Associations between central obesity and asthma in children and adolescents: a case–control study

Introduction: Evidence supports a significant yet weak association between high-body weight and asthma in children. However, most studies investigating the obesity–asthma link use Body Mass Index (BMI) to evaluate body fatness. The relationship between body fat distribution and asthma remains largely unknown, especially in children. This pediatric case–control investigation examined associations between central obesity/high-body weight and asthma diagnosis. Methods: Five-hundred and fourteen children (217 physician diagnosed asthma cases and 297 healthy controls) of 5–11 years were recruited. Height, weight and waist circumference were measured. Asthma symptoms, past medical history, personal lifestyle, socioeconomic status, diet and physical activity history were also collected. Results: A higher proportion of children with asthma were centrally obese [(≥90th waist percentile) 15.2 vs. 9.4%, p<0.0001; (≥90th waist-to-height ratio percentile) 39.6 vs. 24.2%, p<0.0001)]. Regression analyses revealed that centrally obese children were more likely to have asthma (high-waist circumference (OR?=?1.99, 95% CI: 1.07-3.68) and high-waist circumference to height ratio (OR?=?2.24, 95% CI: 1.47-3.40), following adjustment for various confounders. Overweight/obese participants (BMI defined) were more likely to be asthmatic [odds ratio (OR)?=?1.52, 95% confidence interval (CI): 1.03-2.70)] when compared to controls. Conclusions: Presence of central obesity and high-body weight (at least overweight) as assessed by waist circumference, waist-to-height ratio, and BMI are associated with asthma diagnosis. More studies are needed, especially in children and adolescents, to confirm these findings and better understand how body fat distribution impacts the obesity–asthma relationship.     

Maternal depression and risk of injuries in children aged 0–4 years: a population-based cohort study

BackgroundThe association between maternal depression and childhood injuries is underexplored, with existing studies relying on maternal reporting of injury occurrences. We aimed to assess the association between the incidence of three common childhood injuries and exposure to maternal antenatal depression, postnatal depression, or both.MethodsUsing a cohort of 209 418 mother–child pairs who had linked data from the Clinical Practice Research Datalink and Hospital Episode Statistics for 1997–2014, we estimated incidence of poisonings, fractures, and burns per 10 000 person-years from birth to the child's fifth birthday, stratified by whether the mother had antenatal depression, postnatal depression, or both. One child was randomly selected per mother to prevent clustering. Using Poisson regression, we estimated incidence rate ratios (IRRs), adjusted for maternal age at delivery, socioeconomic status, number of older siblings, and number of children aged 0–4 years in the household. The study was approved by the Independent Scientific Advisory Committee for the Medicines and Healthcare products Regulatory Agency in February, 2014.FindingsCrude injury rates were higher for each injury type among children whose mothers had antenatal depression, postnatal depression, or both. Poisoning incidence per 10 000 person-years was 59·6 (95% CI 48·7–72·8) for children of mothers with antenatal depression, 64·4 (57·4–72·2) for children of mothers with postnatal depression, and 74·2 (63·2–87·1) for children of mothers with both, compared with 36·3 (34·8–37·8) for those unexposed to either antenatal or postnatal depression. Similar patterns were seen for fractures and burns. After adjustment, IRRs remained significant for poisonings and burns, with the greatest risk for children whose mothers had both antenatal and postnatal depression (poisonings 1·94, 95% CI 1·63–2·32; burns 1·32, 1·13–1·55). However, there was no significant association between fractures and perinatal depression.InterpretationAntenatal and postnatal depression were associated with a higher risk of child poisonings and burns, suggesting that maternal depression could be a modifiable risk factor for these types of injury. By using routinely collected health data we only identified women who sought medical attention for depression, and were unable to adjust for other variables such as child behaviour. Differences in the ascertainment of injury events between mothers with and without perinatal depression could lead to an overestimation of injury risk. Further work could include assessing certain injuries (eg, long-bone fractures) for which ascertainment is likely to be almost complete.FundingRB is funded by the National Institute for Health Research (NIHR) School for Primary Care Research and the University of Nottingham.     

Media access and anaemia prevalence in children from ethnic minorities aged 6–23 months in central and western China: a cross-sectional study

Background

Reducing anaemia is an important component of children's health. Studies have shown that different media can provide information about safe health practices. However, it is uncertain how amenable ethnic minority parents are to receiving information about health care in China. We aimed to determine the use of media by Chinese parents in rural, under-served regions, and to inform technology-based interventions in diverse populations.

