Representative Cross-sectional Study Research Articles

Understanding the relationships between 24-hour movement behavior, community mobility and the neighborhood built environment for healthy aging in Brazil: The EpiMove study protocol.

The population is aging rapidly worldwide, impacting public health, with countries in the Global South, such as Brazil, aging faster than developed nations. The 24-hour movement behavior is crucial for healthy aging, but its relationship with the neighborhood built environment is underresearched, especially for older adults. The EpiMove Study uses accelerometers and GPS to investigate the relationships between 24-hour movement behavior, community mobility and the neighborhood built environment for healthy aging in older Brazilian adults. The EpiMove Study is a representative cross-sectional study of older adults aged 60 years and older from an urban area in the southern region of Brazil. It consists of two phases. Phase 1 involves conducting home interviews to gather subjective measures of the neighborhood built environment and physical activity. Phase 2 involves delivering devices to participants' homes and collecting objective data on 24-hour movement behavior via wrist-worn wGT3X-BT ActiGraph accelerometers and community-based active transportation via hip-mounted GPS Qstarz-1000XT devices. The data are collected simultaneously over seven consecutive days, along with the participants' reasons for adhering to the study protocol. The EpiMove study will provide a better understanding of the relationships between the perceived neighborhood environment and 24-hour movement behaviors and community-based active transportation among older adults, with a particular focus on whether environmental factors influence these behaviors, which are crucial for healthy aging. The results from the EpiMove study could offer essential evidence for developing public policies and urban interventions that support healthier and more equitable environments for aging populations, particularly in rapidly urbanizing regions.

Work ability and psychosocial work stress - predictors of retirement intention among older teachers.

Many teachers worldwide retire early for health or personal reasons. Predictors could help to identify teachers at risk in order to counteract this development. The study therefore investigates whether the intention to retire can be predicted by work ability, psychosocial work stress and work behaviour. The data came from a representative cross-sectional study of German secondary school teachers (N = 18 971). The analyses included 1496 full-time teachers aged ≥50 years (58% female). Teachers were assigned to 1 of 2 groups based on their intention to take early or regular retirement. A binomial regression model was used to analyze the predictive power of the intention to retire for the following factors: work ability index (WAI) - factor 1, effort-reward ratio (ER ratio), overcommitment (OC), age and gender. In addition, a qualitative analysis of the teachers' suggestions was carried out regarding which measures would make the regular retirement age attainable. Half (49%) of the teachers intended to retire early, with the proportion of women being around twice as high (67%) as men (33%) (d = 0.37). The analyzed predictors explained a total of 22% of the variance. The WAI factor 1 proved to be the most important predictor (variance explanation: 14%). Effort-reward ratio and OC each contributed around 10% to the variance explanation of the retirement intention. The probability of taking early retirement increased with decreasing work ability, increasing ER ratio and a high tendency to overcommit; age and gender were of secondary importance. Teachers suggested a reduction in compulsory hours (46%), relief from extracurricular tasks (45%) and smaller classes (29%) as decisive measures for achieving regular retirement. Work ability index factor 1, ER ratio and OC could be used as part of occupational health prevention programmes to identify and advise older teachers at risk who need support. Int J Occup Med Environ Health. 2024;37(5).

Circadian rhythm and epilepsy: a nationally representative cross-sectional study based on actigraphy data.

The study aims to assess the relationship between epilepsy and circadian rhythms. This study included a cohort of 7,410 participants sourced from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) database. The investigation focused on the comparative analysis of seven nonparametric indices associated with circadian rhythms (Interdaily Stability (IS), Intradaily Variability (IV), Relative Amplitude (RA), L5, M10, L5 start time, and M10 start time) between the overall population and patients with epilepsy. Logistic regression analysis was utilized to assess the potential correlation between the rest-activity circadian rhythm patterns and the presence of epilepsy within the cohort. Compared to the general population, individuals with epilepsy exhibited lower values of IS and M10. Multivariable logistic regression analysis, when IS, RA, and M10 were categorized into four groups based on quartiles, revealed that the odds ratio (IS: OR = 0.36, 95% CI: 0.13, 0.89; RA: OR = 0.25, 95% CI: 0.06, 0.77; M10: OR = 0.24, 95% CI: 0.06, 0.73) for the highest quartile was lower than that for the lowest quartile. Furthermore, after adjustment for confounding factors, participants in the highest quartile compared to those in the lowest quartile of IV and M10 start time demonstrated a higher prevalence of epilepsy. Individuals with epilepsy demonstrate significant alterations in circadian rhythms.

