We aimed to investigate the association between physical activity and successful aging among middle-aged and older adults and study how this association changes with age and time. The mean score of Newcastle-Ottawa Scale assessment was 8.0±0.8. Physically active middle-aged and older adults were more likely to age successfully than sedentary adults (OR=1.64, 95%CI: 1.40-1.94). The effect of physical activity was stronger in the younger group (OR=1.71, 95%CI: 1.41-2.08) than on the older group (OR=1.54, 95%CI: 1.13-2.08). However, the protective effect of physical activity reduced annually by approximately 3%. Physical activity promotes successful aging among middle-aged and older adults especially in the younger population. Being physically active at middle and old age is beneficial to successful aging. We searched for the relevant studies in three online databases: Pubmed, Web of Science, and Embase. Fifteen community-based cohort studies were included. The Newcastle-Ottawa Scale assessment Form was used for quality assessment. Overall, 189,192 participants aged 43.9-79.0 years were analyzed. The odds ratio for successful aging of the most physically active group compared with sedentary group was analyzed. Subgroup analysis was conducted by age group. Univariate Meta-regression was performed according to follow-up years.

Background: The utilization of medical care for gastrointestinal diseases increased over the past decade worldwide. The aim of the study was to investigate the difference between rural and urban patients in seeking medical service for gastrointestinal diseases at ambulatory sector in Taiwan. Methods: From the one-million-people cohort datasets of the National Health Insurance Research Database, the utilization of ambulatory visits for gastrointestinal diseases in 2009 was analyzed. Rural patients were compared with urban and suburban patients as to diagnosis, locality of visits and choice of specialists. Results: Among 295,056 patients who had ambulatory visits for gastrointestinal diseases in 2009, rural patients sought medical care for gastrointestinal diseases more frequently than urban and suburban patients (1.60 ± 3.90 vs. 1.17 ± 3.02 and 1.39 ± 3.47). 83.4% of rural patients with gastrointestinal diseases were treated by non-gastroenterologists in rural areas. Rural people had lower accessibility of specialist care, especially for hepatitis, esophageal disorders and gastroduodenal ulcer. Conclusion: The rural–urban disparity of medical care for gastrointestinal diseases in Taiwan highlighted the importance of the well communication between rural physicians and gastroenterologists. Besides the establishment of the referral system, the medical teleconsultation system and the arrangement of specialist outreach clinics in rural areas might be helpful.

Although the link between hepatic steatosis and lung function has been confirmed, the focus has largely been on central airways. The association between hepatic steatosis and increased peripheral airway resistance has not yet been explored. Hepatic steatosis and increased peripheral resistance are connected with immunity dysregulation. High neutrophil-to-lymphocyte ratio (NLR) and low lymphocyte-to-monocyte ratio (LMR) have been recognized as indicators of immunity dysregulation. In this study, the association between hepatic steatosis and increased peripheral airway resistance was evaluated, and the effect of immunity dysregulation (high NLR/low LMR) on the increased peripheral airway resistance among patients with hepatic steatosis was explored. In this retrospective study, chest or abdomen CT scans and spirometry/impulse oscillometry (IOS) from 2018 to 2019 were used to identify hepatic steatosis and increased central/peripheral airway resistance in patients. Among 1391 enrolled patients, 169 (12.1%) had hepatic steatosis. After 1:1 age and abnormal ALT matching was conducted, clinical data were compared between patients with and without hepatic steatosis. A higher proportion of patients with hepatic steatosis had increased peripheral airway resistance than those without hepatic steatosis (52.7% vs 40.2%, P = .025). Old age, high body mass index, history of diabetes, and high NLR/low LMR were significantly correlated with increased peripheral airway resistance. The presence of hepatic steatosis is associated with increased peripheral airway. High NLR/low LMR is an independent associated factor of increased peripheral airway resistance in patients with hepatic steatosis. It is advisable for patients with hepatic steatosis to regularly monitor their complete blood count/differential count and undergo pulmonary function tests including IOS.

The association between metabolically healthy obesity (MHO) and health-related quality of life (HRQOL) has not been thoroughly evaluated. This study enrolled 906 adult participants aged 35–55 years between 2009 and 2010 in Northern Taiwan; 427 participants were followed up after eight years. Normal weight, overweight, and obesity were evaluated via body mass index. Metabolic health was defined as the absence of cardiometabolic diseases and having ≤1 metabolic risk factor. HRQOL was evaluated using the 36-Item Short Form Health Survey (SF-36), Taiwan version. Generalized linear mixed-effects models were used to analyze the repeated, measured data with adjustment for important covariates. Compared with metabolically healthy normal weight individuals, participants with metabolically unhealthy normal weight and obesity had a significantly poorer physical component summary score (β (95% CI) = −2.17 (−3.38–−0.97) and −2.29 (−3.70–−0.87), respectively). There were no significant differences in physical and mental component summary scores among participants with metabolically healthy normal weight, overweight, and obesity. This study showed that metabolically healthy individuals with obesity and normal weight had similar HRQOL in physical and mental component summary scores. Maintaining metabolic health is an ongoing goal for people with obesity.

INTRODUCTION: Severe hepatic steatosis (HS) and significant hepatic fibrosis indicate severity of metabolic dysfunction-associated steatotic liver disease (MASLD), and the models for early detection are important. Recent studies suggest immunoglobulin G (IgG) glycosylation and microbial consortia may involve in the development of MASLD. This study investigates the utility of IgG glycosylation and microbial consortia in early detection models. METHODS: A total of 111 patients with MASLD categorized into high vs low controlled attenuation parameter (for HS) or high vs low FIB-4 (for fibrosis). We analyzed differences in microbial consortia and IgG1/IgG2 glycosylation features, creating scores for identifying severe HS and significant hepatic fibrosis. The combination scores for identifying severe HS and significant hepatic fibrosis in MASLD patients were derived based on the microbial consortia and IgG1/IgG2 glycosylation features accordingly. RESULTS: Megamonas was linked to severe HS, and Christensenellaceae R-7 , UCG-005 , CAG-56 , and Lachnospira were associated with significant hepatic fibrosis in patients with MASLD. The areas under curve of severe HS- and significant hepatic fibrosis-microbial scores were 0.731 and 0.773, respectively. The ratios of IgG2-N4H5F1/IgG1-N4H5F1 and bisected-IgG2/bisected-IgG1 predicted severe HS, while IgG2-N4H3F1/IgG1-N4H3F1, bisected-IgG1/bisected-IgG2, and IgG1-galactosylation/IgG2-galactosylation index identified significant hepatic fibrosis in MASLD. The combination scores including microbial consortia and glycosylation features achieved areas under curve of 0.776 and 0.810, showing comparable performance with established indices like HS index and FibroAST score. DISCUSSION: The study highlights the effectiveness of combining fecal microbiota and serum IgG glycosylation features in identifying MASLD severity, which are noninferior to the current regularly used models, and suggests the intervention of glycosylation as a promising therapeutic approach for MASLD.