Secular trends in mortality and causes of death among children and adolescents aged 1–19 years in China from 1953 to 2016: a national and subnational variations systematic analysis

Background

The level and pace of mortality, and causes of death in children and adolescents might vary across regions within China. We aimed to analyse the national and subnational mortality trends, and the principal causes of deaths among Chinese children and adolescents aged 1–19 years from 1953 to 2016.

Seroepidemiology of Herpes Simplex virus type 1 and 2 in Western and Southern Switzerland in adults aged 25–74 in 1992–93 : a population-based study

Background

Genital herpes is one of the most prevalent sexually-transmitted diseases, and accounts for a substantial morbidity. Genital herpes puts newborns at risk for very severe disease and also increases the risk of horizontal HIV transmission. It thus stands as an important public health problem. The recent availability of type-specific gG-based assays detecting IgG against HSV-1 and HSV-2 allows to establish the prevalence of each subtype. Worldwide, few data have been published regarding the seroprevalence in general populations of HSV-2, the major causative agent for genital herpes, while no data exist regarding the Swiss population.

Methods

To evaluate the prevalence of IgG antibodies against HSV-1 and HSV-2 in Switzerland, we used a population-based serum repository from a health examination survey conducted in the Western and Southern area of Switzerland in 1992–93. A total of 3,120 sera were analysed by type-specific gG-based ELISA and seroprevalence was correlated with available volunteers characteristics by logistic regression.

Results

Overall, seroprevalence rates were 80.0 ± 0.9% (SE, 95% CI: 78.1–81.8) for HSV-1 and 19.3 ± 0.9% (SE, 95% CI: 17.6–21.1) for HSV-2 in adults 35–64 year old. HSV-1 and HSV-2 seroprevalence increased with age, with a peak HSV-2 seroprevalence in elderly gentlemen, possibly a seroarcheological evidence of sexually transmitted disease epidemics during World War II. Risk factors for HSV-2 infection included female sex, marital status other than married, and size of town of residence larger than 1500 inhabitants. Unexpectedly and conversely to HSV-1, HSV-2 seroprevalence increased with educational level. HSV-2 infection was less prevalent among HSV-1 infected individuals when compared to HSV-1 uninfected individuals. This effect was most apparent among women at high risk for HSV-2 infection.

Conclusions

Our data demonstrate that by the early nineties, HSV-2 had spread quite largely in the Swiss population. However, the epidemiology of HSV-2 in Switzerland presents paradoxical characteristics, e.g. positive correlation with education level, that have not been observed elsewhere.

     

The age-structured incidence and mortality of pulmonary tuberculosis reported in China,in 2005–15: a longitudinal analysis of national surveillance data

Background

With the rapid pace of population ageing, tuberculosis in older people has become a public health challenge in China. However, the age-structured epidemiological transition and its impact on achieving the end tuberculosis targets by 2035 have not been understood well. We analysed the age-structured incidence and mortality of pulmonary tuberculosis reported in China to inform current and future control programmes.

Associations between adolescents’ experience of general practitioners and health outcomes in England: a cross-sectional study of national data

BackgroundAdolescence is a key stage of the life course when lifelong health behaviours and attitudes to health care can be established. Poor experience of consultations with a general practitioner (GP) is common among adolescents, but little is known about whether poor experience in this group is associated with worse health status or outcomes. This study aimed to investigate this association with data from the 2014 Health Behaviour in School-Aged Children (HBSC) survey (England).MethodsWe used logistic regression to analyse data for 5335 participants aged 10–17 years in the HBSC survey. Four aspects of recent GP experience were studied: feeling at ease, being treated with respect, quality of GP explanation, and feeling able to talk about personal matters. Five dichotomised measures of health status or outcome were used (ever self-harmed; fair or poor self-reported health; frequent [at least weekly] low mood, sleeping problems, or headaches). We adjusted for participants’ sex, age, ethnicity, and family affluence score. Of 5178 participants, 1187 (23%) had not visited their GP within the past year and were excluded from the analysis.FindingsOf 3991 adolescents, 3632 (91%) felt treated with respect, 2091 (52%) could talk about personal matters, 1600 (40%) were satisfied with explanations, and 1221 (31%) felt at ease. Participants who reported poor experience of GP care were more likely to have poor health outcomes than were those who reported a good experience. For example, adolescents who did not feel at ease with their GP were more likely to report self-harm (adjusted odds ratio [AOR] 2·65, 95% CI 1·69–4·15; fair or poor health 1·64, 1·28–2·10; low mood 1·51, 1·25–1·82) and sleeping problems (1·41, 1·19–1·66). All GP indicators were associated with self-harm (AOR range 1·64–2·70; quality of GP explanation p=0·006, all others p<0·001) and feeling low (1·46–2·11, all p<0·001). The association with GP experience was less consistent for the other three health outcomes.InterpretationThis cross-sectional, observational study demonstrates that young people who report worse health symptoms, typically also report a poor experience of care. Further research is needed to investigate whether GP experience influences health outcomes—suggesting that improving GP experience might improve health outcomes in this group—or whether poor health status leads to more negative perceptions of care.FundingNone.     

