Dose-response Relationship Research Articles

Long-term effect of eating duration on all-cause mortality under different energy intake and physical activity levels

Abstract The long-term impact of eating duration on the risk of all-cause mortality remains unclear, with limited exploration of how different levels of energy intake and physical activity might influence this impact. To investigate, 24 484 American adults from the National Health and Nutrition Examination Survey spanning 1999–2018 were included. Eating duration was assessed via 24-h dietary recall, and all-cause mortality data were sourced from the National Death Index. The relationship between eating duration and all-cause mortality was analysed using Cox proportional hazards regression models, restricted cubic splines and stratification analysis with complex weighted designs. The median (IQR) of eating duration for participants was 12·5 (11·0, 14·0) h. In this study, 2896 death events were observed, and the median follow-up time (IQR) was 125 (77, 177) months. After multivariable adjustment, compared with Q1, Q2, Q3 and Q4 had reduced risks of all-cause mortality by 17, 15 and 13 %, respectively. Furthermore, each additional hour of eating duration was correlated with a 2 % decrease in the risk of all-cause mortality. Additionally, a non-linear dose–response relationship was observed between eating duration and the risk of all-cause mortality, showing a U-shaped relationship from 8·9 h to 15·3 h (P for non-linearity < 0·05). Interestingly, the non-linear dose–response relationship was observed exclusively among individuals with high energy intake or a lightly active physical activity level. These findings suggest potential health benefits from adjusting eating duration, though further prospective studies are needed for validation.

An investigation to improve a nonlinear mixed-effects approach for EC50 estimation based on multi-donor dose–response data

ABSTRACT Dose–response relationships are important in assessing the efficacy and potency of compounds, which can usually be characterized by a 4-parameter logistic (4-PL) model estimating EC50, slope factor, lower asymptote, and upper asymptote. EC50, the concentration of a compound that induces a response halfway between the baseline and maximum, is a key quantity to evaluate compound potency. For multi-donor dose–response data, it is often of interest to estimate the overall EC50 (i.e. the average EC50 of the population of donors) and its 95% confidence interval (CI). A few multi-donor EC50 estimation methods have been proposed in the literature. Jiang and Kopp-Schneider (2014) systematically compared the meta-analysis approach and the nonlinear mixed-effects approach and concluded that the meta-analysis approach is simple and robust to summarize EC50 estimates from multiple experiments, especially suited in the case of a small number of experiments, while the nonlinear mixed-effects approach has the issue of convergence failures probably due to overparameterization. In this article, we propose a modification of the nonlinear mixed-effects approach by using the stochastic approximation expectation-maximization (SAEM) algorithm to estimate model parameters and using multiple starting points to search for globally optimal values, which can substantially alleviate the issue of convergence failures even for small number of donors (e.g. n = 3), and achieve a smaller absolute median bias and better coverage probability of 95% confidence interval than the meta-analysis approach when the number of donors is not too small (e.g. n ≥ 7).

A comprehensive and systematic review on Curcumin as a promising candidate for the inhibition of melanoma growth: From pre-clinical evidence to molecular mechanisms of action

