Search

This study examines associations between sleep apnea risk and hypertension in a sample of immigrant Chinese and Korean Americans. The dataset included Chinese and Korean patients ages 50–75 recruited from primary care physicians' offices from April 2018 to June 2020 in the Baltimore-Washington DC Metropolitan Area (n = 394). Hypertension risk was determined using a combination of blood pressure measurements, self-reported diagnosis of hypertension by a medical professional, and/or self-reported use of antihypertensive medications. Linear regression models examined the associations between sleep apnea risk and blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Poisson regression models examined associations sleep apnea risk and hypertension. Models controlled for body mass index (BMI), demographic, and socioeconomic risk factors. We further examined models for potential effect modification by age, gender, Asian subgroup, and obesity, as well as effect modification of daytime sleepiness on the association between snoring and hypertension risk. High risk of sleep apnea appeared to be associated positively with SBP (β = 6.77, 95% CI: 0.00–13.53), but not with DBP. The association was positive for hypertension, but it was not statistically significant (PR = 1.11, 95% CI: 0.87–1.41). We did not find effect modification of the associations between sleep apnea and hypertension risk, but we did find that daytime sleepiness moderated the effect of snoring on SBP. Snoring was associated with higher SBP, primarily in the presence of daytime sleepiness, such that predicted SBP was 133.27 mmHg (95% CI: 126.52, 140.02) for someone with both snoring and daytime sleepiness, compared to 123.37 mmHg (95% CI: 120.40, 126.34) for someone neither snoring nor daytime sleepiness. Chinese and Korean immigrants living in the U.S. who are at high risk of sleep apnea have higher SBP on average, even after accounting for sociodemographic characteristics and BMI. : NCT03481296, date of registration: 3/29/2018 [ABSTRACT FROM AUTHOR]

Background & Aims: Although non‐alcoholic fatty liver disease (NAFLD) is becoming a leading cause of hepatocellular carcinoma (HCC), HCC risk in non‐cirrhotic NAFLD received little attention. We aimed to develop and validate an HCC risk prediction model for non‐cirrhotic NAFLD. Methods: A nationwide cohort of non‐cirrhotic NAFLD patients in Korea was recruited to develop a risk prediction model and validate it internally (n = 409 088). A model using a simplified point system was developed by Cox proportional hazard model. K‐fold cross‐validation assessed the accuracy, discrimination and calibration. The model was validated externally using a hospital cohort from Asan Medical Center (n = 8721). Results: An 11‐point HCC risk prediction model for non‐cirrhotic NAFLD was developed using six independent factors of age, sex, diabetes, obesity, serum alanine aminotransferase level and gamma‐glutamyl transferase level (c‐index 0.75). The average area under receiver operating curves (AUROCs) of the model was 0.72 at 5 years and 0.75 at 10 years. In the external validation cohort, the AUROCs were 0.79 [95% confidence interval [CI], 0.59–0.95] at 5 years and 0.84 (95% CI, 0.73–0.94) at 10 years. The calibration plots showed the expected risks corresponded well with the observed risks. Risk stratification categorized patients into the low (score 0–6), moderate (7, 8) and high (9–11; estimated incidence rate >0.2%/year) risk groups. Conclusions: A novel HCC risk prediction model for non‐cirrhotic NAFLD patients was developed and validated with fair performance. The model is expected to serve as a simple and reliable tool to assess HCC risk and assist precision screening of HCC. [ABSTRACT FROM AUTHOR]

Background and Aim: Although obesity is a known risk factor for colorectal neoplasms, the correlation between weight change and colorectal neoplasm is unclear. Thus, we aim to evaluate the association between weight change and advanced colorectal neoplasm (ACRN) recurrence during post‐polypectomy surveillance colonoscopy. Methods: This retrospective cohort study included 7473 participants diagnosed with colorectal neoplasms between 2003 and 2010 who subsequently underwent surveillance colonoscopies until 2020. We analyzed the association between the risk of metachronous ACRN and weight change, defining stable weight as a weight change of <3% and weight gain as a weight increase of ≥3% from baseline during the follow‐up period. Results: During a median 8.5 years of follow‐up, 619 participants (8.3%) developed ACRN. Weight gain was reported as an independent risk factor for metachronous ACRN in a time‐dependent Cox analysis. A weight gain of 3–6% and ≥6% had adjusted hazard ratios (AHRs) of 1.48 (95% confidence interval [CI]: 1.19–1.84) and 2.14 (95% CI: 1.71–2.69), respectively. Participants aged 30–49 and 50–75 years with weight gain of ≥6% showed AHRs of 2.88 (95% CI: 1.96–4.21) and 1.90 (95% CI: 1.43–2.51), respectively. In men and women, weight gain of ≥3% was significantly correlated with metachronous ACRN. Conclusions: Weight gain is associated with an increased risk of metachronous ACRN. Furthermore, weight gain is associated with the recurrence of ACRN in both men and women regardless of age. [ABSTRACT FROM AUTHOR]