To assess the longitudinal change of choroidal thickness (ChT) and tessellated fundus progression in Chinese adults over 4 years. In this population-based longitudinal cohort study, 1646 right eyes of 1646 participants were examined. Fundus photographs were obtained and ChT was measured using swept-source optical coherence tomography. Participants were categorized into high-myopia, low-myopia, and non-myopia groups, and the tessellated fundus was graded 0-3 based on the fundus photographs. The mean baseline age, refractive error, axial length (AL), and macular ChT were 62.51 ± 9.89 years, -0.48 ± 3.18 D, 23.71 ± 1.58 mm, and 199.7 ± 77.3 μm, respectively. At the 4-year follow-up, a significant reduction in macular ChT of 4.05 ± 6.24, 4.44 ± 6.87, and 3.51 ± 5.17 μm per year was observed in the non-myopia, low-myopia, and high-myopia groups, respectively. Age, baseline ChT, and AL changes (with βnon-M = -78.439, βHM = -56.505) were independently related to the rate of macular ChT change (all p < 0.05). Furthermore, the decrease in the ChT distribution pattern varied with different refractive groups. Moreover, 4.31% of the participants had tessellated fundus progression; these participants had more ChT reduction over 4 years than those without tessellated fundus progression (p < 0.001). Choroidal thinning was found to be associated with age and AL elongation. For every 1 mm increase in AL, the decrease rate of ChT in the high-myopia group was slower than that in the non-myopia group. Progression of tessellated fundus was associated with a faster decrease in ChT, highlighting its potential as a biomarker for myopia progression.

Abstract Background Dementia has become an important public health challenge as the aging population in China accelerates, highlighting the need to identify modifiable risk factors. The cumulative atherogenic index of plasma (CumAIP), a marker reflecting long-term dyslipidemia, may contribute to dementia via vascular and inflammatory pathways, but longitudinal evidence in Chinese adults around 60 years of age remains scarce. Methods Data were extracted from three waves of the China Health and Retirement Longitudinal Study (CHARLS): 2012 (Wave 1), 2015 (Wave 3), and 2018 (Wave 4). A total of 6473 participants with complete AIP measurements at 2012 and 2015 were included; CumAIP was computed as the time-weighted average of AIP values, normalized by the 2012–2015 observation duration. Dementia risk (primary outcome) was assessed via the Rotterdam Basic Dementia Risk Model (BDRM) using 2018 data, reflecting a 3-year follow-up with 2015 as the baseline. To validate the BDRM, we conducted a secondary analysis: Spearman rank correlation between 2018 BDRM scores and 2015 CHARLS cognitive function scores. Statistical analyses included: multivariable linear regression with three progressive adjustment tiers (sociodemographic, clinical, lifestyle factors); restricted cubic spline (RCS) curves (3 knots at 10th/50th/90th CumAIP percentiles) for linearity testing; quartile-based analyses (CumAIPQ1–Q4, Q1 as reference) for dose–response relationships; and subgroup (by gender, age, residence, and lifestyle/metabolic factors) and sensitivity analyses [multiple imputation, complete-case analysis, linear regression of CumAIP vs. 2015 cognitive function scores, linear regression of low-density lipoprotein cholesterol (LDL-C) vs. BDRM scores] to validate robustness. Results First, the 2018 BDRM score was significantly negatively correlated with the 2015 cognitive function score (Spearman’s r = − 0.26, P &lt; 0.001). Higher CumAIP was associated with elevated BDRM scores, remaining significant after full adjustment ( β = 0.058, 95% CI 0.018–0.098, P = 0.004). RCS confirmed a linear relationship (nonlinear term P = 0.9671), and quartile analyses showed a dose–response trend (Q4 vs. Q1, β = 0.103, 95% CI 0.009–0.197, P = 0.031). Subgroup effects were more pronounced in females, those aged ≥ 60 years, rural residents, nondrinkers, smokers, and BMI ≥ 24 kg/m 2 . Sensitivity analyses validated robustness: (1) CumAIP correlated positively with 2015 cognitive function ( β = 0.123, 95% CI 0.008–0.237, P = 0.037); (2) LDL-C correlated positively with BDRM scores ( β = 0.019, 95% CI 0.009–0.028, P = 0.0001), with a smaller effect than CumAIP. Conclusion Cumulative elevated CumAIP is independently associated with higher BDRM-estimated dementia risk in Chinese adults (mean age 61.4 ± 8.5 years), with linear and dose-dependent relationships. The association is more prominent in high-risk subgroups: females, aged ≥ 60 years, rural residents, nondrinkers, smokers, and BMI ≥ 24 kg/m 2 . The BDRM’s validity supports its reliability. CumAIP’s stronger association with dementia risk than LDL-C underscores its value as a comprehensive lipid marker for risk stratification. Dynamic lipid monitoring to maintain low CumAIP may aid dementia prevention in these high-risk groups.

