Adjustment For Sociodemographic Variables Research Articles

Neighborhood physical environments and change in cardiometabolic risk factors over 14 years in the study of Women's health across the nation

BackgroundNeighborhood physical environments may influence cardiometabolic health, but prior studies have been inconsistent, and few included long follow-up periods. MethodsChanges in cardiometabolic risk factors were measured for up to 14 years in 2830 midlife women in the Study of Women's Health Across the Nation, a multi-ethnic/racial cohort of women from seven U.S. sites. Data on neighborhood food retail environments (modified Retail Food Environment Index) and walkability (National Walkability Index) were obtained for each woman's residence at each follow-up. Data on neighborhood access to green space, parks, and supermarkets were available for subsets (32–42%) of women. Models tested whether rates of change in cardiometabolic outcomes differed based on neighborhood characteristics, independent of sociodemographic and health-related covariates. ResultsLiving in more (vs. less) walkable neighborhoods was associated with favorable changes in blood pressure outcomes (SBP: −0.27 mmHg/year, p = 0.002; DBP: −0.22 mmHg/year, p < 0.0001; hypertension status: ratio of ORs = 0.79, p < 0.0001), and small declines in waist circumference (−0.09 cm/year, p = 0.03). Small-magnitude associations were also observed between low park access and greater increases in blood pressure outcomes (SBP: 0.37 mmHg/year, p = 0.003; DBP: 0.15 mmHg/year, p = 0.04; hypertension status: ratio of ORs = 1.16, p = .04), though associations involving DBP and hypertension were only present after adjustment for sociodemographic variables. Other associations were statistically unreliable or contrary to hypotheses. ConclusionNeighborhood walkability may have a meaningful influence on trajectories of blood pressure outcomes in women from midlife to early older adulthood, suggesting the need to better understand how individuals interact with their neighborhood environments in pursuit of cardiometabolic health.

Factors associated with the use of oral health care services among Canadian children and youth.

This study investigates the association between dental insurance, income, and dental care access for Canadian children and youth aged 1 to 17 years. It contributes to a baseline understanding of oral health care use before the implementation of the Canadian Dental Care Plan (CDCP). This study used data from the 2019 Canadian Health Survey on Children and Youth (n=47,347). Descriptive statistics and logistic regression models were employed to assess the association of dental insurance, adjusted family net income, and other sociodemographic factors on oral health care visits and cost-related avoidance of oral health care. A large percentage of children under the age of 5 had never visited a dentist (79.8% of 1-year-olds to 16.4% of 4-year-olds). Overall, 89.6% of Canadian children and youth aged 5 to 17 had visited a dental professional within the past 12 months: 93.1% of those who were insured and 78.5% of those who were uninsured. Insured children and youth had a 4.5% cost-related avoidance of dental care, contrasting with 23.3% for uninsured children and youth. After adjustment for sociodemographic variables, children and youth with dental insurance were nearly three times more likely (odds ratio [OR]: 2.94; 95% confidence interval [CI]: 2.60 to 3.33) to have visited a dental professional in the past 12 months than uninsured children and youth. Having dental insurance (OR: 0.19; 95% CI: 0.16 to 0.21) was protective against barriers to seeing a dental professional because of cost. There was a strong income gradient for both dental service outcomes. The study emphasizes the significant association of dental insurance and access to oral health care for children and youth. It highlights a significant gap between insured and uninsured children and youth and points out the influence of sociodemographic and income factors on this disparity.

Vicarious racism, ethnic/racial identity, and sleep among Asian Americans.