BackgroundMelanoma, a highly malignant skin tumor, can develop systemic metastases during the early stage. Several studies of melanoma animal models indicate that curcumin, a natural plant extract, inhibits melanoma growth through various mechanisms. To evaluate the relationships among different experimental conditions, curcumin itself, its derivatives, and special formulations, it is necessary to conduct a systematic review and meta-analysis. PurposeThis meta-analysis aims to evaluate the potential of Curcumin as a drug for inhibiting the growth of melanoma and to determine the optimal dosage range and treatment duration for Curcumin administration. MethodsA systematic search of studies published from inception to December 2023 was conducted across six databases (PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data, and VIP). Methodological quality was assessed using SYRCLE's RoB tool. Study heterogeneity was assessed using Cochran's Q test and I2 statistics. Publication bias risk was evaluated using a funnel plot. All analyses were performed using R (version 4.3.3). Additionally, three-dimensional effect analysis and machine learning techniques were utilized to determine the optimal dosage range and treatment duration for Curcumin administration. ResultsForty studies involving 989 animals were included. The results demonstrated that, relative to the control group, administration of Curcumin resulted in a significant reduction in tumor volume. [SMD=−3.44; 95 % CI (−4.25, −2.63); P<0.01; I2 = 79 %] and tumor weight [SMD=−1.93; 95 % CI (−2.41, −1.45); P<0.01; I2 = 75 %]. Additionally, Curcumin demonstrated a significant capacity to decrease the number of lung tumor nodules and microangiogenesis, as well as to extend survival time, in animal models. The results from three-dimensional effect analysis and machine learning emphasize that the optimal dosage range for Curcumin is 25–50 mg/kg, with an intervention duration of 10–20 days. ConclusionCurcumin can inhibit the growth of melanoma, and the dose-response relationship is not linear. However, further large-scale animal and clinical studies are required to confirm these conclusions.

Unveiling Relationship Between Specific Domain, Intensity, and Dose of Physical Activity and Biological Age: A Cross-Sectional Study.

Existing studies have separately explored the association between specific intensity and domain of physical activity (PA) and biological age (BA), potentially impeding more precise guide. We used data of 5216 middle-aged and older adults aged 45 and over to explore and compare the relationship of different domains, intensities, and doses of PA and BA. Transport-related walking and leisure-time moderate-intensity PA (MPA) were significantly associated with younger BA, rather than other intensity of work-related PA. There were U-shaped dose-response relationships between transport-related BA or leisure-time MPA and BA. In subgroup analyses for older adults, all intensities of PA were significantly associated with decreased BA. These findings highlighted the importance of considering the domain, intensity, and dose of PA in designing effective age-delaying interventions.

Perceived Housing Problems and Depressive Symptoms Among Middle-Aged and Older Americans

ABSTRACT Housing insecurity has been shown to be associated with worse mental health. However, previous studies mostly examined one aspect of housing insecurity (e.g., affordability), and few focused on older adults. This study examined the relationship between perceived housing problems and depressive symptoms among middle-aged and older Americans. Data from the Health and Retirement Study between 2006 and 2018 were used. A total of 7,119 respondents (aged 50+ at baseline in 2006) were followed up every 4 years. Respondents self-reported the status, severity, and duration of their housing problems. Depressive symptoms were assessed by the Center for Epidemiological Studies-Depression Scale. Mixed-effect models examined the association between perceived housing problems and depressive symptoms. Results show about 5%-7% of respondents had housing problems during every study visit and 5.73% of them experienced persistent housing problems over 12 years. Having housing problems was associated with a higher risk of depressive symptoms (incidence risk ratio = 1.29, 95% CI = 1.23, 1.36). A dose–response relationship was observed in the severity and duration of housing problems, with a greater increase of depressive symptoms risk among those experiencing more severe or prolonged housing problems. The dose–response pattern highlighted the importance of early intervention and persistent assistance to those experiencing housing problems.

Monocyte-lymphocyte ratio predicts cardiovascular diseases death in individuals with type 2 diabetes.

Previous studies have shown higher cardiovascular mortality risk with higher monocyte-lymphocyte ratio levels in general population. However, the levels of oxidative stress in individuals with type 2 diabetes are higher than those in the general population, which may affect the link between monocyte-to-lymphocyte ratio and cardiovascular disease deaths. And the association between the monocyte-to-lymphocyte ratio and mortality risk in people with type 2 diabetes still be unknown. This study aimed to investigate the prognostic significance of monocyte-to-lymphocyte ratio in type 2 diabetes. This analysis involved 2,954 individuals with type 2 diabetes from the National Health and Nutrition Examination Survey 1999-2010. The National Death Index records through December 31, 2019, was used to determine all-cause and cardiovascular mortality. The prognostic roles were determined using Cox regression models, restricted cubic spline analysis, and time-dependent receiver operating characteristic curve analysis. During an average follow-up period of 12.4 years, a total of 1,007 deaths occurred, while 252 were due to cardiovascular disease. An elevated monocyte-to-lymphocyte ratio level exhibited a significant dose-response relationship with an increased risk of all-cause mortality (1.34 [95% CI 1.12, 1.60] for all-cause mortality [Ptrend = 0.001]). The multivariable-adjusted HR was 1.81 (95% CI 1.25, 2.63) (Ptrend = 0.001) for cardiovascular mortality indicating a U-shaped relationship (Pnonlinear = 0.013). The results of this study indicate a U-shaped relationship between the monocyte-to-lymphocyte ratio and cardiovascular mortality in individuals with diabetes. Both very low and high monocyte-to-lymphocyte ratio monocyte-to-lymphocyte ratio values were found to be associated with increased cardiovascular mortality risk.