Preconception alanine aminotransferase concentrations and risk of preterm birth in rural Chinese women aged 20–49 years: a population-based cohort study

Background

Previous studies have shown maternal hepatitis B virus infection is associated with preterm birth. However, whether liver dysfunction caused by hepatitis B virus infection or other factors can lead to preterm delivery needs further exploration. Serum alanine aminotransferase (ALT) is a sensitive indicator of liver function, but few studies have investigated the association between serum ALT concentrations and preterm birth. We aimed to examine the relationship between maternal preconception ALT concentration and risk of preterm birth.

Sleep duration and risk markers for type 2 diabetes: a cross-sectional study in children aged 9–10 years

BackgroundShorter sleep duration has been associated with obesity, increased cardiovascular morbidity, and mortality in adults and with obesity in children. However, effects on childhood risk markers for cardiometabolic disease have been little studied. We examined associations between self-reported sleep duration and cardiometabolic risk markers in children and whether sleep duration might explain ethnic differences in insulin resistance.MethodsThis was a cross-sectional study of 4560 children aged 9–10 years, predominantly of white European, South Asian, and black African origin, from 200 UK primary schools. Children were asked to recall usual time of going to sleep and awakening on a school day. Fasting blood samples provided concentrations of serum insulin, plasma glucose, HbA_1c, and serum lipids. Physical measures included height, weight, bioimpedance, and blood pressures. Multilevel linear regression models examined the association of sleep duration (in hours) with blood markers and anthropometric measures, adjusted for sex, age quartiles, month, ethnicity, socioeconomic status, observer (physical measures only), and random effect for school; percentange changes are given for log transformed outcomes. Informed consent was obtained from parents or children, and ethics approval was given by the Multicentre Research Ethics Committee (Wales).FindingsMedian sleep duration was 10·5 h (95% central range 8–12). On average, white European children slept longer than South Asian and black African children (10·4 h/night, 10·2, and 10·1, respectively). There were strong inverse graded associations between sleep duration, adiposity, and diabetes risk markers. Per hour increase in sleep duration was associated with 0·8 kg/m³ lower ponderal index (95% CI 1·2–0·3), 0·03 kg/m⁵ lower fat-mass index (0·05–0·0), 1·73% lower HOMA (homoeostatis model assessment) insulin resistance (0·50–3·91), 2·43% lower fasting glucose (0·86–3·97), and 0·19% lower HbA_1c (0·0–0·39) after adjustment. Associations with diabetes risk markers remained after adjustment for adiposity and objective measures of physical activity. Sleep duration did not account for ethnic differences in insulin resistance, and was unrelated to blood pressure and serum lipids.InterpretationThe inverse association between type 2 diabetes risk markers and sleep duration in childhood is novel. Intervention studies are needed to establish causal associations, especially since increased sleep duration might offer a strategy for early prevention of type 2 diabetes.FundingThis research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (South London) and by grants from Diabetes UK and the Wellcome Trust.     