Vicarious racism-witnessing or hearing about other individuals of one's ethnic/racial group being the target of racism-has been salient among Asian Americans during the coronavirus disease (COVID-19) pandemic. There is emerging evidence that such experiences adversely impact several health-related outcomes, including sleep. The present study examines associations between vicarious racism and subjective sleep duration and quality, and the potential moderating role of ethnic/racial identity (ERI). Multivariable regression models assessed the association between vicarious racism, private regard, and centrality on self-reported sleep disturbance and duration. The sample consisted of an online sample of 600 Asian American adults (Mage = 38.55, SDage = 17.11; 65.17% female; 60% ≥ Bachelor's degree) recruited from May to June 2020. Vicarious racism was associated with compromised sleep quality and duration, including after adjustment for sociodemographic variables that have been linked to sleep. Private regard toward one's own ethnic/racial group and centrality of ethnicity/race to self-identity buffered the association between vicarious racism and sleep quality and duration. Adverse effects of high vicarious racism on sleep quality and duration were lessened among respondents reporting high levels of ERI private regard and centrality. Findings from this study extend research on racism and sleep by examining vicarious racism, an understudied facet of racism, and by focusing specifically on Asian Americans and in the context of the COVID-19 pandemic. Future research and practice should consider expanding research on discrimination to include a broader range of unjust experiences. Vicarious racism contributes to health hazards experienced by Asian Americans during the COVID-19 pandemic. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Digital alcohol and cannabis ads, consumption frequency, and driving under the influence.

Little is known about the consequences of substance-related advertising on driving under the influence of alcohol (DUIA) or cannabis (DUIC). This study seeks to estimate associations between substance-related digital advertising exposures and DUIA and DUIC, respectively, in a sample of young adults. The Rhode Island Young Adult Survey 2022 was a cross-sectional web-based survey of N=1,022 adults aged 18-25 years. Analyses were conducted among lifetime alcohol users (n=824) and lifetime cannabis users (n=471). Prevalence of past 30-day digital ad exposure to alcohol and cannabis, respectively, was assessed, as well as prevalence of past month DUIA and DUIC. Multivariable logistic regressions examined the association between digital ad exposure and substance use among lifetime users, and ad exposure and DUI among current users. 54.4% of participants reported past 30-day exposure to digital alcohol advertising, and 33.5% reported exposure to digital cannabis advertising. Exposure to social media alcohol advertising was associated with higher odds of DUIA after adjustment for sociodemographic variables (OR[95%CI]=2.14[1.07,4.28]), but not after accounting for frequency of use. Odds of DUIC remained significantly higher for those exposed to app-based cannabis advertising after adjusting for sociodemographic variables (OR[95%CI]=4.36[1.76,10.8]) and frequency of use (OR[95%CI]= 3.96[1.53,10.2]). Since social media alcohol ad exposure may be indirectly linked with DUIA and app-based cannabis ad exposure may be directly linked to frequency of use and DUIC, legislators should consider comprehensive substance-related ad regulations and bans.

Association Between Hearing Loss, Asymmetric Hearing, and Postural Instability.

Recent studies have suggested that older adults with hearing loss (HL) are at a greater risk of postural instability than those with normal hearing. However, little is known regarding this association in middle-aged individuals. The relationships between HL laterality, asymmetric hearing, and posture control are similarly unclear. The purpose of this study was to investigate the effects of hearing status on postural control and to explore the dose-response relationship between the hearing threshold and postural instability risk in middle-aged adults. This cross-sectional study included 1308 participants aged 40 to 69 years with complete audiometric and standing balance function data from the 2001-2004 National Health and Nutrition Examination Survey. Speech-frequency HL was defined as a pure-tone average at 0.5, 1, 2, and 4 kHz of >25 dB in the better-hearing ear; high-frequency HL was defined as a pure-tone average at 3, 4, and 6 kHz of >25 dB. Asymmetric hearing was defined as a difference in the pure-tone average >15 dB between ears. Postural instability was defined as participants ending the modified Romberg test in condition 4. After adjustment for sociodemographic variables, lifestyle, and comorbidities, speech-frequency HL, except for unilateral HL, was associated with increased postural instability (mild HL: odds ratio [OR], 2.33; 95% confidence interval [CI], 1.25-4.35; moderate-to-severe HL: OR, 3.59; 95% CI, 1.61-8.03). Compared with individuals with normal bilateral hearing, participants with bilateral HL also showed a higher risk of postural instability (OR, 2.88; 95% CI, 1.61-5.14). The OR for postural instability among participants with asymmetric hearing compared with those with symmetric hearing was 2.75 (95% CI, 1.37-5.52). Furthermore, each 10 dB increase in the speech-frequency hearing threshold was associated with a 44% higher risk of postural instability. Hearing loss is associated with poorer postural control. Individuals with asymmetric hearing have a higher postural instability risk compared with those with symmetric hearing. Further studies are needed to confirm these findings and the causality. Moreover, future studies are warranted to assess whether hearing aids are beneficial for the restoration of impaired balance functions.