How the development of chronic morbidity and multimorbidity depends on natural age of menopause: Results from nationally representative cross-sectional Indian study

ABSTRACT Background: Multimorbidity development is linked with the age at menopause. Fewer studies are available to support the findings. This study was conducted to find, how multimorbidity is associated with the natural age of menopause. Methodology: LASI-1, a longitudinal study, collected detailed information on the psychological, social, economic, and health aspects of aging in India. Wave-1 data collection was done in all 35 states and union territories in India. Baseline data was collected from year 2017–2019. As the current study was a secondary data analysis to find the association between multimorbidity and age of menopause, only eligible women’s relevant data was analyzed. Results: A total of 25,256 women were analyzed, 67.8% of participants had at least one comorbidity. The mean age was 58.5 ± 10.17 years. 57.04% and 13.45% women had optimal or suboptimal menopause, while 7.4%, 17.5%, and 4.4% had premature, early, and delayed menopause. A significant association was found for the presence of multimorbidity and premature (AOR 1.19 (1.07–1.32)), early menopause (AOR 1.18 (1.10–1.27)), and optimal age of menopause (AOR 0.83 (0.78–0.88)). Conclusion: There is a high burden of multimorbidity and it is associated with the natural age of menopause. This study would be helpful for effective policymaking and a better primary healthcare approach to deal with the condition.

Association of anemia with poor housing quality among older Indian adults: Multilevel modeling analysis of nationally representative cross-sectional study in India

ABSTRACT Introduction: Anemia is an important public health disorder. There is a significant chunk of India’s population residing in poor housing quality with inadequate sanitation and hygiene, which might lead to higher anemia prevalence. The objective was to determine the association between anemia with poor housing quality among the older Indian adult population (≥45 years) as per residence. Methods: This study analyzed the nationally representative dataset of the Longitudinal Ageing Study in India (LASI 2017–18, Wave-1). Bivariate analysis and logistic regression were conducted to show the association of anemia (outcome variable) with poor housing quality (explanatory variable). Multivariable logistic regression was conducted by adjusting for covariates as per their models. P value <0.05 was considered statistically significant. STATA version 17 was used for analysis. Results: Our study found that higher adjusted odds of having anemia among older Indian adults were observed among participants with overcrowding (AOR 1.30, 95%CI 1.19–1.42), having access to open/nonsanitary toilet facility (AOR 1.56, 95%CI 1.41–1.72), no electric supply (AOR 1.31, 95%CI 1.12–1.53), and overall poor housing quality (AOR 1.34, 95%CI 1.21–1.48). All of these associations were even higher in urban areas except for having access to open/nonsanitary toilet facilities, which was much higher in rural areas (AOR 1.61, 95%CI 1.45–1.79). Conclusion: Through a nationally representative large dataset, this study generated compelling evidence despite several obstacles indicating a positive association between anemia and poor housing quality among older Indian adults. It might raise awareness and assist individuals in steering clear of the negative effects of overcrowding, using open/nonsanitary toilet facilities, lack of electric supply, and overall housing quality on anemia status. It is advised to conduct additional research to determine temporality and causation.

