The economic burden of diabetes has increased over time with disease severity. Previous publications investigating the effects of physical activity (PA) on medical costs have made use of small sample sizes. We assessed the relationship between PA and 1-year medical expenditure among Taiwanese patients with type-2 diabetes mellitus (T2DM). Data were recruited from three governmental databases, including the 2012 adult preventive health service database. Participants were grouped as inactive (no exercise), insufficiently active (exercise < 150 minutes/week), and sufficiently active (exercise >150 minutes/week) individuals. Patients were stratified according to age and Charlson score. Multivariate linear regression models were used to determine β-coefficients and their P values. Overall, 218,960 individuals were identified with diabetes. The prevalence of the disease was 13.1% among sufficiently active, 35% among insufficiently active, and 51.9% among physically inactive adults. In general, patients who had exercise >150 minutes/week had lower health care spending (i.e., US$ 755.83) followed by those who had less than 150 minutes/week (US$ 880.08) when compared with inactive patients ( P < .0001). Moreover, health care costs derived from outpatient or inpatient care were lower for sufficiently active than inactive participants ( P < .0001). Compared with being sedentary, PA was associated with lower health care costs of Taiwanese adults with diabetes mellitus.

Calcific tendinitis (CT) of the shoulder is a painful disorder usually identified in individuals aged 40 and 60 years. The estimated global prevalence of CT is 2.7% to 36%. We examined the association of hyperlipidemia and sex with CT of the shoulder using Taiwan Biobank (TWB) and the National Health Insurance Research Database (NHIRD). Data were available for 9903 TWB participants who were recruited between 2008 and 2015. We used multiple logistic regression analysis to estimate the odds ratios (OR) and 95% confidence intervals (CI) for CT of the shoulder. Overall, 1564 women, and 1491 men were identified with hyperlipidemia. Women, compared to men, had higher odds of CT of the shoulder (OR, 1.53; 95% CI, 1.08–2.16). Hyperlipidemia, compared to no hyperlipidemia, was associated with an increased risk of CT (OR, 1.40; 95% CI, 1.02–1.93). The test for interaction was significant for sex and hyperlipidemia ( P = .006). After stratification, the odds ratio for CT was 1.95 (95% CI, 1.30–2.92) in women and 0.82 (95% CI, 0.48–1.39) in men, respectively. Compared to men with no hyperlipidemia, the odds ratio was 0.86 (95% CI, 0.53–1.38) for men with hyperlipidemia and 2.00 (95% CI, 1.29–3.10) for women with hyperlipidemia. Importantly, our findings indicated that the risk for CT of the shoulder was higher among Taiwanese women with hyperlipidemia. However, CT risk among their male counterparts with hyperlipidemia was not significant.

MASA was not useful in differentiating aspirators and nonaspirators and between silent and overt aspirators in severely disabled cerebral palsy, but it could predict oral dysfunction in videofluoroscopic swallowing studies.

Increased ventilation during exercise in polluted areas could trigger airway inflammation. We evaluated blood DNA methylation of the SOX2-promoter region in relation to exercise and PM2.5 in Taiwanese adults. Data of 948 participants aged 30–70 years were retrieved from the Taiwan Biobank Database (2008–2015) and the Air Quality Monitoring Database (2006–2011). PM2.5 was positively associated with SOX2-promoter methylation (β = 0.000216; p < 0.0001). The interaction between PM2.5 and exercise on SOX2-promoter methylation was significant (p = 0.0146). After stratification by exercise habits, PM2.5 was positively associated with SOX2 methylation in only individuals who did regular exercise (β = 0.0003490; p < 0.0001). After stratification by exercise habits and residential areas, SOX2-promoter methylation levels in those who lived in the southern area were higher for both the regular exercise (β = 0.00272; p = 0.0172) and no regular exercise groups (β = 0.002610 and p = 0.0162). SOX2-promoter methylation levels in those who lived in the northern area and did regular exercise were lower; β = -0.00314 (p = 0.0036). In conclusion, PM2.5 was positively associated with SOX2-promoter methylation in participants who did regular exercise. Living in the southern area was positively associated with SOX2-promoter methylation regardless of exercise habits.