Depression mediates the association between health literacy and health-related quality of life after myocardial infarction.

So far, health literacy (HL) and its related factors in patients with acute myocardial infarction received little attention. Thus, the objective of this study was to investigate the associations between the different dimensions of HL and disease-specific health-related quality of life (HRQOL), and factors that may affect these relations in patients after acute myocardial infarction (AMI). All survivors of AMI between June 2020 and September 2021, from the Myocardial Infarction Registry Augsburg (n=882) received a postal questionnaire on HL [Health Literacy Questionnaire (HLQ)], HRQOL (MacNew Heart Disease HRQOL questionnaire) and depression (Patient Health Questionnaire). From the 592 respondents, 546 could be included in the analysis. Multivariable linear regression models were performed to investigate the associations between the nine subscales of the HLQ and the total score and three subscales of the MacNew questionnaire. A mediation analysis was performed to estimate direct and indirect effects of HL on HRQOL taking into account the mediating effect of depression. In the sample of 546 patients (72.5% male, mean age 68.5 ± 12.2 years), patients with poor education showed significantly lower HLQ scores. Significant associations between the subscales of the HLQ and the MacNew were found, which remained significant after adjustment for sociodemographic variables with few exceptions. More than 50% of the association between HL and HRQOL was mediated by depression in seven HLQ subscales and a complete mediating effect was found for the HLQ subscales 'Actively managing my health' and 'Appraisal of health information'. Depression mediates the associations between HL and disease-specific HRQOL in patients with myocardial infarction.

Association between participation in social network service groups and offline social networks.

Although some previous studies have suggested using a social networking service (SNS) to create and maintain offline social networks among younger generations, whether similar outcomes would apply to middle-aged and older individuals is uncertain. This study aimed to examine the association between participation in groups via SNS and greater offline social networks among middle-aged and older individuals. We conducted a web-based questionnaire survey on 3106 respondents from September to October 2021 among members of "the Shumi-to Club," an SNS in Japan. They indicated the number of SNS groups they belonged to and were classified into two categories, namely, those with and without participation in SNS groups. The current study assessed offline social networks using the total frequency of face-to-face interactions with distant family members and friends. Ordinal logistic regression analyses were performed, and the frequency of offline interactions was set as the outcome with adjustment for sociodemographic variables and self-rated health. Approximately 70.8% (n = 2200) of the participants belonged to SNS groups. Participation in SNS groups was associated with higher frequencies of face-to-face interaction with friends (odds ratio [95% confidential intervals]: 1.78 [1.53-2.07]). However, the current study found no association between belonging to a group and face-to-face interaction with distant family members (1.09 [0.93-1.26]). The participation in SNS groups potentially promotes offline social networks, particularly with friends. Geriatr Gerontol Int 2024; 24: 279-284.

Association between perceived stress and history of intimate partner violence throughout life and during the COVID-19 pandemic.