The onset of COVID-19 and subsequent restrictive measures have impacted various infectious diseases, including hepatitis B virus (HBV). This study explored the epidemiological characteristics of HBV infection in Chinese adults before, during the pandemic, and after the easing of restrictive measures. This population-based cohort study used the data from 23,316 adult patients in the southwest of China who had HBV DNA tests from 1 January 2018 to 31 December 2023. HBV DNA was detected in patient serum using real-time fluorescent quantitative PCR. The positive rate of HBV detection was adjusted by age groups, sex, patient types, and seasons, stratified by the stages of the COVID-19 pandemic. Our analysis revealed significant variations in HBV DNA test positivity rates, primarily influenced by age and the pandemic stages. Positivity rates were highest in the 18-25 age group at 0.50 and decreased with advancing age. Males under 35 were at higher risk. Inpatients had the highest positivity rate at 0.42, with seasonal fluctuations peaking in winter. The pandemic stages significantly affected positivity rates, especially in the 36-45 and 56-65 age groups. The findings highlight a complex interplay between pandemic conditions and observed positivity rates. The increase likely stemmed from multiple factors, including shifted testing focus, altered healthcare-seeking behavior, and potential viral reactivation. The COVID-19 response offers insights for optimizing future viral hepatitis control strategies during public health emergencies. Future research should expand demographic and geographic scope and investigate behavioral/social determinants to elucidate underlying mechanisms and guide targeted interventions.

China is experiencing rapid population aging and increasing dementia cases. Although existing evidence suggests a link between social participation (SP) and cognitive function (CF) in older adults, few studies have explored their long-term patterns and interplay across urban-rural groups. We utilized five waves (2011, 2013, 2015, 2018 and 2020) of multivariate longitudinal data from the China Health and Retirement Longitudinal Study, categorizing participants into urban and rural groups by residence. A group-based dual trajectory model was employed to examine the heterogeneous trajectories and bidirectional association of social participation and cognitive function among 4,133 participants. Binary and multinomial logistic regression analyses were used to explore the predictors of different trajectories. A multigroup cross-lagged panel model was applied to explore the bidirectional associations between social participation and cognitive function. Among the rural participants, three social participation trajectories were identified: "No SP" (45.2%), "Low SP" (47.5%) and "Moderate SP" (7.3%), and the urban areas included two: "No SP" (62.3%) and "Low SP" (37.7%). There were three patterns of cognitive function in rural areas: "Low-Decline CF" (28.4%), "Moderate-Decline CF" (39.0%) and "High-Decline CF" (32.6%), while urban areas had two: "Low-Decline CF" (49.8%) and "High-Decline CF" (50.2%). Sleep duration was a common risk factor for SP and CF in rural participants (p < 0.05). Individuals with higher levels of social participation were also more likely to exhibit better cognitive function (rural: 79.08%; urban: 65.89%). The cross-lagged analysis showed that cognitive function at the previous wave had a significant positive effect on subsequent social participation (p < 0.05). The long-term developmental trajectories of social participation and cognitive function are synchronized, primarily driven by the positive effect of cognitive function on social participation. Rural older adults exhibited greater heterogeneity in their trajectories and more complex predictors than their urban counterparts. Interventions targeted at the urban‒rural context are recommended to reduce cognitive decline and promote health equity.