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

ObjectivesVitamin 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.MethodsWe 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.ResultsA 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.ConclusionSerum 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.

Association between the serum albumin–creatinine ratio and 28-day intensive care unit mortality among patients with sepsis: a multicenter retrospective cohort study

IntroductionSepsis is a substantial global health challenge with a considerable disease burden. Despite advancements in sepsis research, the mortality rates associated with this condition remain high. The relationship between the serum albumin-to-creatinine ratio (sACR) and mortality in patients with sepsis remains unclear. Therefore, this study aimed to investigate the association between the sACR and 28-day mortality in intensive care unit (ICU) patients with sepsis.MethodsIn this retrospective cohort study, we used data sourced from the eICU Collaborative Research Database. The primary exposure variable was sACR, and the primary outcome measure was mortality within 28 days after ICU admission. Statistical analyses included univariate and multivariate logistic regression models, generalized additive models, and two-piecewise linear regression models, which were employed to explore non-linear relationships and threshold effects between sACR and mortality.ResultsThe study cohort comprised 9,690 ICU patients with sepsis, with a 28-day mortality rate of 9.99%. The results of the multivariate logistic regression model indicated that elevated sACR levels were significantly associated with a reduced risk of mortality (odds ratio = 0.78, 95% confidence interval: 0.71–0.87, p &amp;lt; 0.001), even after adjusting for potential confounding variables. Curve fitting revealed a non-linear relationship between sACR and 28-day mortality, with an inflection point of 4.79.DiscussionThis study demonstrated that sACR is an independent risk factor for 28-day mortality in ICU patients with sepsis, exhibiting a non-linear negative dose–response relationship and a threshold effect. These findings may serve as early warning indicators in high-risk populations.

The association of serum albumin with 28 day mortality in critically ill patients undergoing dialysis: a secondary analysis based on the eICU collaborative research database

BackgroundThe relationship between serum albumin and prognosis in critically ill patients has been studied, however, there is a paucity of exploration into non-linear relationships, particularly in critically ill patients undergoing dialysis. This study intends to investigate the association between serum albumin (ALB) and 28 day mortality in critically ill patients undergoing dialysis.MethodsWe conducted a multi-center retrospective cohort study of patients undergoing dialysis by utilising data from the eICU Collaborative Research Database from 208 distinct ICUs across the United States between 2014 and 2015. The study focused on mortality within 28 days of ICU admission. We employed univariate analysis, multi-factor logistic regression, subgroup analysis, curve-fitting, and threshold effect analysis to examine the correlation between ALB levels and 28 day mortality.ResultsAmong the 2,315 patients with a median age of 63 years, 205 (8.86%) died within 28 days of ICU admission. When ALB level was < 2.7 g/dL, the mortality decreased with an adjusted odds ratio (OR) of 0.34 (95% CI 0.22–0.51, P < 0.0001) for every 1 increment in the ALB. However, no significant mortality changes were observed when ALB levels were at or above this threshold.ConclusionOur study identifies a nonlinear dose–response relationship between serum ALB levels and 28 day mortality in critically ill patients undergoing dialysis, with a specific turning point observed. This finding underscores a significant negative correlation between ALB levels and mortality risk, with lower ALB levels being associated with higher mortality risk in this particular population.