Intimate Partner Violence (IPV) is a significant public health issue, characterized by being a highly stressful experience for its victims. The relationship between IPV and stress creates a harmful cycle with broad health implications, affecting individuals and society at large. Despite its significance, there's a noticeable lack of research on this topic, especially regarding IPV throughout one's life and during the pandemic. To verify the association between perceived stress and the history of intimate partner violence throughout life and during the COVID-19 pandemic. Analytical cross-sectional epidemiological study with a sample of 1,086 women. Sociodemographic information and violence history, assessed using the World Health Organization Violence Against Women (WHO VAW STUDY), along with perceived stress measured by the short version of the Perceived Stress Scale (PSS), were collected. The sampling process unfolded through multiple stages. For bivariate analyses, the t-test and ANOVA were performed, whereas for multivariate analyses simple and multiple linear regression were performed. The software Stata® version 15.1 and R® were used. Women who reported having suffered intimate partner violence throughout their lives had higher means of stress (18.49), with an average increase of 4 points without adjustments and 3.5 points after adjustments for sociodemographic variables. Similarly, during the COVID-19 pandemic (19.01), stress increased by an average of 3.3 points, which was reduced to 2.8 points after adjustments. The results indicate an association between intimate partner violence and an increase in women's perceived stress, both throughout life and during the pandemic. The importance of preventive approaches, promoting gender equality and preventing IPV from the early stages of life is highlighted. In addition, they underscore the urgency of evidence-based interventions of a comprehensive nature to deal with this complex issue in a careful and effective manner. The cross-sectional nature of this study limits the inference of causality, and an additional limitation is acknowledged concerning information bias. This bias relates to the multifaceted issues surrounding the concept of violence, potentially influencing the accuracy of participants' information and complicating the measurement of violence.

Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents.

Attention-deficit hyperactivity disorder (ADHD) and disordered eating (DE) are both highly prevalent among adolescents, but their relationship is understudied. This study examines their possible association in a nationally representative sample of adolescents. Participants in the Israeli Youth Health and Nutrition Survey (2015-2016), a cross-sectional, school-based study, completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. An affirmative reply to at least two SCOFF items was considered a DE case. Multivariable logistic regression evaluated the ADHD-DE association and the associations between ADHD and individual SCOFF items, controlling for age, sex, socioeconomic status, and body mass index. Of 4616 participants (12-18 years, 50.2% male), 654 reported an ADHD diagnosis. DE prevalence among ADHD adolescents was significantly higher than the non-ADHD group (50.2% vs. 43.9%, p = 0.003). Controlling for potential covariates, the association between ADHD and DE remained significant (OR = 1.409; 95% CI: 1.170-1.697), as did associations between ADHD and three SCOFF items. No difference in DE prevalence was found between stimulant-treated (n = 287) and untreated (n = 326) adolescents with ADHD. Adolescents with ADHD are more likely to experience DE. As DE can herald an imminent eating disorder, early identification is crucial. Further studies are needed to determine the ADHD-DE relationship's causality. Disordered eating (DE) and attention-deficit hyperactivity disorder (ADHD) are common among adolescents, and significantly affect health and well-being. This study examined the association between ADHD and DE in adolescents using the SCOFF questionnaire. Following adjustment for sociodemographic variables and BMI z-score, ADHD was associated with a 41% increased odds for DE. This study established the association between ADHD and DE, using a well-known questionnaire, in a large, nationally representative sample of adolescents. Monitoring eating behaviors and attitudes among adolescents with ADHD should be a priority, to minimize the risk of developing an eating disorder and its harmful consequences.

Association of Time in Bed, Social Jetlag, and Sleep Disturbances With Cognitive Performance in Children With ADHD

Objectives: Children with ADHD commonly exhibit sleep disturbances, but there is limited knowledge about how sleep and sleep timing are associated with cognitive dysfunction in children with ADHD. Methods: Participants were 350 children aged 5 to 12 years diagnosed with ADHD. Three sleep-related constructs—time in bed, social jetlag (i.e., discrepancy in sleep timing pattern between school nights and weekend nights), and sleep disturbances were measured using a caregiver-report questionnaire. Linear regression models assessed the associations between sleep-related constructs and cognitive performance. Results: After adjustment for sociodemographic variables, there were few associations between time in bed or sleep disturbances and cognitive performance, however, greater social jetlag was negatively associated with processing speed (β = −.20, 95% CI [−0.35, −0.06]), visually-based reasoning (β = −.13, 95% CI [−0.27, 0.00]), and language-based reasoning (β = −.22, 95% CI [−0.36, −0.08]); all p < .05). Conclusion: Social jetlag, but not time in bed or disturbances, was associated with lower cognitive performance among children with ADHD.