Previous studies have established visceral adiposity as a risk factor for cardiovascular disease (CVD), but the relationship between longitudinal changes in Chinese Visceral Adiposity Index (CVAI) and CVD risk has not been thoroughly investigated. This study aimed to investigate the longitudinal association between CVAI changes and CVD risk in Chinese middle-aged and older adults. A total of 3,805 CVD-free participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (CHARLS) were followed from 2015 until 2020 (median follow-up: 4.9 years) to detect incident CVD. Participants were categorized based on CVAI changes using K-means clustering. During follow-up, 375 participants (9.86%) developed CVD. Multivariable-adjusted Cox proportional hazards regression and restricted cubic spline regression models were used for data analysis. Compared with the low-increasing CVAI group, the hazard ratios (HR) were 1.25 (95% confidence interval [CI], 0.89 to 1.74) for moderate-increasing, 1.56 (95% CI, 1.09 to 2.24) for moderate high-increasing, and 1.87 (95% CI, 1.21 to 2.89) for high-increasing CVAI groups (P for trend = 0.002). Each standard deviation increase in cumulative CVAI was associated with a 20% increased CVD risk (HR 1.20, 95% CI, 1.06 to 1.37). The relationship was linear (P for nonlinearity = 0.998). Cumulative CVAI showed modest predictive performance (area under the curve 0.598), slightly better than body mass index, waist circumference, and Visceral Adiposity Index. These findings suggest CVAI changes may provide additional information for comprehensive CVD risk assessment, though further validation is needed given the modest predictive accuracy.

Cognitive decline is a critical public health concern among older adults. While physical activity (PA) is a recognized modifiable factor for mitigating cognitive deterioration, the specific impact of long-term PA trajectories on the rate of cognitive decline remains understudied, particularly in China. A longitudinal cohort of 3,471 participants aged ≥ 60years from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. PA trajectories were identified via group-based trajectory modeling (GBTM) on the basis of self-reported PA data from four waves (2011, 2013, 2015, and 2018). Global cognitive function, assessed by episodic memory and mental intactness, was measured repeatedly. Associations between PA trajectories and cognitive decline were analyzed using linear mixed models adjusted for demographic, lifestyle, and health-related factors. Two distinct PA trajectories were identified: a high decreasing trajectory group (43.4%) and a low increasing trajectory group (56.6%). The high decreasing trajectory group initially had higher PA levels but experienced a slight decline, whereas the low increasing trajectory group started with lower PA levels but showed gradual increases. Participants in the high decreasing trajectory group exhibited significantly slower declines in global cognition (β = 0.106, 95% CI: 0.072, 0.140, P < 0.001) and mental intactness (β = 0.116, 95% CI: 0.078, 0.154, P < 0.001) compared to the low increasing trajectory group. Subgroup analysis revealed that participants aged ≥ 75years, females, those with higher education levels, and rural residents experienced slower cognitive decline. Sensitivity analyses confirmed the robustness of these findings. Sustaining higher levels of physical activity over time is associated with a slower rate of cognitive decline in older Chinese adults. This protective effect is especially pronounced in specific demographic subgroups.

Extreme climate events are increasingly recognized as important environmental determinants of health. However, their associations with stroke incidence remain unclear, particularly among aging populations in developing countries. We conducted a cross-sectional study to examine the associations between four types of extreme climate events-extreme low temperature (LTD), extreme high temperature (HTD), extreme rainfall (ERD), and extreme drought (EDD)-and stroke among Chinese adults aged over 45 years. Climate data were obtained from the Climate Physical Risk Index (CPRI), developed using NOAA meteorological records, while health and demographic data were drawn from the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS). Multivariable logistic regression models were applied to estimate the odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic, behavioral, and clinical covariates. Subgroup analyses were conducted to explore potential effect modifications including sex, residence, education status, marital status, smoking status, drinking frequency, and regional category. Extreme climate events are increasingly recognized as important environmental determinants of health. However, their associations with stroke incidence remain unclear, particularly among aging populations in developing countries. We conducted a cross-sectional study to examine the associations between four types of extreme climate events-extreme low temperature (LTD), extreme high temperature (HTD), extreme rainfall (ERD), and extreme drought (EDD)-and stroke among Chinese adults aged over 45 years. Climate data were obtained from the Climate Physical Risk Index (CPRI), developed using NOAA meteorological records, while health and demographic data were drawn from the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS). Multivariable logistic regression models were applied to estimate the odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic, behavioral, and clinical covariates. Subgroup analyses were conducted to explore potential effect modifications including sex, residence, education status, marital status, smoking status, drinking frequency, and regional category. LTD was significantly associated with a lower incidence of stroke in all models (fully adjusted OR = 0.98, 95% CI: 0.95-1.00, p = 0.007). In contrast, EDD was associated with a higher incidence of stroke in the fully adjusted model (OR = 1.02, 95% CI: 1.00-1.04, p = 0.035). No significant associations were found for HTD or ERD in the overall analysis. Subgroup analyses revealed stronger associations of LTD and EDD with stroke among females, non-smokers, non-drinkers, and residents in specific regions. Our findings suggest a potentially protective role of extreme low temperatures and a modest adverse effect of extreme drought on stroke incidence among middle-aged and older adults in China. These associations vary across population subgroups and underscore the nEDD for climate-adaptive public health strategies tailored to vulnerable populations.