Associations Between Relative Lower and Upper Body Strength and Hyperinsulinemia in US Adults: 1999-2002 and 2011-2014 NHANES.

Churilla, JR, Boyer, WR, Richardson, MR, and Williams, CC. Associations between relative lower and upper body strength and hyperinsulinemia in U.S. Adults: NHANES 1999-2002 and 2011-2014. J Strength Cond Res XX(X): 000-000, 2024-Skeletal muscle (SM) is an insulin-sensitive tissue that aids in glucose homeostasis. Insulin resistance leads to chronic hyperglycemia and type 2 diabetes. Previous evidence suggests that greater SM strength and size improve insulin dynamics. The primary aim of this study was to examine the association(s) between relative lower and upper body strength and hyperinsulinemia in a nationally representative sample of US adults. Samples of adult (≥50 years) subjects in the 1999-2002 (N = 1,097) and adults (≥20 years) in the 2011-2014 (N = 2,576) National Health and Nutrition Examination Survey were used in the analyses. Significance was set at p ≤ 0.05 for regression models. Quartiles (Q) of relative lower body strength (RLBS [N·BMI-1]) and relative grip strength (RGS [kg·BMI-1]) were created. Hyperinsulinemia was calculated using the weighted 75th percentile of log-fasted insulin among adults without diabetes. Inverse dose-response relationships were found for decreasing prevalence estimates of hyperinsulinemia by increasing Q of both RLBS and RGS. Similar dose-response associations were revealed for increasing Q of both RLBS and RGS and mean insulin concentrations. Following adjustment for demographic and lifestyle variables, subjects in Q2, Q3, and Q4 of RLBS were found to have significantly lower odds of hyperinsulinemia (OR 0.58 [P = 0.05], OR 0.38, OR 0.22 [p < 0.05 for both], respectively). Subjects in Q2, Q3, and Q4 of RGS were also found to have lower odds of hyperinsulinemia (OR 0.30; OR 0.14; OR 0.05 [p < 0.0001 for all]), respectively. These data suggest RLBS and RGS may both be favorably associated with insulin homeostasis.

Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures

Postoperative pneumonia (POP) is a common complication after hip fracture surgery and is associated with increased mortality and other complications in elderly patients. This study aims to evaluate biomarkers, especially the glucose-albumin ratio (GAR), for predicting POP in elderly hip fracture patients. A total of 1279 elderly patients admitted to our hospital with hip fractures were included. We assessed 29 biomarkers and focused on GAR to determine its prognostic and predictive value for POP. Multivariable logistic regression and propensity score-matched analyses were conducted to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for POP, adjusting for potential confounders. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cut-off of GAR for predicting POP. Among the biomarkers and combinations assessed, GAR demonstrated superior predictive capability for POP in elderly hip fracture patients. ROC analyses showed moderate predictive accuracy of GAR for POP, with an area under the curve of 0.750. Using the optimal cut-off of 0.175, the high GAR group was significantly associated with increased odds of POP (adjusted OR 2.14, 95%, CI 1.50–3.05). These associations remained significant after propensity score matching and subgroup analyses. Dose–response relationships between GAR and POP were observed. In conclusion, GAR may be a promising biomarker to predict POP risk in elderly hip fracture patients. Further studies are warranted to validate its clinical utility. However, this study has certain limitations, including its retrospective design, potential for selection bias due to the exclusion criteria, and the single-center nature of the study, which should be addressed in future prospective, multicenter studies.