Duration of remote work and a positive diagnosis of COVID-19: an analysis of PNAD COVID19 data

The scope of this work was to assess the association between the duration of remote work and a positive diagnosis of COVID-19 among individuals employed in Brazil. Data from the PNAD COVID19 (2020) survey were consulted. The variables in the work situation described included: absence from work due to physical distancing, work segment (work sector and formality: formal or informal private, military, statutory civil servant, CLT public sector, informal public sector, employer, self-employed/unpaid worker) and duration of remote work (no remote work for 1-2 months, 3-4 months, 5-7 months, respectively). The association between duration of remote work (exposure) and positive diagnosis for COVID-19 (outcome) was estimated by Cox regression, with adjustment for sociodemographic variables and work segment. The positive diagnosis of COVID-19 increased from 2.1% to 4.8% between July and November, and the frequency of remote work decreased from 11.6% to 9.5% between May and November. The risk of a positive diagnosis of COVID-19 was lower for people working remotely for 3-4 months, (HR=0.79; CI95%=0.67;0.92) and 5-7 months (HR=0.57; CI95%=0.48;0.67) compared to those who did not work remotely. There was a slight decrease in the percentage of remote work employees, and a longer duration reduced the risk of a positive diagnosis for COVID-19.

Prospective associations between adolescent risky substance use and school dropout and the role of externalising and internalising problems.

Background: The aim of the present study was to assess to what extent risky substance use (RSU) acts as an important risk factor for school dropout from upper secondary school in a prospective study of Norwegian adolescents, and how externalising and internalising mental health problems influenced this association. Methods: We used data from a large population-based survey (the youth@hordaland-survey), which included adolescents aged 16-19 years. The predictor variables were self-reported RSU. The survey was linked with prospective data from the Norwegian Education Database, following the adolescents to 21-23 years of age. The outcome variable was registry-based school dropout within five years after starting upper secondary school. The analyses were adjusted for sex, age, socioeconomic status, and externalising and internalising problems. Results: After adjustment for sociodemographic variables, all indicators of RSU were prospectively associated with school dropout (adjusted odds ratios 1.26-2.25; all p values <.01). While internalising problems only slightly changed these estimates, the associations were substantially attenuated by externalising problems. Still, all measures of RSU, except frequent alcohol intoxication, remained positively associated with school dropout in the fully adjusted models. For the youngest students, all associations between RSU and school dropout were significant. Conclusions: Adolescent RSU is a strong predictor for school dropout, and externalising problems explained a considerable proportion of this effect. Prevention efforts to reduce student substance could improve academic outcomes among upper secondary school students, and such efforts may benefit from also targeting co-occurring externalising problems.

Assessing the Effect of Cancer Diagnosis on Beliefs about Comorbid Diabetes

ObjectivesIncreasingly, patients diagnosed with cancer also live with chronic comorbidities, and it is important to understand the impact of a new cancer diagnosis on perceptions about preexisting conditions. This study assessed the effect of cancer diagnosis on beliefs about comorbid diabetes mellitus and assessed changes in beliefs about cancer and diabetes over time. Data SourcesWe recruited 75 patients with type 2 diabetes who were newly diagnosed with early-stage breast, prostate, lung, or colorectal cancer and 104 age-, sex-, and hemoglobin A1c−matched controls. Participants completed the Brief Illness Perception Questionnaire four times over 12 months. The authors examined within-patient and between-group differences in cancer and diabetes beliefs at baseline and over time. ResultsOverall, diabetes beliefs did not differ between cancer patients and controls at baseline. Cancer patients’ beliefs about diabetes varied significantly over time; they reported less concern about cancer, less emotional effect, and greater cancer knowledge over time. Participants without cancer were significantly more likely to report that diabetes affected their life across all time points, though this effect did not persist after adjustment for sociodemographic variables. ConclusionWhile all patients’ diabetes beliefs were similar at baseline and 12 months, cancer patients’ beliefs about both illnesses fluctuated during the months following cancer diagnosis. Implications for Nursing PracticeOncology nurses can play a key role in recognizing the effects of cancer diagnosis on beliefs about comorbid conditions and fluctuations in these beliefs during treatment. Assessing and communicating patient beliefs between oncology and other practitioners could produce more effective care plans based on patients’ current outlook on their health.