Association between prognostic nutritional index and stroke: A nationally representative cross-sectional study from NHANES

BackgroundThe correlation between the prognostic nutritional index (PNI) and the risk of stroke has become a hot spot within the medical research community. The available evidence from a large sample regarding the correlation between PNI and stroke is inadequate. There is also a need for more research analysis from national surveys. ObjectiveThe principal goal of this research is to improve our understanding of the relationship between PNI and the risk of stroke. This study also intends to investigate the potential synergistic influence of PNI on stroke in combination with other interacting variables. MethodsA cross-sectional study was conducted with 35,549 participants selected from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 cycle. Information was gathered from all participants regarding the following: lymphocyte count, albumin levels, stroke occurrence, age, sex, race/ethnicity, education level, poverty income ratio (PIR), marital status, body mass index (BMI), smoking habits, drinking status, physical activity measured in total metabolic equivalents (PA_total_MET), diabetes status, glycohemoglobin levels, total cholesterol, direct high-density lipoprotein cholesterol(direct HDL-cholesterol), hypertension, and coronary heart disease. Curve fitting, subgroup analysis, and multifactor weighted logistic regression analysis were used to examine the relationship between PNI and stroke. ResultsThe overall prevalence of stroke was found to be 3.9%, PNI quartile 4(Q4) had an increased prevalence of stroke than quartile 1, 2, and 3(Q1,2,3). Our research suggested a negative association between PNI and the risk of stroke, as indicated by the odds ratio (OR=0.98) with a 95% confidence interval (CI=0.97∼0.99) and a p-value <0.05 (P=0.005), even after adjusting for all confounders. Subsequent subgroup analysis indicated a significant difference in the impact of PNI on stroke between individuals with different body mass index(BMI) levels (p for interaction = 0.02). ConclusionOur findings underscore that lower PNI in US adults is associated with an increased stroke risk, shedding light on a potential interrelationship between nutrition, inflammatory parameters, and stroke.

Associations of sociodemographic and smoking characteristics with intention to quit among Chinese adults aged 20–69 years who smoke: Findings from nationwide China Health Literacy Survey during 2018–19

ObjectiveTo identify factors influencing the intention to quit (ItQ) among Chinese who smoke, focusing on 10th Revision of the International Classification of Diseases (ICD-10) Nicotine dependence. Additionally, to estimate the number of individuals with ItQ, supporting optimal allocation of cessation resources. MethodsThis study used data from the 2018 China Health Literacy Survey, a nationally representative cross-sectional study with 20,288 participants who smoke currently aged 20–69 years. The ItQ proportions were estimated overall and by subgroup. Logistic regression was employed to estimate ORs and 95 % CIs for ItQ. The number of people who smoke with ItQ was estimated based on the census data. ResultsIn China, 41.34 % of individuals who smoke had ItQ, higher in females (44.89 %) than males (41.34 %). Provincial proportions ranged from 23.53 % to 63.56 %. ItQ was significantly associated with smoking characteristics, including occasional smoking (OR = 2.08, 95 % CI = 1.88–2.20), fewer pack-years (OR = 0.70, 95 % CI = 0.68–0.73), older smoking initiation age (OR = 1.22, 95 % CI = 1.18–1.27), and ICD-10 Nicotine dependence (OR = 1.12, 95 % CI = 1.06–1.19), as well as age, sex, socioeconomic factors, and health status. Withdrawal symptoms were positively associated with ItQ in individuals who smoke without ICD-10 Nicotine dependence but negatively in those with ICD-10 Nicotine dependence. An estimated 100.3 million adults aged 20–69 in China have ItQ, with 52.14 million suffering from ICD-10 Nicotine dependence. ConclusionsThe intention to quit smoking among Chinese who smoke is low and varies by ICD-10 Nicotine dependence and region, underscoring the need for targeted smoking cessation interventions across diverse smoking populations.

Associations of the fat-free mass index and the fat mass index with the risk of developing diabetes and prediabetes in US adults: a nationally representative cross-sectional study