Effectiveness of the GoActive intervention to increase physical activity in adolescents aged 13–14 years: a cluster randomised controlled trial

BackgroundAdolescent physical activity levels are low and are associated with rising disease risk and social disadvantage at increasingly early ages. We aimed to assess the effectiveness of a school-based programme (GoActive) to increase moderate-to-vigorous physical activity (MVPA) in adolescents.MethodsIn this cluster randomised controlled trial, non-fee-paying, co-educational schools including Year 9 students (aged 13–14 years) in Cambridgeshire or Essex, UK, were eligible for inclusion; within participating schools, all Year 9 students were eligible. Schools were computer-randomised (1:1) to either the control or intervention group, stratified by school-level pupil premium (below vs above county-specific median) and county (Cambridgeshire vs Essex). Measurement staff were masked to allocation; investigators were not masked because of necessary school contact. The iteratively developed, feasibility-tested and refined 12-week intervention trained older adolescents (mentors) and in-class peer leaders to encourage classes to undertake two new weekly activities. Training sessions consisted of an initial session between facilitators and mentors lasting at least 1 h followed by six 30 min meetings every week during the first six weeks and meetings approximately every 2 weeks thereafter. Mentors met with peer leaders weekly. Students and classes gained points and rewards for activity in and out of school. The primary outcome was mean daily minutes of accelerometer-assessed MVPA at 10 months post-intervention, assessed in the complete case population (ie, all students who had a 10-month post-intervention measurement and [in the intervention group] wore the accelerometer) under the intention-to-treat principle, and in the per-protocol population (ie, students who also reported weekly class activities and logged points). Ethical approval was granted from the University of Cambridge Psychology Ethics Committee (PRE.126.2016). This study is registered with the International Standard Randomised Controlled Trials registry, number ISRCTN31583496.FindingsOf 103 eligible schools, 16 enrolled in the study. 2862 Year 9 students were eligible, of whom 1319 were in the eight control schools (mean of 165 [SD 62] students per school) and 1543 were in the eight intervention schools (mean 193 [SD 43] per school; intraclass correlation coefficient=0·03 for school-level MVPA). 2167 (76%) of 2862 students had a 10-month post-intervention measurement; we analysed the primary outcome in 1874 participants (65%) due to expected low levels of accelerometer wear (871 [66%] in control schools; 1003 [65%] in intervention schools); analyses were adequately powered to detect an effect. At 10 months, time spent doing MVPA did not differ significantly between adolescents at intervention schools versus those at control schools (mean difference –1·91 min [95% CI –5·53 to 1·70]; p=0·32). In the per protocol population (285 students in intervention schools and 871 in control schools at 10 months), results were similar (mean difference –1·87 min [–6·80 to 3·06]; p=0·47]).InterpretationThe rigorously developed school-based GoActive intervention was no more effective than standard school practice at increasing adolescent physical activity. Authorities should be cautious about commissioning and proliferating school-based health promotion strategies and realistic about expectations of effect.FundingUK National Institute for Health Research (NIHR) Public Health Research Programme (13/90/18).     

Infection-induced anaemia: a cross-sectional study of 14,636 German travellers aged 20–49 years

Background

Anaemia is a frequently diagnosed condition which can develop as a consequence of numerous factors, including infectious diseases (IDs). Travelling, especially in sub-/tropical regions, leads to an elevated risk of contracting IDs. The aim of our study was to assess the epidemiological significance of IDs in inducing anaemia among a large cohort of returned travellers.

Methods

This was a cross-sectional study in which data on 17,009 returned travellers aged 20–49 years who consulted the travel medicine clinic of the University of Munich between 1999 and 2011 were retrieved and analysed.

Results

Of the returned travellers, 8.3 % (6.0 % of males/10.4 % of females) were diagnosed with anaemia. The prevalence of anaemia was significantly elevated among patients of African (21.4/28.3 %) and Asian (11.6/15.7 %) origin. When the study population was restricted to the 14,636 travellers of German origin, 7.1 % of the returned travellers (4.6/9.6 %) were diagnosed with anaemia. The prevalence was significantly elevated among patients who travelled for >30 days (5.7 of males/10.6 % of females) and for male travellers visiting friends and relatives (7.7 %). However, these correlations were confounded by malaria. The prevalence of anaemia was significantly elevated only among returned travellers diagnosed with malaria (36.1 of males/26.9 % of females) and with symptomatic intestinal Entamoeba histolytica infections (30.0/33.3 %).

Conclusion

Following the exclusion of confounding by malaria from the statistical analysis, the prevalence of anaemia was found to be significantly elevated among patients of African and Asian origin, and among patients of German origin who had travelled for >30 days, it could be mainly attributable to chronic, long-lasting causes. Although more than 550 travel-associated IDs were assessed in our study, only symptomatic intestinal Entamoeba histolytica infections and, to an even larger extent, malaria were determined to be of epidemiological significance for inducing anaemia among travellers.     