The association between vitamin intake and endometriosis: a cross-sectional study of the NHANES 1999–2006

BackgroundEndometriosis is a common cause of female reproductive problems, and vitamin intake may affect its incidence. Therefore, we further explored the association between multivitamin intake and endometriosis in a large population-based study.MethodsThis study included 3351 participants from the National Health and Nutrition Examination Survey (NHANES) 1999–2006. The dietary intake of eight vitamins was calculated as the average of two 24-h recall interviews, and information on endometriosis was obtained through questionnaires that included gynecological history. Multiple logistic regression analysis was used to explore the relationship between multivitamin intake and endometriosis. Smoothed curve fitting analysis was employed to assess the dose–response relationship between vitamins and endometriosis. Finally, subgroup analysis and interaction tests were conducted to determine the association of covariates between vitamins and endometriosis.ResultsIn this large-scale cross-sectional study, multiple logistic regression analysis showed that the intake of vitamins A, B1, B2, B6, C and folate was negatively associated with the occurrence of endometriosis. The odds ratios associated with a per-SD increase were 0.836 (95%CI: 0.702, 0.997), 0.817 (95%CI: 0.702, 0.951), 0.860 (95%CI: 0.746, 0.991), 0.784 (95%CI: 0.669, 0.919), 0.845 (95%CI: 0.718, 0.994), and 0.772 (95%CI: 0.660, 0.903), respectively. Smoothed curve fitting analysis revealed that the intake of vitamins A, B1, B2, B6, C, and folate was negatively associated with the risk of endometriosis (P < 0.05). Vitamin E showed a saturating effect, with an optimal cutoff point at 13.18. Below this cutoff, the intake of vitamin E was negatively correlated with the risk of endometriosis (OR = 0.947, 95% CI: 0.906, 0.989), whereas above the cutoff, there was no significant correlation between vitamin E intake and the risk of endometriosis (OR = 1.001, 95% CI: 0.997, 1.005).ConclusionsThe results of this study indicate a significant linear negative correlation between the intake of vitamins A, B1, B2, B6, C, and folate, and the risk of endometriosis, and reveal a threshold effect for vitamin E intake on the risk of endometriosis. These findings could inform clinical dietary interventions and may support the development of preventive strategies for endometriosis, potentially aiding in its reduction.

Association between neutrophil-percentage-to-albumin ratio (NPAR) and metabolic syndrome risk: insights from a large US population-based study

Metabolic syndrome (MetS) is a cluster of conditions that increase the risk of cardiovascular disease and diabetes. This study aimed to investigate the association between Neutrophil-Percentage-to-Albumin Ratio (NPAR) and MetS in a large, nationally representative US population. We analyzed data from 28,178 participants in the National Health and Nutrition Examination Survey (NHANES) 2005–2018. Logistic regression models were used to evaluate the association between NPAR and MetS. Restricted cubic spline (RCS) models were employed to assess the dose-response relationship. Mediation analyses were conducted to explore potential mediating effects of serum uric acid and triglyceride-glucose (TyG) index. After adjusting for confounders, participants in the highest NPAR quartile had a 14% higher risk of MetS compared to those in the lowest quartile (OR 1.14, 95%CI 1.03–1.27, P = 0.010). RCS models revealed a monotonic increasing trend between NPAR and MetS risk (P for overall association = 0.002). Mediation analyses showed that serum uric acid and TyG index mediated 14.93% and 29.45% of the total effect of NPAR on MetS, respectively. Subgroup analyses indicated that the positive association between NPAR and MetS was more pronounced in Mexican Americans, individuals aged 20–65 years, those with lower income, males, current smokers, and moderate drinkers. Higher NPAR is associated with increased risk of MetS in the US adult population. This association is partially mediated by serum uric acid and TyG index. These findings suggest that NPAR may serve as a novel biomarker for MetS risk assessment and provide insights into potential mechanisms linking inflammation and metabolic disorders.