BackgroundObesity and overweight, as determined by the body mass index (BMI), are harmful to metabolic health. However, the BMI can not reflect body composition or fat distribution. The fat-free mass index (FFMI) and the fat mass index (FMI) can provide more information on body composition. The aim of the observational research was to determine whether the FMI and the FFMI are significantly associated with the risk of developing diabetes and prediabetes.MethodsThe investigators included data for 10,085 National Health and Nutrition Examination Survey (2011–2018) participants aged over 20 years who underwent dual-energy X-ray absorptiometry (DXA). The FFMI and the FMI were determined based on total fat mass and lean mass measured by DXA. Diabetes and prediabetes status were determined by medical history and laboratory examination. Logistic regression analyses were performed to explore the correlations between the FMI/FFMI and the risk of developing diabetes/prediabetes. Restricted cubic spline analysis was used to explore underlying nonlinear associations.ResultsIn the present study, 1,135 patients were diagnosed with diabetes, 3,258 had prediabetes, and 5,692 were classified as control participants. The FFMI (odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.04–1.16) and the FMI (OR = 1.08, 95% CI = 1.04–1.12) were independently related to an increased risk of developing diabetes. Moreover, the FFMI (OR 1.08, 95% CI 1.02–1.16) and the FMI (OR 1.07, 95% CI 1.02–1.13) also independently correlated with a rising risk of developing prediabetes. The restricted cubic spline (RCS) outcomes suggested that the associations are approximately linear.ConclusionsBoth the FMI and the FFMI significantly correlated with the danger of developing diabetes and prediabetes, and the correlations are approximately linear.

Perceived support for climate policy in Australia: The asymmetrical influence of voting behaviour

A comprehensive policy response from wealthy nations is a necessary step to limiting catastrophic climate change. Community attitudes toward policy, and polarisation along political lines, may threaten this response. Using two representative cross-sectional survey studies of Australian voters (N = 2013; N = 3834), we test levels of support for a range of climate policies, levels of partisan polarisation, and whether people misperceive support among other partisans (false polarisation). Importantly, we investigate how perceptions differ across voting groups spanning left-wing, centre-left-wing, centre-right-wing, and right-wing voting orientations. In Study 1, we find support for climate policy across the political spectrum. However, assumed support from others is routinely underestimated, with support estimates decreasing the less socially proximal the group being estimated is. Meanwhile, perceptions of others’ support relates positively to perceptions of policy legitimacy. While policy support is associated with partisanship, in Study 2 we find left-wing voters perceive partisan polarisation to be greater than it actually is (false polarisation), while right-wing voters underestimate actual polarisation. We also find perceived polarisation is associated with higher levels of issue relevance. We discuss our findings with respect to intergroup processes, and recommend that community consensus regarding support for climate policy action be emphasised.

Association of blood vitamin A with osteoarthritis: a nationally representative cross-sectional study.

Vitamin A plays an important role in health, especially regarding its impact on bone tissue. Vitamin A can lead to bone damage and deformity, thus becoming an important causative factor in osteoarthritis. In this study, we aimed to evaluate the association of serum vitamin A with osteoarthritis. We included participants who self-reported whether they had OA in NHANES 2001-2006 and NHANES 2017-2018 to explore the association and dose-response relationship between vitamin A concentration and risk of osteoarthritis through weighted multivariate logistic models and restricted cubic splines. Sensitivity and stratification analyses were also used to assess the robustness of the results. A total of 18,034 participants were included in this study, and a linear association between serum vitamin A concentration and osteoarthritis risk was observed. The OR of osteoarthritis was 1.22 (95% CI: 0.98, 1.52), 1.40 (95% CI: 1.05,1.85), and 1.47 (95% CI: 1.14, 1.91) for participants in the second, third, and fourth quartiles, respectively, compared with the lowest vitamin A reference group. Similar results were obtained when sensitivity and stratification analyses were performed. Serum vitamin A is positively associated with osteoarthritis risk. Within a certain range of vitamin A concentrations, vitamin A is a protective factor against osteoarthritis, beyond which it becomes a causative factor for osteoarthritis.