Severity of acute respiratory distress syndrome and echocardiographic findings in clinical practice–an echocardiographic pilot study

BackgroundsThe still high poor outcome of ARDS may be more consequence of circulatory failure than hypoxemia per se. For patients with circulatory failure and ARDS, hemodynamic instability is directly related to ARDS following pulmonary circulation dysfunction and its consequence - right ventricular (RV) dysfunction.ObjectivesWe hypothesize that in the era of protective ventilation, echocardiographic abnormalities did not parallel ARDS severity, defined by the degree of hypoxemia.MethodsWe included 63 consecutively identified mechanically ventilated ARDS patients (1st January 2015 to 31th December 2016). All had echocardiography performed routinely within the first 12 h after ICU admission.ResultsThe analysis included 110 exams. Twenty-eight patients had severe ARDS (28/63, 44.4%), 27 had moderate ARDS (27/63, 42.1%) and 8 mild ARDS (8/63, 12.7%).There was no difference in echocardiographic findings between mild-moderate and severe ARDS. At Pearson's linear regression analysis, TAPSE was directly correlated with LVEF (r = 0.22, p = 0.021) and inversely with sPAP (r = −0.37, p < 0.001). Systolic pulmonary arterial pressure (sPAP) showed a direct correlation with pCO₂ (r = 0.30, p = 0.002) and an inverse one with pH (r = −0.35, p < 0.001) and TAPSE (r =−0.35, p < 0.001).ConclusionsAmong patients with ARDS, the severity of disease (as indicated by pO2) does not translate into specific cardiac abnormalities, detected by echocardiography. However, RV function (as indicated by TAPSE) is inversely related to pCO₂ and to sPAP (which therefore may be underestimated in presence ofRV dysfunction). Our data strongly suggest that in mechanically ventilated ARDS, the interpretation of echo findings should consider also pCO₂ values.     

Stressful life events and psychological distress of the very old: does social support have a moderating effect?

The purpose of this paper was to examine whether social support has a moderating effect on the relationship between exposure to stressful life events and psychological distress. To test this, 224 men and women aged 81-86 were sampled from two municipal regional counties: Sherbrooke (and vicinity) and Trois-Rivières, in the Province of Quebec, Canada. The French version of the Geriatric Scale of Recent Life Events, the Psychiatric Symptom Index, and the Social Provision Scale were used. Multiple regression analyses revealed that social support did not cancel out the deleterious effect of life events on the outcome measure. The negative aspect of social interaction may explain why social support did not have a protective effect. Also, social isolation resulting from psychological distress could reduce the opportunity for instrumental help and emotional support.     

From the Cover: Male tolerance and male–male bonds in a multilevel primate society