Association of Stress With Cognitive Function Among Older Black and White US Adults

Perceived stress can have long-term physiological and psychological consequences and has shown to be a modifiable risk factor for Alzheimer disease and related dementias. To investigate the association between perceived stress and cognitive impairment in a large cohort study of Black and White participants aged 45 years or older. The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study is a national population-based cohort of 30 239 Black and White participants aged 45 years or older, sampled from the US population. Participants were recruited from 2003 to 2007, with ongoing annual follow-up. Data were collected by telephone, self-administered questionnaires, and an in-home examination. Statistical analysis was performed from May 2021 to March 2022. Perceived stress was measured using the 4-item version of the Cohen Perceived Stress Scale. It was assessed at the baseline visit and during 1 follow-up visit. Cognitive function was assessed with the Six-Item Screener (SIS); participants with a score below 5 were considered to have cognitive impairment. Incident cognitive impairment was defined as a shift from intact cognition (SIS score >4) at the first assessment to impaired cognition (SIS score ≤4) at the latest available assessment. The final analytical sample included 24 448 participants (14 646 women [59.9%]; median age, 64 years [range, 45-98 years]; 10 177 Black participants [41.6%] and 14 271 White participants [58.4%]). A total of 5589 participants (22.9%) reported elevated levels of stress. Elevated levels of perceived stress (dichotomized as low stress vs elevated stress) were associated with 1.37 times higher odds of poor cognition after adjustment for sociodemographic variables, cardiovascular risk factors, and depression (adjusted odds ratio [AOR], 1.37; 95% CI, 1.22-1.53). The association of the change in the Perceived Stress Scale score with incident cognitive impairment was significant in both the unadjusted model (OR, 1.62; 95% CI, 1.46-1.80) and after adjustment for sociodemographic variables, cardiovascular risk factors, and depression (AOR, 1.39; 95% CI, 1.22-1.58). There was no interaction with age, race, and sex. This study suggests that there is an independent association between perceived stress and both prevalent and incident cognitive impairment. The findings suggest the need for regular screening and targeted interventions for stress among older adults.

Dietary selenium intake in relation to non-alcoholic fatty liver disease assessed by fatty liver index and hepatic steatosis index; a cross-sectional study on the baseline data of prospective PERSIAN Kavar cohort study.

BackgroundThere is limited and conflicting evidence on the association between selenium and non-alcoholic fatty liver disease (NAFLD). Therefore, the present population-based cross-sectional study aimed to explore the relationship between dietary selenium intake and the risk of NAFLD.MethodsA total of 3026 subjects from the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Kavar cohort study were included in the analysis. The daily selenium intake was evaluated using a semi-quantitative food frequency questionnaire, and energy-adjusted quintiles of selenium intake (µg/day) were calculated. NAFLD was defined as the fatty liver index (FLI) ≥ 60 or the hepatic steatosis index (HSI) > 36. The association between dietary selenium intake and NAFLD was evaluated using logistic regression analysis.ResultsThe prevalence rates of NAFLD were 56.4% and 51.9%, based on the FLI and HSI markers, respectively. The odds ratios (ORs) for FLI-defined NAFLD were 1.31 (95% confidence interval (CI): 1.01–1.70) and 1.50 (95% CI: 1.13–1.99) for the fourth and fifth quintiles of selenium intake, respectively, after adjustment for sociodemographic variables, smoking status, alcohol drinking, physical activity, and dietary factors (P trend = 0.002). There was also a similar association between selenium intakes and HSI-defined NAFLD (OR = 1.34 (95% CI: 1.03–1.75) for the fourth quintile and OR = 1.50 (95% CI: 1.12–2.01) for the fifth quintile of selenium intake) (P trend = 0.006).ConclusionIn this large sample study, we observed a weak positive association between dietary selenium intake and NAFLD risk.

Colchicine and risk of hospitalization due to COVID-19: A population-based study.

