The aim of this study was to investigate the associations between the triglyceride-glucose (TyG) index, a marker of insulin resistance, and microangiopathies and macroangiopathies in patients with type 2 diabetes mellitus (DM). Our study enrolled 1990 type 2 diabetic patients from local hospitals in Taiwan during the period of 2002–2004. Multivariate logistic regression analysis was used to identify the factors related to microangiopathies, macroangiopathiess and TyG index. The patients were stratified by TyG index quartile (Q1–Q4). Adjusted odds ratios (aORs) of albuminuria for Q3 versus Q1 and Q4 versus Q1 were 1.424 (95% confidence interval [CI], 1.062–1.910, p = 0.018) and 1.948 (95% CI, 1.437–2.642, p < 0.001), respectively. The aOR of cerebrovascular disease (CVA) was 2.264 for Q4 versus Q1 (95% CI, 1.243–4.122, p = 0.008), but there were no significant associations with diabetic retinopathy (DR), coronary artery disease (CAD) or peripheral artery occlusive disease (PAOD). Significant stepwise increases were found in CVA (p = 0.0013) and albuminuria ≥30 mg/g (p < 0.001) corresponding to TyG index quartiles, but not DR (p = 0.573), CAD (p = 0.880) or PAOD (p = 0.223). There was a significant association between a high TyG index and a high risk of microalbuminuria and CVA in the study cohort. Further studies to investigate the use of medications in patients with DM to prevent micro- and macro-angiopathies are thus warranted.

This study aimed to evaluate the performance of 11 obesity-related indices, including body mass index (BMI), waist circumference, waist-to-height ratio, waist–hip ratio, a body shape index, abdominal volume index, body adiposity index, body roundness index, conicity index, visceral adiposity index (VAI), and triglyceride glucose (TyG) index, in identifying metabolic syndrome (MetS) in adults. The information of 5000 participants was obtained from the Taiwan Biobank. Logistic regression analyses were performed to determine the associations between MetS and obesity-related indices with odds ratio (ORs). The predictive performance of the indices to identify MetS was compared using receiver operating characteristic (ROC) curves and areas under curves (AUCs). Multivariate-adjusted logistic regression showed that the ORs for MetS increased across the quartiles of each index. ROC curves analysis demonstrated that TyG index had the greatest AUC in men (AUC = 0.850) and women (AUC = 0.890). Furthermore, VAI had the greatest AUC in men (AUC = 0.867) and women (AUC = 0.925) aged 30−50 years, while TyG index had the greatest AUC in men (AUC = 0.849) and women (AUC = 0.854) aged 51−70 years. Among the studied obesity-related indices, TyG index and VAI exhibited the best performance for identifying MetS in adults. TyG index and VAI may be the relevant indices to assess MetS in clinical practice.

Osteoporosis is defined as a systemic skeletal disease characterized by a reduction in bone mass and microarchitectural deterioration of bone tissue. Previous studies have reported associations between air pollution and lower bone mineral density; however, few studies have investigated the association between air pollution and osteoporosis. In this study, we combined two databases, the first including 5000 individuals registered in the Taiwan Biobank, and the second containing detailed daily data on air pollution. After multivariable adjustments, ozone (O₃) (unstandardized coefficient β, 0.015; p = 0.008) was significantly positively associated with T-score, whereas carbon monoxide (CO) (unstandardized coefficient β, −0.809; p < 0.001), sulfur dioxide (SO₂) (unstandardized coefficient β, −0.050; p = 0.005), nitric oxide (NO) (unstandardized coefficient β, −0.040; p < 0.001), nitrogen dioxide (NO₂) (unstandardized coefficient β, −0.023; p < 0.001), and nitrogen oxide (NO_x) (unstandardized coefficient β, −0.017; p < 0.001) were significantly negatively associated with T-score. The interactions between CO and NO_x (p = 0.001) and SO₂ and NO₂ (p = 0.004) on T-score were statistically significant. An increase in exposure to CO, NO and NO_x was associated with a faster decline in T-score in the female participants compared to the male participants. In addition, an increase in O₃ was associated with a faster increase in T-score in the female participants compared to the male participants. In conclusion, the air pollutants CO, SO₂, NO, NO₂, and NO_x were associated with osteoporosis. In addition, there were interaction and synergetic effects between CO and NO_x and SO₂ and NO₂ on T-score. We also observed differences in the associations between air pollutants and T-score between the female and male participants.