Association of ABO Blood Groups with Osteoporotic Hip Fracture Susceptibility in Chinese Adults.

Midlife obesity is a known risk factor for cognitive impairment, whereas its association in late life is complex, giving rise to the concept of the 'obesity paradox.' The weight-adjusted waist index (WWI), an indicator reflecting central obesity, has recently emerged. However, evidence regarding the association between WWI and cognitive impairment in Chinese older adults remains scarce. This study explores WWI's association with cognitive decline in older adults, addressing gaps in central obesity's role in neurocognitive health. A total of 5001 older adults aged ≥65 years with normal cognition from the Chinese Longitudinal Healthy Longevity Survey were included in this longitudinal analysis, with a median follow-up duration of 4 years. A time-varying Cox proportional hazards regression model was used to evaluate the association between WWI, waist circumference (WC), body mass index (BMI) and incident cognitive impairment. Nonlinear correlations were investigated using restricted-cubic-spline curves. Subgroup analyses and sensitivity analyses were conducted to enhance the robustness of findings. The incidence of cognitive impairment across the four WWI quartile groups (Q1-Q4) was 6.7%, 7.8%, 9.3% and 13.4%, respectively. WWI was positively associated with incident cognitive impairment, whether treated as a continuous variable (hazard ratio [HR] = 1.14, 95% confidence interval [95% CI] = 1.06-1.23) or a categorised variable (Q4 vs. Q1: HR = 1.70, 95% CI = 1.29-2.24; Q3 vs. Q1: HR = 1.43, 95% CI = 1.08-1.90) in models adjusted for multiple covariates. WC showed a similar trend, while BMI demonstrated no significant association. Associations persisted across subgroups and sensitivity analyses. Elevated WWI and WC, but not BMI, were significantly associated with an increased risk of incident cognitive impairment. The findings suggested that WWI may be a more precise indicator of the association between obesity and cognitive impairment.

Loneliness trajectories and the effects of adverse childhood experience among middle-aged and older Chinese adults.

Background Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized as a major public health concern, with rising prevalence worldwide. The alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio has emerged as a potential marker of metabolic dysfunction, but its association with NAFLD remains underexplored, particularly in Chinese populations. This study aimed to investigate the independent and nonlinear association between the ALT/HDL-C ratio and NAFLD in Chinese adults. Methods This was a secondary analysis of a cross-sectional dataset. A total of 1,592 Chinese adults aged 40–70 years who underwent health checkups were included. NAFLD was diagnosed via abdominal ultrasound. The ALT/HDL-C ratio was calculated and analyzed as both a continuous and categorical variable (tertiles). Multivariable logistic regression, restricted cubic spline (RCS) analysis, and receiver operating characteristic curves were used to assess the association and predictive performance of the ALT/HDL-C ratio for NAFLD. Results The prevalence of NAFLD was 61.1%. After full adjustment, each one standard deviation increase in the ALT/HDL-C ratio was associated with a 79% higher odds of NAFLD (odds ratio [OR] = 1.79, 95% CI: 1.39–2.31, p &amp;lt; 0.001). A significant positive trend was observed across ALT/HDL-C tertiles (p for trend &amp;lt; 0.001). RCS analysis revealed a non-linear association ( p for non-linearity = 0.002). Subgroup analyses showed a stronger association in females (OR = 3.89, p &amp;lt; 0.001) than in males (OR = 1.66, p &amp;lt; 0.001). However, no significant association was observed among adults aged ≥ 60 years (OR = 1.49, 95% CI 0.90–2.48, p = 0.125). The ALT/HDL-C ratio demonstrated superior predictive performance (area under the curve = 0.710) compared to ALT or HDL-C alone. Conclusion The ALT/HDL-C ratio is independently and nonlinearly associated with NAFLD in Chinese adults, with a particularly strong association in non-elderly individuals and women. This simple and readily available biomarker shows promise for enhancing NAFLD risk stratification in middle-aged adults, while its utility in the elderly population may be limited and requires further investigation.

