作者: Råstam, Lennart ; Sundquist, Kristina ; Frostegård, Johan ; Carrera‐Bastos, Pedro ; Fontes‐Villalba, Maelán ; Åkerfeldt, Torbjörn ; Granfeldt, Yvonne ; Lindblad, Ulf ; Ahrén, Bo ; Jönsson, Tommy

AbstractObjectivesExperimental and small human studies have indicated that high total adiponectin levels have beneficial cardiometabolic effects. In contrast, however, high total adiponectin levels are also associated with higher all‐cause and cardiovascular mortality in thoroughly adjusted epidemiological studies. To gain further insight into these seemingly contradictory results, we report results on total adiponectin from the indigenous Melanesian population of Kitava, Trobriand Islands, Papua New Guinea, where an apparent absence of cardiometabolic disease has been previously reported.MethodsFasting levels of serum total adiponectin were measured cross‐sectionally in ≥40‐year‐old Kitavans (n = 102) and Swedish controls matched for age and sex (n = 108). Multivariable linear regression was used for the analysis of associations with total adiponectin when controlled for group, sex, smoking, hypertension and/or type 2 diabetes, age, and body mass index.ResultsTotal adiponectin was lower for Kitavans compared to Swedish controls (Median [Mdn] 4.6 μg/mL, range 1.0–206 μg/mL and Mdn 9.7 μg/mL, range 3.1–104 μg/mL, respectively, r = .64, p < .001). Lower total adiponectin was associated with Kitavan group, male sex (only in Swedish controls), smoking (only in Kitavans and Swedish controls combined), younger age (not in Swedish controls), higher BMI, lower total, low‐density lipoprotein, high‐density lipoprotein (HDL) (only in Kitavans and Swedish controls combined), and non‐HDL cholesterol, and higher anti‐PC IgG (only in Kitavans and Swedish controls combined).ConclusionTotal adiponectin in Kitavans was significantly lower than in Swedish controls.

American Journal of Audiology

Benefit–Cost Analyses of Hearing Aids, Over-the-Counter Hearing Devices, and Hearing Care Services

Article

作者: Huntington-Klein, Nick ; Jilla, Anna Marie ; Baldwin, Jonathan D. ; Johnson, Carole E.

Purpose:Limited accessibility to hearing health care threatens healthy aging in place for older adults with hearing loss. A willingness-to-pay (WTP) approach was used to determine benefits and value of prescription advanced digital technology (ADT) hearing aids, over-the-counter (OTC) hearing devices, and rehabilitative services using benefit–cost analyses.Method: This study was a cross-sectional survey with chart review of hearing aid users at two independent audiology practices. Seventy hearing aid users (response rate: 15.6%) provided their WTP for ADT prescription hearing aids, OTC hearing devices, and hearing rehabilitative services. Benefit–cost ratios and net social benefit were calculated using deterministic and exploratory approaches. Point estimates for benefit–cost ratios and net social benefit were derived using bootstrap sampling with replacement ( N = 5,000). Results: Median WTP for ADT prescription hearing aids and rehabilitative services were $2,000 and $250, respectively. WTP was lowest for OTC devices ( Mdn = $0; maximum = $500). Benefit–cost ratios and net social benefit for ADT prescription hearing aids, OTC devices, and hearing rehabilitative services favored these interventions when out-of-pocket costs remained low. Benefit–cost analyses also produced results favoring prescription ADT hearing aid intervention with costs as high as $1,530 per device. Conclusions:WTP results indicated that all interventions under study have a measurable consumer-perceived benefit. Results of benefit–cost analyses favored the interventions but only when costs were lower than market prices. The benefit–cost analysis results for hearing care services underscore their value when provided as part of a comprehensive rehabilitative plan that may inform future health policy changes.

Nutrients2区 · 医学

Optimal Dietary Intake Composition of Choline and Betaine Is Associated with Minimized Visceral Obesity-Related Hepatic Steatosis in a Case-Control Study

2区 · 医学

ArticleOA

作者: Kuo, Chang-Sheng ; Doong, Jia-Yau ; Huang, Rwei-Fen S. ; Lin, Yu-Shun ; Wang, Bei-Wen ; Lee, Fu-Jen ; Chang, Chi-Yang ; Chang, Ting-Yu ; Wu, Chien-Hsien

Few studies on humans have comprehensively evaluated the intake composition of methyl-donor nutrients (MDNs: choline, betaine, and folate) in relation to visceral obesity (VOB)-related hepatic steatosis (HS), the hallmark of non-alcoholic fatty liver diseases. In this case–control study, we recruited 105 patients with HS and 104 without HS (controls). HS was diagnosed through ultrasound examination. VOB was measured using a whole-body analyzer. MDN intake was assessed using a validated quantitative food frequency questionnaire. After adjustment for multiple HS risk factors, total choline intake was the most significant dietary determinant of HS in patients with VOB (Beta: −0.41, p = 0.01). Low intake of choline (<6.9 mg/kg body weight), betaine (<3.1 mg/kg body weight), and folate (<8.8 μg/kg body weight) predicted increased odds ratios (ORs) of VOB-related HS (choline: OR: 22, 95% confidence interval [CI]: 6.5–80; betaine: OR: 14, 95% CI: 4.4–50; and folate: OR: 19, 95% CI: 5.2–74). Combined high intake of choline and betaine, but not folate, was associated with an 81% reduction in VOB-related HS (OR: 0.19, 95% CI: 0.05–0.69). Our data suggest that the optimal intake of choline and betaine can minimize the risk of VOB-related HS in a threshold-dependent manner.

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