Colchicine is one of the most widely studied and best-known anti-inflammatory treatments. This study aimed to assess the effect of colchicine on risk of hospitalization due to COVID-19; and its effect on susceptibility to and severity of the virus in patients with COVID-19.We carried out a population-based case-control study. The following groups were applied: (1) to assess risk of hospitalization, cases were patients with a positive PCR who were hospitalized due to COVID-19, and controls without a positive PCR; (2) to assess susceptibility to COVID-19, cases were patients with a positive PCR (hospitalized and non-hospitalized), and the same controls; (3) to determine potential severity, cases were subjects with COVID-19 hospitalized, and controls patients with COVID-19 nonhospitalised. Different electronic, linked, administrative health and clinical databases were used to extract data on sociodemographic variables, comorbidities, and medications dispensed.The study covered 3060 subjects with a positive PCR who were hospitalized, 26 757 with a positive PCR who were not hospitalized, and 56 785 healthy controls. After adjustment for sociodemographic variables, comorbidities and other treatments, colchicine did not modify risk of hospitalization due to COVID-19 (adjusted odd ratio [OR] 1.08 [95% confidence interval (CI) 0.76-1.53]), patients' susceptibility to contracting the disease (adjusted OR 1.12 (95%CI 0.91-1.37)) or the severity of the infection (adjusted OR 1.03 [95%CI 0.67-1.59]).Our results would neither support the prophylactic use of colchicine for prevention of the infection or hospitalization in any type of patient, nor justify the withdrawal of colchicine treatment due to a higher risk of contracting COVID-19.

The association of diabetes, subclinical hypothyroidism and carotid intima-media thickness: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil)

IntroductionThe association of diabetes with subclinical thyroid diseases may increase the risk of cardiovascular diseases. We analyzed the association of subclinical hypothyroidism, diabetes, and both diseases with carotid Intima-Media Thickness (cIMT) as a surrogate maker for early cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). MethodsCross-sectional analysis with data from the 3rd visit (2017‒2019). Linear regression models were used to evaluate the association of subclinical hypothyroidism, diabetes and of both diseases with a cIMT presented as Beta (95% Confidence Interval ‒ 95% CI) without adjustment, with adjustment for sociodemographic variables (Model 1) and multivariable adjustment (Model 1 more cardiovascular risk factors). We also used logistic regression models to analyze the Odds Ratio (OR) and 95% CI for the association of both diseases using cIMT > P75%. ResultsAfter the exclusion of patients with previous cardiovascular disease, 5,077 participants with no diseases, 1578 with diabetes, 662 with subclinical hypothyroidism, and 234 with both diseases were included in the analysis. Linear regression models showed an association of cIMT with only diabetes (β = 0.019; 95% CI 0.012 to 0.027; p < 0.0001) and subclinical hypothyroidism more diabetes (β = 0.03; 95% CI 0.010‒0.047, p < 0.0001). The logistic regression model reported an association between diabetes and CIMT higher than P75% (OR = 1.49, 95% CI 1.30‒1.71). No interaction between diabetes and subclinical hypothyroidism was detected using cIMT respectively as a continuous (p = 0.29) or as a categorical variable (p = 0.92). DiscussionDiabetes was associated with higher cIMT values. However, no additive effect of subclinical hypothyroidism associated with diabetes over cIMT was detected.

Increasing Overnight Fluid Intake and Kidney Function During Ramadan Fasting: A Randomized Controlled Trial

All healthy Arab individuals are obligated to abstain from eating, drinking, and sexual relations from dawn to sunset during Ramadan, which is one of the 5 pillars of Islam. Fasting effects various body systems, apart from the renal system. Fasting can also increase serum creatinine levels because of dehydration. Our aim was to examine the effects of increased fluid intake during the night on serum creatinine and urea levels. This randomized controlled trial included 58 healthy subjects who were randomly divided into 2 groups of 29. The hydrated group drank 2 to 3 L of fluid from sunset to the dawn of the next day. Kidney function was measured before, during, and 1 month after Ramadan. After adjustment for sociodemographic variables, the control group exhibited higher means of serum concentrations of creatinine and urea and lower estimated glomerular filtration rate than the hydrated group. The Ramadan group exhibited highest means of serum levels of creatinine and urea and the lowest estimated glomerular filtration rate compared with the pre- and post-Ramadan periods. All results were statistically significant at P <.05. We found that Ramadan fasting was not associated with a permanent increase in serum creatinine or urea. For those groups with a high fluid intake, serum creatinine and urea were significantly lower than the controls suggesting a favorable effect of hydration during the nonfasting hours. This compensated with the dehydration occurring during daylight, as dehydration is responsible for increased concentrations of urea and creatinine. This study adds further evidence that Ramadan fasting does not affect the renal system of healthy subjects; however, fluids should be increased at night, during nonfasting hours.

