sen=0.59；Spe=0.65) to 0.94(Sen=0.62；Spe=0.60) and 0.83(Sen=0.63；Spe=0.54) to 0.86(Sen=0.69；Spe=0.58) to 0.93(Sen=0.55；Spe=0.68) for females when the age is up to 65 years old, which is also increased by period. The cut-point of BMI for males is increase from23.66(Sen=0.57；Spe=0.71) to 23.70(Sen=0.62；Spe=0.61) -23.99(Sen=0.64；Spe=0.58) and 23.41(Sen=0.68；Spe=0.44) to 24.40(Sen=0.62；Spe=0.55)-25.73 (Sen=0.60；Spe=0.61)for females. The cut-point of BMI_WHR for males is increase from 19.93(Sen=0.72；Spe=0.60) to 21.51(Sen=0.66；Spe=0.63)- 22.66(Sen=0.65；Spe=0.59) and 20.20(Sen=0.62；Spe=0.49) to 22.12(Sen=0.57；Spe=0.65)- 24.32(Sen=0.56；Spe=0.68) for females.
Conclusion: 1.Different period, different ages, different gender, three indicators, larger BMI,WHR,BMI_WHR value HDL-C less than 46mg/dL, the higher the risk and up to the dose-response relationship.2. The cup point of HDL_C<46mg/dL predicted from WHR, BMI and BMI_WHR for people who ages is up to 65 years old in these three periods is increased by periods. Also, BMI_WHR of males is more sensitive than WHR and BMI.3.In the 19-44 and 45-64 age group, the WHR and BMI_WHR the optimal cut point with the age increase, but BMI did not. In the early data(1993-1996)WHR have better sensitivity, and 2005-2008 information,19-44 years old group WHR have higher sensitivity,45-64 years old group BMI_ WHR have higher sensitivity.4. Different ages have different optimal cutoff value of obesity indexes：To1993-1996：For males ages between 19 to 44 years old, the cut-point of BMI is 23.56；WHR is 0.83；BMI_WHR is 20.26。.For females ages between 19 to 44 years old, the cut-point of BMI is 24.27；WHR is 0.76；BMI_WHR is 17.52。For males ages between 45 to 64 years old, the cut-point of BMI is 25.15；WHR is 0.88；BMI_WHR is 21.67。For females ages between 45 to 64 years old, the cut-point of BMI is 25.12；WHR is 0.80；BMI_WHR is 20.48。To 2005-2008：For males ages between 19 to 44 years old, the cut-point of BMI is 25.29；WHR is 0.87；BMI_WHR is 20.84。.For females ages between 19 to 44 years old, the cut-point of BMI is 23.47；WHR is 0.81；BMI_WHR is 18.79。For males ages between 45 to 64 years old, the cut-point of BMI is 24.85；WHR is 0.92；BMI_WHR is 22.36。For females ages between 45 to 64 years old, the cut-point of BMI is 25.88；WHR is 0.87；BMI_WHR is 21.40。
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