Oral health behavior associated with cardiometabolic outcomes: A nationally representative cross-sectional study in Portugal

BackgroundOral diseases are associated with the development of cardiometabolic diseases. This study aimed to evaluate the relationship between oral health behaviors (tooth brushing and oral health appointments) with cardiometabolic diseases. MethodsData from the First National Health Examination Survey were used. Participants aged 25–74 years and diagnosis of acute myocardial infarction (n = 4442), stroke (n = 4441), hypertension (n = 4450) and diabetes (n = 4327) were analyzed. A fifth subsample (n = 2555) included participants aged 40–69 for calculating cardiovascular risk. Poor oral health behavior was defined as brushing once a day or less and having the last oral health appointment at 12 months or more. Poisson regression models assessed the relationship between poor oral health behavior and these cardiometabolic outcomes. ResultsAmong 4.450 participants, 20.5 % had poor oral health behavior. A statistically significant association was found between poor oral health behavior with diabetes (PR: 1.44 [95 % CI: 1.10–1.98], and high/very high cardiovascular risk (PR: 1.42 [95 % CI: 1.25–1.62]). In the sensitivity analysis the association with diabetes and high/very high cardiovascular risk persisted when considering only brushing behavior but not when considering only oral health appointments at 12 months or more. ConclusionsIndividuals with poor oral health behavior had a higher prevalence of diabetes and high/very high cardiovascular risk. Sensitivity analysis suggested that regular tooth brushing may be the main behavior for preventing diabetes and cardiovascular risk. The results suggest that regular tooth brushing may act in prevention for diabetes and cardiovascular risk.

Malnutrition in Guinea-Bissau: a country wide representative cross-sectional study

Abstract Background According to the WHO, malnutrition refers to deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients. Children under five are especially vulnerable to malnutrition. The problem is widespread, but it is particularly prevalent in West African countries, where a prevalence of 30% stunting, 6.7% wasting and 2.4% overweight was described in 2022. In this study, we aimed to evaluate malnutrition in Guinea-Bissau (GB), a low-income country in West Africa. Methods We conducted a cross-sectional study between May and June 2023 on a representative sample of 1608 children aged 6 to 59 months, who had access to health care in all 11 regions of GB. Nutritional status was assessed by evaluating weight for height/length, weight for age, height/length for age, and hemoglobin concentration was determined using a portable hemoglobin analyzer. Furthermore, semi-structured questionnaires were applied to children’s parents, including questions on sociodemographic and behavioral factors, such as ethnicity, parental literacy, health care, and dietary patterns. Results 802 boys and 806 girls were included in the study, with a mean age of 26 months. Malnutrition rates were comparable to those described in other West African countries. We found wasting rates of 8,3%, stunting rates of 24,3%, low weight rates of 17,4%, and overweight rates of 2,4% among children under five. Importantly, 55.9% of the children had anemia: 23.6% had mild anemia, 31.1% had moderate anemia, and 1.2% had severe anemia. Statistical analyses are underway to investigate factors associated with malnutrition. Conclusions An important challenge in global health is combating malnutrition in all its forms. The identified prevalence of malnutrition in GB is high and emphasizes the importance of developing strategies and policies with local authorities so that the Sustainable Development Goals and Global Goals of Nutrition can be achieved and health outcomes improved. Key messages • Collaboration essential: researchers, policymakers, healthcare, and local authorities must unite for targeted malnutrition interventions. • Sustainable development in GB hinges on addressing malnutrition among its children through concerted efforts.

The association between brominated flame retardants exposure with Parkinson's disease in US adults: a cross-sectional study of the National Health and Nutrition Examination Survey 2009-2016.

