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To examine the interaction between waist circumference (WC) and serum 25-hydroxyvitamin D (25(OH)D) level in their associations with serum lipids.
Cross-sectional study. The associations of serum 25(OH)D with total cholesterol, HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), LDL-C:HDL-C and TAG were examined using multiple linear regression. Effect modification by WC was assessed through cross-product interaction terms between 25(OH)D and WC categories (abdominal overweight, 80–<88 cm in females/94–<102 cm in males; abdominal obesity, ≥88 cm in females/≥102 cm in males).
The US National Health and Nutrition Examination Survey waves 2001–2006.
Non-pregnant fasting participants (n 4342) aged ≥20 years.
Lower 25(OH)D levels were significantly associated with lower HDL-C levels as well as with higher LDL-C:HDL-C and TAG levels in abdominally obese participants, but not in abdominally overweight or normal-waist participants. In contrast, lower 25(OH)D levels were associated with lower levels of total cholesterol and LDL-C in abdominally overweight and normal-waist participants only, but this association was only partly significant. However, a significant difference in the association between 25(OH)D and the lipids according to WC category was found only for LDL-C:HDL-C (P for interaction=0·02).
Our results from this large, cross-sectional sample suggest that the association between lower 25(OH)D levels and an unfavourable lipid profile is stronger in individuals with abdominal obesity than in those with abdominal overweight or a normal WC.
Suicide prediction during psychiatric in-patient treatment remains an
To identify determinants of railway suicides in individuals receiving
in-patient psychiatric treatment.
The study population was drawn from patients admitted to six psychiatric
hospitals in Germany during a 10-year period (1997–2006). Data from 101
railway suicide cases were compared with a control group of 101
discharged patients matched for age, gender and diagnosis.
Predictors of suicide were change of therapist (OR = 22.86,
P = 0.004), suicidal ideation (OR = 7.92,
P<0.001), negative or unchanged therapeutic course
(OR = 7.73, P<0.001), need of polypharmaceutical
treatment (OR = 2.81, P = 0.04) and unemployment (OR =
2.72, P = 0.04). Neither restlessness nor impulsivity
predicted in-patient suicide.
Suicidal ideation, unfavourable clinical course and the use of multiple
psychotropic substances (reflecting the severity of illness) were strong
determinants of railway suicides. The most salient finding was the vital
impact of a change of therapist. These findings deserve integration into
the clinical management of patients with serious mental disease.
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