Inverse Association Research Articles

The association between food production, food security, household consumer behaviour and waist‐hip ratio amongst women in smallholder farming households in Kilifi County, Kenya

AbstractFood insecurity disproportionately affects smallholder farming households and within them women, who bear primary caregiving responsibilities and contend with time and resource constraints that heighten their vulnerability to adverse nutrition‐related health outcomes. This study cross‐sectionally investigates the association between food production practices, household consumer behaviour, and the experience of food insecurity with women's waist‐hip ratio (WHR), a key indicator of abdominal obesity, in a coastal community in Kenya. In total, 394 households were randomly selected from a list of farming households in Kaloleni and Rabai sub‐counties of Kilifi. Trained enumerators administered questionnaires to adult female family members who play a pivotal role in household management. Household dietary diversity scores (HDDS) were computed from 16 food groups consumed in the 7 days preceding the survey. Waist‐hip measurements focused on these females, representing vulnerable populations. Pathway‐based regression models were constructed using STATA version 13 (p < 0.05). Most households practised mixed farming (59.9%) and monocropping (73.2%) and most female respondents were widowed (75.1%) with limited education (73.1% had no formal education) and over 20 years of farming experience. Food insecurity was prevalent, affecting 80.7% of households. Limited dietary diversity was noted with an average HDDS of 9. The most commonly consumed foods were cereals, spices, condiments and beverages, while meat, eggs and fruits were infrequently eaten. An inverse association was observed between HDDS and WHR (standardised regression coefficient = −0.1328; p = 0.026) but while food insecurity was inversely associated with both HDD and WHR, these associations did not reach statistical significance (HDDS‐standardised regression coefficient −0.0294; p = 0.592: WHR‐standardised regression coefficient −0.0155; p = 0.791). Existing research has primarily addressed the undernutrition and hunger‐related impacts of food insecurity. The findings underscore the need to better understand the complex interplay between food insecurity and nutritional health, including markers of adiposity, to effectively promote health.

The association between the fluoxetine use and the occurrence of coronary heart disease: a nationwide retrospective cohort study

BackgroundWe explored if the administration of fluoxetine, recognized for its potential in adipocyte browning, entails a differential risk of coronary heart disease (CHD) in comparison to other SSRI medications.MethodsUsing the National Health Insurance Research Database of Taiwan from 2000 to 2013, we conducted a retrospective cohort study. The exposure cohort comprised individuals prescribed fluoxetine for over 90 days (n = 2,228). Conversely, those administered other SSRIs (excluding fluoxetine) for a duration surpassing 90 days were designated as the non-exposed cohort (n = 8,912). CHD incidence served as our primary outcome measure, and we employed Cox proportional hazards models to scrutinize the relationship between fluoxetine exposure and CHD development rates.ResultsCompared with the non-exposed cohort, the fluoxetine use had a significantly decreased 21% risk of developing CHD in the exposed cohort (adjusted hazard ratio: 0.79%, 95% confidence interval: 0.68–0.92). Noticeably, results indicated that there was an inverse association between the fluoxetine exposure and the risk of CHD, regardless of whether men, women or other age groups.ConclusionOur findings suggest that clinical use of fluoxetine was associated with a 21% reduced risk of CHD relative to other SSRI prescriptions.

Does cybercrime affect brand loyalty to deposit money banks in Nigeria

The financial service industry, especially banking, has benefited greatly from the introduction of information technology. The technology has allowed them to offer a wide range of electronic banking services that have expanded scope of participants. This, however, has exposed the banks to cybercrime risk, posing serious threat to their survival. The study aimed to determine how the brand loyalty of the banks’ customers is affected by cybercrime associated to the use of e-banking platforms. The study used self-structured and administered questionnaires to gather primary data from 200 clients from (10) deposit money banks (DMBs) and examine the effects of cybercrime on customers brand loyalty. A regression analysis was performed to investigate the relationship between customer brand loyalty and the considered cybercrime activities. The finding identifies a strong inverse association between brand loyalty and financial losses brought on by cybercrime. Also, the evidence shows that card theft significantly reduces brand loyalty. The study further discovers that recurring security vulnerabilities significantly reduce brand loyalty and lastly, the paper demonstrates that the most notable adverse effect on brand loyalty was caused by identity theft. The study's conclusions demonstrate a strong and unfavourable correlation between consumer brand loyalty and cybercrime. The article offers comprehensive recommendations, including policies, strategies, and interventions that show how cybercrime can be combated to reduce the risk of thefts in the banking sector.