Abnormal glucose metabolism, including diabetes and prediabetes, significantly contributes to cardiovascular disease and mortality worldwide. Socioeconomic status (SES) has been identified as a critical determinant of health outcomes, but it remains unclear whether sex difference exists in the impact of SES on mortality among adults with abnormal glucose metabolism. Data was used from the China Health and Retirement Longitudinal Study (CHARLS), involving participants aged 45years or older with abnormal glucose metabolism at baseline (2011) and participated at least one subsequent survey (2013, 2015, and 2018). SES was categorized as low, medium, and high according to the educational level, rural-urban residence, and household income. Multivariate Cox proportional hazards regression models were used to evaluate the associations between SES and all-cause mortality among participants stratified by sex. A total of 5146 participants (60.06 ± 9.16years old, females: 53.5%) were included in this study. The hazard ratio (HR) of mortality was 1.54 (95% CI: 1.20-1.98) for medium SES and 1.52 (95% CI: 1.18-1.96) for low SES compared to those with high SES. Stratified analyses revealed that the significant association was observed in Males, with HR of 1.69 (95% CI: 1.24-2.31) for medium SES and 1.63 (95% CI: 1.18-2.27) for low SES, while the associations were not statistically significant in females. Low SES was associated with higher all-cause mortality in Chinese adults with abnormal glucose metabolism, particularly among males. These findings underscore the need for targeted public health interventions addressing SES-related disparities to reduce mortality in this population.

BackgroundWith global population ageing, the mental health of older adults is a significant public health concern. Depression and depressive symptoms are increasingly prevalent and have been shown to influence healthcare utilization, but the mechanisms underlying these effects operate remain underexplored, particularly among older adults in China. Building on this context, this study draws on the Andersen behavioral model to explore the associations between depressive symptoms and healthcare utilization among older adults in China.MethodsUsing data from the 2018 China Health and Retirement Longitudinal Study, a nationally representative sample of 7,777 individuals aged 60 and above was analyzed. A Bayesian Generalized Structural Equation Model was constructed within the framework of the Andersen behavioral model to estimate both the direct and indirect associations between depressive symptoms and inpatient healthcare utilization.ResultsResults showed a direct association between depressive symptoms and inpatient healthcare utilization (0.16, 95% HDI: 0.02, 0.29), accounting for a small portion of the total association. The remaining 93.55% operated through indirect pathways, with health status, chronic diseases, satisfaction with health, activities of daily living limitations, disability, and alcohol use identified as key mediators. The model showed strong convergence and estimation stability.ConclusionsThese findings highlight the importance of distinguishing between direct and indirect associations when evaluating the relationship between depressive symptoms and healthcare utilization. Such differentiation helps to clarify the underlying mechanisms and provides an empirical basis for developing more targeted interventions to improve healthcare service use among Chinese older adults with depressive symptoms.

Introduction The global increase in the incidence of early-onset cancer underscores the urgent need to understand the behavioral determinants of prevention effectiveness. This study aimed to examine the fundamental roles of supernatural and scientific beliefs in shaping health-related cognitions and their potentially conflicting influences on cancer prevention behaviors. Methods Based on health locus of control (HLOC) theory, a dual-pathway attitudinal model was developed and tested using a two-step procedure to validate the model with data from a national survey ( N = 938) of young Chinese adults. Results The results indicated that both supernatural and scientific beliefs significantly predicted cancer control beliefs and prevention behaviors. Specifically, Chinese supernatural beliefs negatively predicted cancer prevention behaviors through cancer fatalism (external HLOC). In contrast, positive scientific attitudes were positively associated with cancer prevention behaviors through cancer controllability (internal HLOC). Furthermore, positive scientific attitudes mitigated the detrimental effects of supernatural beliefs on cancer prevention behaviors by reducing cancer fatalism and strengthening perceived cancer controllability. Discussion These findings elucidate the underlying factors contributing to both effective and ineffective cancer prevention and identify potential pathways for intervention and education. Both theoretical and practical implications are discussed.