Increasing evidence suggests that environmental factors play a crucial role in the pathogenesis of Parkinson's disease (PD). Humans are simultaneously exposed to multiple brominated flame retardants (BFRs) in the environment. However, the relationship between BFRs and PD remains unclear. This study was designed to investigate the overall association between BFRs and PD in a nationally representative US population and to further identify significant chemicals. This study used data from 7,161 NHANES participants from 2009 through 2016. The serum BFRs registry included PBDE-28, PBDE-47, PBDE-85, PBDE-99, PBDE-100, PBDE-153, PBDE-154, PBDE-183, PBDE-209, and PBB-153. A survey-weighted generalized logistic regression model with restricted cubic splines (RCS) was used to evaluate the association between single BFRs exposure and periodontitis. Meanwhile, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used to evaluate the overall association of mixed frankincense powder with periodontitis and to identify significant chemicals. Sensitivity analysis was performed to evaluate the robustness of the results. Among the 7,161 participants, 65 had PD. PD patients were older (mean age 57.79 vs. 46.57 years) and had a higher proportion of females (70.86%) compared to non-PD participants. Serum levels of PBB-153 were significantly higher in those with PD. Logistic regression analyses revealed a non-linear, inverted U-shaped relationship between serum PBB-153 and PD risk. The risk of PD increased with higher PBB-153 levels up to the 3rd quartile (Q3), beyond which the risk declined (Q3 vs. Q1: OR = 4.98, 95% CI = 1.79-13.86; Q4 vs. Q1: OR = 3.23, 95% CI = 1.03-10.08). PBB-153 (43.40%), PBDE-153 (24.75%), and PBDE-85 (19.51%) contributed most to the weighted quantile sum index associated with PD risk. Bayesian kernel machine regression confirmed the inverted U-shaped dose-response pattern for PBB-153 and the overall BFR mixture. Restricted cubic spline analyses corroborated the non-linear relationship between PBB-153 and PD, which was more pronounced among women and those aged 37-58 years. Sensitivity analyses substantiated these findings. This nationally representative cross-sectional study revealed a novel non-linear, inverted U-shaped relationship between serum levels of the brominated flame retardant PBB-153 and Parkinson's disease risk in U.S. adults. The risk increased with higher PBB-153 exposure up to a point, beyond which it declined. This complex dose-response pattern highlights the importance of considering potential hormetic mechanisms and effect modifiers when evaluating environmental exposures and neurodegenerative diseases. Further research is warranted to elucidate the underlying biological pathways and inform risk mitigation strategies.

Social network size and endorsement of political violence in the US

BackgroundIn recent years, the United States (US) has witnessed a rise in political violence. Prior research has found that an individual’s social network is associated with their likelihood of engaging in various forms of violence, but research on social networks and political violence in the US context is limited. This study examined associations between social network size and endorsement of political violence in a recent nationally representative survey and explored how the relationship varied by use of social media as a major news source, perceptions of the government as an enemy, and membership in a marginalized or privileged racial or ethnic group.MethodsThis was a nationally representative cross-sectional survey study of adults aged 18 and older in the US, administered from May 13-June 2, 2022. The exposure was social network size, defined by the number of strong social connections. We examined three violence-related outcomes: support for non-political violence, support for political violence, and personal willingness to engage in political violence. We estimated prevalence ratios for associations using survey-weighted Poisson regression with robust standard errors, adjusting for hypothesized confounders and including interaction terms to examine effect measure modification.ResultsThe sample included 8,620 respondents. Median age was 48.4 years (95% CI = 47.9–48.8), 51.5% were female (95% CI = 50.4–52.7%), and 62.7% self-identified as non-Hispanic White (95% CI = 61.4–65.9%). In adjusted models, those with zero strong connections were more likely than those with 1–4 strong social connections to consider political violence usually/always justified in general (PR = 2.43, 95% CI = 1.47–4.01). Those with 50 + strong connections were more likely than those with 1–4 strong social connections to consider political violence usually/always justified in at least one situation (PR = 1.19, 95% CI = 1.03–1.37) and were more likely to report being willing to personally use political violence (PR = 1.52, 95% CI = 1.13–2.04). Associations varied somewhat by social media use, perceptions of the government as an enemy, and racialized identity.ConclusionsIndividuals who reported very few and very many strong social connections were more likely than others to support political violence or be personally willing to engage in it in one form or another. Findings point toward potential intervention and prevention opportunities.

The association of glyphosate exposure with kidney stones in American adults: A nationally representative cross-sectional study