Male relationships in most species of mammals generally are characterized by intense intrasexual competition, with little bonding among unrelated individuals. In contrast, human societies are characterized by high levels of cooperation and strong bonds among both related and unrelated males. The emergence of cooperative male–male relationships has been linked to the multilevel structure of traditional human societies. Based on an analysis of the patterns of spatial and social interaction in combination with genetic relatedness data of wild Guinea baboons (Papio papio), we show that this species exhibits a multilevel social organization in which males maintain strong bonds and are highly tolerant of each other. Several “units” of males with their associated females form “parties,” which team up as “gangs.” Several gangs of the same “community” use the same home range. Males formed strong bonds predominantly within parties; however, these bonds were not correlated with genetic relatedness. Agonistic interactions were relatively rare and were restricted to a few dyads. Although the social organization of Guinea baboons resembles that of hamadryas baboons, we found stronger male–male affiliation and more elaborate greeting rituals among male Guinea baboons and less aggression toward females. Thus, the social relationships of male Guinea baboons differ markedly from those of other members of the genus, adding valuable comparative data to test hypotheses regarding social evolution. We suggest that this species constitutes an intriguing model to study the predictors and fitness benefits of male bonds, thus contributing to a better understanding of the evolution of this important facet of human social behavior.Traditional human societies typically consist of stable communities comprising several conjugal family groups (1). Sexual relationships are predominantly monogamous, and individuals of both sexes may disperse from their family groups or stay, resulting in coresidence of both brothers and sisters (2). Strikingly, men from different family groups may form long-term alliances within the community, resulting in cooperative relationships among individuals who often are not genetic relatives (3). The advent of such exceptional cooperative relationships within human societies has been linked to their multilevel organization (4). However, what are the evolutionary dynamics that give rise to multilevel systems in the first place, and how do social organization and cooperative tendencies stabilize each other?Evolutionary game theory has been used to model the conditions that favor cooperation among unrelated individuals (5, 6). Such analyses reveal that the evolutionary dynamics have a strong spatial component, in which cooperators prevail against defectors by forming clusters within the social network (7). This theoretical insight is bolstered by empirical studies of the Hadza, a population of hunter-gatherers in Tanzania. In this study, cooperators were found to cluster in physical space, i.e., in the same camp (8). Assortative processes thus may stabilize cooperation, and vice versa.Further empirical evidence to explain key facets of human social evolution comes from comparative studies of nonhuman primates (9–11) and other mammalian species as well. Among mammals, cooperative relationships among unrelated individuals are considered generally rare (12), particularly among males, who—according to sexual selection theory—are predicted to compete with other males over access to females. However, there are notable exceptions, including cooperative hunting and territorial patrols by chimpanzees (Pan troglodytes) (13), joint foraging by male coastal river otters (Lontra canadensis) (14), and the defense of females by male dolphins, Tursiops spp. (15). Such instances of cooperative behavior among unrelated animals can be explained by mutualism, whereby individuals benefit immediately from cooperating, and by reciprocity, whereby one individual experiences a short-term cost by cooperating but obtains a future benefit greater than the initial investment (16, 17).We here show that Guinea baboons (Papio papio) live in a multilevel society with extensive cooperation among unrelated males. Until now, comparatively little attention had been paid to this species, and its social organization was disputed. Although some previous studies, mainly from captivity or short field stints, suggested that Guinea baboon groups, like groups of hamadryas baboons (Papio hamadryas) (18), are comprised of one-male units that aggregate into larger parties (19, 20), other studies suggested a multimale/multifemale organization comparable to that of savanna baboons (21) or one that differs from both the savanna and the hamadryas baboon types (22, 23). However, quantitative data from observations of individually identified animals in the wild were lacking.We used ranging data collected from animals equipped with Global Positioning System (GPS) collars, proximity, and behavioral measures recorded during focal observations from individually identified males, as well as population genetic analyses based on microsatellites to describe the association patterns and individual interactions of Guinea baboons in space and time. Our aim was to contribute to a deeper understanding of the link between social organization and the formation of male bonds and to provide critical empirical evidence for modeling the processes that gave rise to some of the hallmarks in human evolution.     

Oxidative DNA damage in peripheral leukocytes and its association with expression and polymorphisms of hOGG1： A study of adolescents in a high risk region for hepatocellular carcinoma in China

AIM: To study the oxidative DNA damage to adolescents of hepatocellular carcinoma (HCC) families in Guangxi Zhuang Autonomous Region, China. METHODS: Peripheral leukocytes‘‘ DNA 7, 8-dihydro-8-oxoguanine (8-oxoG) and repair enzyme hOGG1 were quantified by flow-cytometry, hOGG1-Cys326Ser single nucleotide polymorphism (SNP) was distinguished by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) assay. RESULTS: There was a positive correlation between 8-oxoG and repair enzyme hOGG1 expression (P&lt;0.001). HCC children (n=21) in Fusui county had a higher level of hOGG1(P&lt;0.01) and a lower level of 8-oxoG (P&lt;0.05) than the controls (n=63) in Nanning city. Children in Nanning exposed to passive-smoking had a higher hOGG1 expression (P&lt;0.05)than the non-exposers. 8-oxoG and hOGG1 were negatively correlated with body mass index, while hOGG1 was positively correlated with age. There was a peak of 8-oxoG level nearby the 12 year point. Individuals with the hOGG, 326Ser allele had a significantly marginal higher concentration of leukocyte 8-oxoG level than hOGG1 326Cys allele. CONCLUSION: This is the first report using flow-cytometry to simultaneously quantify both the DNA oxidative damage and its repairing enzyme hOGG1. The results provide new insights towards a better understanding of the mechanisms of oxidative stress in a population highly susceptible to hepatocarcinogenesis.