Studies have suggested that there may be common pathogenic pathways linking osteoporosis and metabolic syndrome (MetS) due to the multiple risk factors for atherosclerotic cardiovascular disease caused by MetS. However, results on the association between MetS and bone health are inconsistent and sometimes contradictory. In this study, we aimed to investigate the associations between the effects of MetS risk factors and bone mineral density (BMD) T-score in a longitudinal study of 27,033 participants from the Taiwan Biobank with a follow-up period of 4 years. BMD of the calcaneus was measured in the non-dominant foot using ultrasound in the Taiwanese population. The overall prevalence rates of MetS were 16.7% (baseline) and 21.2% (follow-up). The participants were stratified into four groups according to the status of MetS (no/yes at baseline and follow-up). We investigated associations between MetS and its five components (baseline, follow-up) with BMD ΔT-score and found that the (no, yes) MetS group, (no, yes) abdominal obesity group, (no, yes) hypertriglyceridemia group, and (no, yes) low high-density lipoprotein (HDL) cholesterol group had the lowest ΔT-score. Furthermore, in the (no, yes) MetS group, high Δwaist circumference (p = 0.009), high Δtriglycerides (p = 0.004), low ΔHDL cholesterol (p = 0.034), and low Δsystolic blood pressure (p = 0.020) were significantly associated with low ΔT-score, but Δfasting glucose was not. In conclusion, in this large population-based cohort study, our data provide evidence that the development of MetS is strongly associated with increased rates of BMD loss in the Taiwanese population. This suggests that the prevention of MetS should be taken into consideration in the prevention of osteoporosis in the Taiwanese population.

Background: Anemia in intertrochanteric fractures (ITFs) is associated with higher morbidity and mortality and is an independent risk factor of functional mobility. Numerous studies have examined blood loss after different fixation systems. However, there is limited literature assessing the correlation of different variables that could influence blood loss in ITFs. The purpose of this study is to assess blood loss in ITFs stabilized using either dynamic hip screw (DHS) or cephalomedullary nail (CMN). Materials and methods: Perioperative blood loss was evaluated in 621 consecutive patients treated for ITFs with DHS and CMN between March 2011 and January 2021. Estimated blood loss (EBL) was calculated using the modified Lisander formula. Multivariable linear regression was performed to assess associations between implant type and EBL, adjusting for age, sex, BMI, ASA score, fracture pattern (AO/OTA type 31A1 and 31A2), anticoagulant use, and time to surgery (early: <48 h vs. late: ≥48 h). Results: DHS was associated with significantly lower EBL (613.7 mL vs. 728.7 mL; p < 0.001). In multivariable analysis, CMN was independently associated with higher blood loss (β = 119.4 mL; 95% CI 42.2–196.7; p = 0.003). Use of anticoagulants, male sex, and higher fracture severity (A2 vs. A1) were also associated with increased blood loss. DHS showed a trend toward lower transfusion volume (CMN vs. DHS, β = 65.3 mL; 95% CI -46.8–102.0; p = 0.138), though implant type was not a significant predictor of transfusion requirement (CMN vs. DHS, OR = 1.040; p = 0.212). Surprisingly, anticoagulant use was associated with slightly lower EBL (β= -109.5 mL; 95% CI -186.7– -32.3; p = 0.006). Conclusions: DHS was associated with lower perioperative blood loss and reduced transfused volume compared to CMN in AO/OTA type 31A1 and 31A2 ITFs. These findings support DHS as a potential option for patients at higher risk of anemia or transfusion-related complications.