Association between dietary omega-3 fatty acid intake and all-cause mortality in patients with osteoarthritis: a population-based prospective cohort study

A correlation between omega-3 polyunsaturated fatty acids (omega-3 PUFAs) and osteoarthritis (OA) incidence has been established, but research on the long-term outlook of OA patients remains limited. This study investigates the association between omega-3 PUFA intake and the risk of all-cause and cardiovascular (CV) mortality in the U.S. OA population. A cohort of 3,467 OA patients from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 was studied. Cox proportional hazards regression models, Kaplan-Meier curves, and subgroup analyses were used to evaluate the relationship between omega-3 PUFA intake and mortality. The dose-response relationship was examined using a restricted cubic spline (RCS) model. Among the 3,467 OA patients, there were 459 all-cause deaths and 175 CV deaths. Omega-3 PUFAs were significantly negatively correlated with all-cause mortality (95% CI: 0.59–0.93, p = 0.011) but not with CV mortality (95% CI: 0.29–1.04, p = 0.056). Higher omega-3 PUFA intake was associated with a 49% decrease in all-cause mortality. Kaplan-Meier curves showed lower all-cause mortality rates in those with higher omega-3 PUFA intake. The inverse correlation was more pronounced among individuals living with a partner. The dose-response analysis indicated a linear negative relationship between omega-3 PUFA intake and all-cause mortality. Increased intake of omega-3 PUFAs is associated with a decreased risk of all-cause mortality in OA patients.

Chronic Musculoskeletal Pain and Risk of Incident Parkinson's Disease: A 13-Year Longitudinal Study.

Chronic musculoskeletal pain often co-occurs with Parkinson's disease (PD); however, whether individuals with chronic pain have a higher risk of developing PD is unclear. To investigate the associations between chronic pain and incident risk of three neurodegenerative parkinsonism categories including PD, multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). This study included 355,890 participants (mean [standard deviation] age, 56.51 [8.07] years, 48.40% male) who did not have parkinsonism at baseline from a population-based cohort. Musculoskeletal pain in the hip, neck/shoulder, back, knee, or "all over the body" was assessed. Chronic pain was defined if pain lasted ≥3 months. Participants were categorized into four groups: no chronic pain, having one or two, three or four sites, and pain "all over the body." The diagnosis of PD, MSA, and PSP used self-reports, hospital records, and death registries. Multivariable-adjusted Cox regression was performed for the analyses. Over a median follow-up of 13.0 years, 2044 participants developed PD, 77 participants developed MSA, and 126 participants developed PSP. In multivariable analyses, there was a dose-response relationship between number of chronic pain sites and incident risk of PD (hazard ratio, 1.15; 95% confidence interval, 1.07-1.23). Participants with one or two pain sites and three or four pain sites had an 11% and 49% increased risk of developing PD, respectively. There were no associations between chronic pain and MSA or PSP. Chronic musculoskeletal pain was independently associated with PD, suggesting that chronic pain could be used to identify individuals at risk of developing PD. © 2024 International Parkinson and Movement Disorder Society.

Television viewing, oxidative stress, and kidney stone risk in males: a cross-sectional study with mediation analysis of the NHANES data (2011-2018 years).

To explore the association between television viewing time (TV-hours) and dietary oxidative balance score (DOBS) with the kidney stone risk in males. We analyzed age, poverty to income ratio, race, education, hypertension, diabetes, smoke, alcohol use, triglycerides, TV-hours, and DOBS data in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Multivariable logistic regression was uesd to evaluate the associations between TV-hours, lifestyle OBS (LOBS), DOBS, Total OBS (TOBS), and the risk of kidney stones. Interaction terms between subgroup measures were used to test for effect modification across subgroups. Mediation analysis was performed to explore the mediating effect of DOBS on the association between TV-hours and kidney stones. The restricted cubic spline (RCS) was applied to describe dose-response relationships between TV-hours and risk of kidney stones as well. The study included 4167 males aged 20 and older, including 417 patients with kidney stones. The results showed that five or more TV-hours a day was associated with a higher risk of kidney stones [odds ratio (OR) = 1.16, (95% CI: 1.04-1.29), p = 0.01], and higher DOBS level was associated with a lower risk of kidney stones [OR = 0.97, (95% CI: 0.95-0.99), p = 0.004]. This association was remarkably consistent across TV-hours subgroups by age, race, alcohol use, hypertension and diabetes. According to the mediation analysis results, prolonged TV-hours is associated with an increased risk of kidney stones, this association is not mediated by DOBS. In other words, the impact of TV-hours on kidney stones risk is mainly a direct effect. When TV-hours is more than 2hours, the odds ratio began to be greater than 1. Overall, TV-hours was positively associated with kidney stones in males, whereas low DOBS was associated with kidney stones in males. This study suggests that an antioxidant diet and reduced television viewing time may be effective measures to prevent kidney stones in males.