Impact of heatwaves on health-related quality of life in older Chinese adults: A longitudinal cohort study.

Obesity has emerged as a global health crisis. Increasing evidence suggests that imbalances in gut and oral microbiota are linked to obesity, with specific microbial profiles influencing metabolic dysfunction and weight gain. Given the distinct ecological niches and the importance of gut and oral microbiota in obesity, this study analyzed both oral and fecal microbiota in adults with obesity, aiming to identify potential niche-specific microbial signatures associated with the condition. The comparison of fecal and oral microbiota communities between individuals with obesity and non-obese controls revealed significant differences in microbial composition and diversity. The predominant genera identified in both sample types were Prevotella, Faecalibacterium, Streptococcus, and Porphyromonas. A notable restructuring of microbial communities was observed between fecal and oral samples, regardless of obesity status. Furthermore, obesity-associated changes in microbial co-occurrence networks were found to be niche-specific, with reduced modularity in stool samples. In contrast, saliva microbial networks appeared to be more compartmentalized than those in stool. MaAsLin 3 and ANCOM-BC2 analyses identified five niche-specific taxa associated with obesity. These included positive associations in saliva with Granulicatella sp902479935, Lancefieldella sp938036925, Peptostreptococcus stomatis, Rothia sp916715725, as well as a negative association in saliva with Faecalibacterium sp934503275. Mediation analysis indicated that the second principal component partially mediated these effects, with Lancefieldella sp938036925 and others serving as positive contributors. The taxa Wolinella, Phocaeicola, and Bulleidia, which exhibited high abundance in saliva, were consistently selected by all machine learning models. This study contributes to the growing body of literature investigating the relationship between obesity and microbial communities. Using 16S rRNA gene amplicon sequencing, we characterized distinct microbial compositions in both saliva and fecal samples from individuals with obesity compared to normal-weight controls within a defined geographic population. The results suggest that the salivary microbiome may contain potential associative biomarkers indicative of obesity risk, warranting further in-depth investigation.

Emerging evidence has suggested that persistent organic pollutants (POPs) are linked with cardiovascular disease. However, limited evidence has systematically investigated the association between different types of POPs, individually or as mixtures, and heart rate variability (HRV). In a community of 159 Chinese adults, we measured the serum concentrations of 100 POPs and assessed 7 HRV indicators. Single-pollutant-based robust linear regression and the least absolute shrinkage and selection operator regression were applied to identify significant POP-HRV pairs. Weighted quantile sum and Bayesian kernel machine regression models were used to assess the joint associations of POPs overlapping. Propetamphos, phosalone, metolachlor, and hexachlorobenzene were consistently associated with HRV indicators in both single-pollutant and least absolute shrinkage and selection operator models (all false discovery rate <0.2). One ln-unit increase of propetamphos was related with a 19.25% (95% CI: 6.83%, 30.02%) decrease in the root mean square successive difference (r-MSSD) and 20.08% (95% CI: 7.92%, 30.6%) decrease in very high frequency. However, p1 ln-unit increase of hexachlorobenzene was associated with a 35.17% (95% CI: 13.39%, 61.14%) and 31.21% (95% CI: 9.72%, 56.91%) increase in r-MSSD and very high frequency. Mixture analyses presented that co-exposure to POPs was associated with the lower value of r-MSSD and very high frequency, dominated by propetamphos. This exploratory study suggested that POPs exposure might be linked to changes in HRV, with propetamphos as a potential key driver. The preliminary findings fill a knowledge gap concerning complex mixtures and offer a theoretical basis for future research into POPs exposure management and cardiovascular disease prevention.