Exploring multi-omics and clinical characteristics linked to accelerated biological aging in Asian women of reproductive age: insights from the S-PRESTO study

BackgroundPhenotypic age (PhenoAge), a widely used marker of biological aging, has been shown to be a robust predictor of all-cause mortality and morbidity in different populations. Existing studies on biological aging have primarily focused on individual domains, resulting in a lack of a comprehensive understanding of the multi-systemic dysregulation that occurs in aging.MethodsPhenoAge was evaluated based on a linear combination of chronological age (CA) and 9 clinical biomarkers in 952 multi-ethnic Asian women of reproductive age. Phenotypic age acceleration (PhenoAgeAccel), an aging biomarker, represents PhenoAge after adjusting for CA. This study conducts an in-depth association analysis of PhenoAgeAccel with clinical, nutritional, lipidomic, gut microbiome, and genetic factors.ResultsHigher adiposity, glycaemia, plasma saturated fatty acids, kynurenine pathway metabolites, GlycA, riboflavin, nicotinamide, and insulin-like growth factor binding proteins were positively associated with PhenoAgeAccel. Conversely, a healthier diet and higher levels of pyridoxal phosphate, all-trans retinol, betaine, tryptophan, glutamine, histidine, apolipoprotein B, and insulin-like growth factors were inversely associated with PhenoAgeAccel. Lipidomic analysis found 132 lipid species linked to PhenoAgeAccel, with PC(O-36:0) showing the strongest positive association and CE(24:5) demonstrating the strongest inverse association. A genome-wide association study identified rs9864994 as the top genetic variant (P = 5.69E-07) from the ZDHHC19 gene. Gut microbiome analysis revealed that Erysipelotrichaceae UCG-003 and Bacteroides vulgatus were inversely associated with PhenoAgeAccel. Integrative network analysis of aging-related factors underscored the intricate links among clinical, nutritional and lipidomic variables, such as positive associations between kynurenine pathway metabolites, amino acids, adiposity, and insulin resistance. Furthermore, potential mediation effects of blood biomarkers related to inflammation, immune response, and nutritional and energy metabolism were observed in the associations of diet, adiposity, genetic variants, and gut microbial species with PhenoAgeAccel.ConclusionsOur findings provide a comprehensive analysis of aging-related factors across multiple platforms, delineating their complex interconnections. This study is the first to report novel signatures in lipidomics, gut microbiome and blood biomarkers specifically associated with PhenoAgeAccel. These insights are invaluable in understanding the molecular and metabolic mechanisms underlying biological aging and shed light on potential interventions to mitigate accelerated biological aging by targeting modifiable factors.

Multiple Personal Income Taxes and Financial Well-Being of Employees in Tertiary Institutions

This study aimed to interrogate the relationship between multiple personal income taxes and public workers’ financial wellbeing. The paper therefore examined the relationships between pay as you earn, Bayelsa Health Insurance Scheme, Education Trust Funds and worker’s disposable income as proxies for objective financial wellbeing in (the public) tertiary institutions of Bayelsa State. The study adopted a quantitative design, and data were collected through the Salary Structure of teaching and non-teaching staff from Bayelsa State owned University of Africa and Niger Delta University in Nigeria. The data were analyzed by applying simple regression and correlation analysis. The findings revealed that there was a positive significant relationship between multiple personal income taxes and workers’ financial wellbeing in Bayelsa State tertiary institutions. However, at the entity level, the Bayelsa Health Insurance Scheme (BHIS) variable had a positive substantial impact on workers’ financial wellbeing; whilst, Pay as You Earn (PAYE) has a negative significant effect on workers’ financial wellbeing. Whereas Education Trust Funds (EDTF) variable had an inverse non-significant association with workers’ financial wellbeing in Bayelsa State. Therefore, we recommend a fair and equitable tax policy framework to sustain adequate pay for public servants and reduce employees’ turnover in the state.