Ultrasonic-assisted DES extraction optimization, characterization, antioxidant and in silico study of polysaccharides from Angelica dahurica Radix

In this study, polysaccharides from Angelica dahurica Radix (ADR) were extracted by using ultrasonic-assisted deep eutectic solvent (DES) extraction method. The DES consist of choline chloride (HBA, hydrogen bonding acceptor) and 1, 4-butanediol (HBD, hydrogen bonding donor) with the molar ratio of 1:3 was proved as the best system for polysaccharides extraction. A Box-Behnken design with three factors and three levels was utilized to optimize ultrasonic power, extraction time and temperature for increased polysaccharides yield. The optimal extraction parameters were determined as follows: DES water content of 20 %, liquid–solid ratio of 10:1 mL/g, ultrasonic time of 21 min, temperature at 60 °C, and ultrasonic power of 435 W. These conditions yielded an extraction rate nearly matching the theoretical predicted value of the response surface model, surpassing the traditional hot water extraction method by 1.33 times and requiring less time. The antioxidant polysaccharides was assessed using DPPH,ABTS and Hydroxyl methods, which indicated that ADRP extracted by ultrasound assisted DES had excellent antioxidant capacity and showed a dose–response relationship with drug concentration. Structural analysis identified ADR polysaccharides as a heteropolysaccharide rich in sugar aldonic acids—namely, fucose, rhamnose, arabinose, galactose and glucose—with molar ratios of 0.47:1.99:17.61:64.76:15.17. The polysaccharides’ number-average molecular weight was determined to be 97.422 kDa, with a weight-average molecular weight of 245.678 kDa. Network pharmacology and molecular docking analysis suggest that the monosaccharides Rha and Ara could potentially interact with the proteins GSR and GSTA1, respectively, indicating that ADRP had good antioxidant potential and could be applied in multiple fields with promising development prospects in the future.

Exploring the Synergistic Effects of Concurrent Exercise for Managing Type-II Diabetes Mellitus: A Meta-Analysis.

The effectiveness of concurrent exercise (CE) as an emerging approach for type-II diabetes mellitus (T2DM) patients was evaluated through a comprehensive search on Google Scholar, PubMed, Pedro, CINAHL, and Medline from 2015 to March 2023. Sixteen RCTs were selected which evaluated CE (aerobic + resistance in the same session) effects on a minimum of three days/week among T2DM patients, and the control group received usual care or no exercise. Studies that evaluated at least one glycaemic variable, i.e. HbA1C, fasting blood glucose level (FBGL), andHomeostatic Model Assessment for Insulin Resistance (HOMA-IR), were eligible. Intervention with a follow-up period of ≥8 weeks, patients of any age and gender, and literature in the English language were included. A rigorous review was performed using the Cochrane Collaboration risk of bias tool (RoB 2) to minimise biases, which include the randomisation process, deviation from intended intervention, missing outcome data, outcome measurement, and selection bias. CE significantly improved HbA1C (95% CI of -0.654 to 0.363, I2 = 84.92% moderate heterogeneity), FBGL (95% CI of -0.239 to 1.145, I2 = 93.74% - high level of heterogeneity), and insulin resistance (HOMA-IR) (95% CI of -0.593 to 0.544, I2 = 92.85% - high level of heterogeneity). Collectively, findings indicate the potential of CE as an intervention to impact glycaemic control in T2DM patients positively. However, the relatively high I² values suggest notable variability among studies, and further research to explore the factors contributing to this heterogeneity, exercise protocol along with progression, and duration of diabetes are needed, which is more challenging to determine a precise dose-response relationship. Therefore, more studies are required to provide thorough insights into these components for T2DM management. Key Words: Glycated haemoglobin, Glycaemic control, Insulin resistance, Physical exercise, Type-II diabetes mellitus.