ObjectiveGlyphosate has been ubiquitously present in our living environment due to its efficient herbicidal ability, but its association with the prevalence of kidney stones remains uncertain. This study aims to explore the impact of glyphosate exposure on kidney stones and to investigate the mediating effects of some serologic indicators. Furthermore, we attempt to identify the specific populations at greater risk of exposure. MethodsThis is a cross-sectional study of the U.S. adult population examining the association between glyphosate exposure and kidney stones based on data from the 2013–2018 National Health and Nutrition Examination Survey (NHANES). We implemented multi-model-adjusted logistic regression and smoothed curve fitting to explore the connection between them. Further subgroup analyses were conducted to confirm the magnitude of exposure risk in specific populations. Mediation effects analysis served to provide insight into the underlying mechanisms of the link. ResultsA total of 4302 participants' health data were ultimately analyzed, and the prevalence of kidney stones was 10.85 %. Participants with the highest urinary glyphosate(uGLY) content(Q3) had a higher prevalence of kidney stones compared with participants with the lowest uGLY content(Q1) (OR=1.70, 95 %CI: 1.10–2.63). Smoothed curve fitting revealed a linear positive association between ln-transformed uGLY and kidney stones (OR=1.21,95 %CI:1.08–1.37, LLR=0.291), and this exposure-outcome effect was at greater risk in men (OR=1.24,95 %CI: 1.05–1.46), non-Hispanic whites (OR=1.29, 95 %CI: 1.09–1.53), and hypertensive groups (OR=1.23,95 %CI: 1.05–1.44). Serum biochemical markers HDL, ALP, and serum glucose partially mediated the correlation between glyphosate and kidney stones (2.44–4.20 %). ConclusionGlyphosate exposure is significantly associated with the prevalence of kidney stones. In men, non-Hispanic whites, and hypertensive populations, the management of glyphosate exposure should be emphasized, and appropriate protective strategies may be beneficial in reducing the burden of kidney stones. More high-quality clinical inquiries and animal toxicology experiments are still required to verify the reliability of our findings and their underlying mechanisms.

Investigating nonlinear associations between neutrophil percentage to albumin ratio and cardiovascular disease: a nationally representative cross-sectional study

While the negative consequences of particular illnesses have been associated with the neutrophil percentage to albumin ratio (NPAR), its association with cardiovascular disease (CVD) is still lacking in the broader public. This study examines the relationship between NPAR and CVD prevalence using information from the National Health and Nutrition Examination Survey (NHANES), with particular attention to potential nonlinear associations. This analysis included 26,225 adults from NHANES 2011–2020. We investigated the association between NPAR levels and CVD using weighted generalized linear models, subgroup analysis, threshold effects, receiver operating characteristic (ROC) curves, and sensitivity analysis. Restricted cubic splines were used to assess potential nonlinearity in the NPAR-CVD association. Elevated NPAR levels were significantly associated with increased CVD prevalence (P < 0.001). In model 3, individuals in the highest NPAR quartile had a 46% greater CVD prevalence compared to those in the lowest quartile [OR: 1.46 (1.16, 1.83), P = 0.002], a finding consistent across unweighted logistic regression models. This association remained unchanged by various factors (P > 0.05). While restricted cubic spline analysis indicated potential nonlinearity, it did not significantly improve model fit over the linear model (P > 0.05). This study identifies a significant association between NPAR and CVD prevalence among the broader populace, suggesting the potential influence of inflammation on cardiovascular disease.

Investigation of factors associated with delayed initiation of breastfeeding in Papua New Guinea: a cross-sectional study

BackgroundBreastfeeding within the first hour of birth is critical for newborn survival. However, in Papua New Guinea (PNG), about 40% of newborns are not breastfed within the first hour of...

10-year risk for cardiovascular diseases according to the WHO prediction chart: findings from the National Health and Morbidity Survey (NHMS) 2019