Intrinsic capacity and 10-year mortality: Findings from a cohort of older people.

Longitudinal data with regard to the association between intrinsic capacity (IC) and mortality is required for prevention efforts. We examined the association between IC and 10-year mortality among older people. We recruited a cohort of 2032 Chinese people aged 70years and older, 1371 of them could be traced over follow-up, of which 1096 died within 10years. Of those who were traceable, 846 were complete cases regarding the data for the exposure, outcome and covariates. Multiple imputation was used to handle missing data. Nine indicators were included to represent the construct of IC. All-cause mortality was collected from the Death Registry. Multivariable Cox proportional hazard regression model and Kaplan-Meier estimator were used to assess the association between IC and mortality. The mean age of the 2032 participants was 79.7years and 51% were female. Compared with those in the lowest (best) quartile of IC, those in the highest (worst) quartile were associated with 1.48-fold (95% CI 1.21-1.82) higher risk of mortality, after adjustment for sociodemographic variables. When past medical illnesses were further adjusted, the hazard ratio was attenuated (1.41; 95% CI 1.15-1.73). Kaplan-Meier estimator for survival probability similarly showed a graded mortality pattern. The association between IC and mortality remained similar when the analysis was confined to community-dwelling older people. IC is associated with mortality in a dose-response fashion. Assessment of IC should be instituted in community and institutional settings to enable formulation of early interventions.

Differential uranium exposure and its association with hypertension and elevated blood pressure in American Indian communities in the Strong Heart Family Study

Background: Urinary uranium (U) is present at higher concentrations in American Indian (AI) participants in the Strong Heart Study compared to the general US population. Cardiovascular disease is the leading cause of death among American Indians, of which hypertension is an important risk factor. We evaluated the association between U exposure and incident hypertension and increased blood pressure (BP) among Strong Heart Family Study (SHFS) participants. Methods: We included 1453 SHFS participants with baseline visits in 1998-1999 or 2001–2003, and follow-up visits in 2001-2003 and/or 2006–2009. We estimated the association of urinary U exposure with changes in systolic BP and diastolic BP levels using linear regressions, and hypertension incidence using Poisson regression with robust variance, accounting for family clustering. Results: Median (IQR) urinary uranium levels were 0.029 (0.013, 0.059) &amp;#x3bc;g/g creatinine. At follow-up, 17.4% of participants developed hypertension. After adjustment for sociodemographic variables, eGFR, pre-diabetes status, and BMI, comparing the highest to lowest urinary uranium quartiles, the RR (95% CI) of incident hypertension was 1.38 (1.00, 1.91) and the mean difference (95% CI) in systolic BP levels between baseline and follow-up was -2.00 (-3.83, -0.16) mmHg. After adjustment for urinary cadmium and arsenic, the corresponding RR (95% CI) was 1.44 (1.04, 1.99) and the mean difference (95% CI) for systolic BP between baseline and follow-up was -1.48 (-3.32, 0.37) mmHg. The association between uranium and blood pressure levels at follow-up was non-linear, with an increased risk at higher urinary uranium levels. Conclusions: These findings suggest moderate increased risk for hypertension at urinary uranium levels greater than 0.06 &amp;#x3bc;g/g, typical of the Southwest and Great Plains, furthermore a potential association with higher systolic BP levels and higher uranium exposure levels. Further work is needed to assess the cardiovascular effects of chronic uranium exposure in US populations. Keywords: Uranium, hypertension, blood pressure