Association of premature natural and surgical menopause with incidence of depression requiring hospitalization: A prospective cohort study

BACKGROUNDPremature menopause is associated with depression in postmenopausal women. However, current evidence ignores the differences between premature natural and surgical menopause, and there is a lack of exploration of the mechanisms underlying the association between premature menopause and depression. OBJECTIVETo examine the association of premature natural and surgical menopause with incidence of depression requiring hospitalization, and to evaluate whether frailty and menopausal hormone therapy (MHT) are significant factors contributing to a higher incidence of depression requiring hospitalization associated with premature natural and surgical menopause, in comparison to women who experience menopause at age 40 and older. STUDY DESIGNThis cohort included 139691 postmenopausal women from the UK Biobank, 44734 of whom participated the 7-y online mental health survey. Reproductive histories were obtained at enrollment. Depression requiring hospitalization was identified based on electronic health records and the Patient Health Questionnaire (PHQ) - 9. Cox proportional hazard models and Poisson regression models were fitted. RESULTSDuring a median (IQR) follow-up of 12.53 (11.71-13.25) years, 7563 participants (5.41%) developed depression requiring hospitalization. In the fully adjusted model, compared with women who experienced menopause≥ 40, the HRs (95% CIs) of those with premature natural and surgical menopause for depression requiring hospitalization were 1.27 (1.17-1.38) and 1.76 (1.43-2.16), respectively. Similar findings were observed in the association of premature natural (RR = 1.17, 95% CI: 1.00-1.39) and surgical menopause (RR = 1.62, 95% CI: 1.05-2.51) with depression as measured by the PHQ-9 score. An inverse dose-response relationship was observed in the analysis of alternate age thresholds and depression requiring hospitalization. When premature natural menopause was compared with women who experienced menopause≥ 40, the proportion of the mediating effect of frailty and MHT on depression requiring hospitalization was 27.43% (9.53%-229.00%) and 65.15% (45.57%-136.00%), respectively. When premature surgical menopause was compared with women who experienced menopause≥ 40, the proportion of the mediating effect of frailty and MHT on depression requiring hospitalization was 8.30% (2.59%-34.00%), 42.90% (27.96%-81.00%), respectively. CONCLUSIONPremature menopause, especially surgical premature menopause, is significantly associated with depression requiring hospitalization in women. Frailty and adjustment of hormone therapy strategies during menopause may be potential targets for intervention.

Independent and joint relationships of cardiorespiratory fitness and body mass index with liver fat content.

To investigate the relationship between cardiorespiratory fitness (CRF) and liver fat content (LFC) in community-based participants and highlight their relationship in people with different body mass indices (BMIs). Using UK Biobank data, CRF was estimated with bicycle ergometer fitness testing and was evaluated based on physical work capacity at 75% maximum heart rate (PWC75%). LFC was quantified through liver proton density fat fraction (PDFF) on magnetic resonance imaging. Multivariate linear regression models were used to analyse the associations of CRF and BMI with absolute reduction and percentage change in PDFF (%). In total, 5765 participants with a mean age of 55.57 years and a median (range) follow-up of 10.7 (4.0-17.7) years were included. Compared with the lowest PWC75% tertile, the absolute reduction and percentage change in PDFF in the highest PWC75% tertile were -0.450 (95% confidence interval [CI] -0.699 to -0.192) and -4.152 (95% CI -6.044 to -2.104), respectively. These associations were independent of BMI, and individuals with obesity and normal weight had the largest absolute reduction and percentage change in LFC, respectively (p for interaction <0.001). Joint analysis showed that PWC75% and BMI had a negative dose-response relationship with PDFF. These associations were consistent in different sex and age subgroups (p for interaction >0.05). There was a significant negative association between CRF and LFC, and this association was independent of BMI. The results of this study strongly recommend improving CRF to mitigate LFC.