While metabolic dysfunction-associated steatotic liver disease (MASLD) increasingly affects non-obese individuals, current screening approaches show poor performance in this population. We investigated whether the Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) could better identify MASLD risk than traditional measures in non-obese adults, and examined how the triglyceride-glucose (TyG) index might mediate this relationship. Using data from the Dryad public database, we followed 16,173 Chinese non-obese adults (BMI < 25kg/m²) without baseline MASLD for 5 years. MASLD diagnosis relied on abdominal ultrasonography. We applied multivariable logistic regression to assess cross-sectional associations and Cox models for incident disease risk. Restricted cubic splines revealed dose-response patterns in sex-stratified analyses, while structural equation modeling quantified TyG index mediation effects. Our cohort included 8,483 men and 7,690 women. After full adjustment, each standard deviation increased in CUN-BAE linked to 35% higher MASLD risk (HR = 1.35, 95% CI: 1.29-1.41, P < 0.001). Comparing top versus bottom tertiles showed 95% increased risk (HR = 1.95, 95% CI: 1.74-2.18, P < 0.001). Five-year cumulative incidence rose from 8.4% (lowest tertile) to 15.8% (middle) to 18.9% (highest tertile, Log-rank P < 0.0001). Cubic spline analysis uncovered sex differences: women showed a sharp risk increase above CUN-BAE 31.2, while men displayed more gradual, linear patterns. The TyG index accounted for 24.7% of the CUN-BAE-MASLD association (P < 0.001). CUN-BAE effectively predicts MASLD development in Chinese non-obese adults through clear dose-response relationships that differ by sex. Since TyG index only partially explains this association, insulin resistance appears important but insufficient to account for the full relationship. CUN-BAE could serve as a practical screening tool to identify high-risk individuals missed by conventional BMI-based approaches, enabling more precise risk stratification in non-obese populations.

BackgroundSarcopenia is an age-related condition characterized by loss of muscle mass and function. Nephrolithiasis represents a prevalent urological disorder that imposes a substantial burden on healthcare resources. However, the association between sarcopenia and nephrolithiasis remains poorly characterized.MethodsA total of 2586 older adults were included in this cross-sectional study. We used the univariate and multivariate logistic regression models to assess the relationship between nephrolithiasis and sarcopenia. Additionally, stratified analyses and propensity score matching (PSM) were performed to account for potential confounding factors.ResultsThe prevalence of sarcopenia in the present study was 7.2%. In Model 4, which integrated for all relevant covariates, nephrolithiasis was associated with approximately a 190% increased prevalence of sarcopenia compared to non-nephrolithiasis patients (OR: 2.912, 95% CI: 1.708–4.968, P <0.001). Following PSM, the results also confirmed the association between nephrolithiasis and sarcopenia (OR: 4.426, 95% CI: 1.547–12.661, P = 0.006). Notably, this association was more pronounced in subgroups including males (OR: 3.296, 95% CI: 1.436–7.564, P = 0.005), lower education level (OR: 8.127, 95% CI: 3.057–21.609, P <0.001), and diabetes (OR: 6.686, 95% CI: 2.626–17.027, P <0.001).ConclusionOur findings demonstrate that nephrolithiasis is positively related to the potential risk of sarcopenia in Chinese older adults. This finding indicates that nephrolithiasis may contribute to sarcopenia development, thereby emphasizing that prevention and intervention strategies for sarcopenia should account for the adverse effects of nephrolithiasis.

Dietary patterns targeting cardiometabolic health, such as the Mediterranean diet, DASH diet, and the Chinese Healthy Heart (CHH) dietary pattern have demonstrated lipid-lowering effects, yet culturally adapted strategies for older adults in northern China remain understudied. This study developed a combined MeDi-DASH-CHH dietary pattern by integrating key components of Western evidence-based diets (Mediterranean and DASH) with local dietary preferences (e.g., whole grain consumption, seasonal vegetable intake) to evaluate its impact on blood lipid control in northern Chinese older adults with dyslipidemia. A total of 210 dyslipidemic adults aged 60-75 years were stratified by sex, then randomized (1:1) to a 6-month intervention group (MeDi-DASH-CHH diet, with emphasized intake of aquatic products, dairy, and whole grains) or a control group (conventional guidance per Dietary Guidelines for Chinese Residents (2024)). Both groups received monthly follow-up visits. The primary outcome was the changes from baseline to six months in lipoprotein cholesterol (LDL-C). Secondary outcomes included changes in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), dietary intake, and body composition indicators. After intervention, the intervention group showed improvements in lipid profiles compared to the control group (all P < 0.05). Dietary intake indicated increased consumption of whole grains, potatoes, vegetables, fruits, aquatic products, dairy products, and nuts, alongside reduced intake of livestock meat, poultry meat, and egg intake. The combined MeDi-DASH-CHH dietary effectively improves lipid profiles and promotes healthier eating behaviors in older adults with dyslipidemia in northern China.