BackgroundThere has been a significant increase in the incidence of cardiovascular disease (CVD) in Malaysia. It is important to identify the group at high risk of CVD. This study aimed to assess the population distribution and factors associated with 10-year CVD risk among adults aged 40 to 74 years in Malaysia.MethodsThis study used secondary data from the NHMS 2019, a nationally representative cross-sectional population study. The following measurements were collected: anthropometric, systolic blood pressure, fasting blood glucose, total cholesterol, smoking, and sociodemographic. The 2019 WHO Southeast Asia laboratory-based charts were used to estimate individuals’ CVD risk. These charts predict significant cardiovascular events over ten years. Multiple logistic regression analysis was employed to ascertain the factors that are linked to elevated or extremely elevated risk of CVD.ResultsA total of 5,503 respondents were included in the analysis. Less than one-quarter of the respondents were current smokers and obese. Approximately 41.7%, 30.9%, and 22.5% of the participants had extremely low risk (less than 5%), low risk (between 5% and less than 10%), and moderate risk (between 10% and less than 20%), respectively. A total of 4.9% of the participants were categorised as having high (20% to < 30%) or very high (CVD) risk (≥ 30%). This classification was more prevalent among males (7.3%) than among females (2.5%; p < 0.001). The factors associated with high/very high CVD risk were unemployment (aOR = 1.88, 95% CI = 1.47–2.40), those with non-formal and primary education level (aOR = 2.36, 95% CI = 1.36 − 4.12 and aOR = 3.28, 95% CI = 2.10 − 5.12, respectively), and being physically inactive with obesity (aOR = 2.19, 95% CI = 1.18 − 4.08).ConclusionsThis study revealed that almost 5% of the population in Malaysia has a high 10-year CVD risk. These findings highlight Malaysia’s urgent need for comprehensive CVD prevention efforts.

Twenty-four hour urinary sodium and potassium excretion in adult population of Slovenia: results of the Manjsoli.si/2022 study.

The objective of study was to assess 24-h urinary Na and K excretion and estimate the average salt and K intakes in a nationally representative sample of the adult population of Slovenia. A nationally representative cross-sectional study was conducted in four stages between September and November 2022: study questionnaire, physical measurements, 24-h urine collection and laboratory analysis. Slovenia. We invited 2000 adult, non-institutionalised inhabitants of Slovenia, aged between 25 and 64 years. A stratified two-staged sample was selected from this population by the Statistical Office of Slovenia, using sampling from the Central Population Register. According to the WHO methodology, additional eligibility criteria were screened before participating. A total of 518 individuals participated in all four stages of the study, resulting in a response rate of 30 %. The mean 24-h urinary Na excretion was 168 mmol/d (95 % CI 156, 180), which corresponds to a mean estimated intake of 10·3 g salt/d (95 % CI 9·6, 11·1). Mean 24-h urinary K excretion was 65·4 mmol/d (95 % CI 63·2, 67·5), and the estimated mean K intake was 2·93 g/d (95 % CI 2·84, 3·03). There were statistically significant differences in mean intakes between males and females. The mean sodium-to-potassium ratio was 2·7 (95 % CI 2·5, 2·8). The study results highlighted that the salt intake in the adult population of Slovenia remains much higher than recommended by the WHO, and K intakes are insufficient, as most participants did not meet the recommendations.

Association between neutrophil-to-high-density lipoprotein cholesterol ratio and metabolic dysfunction-associated steatotic liver disease and liver fibrosis in the US population: a nationally representative cross-sectional study using NHANES data from 2017 to 2020

BackgroundThe neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) has emerged as a promising biomarker for assessing inflammation and lipid dysregulation. Increasing evidence indicates that these metabolic disturbances play a crucial role in the development of metabolic dysfunction-associated steatotic liver disease(MASLD). This study aims to investigate the association between NHR, MASLD, and liver fibrosis.MethodsThis cross-sectional study analyzed data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES). Weighted multivariate logistic regression models were used to investigate the association between NHR and both MASLD and liver fibrosis. Smoothed curve fitting and threshold effect analysis were performed to detect potential nonlinear relationships. Subgroup analyses were conducted to assess the consistency of these associations across different groups.ResultsThe study involved 4,761 participants. We observed a significant positive association between NHR and MASLD (OR = 1.20, 95% CI: 1.09–1.31). However, there was no significant association between NHR and liver fibrosis (OR = 1.01; 95% CI: 0.94–1.09). The analysis of smoothed curve fitting and threshold effect revealed an inverted U-shaped relationship between NHR and MASLD, with a turning point at 5.63.ConclusionOur findings indicate a positive correlation between elevated NHR levels and MASLD prevalence. However, we did not observe a significant association between NHR and liver fibrosis prevalence. Further prospective research is needed to validate these findings in a longitudinal setting.