Associations of sugary beverage intake with type 2 diabetes and the role of physical activity: a prospective cohort study

BackgroundHigher consumption of sugary beverages (SB) has been associated with type 2 diabetes (T2D), but whether these associations are modified by physical activity remains unclear. This study aimed to examine the associations of SB intake, including sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), and natural juices (NJ) with the risk of incident T2D, and the potential role of physical activity.MethodsWe included 153,862 diabetes-free participants in the UK Biobank who completed both the International Physical Activity Questionnaire at recruitment (2006–2010) and at least one 24-h dietary recall questionnaire in 2009–2012. We assessed the associations of each SB with the risk of incident T2D using Cox proportional hazard models, and explored the interactions between each SB and physical activity.ResultsDuring a median follow-up of 11.8 years, 6631 participants developed incident T2D. Participants consuming more SSB and ASB (comparing > 2 to 0 unit/d) had a higher hazard of T2D (hazard ratio [HR]: 1.17, 95% confidence interval [CI]: 1.05–1.31 for SSB; 1.54, 1.37–1.74 for ASB), while medium intake of NJ showed an inverse association (HR> 0–1 vs. 0 unit/d: 0.87, 95% CI: 0.82–0.92; HR> 1–2 vs. 0 unit/d: 0.88, 95% CI: 0.81–0.97) with incident T2D. No significant interactions between physical activity and SSB/ASB were found (P-interaction=0.204 for SSB, 0.926 for ASB), but the protective association of medium NJ intake with T2D was stronger among participants with higher level of physical activity (P-interaction = 0.043).ConclusionsHigher intake of SSB and ASB was related to higher risks of T2D. Medium NJ intake was associated with a lower risk of T2D, particularly among individuals with higher physical activity level. These findings emphasized the importance of healthy beverage intake and adequate physical activity in diabetes prevention.

Associations Between Mosaic Loss of Sex Chromosomes and Incident Hospitalization for Atrial Fibrillation in the United Kingdom.

Mosaic loss of chromosome Y (mLOY) in leukocytes of men reflects genomic instability from aging, smoking, and environmental exposures. A similar mosaic loss of chromosome X (mLOX) occurs among women. However, the associations between mLOY, mLOX, and risk of incident heart diseases are unclear. We estimated associations between mLOY, mLOX, and risk of incident heart diseases requiring hospitalization, including atrial fibrillation, myocardial infarction, ischemic heart disease, cardiomyopathy, and heart failure. We analyzed 190 613 men and 224 853 women with genotyping data from the UK Biobank. Among these participants, there were 37 037 men with mLOY and 13 978 women with mLOX detected using the Mosaic Chromosomal Alterations caller. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% CIs of each incident heart disease in relation to mLOY in men and mLOX in women. Additionally, Mendelian randomization was conducted to estimate causal associations. Among men, detectable mLOY was associated with elevated risk of atrial fibrillation (HR, 1.06 [95% CI, 1.03-1.11]). The associations were apparent in both never smokers (HR, 1.07 [95% CI, 1.01-1.14]) and ever smokers (HR, 1.05 [95% CI, 1.01-1.11]) as well as men aged >60 and ≤60 years. Mendelian randomization analyses supported causal associations between mLOY and atrial fibrillation (HRMR-PRESSO, 1.15 [95% CI, 1.13-1.18]). Among postmenopausal women, we found a suggestive inverse association between detectable mLOX and atrial fibrillation risk (HR, 0.90 [95% CI, 0.83-0.98]). However, associations with mLOY and mLOX were not found for other heart diseases. Our findings suggest that mLOY and mLOX reflect sex-specific biological processes or exposure profiles related to incident atrial fibrillation requiring hospitalization.

Causal correlations between inflammatory proteins and heart failure: A two-sample Mendelian randomization analysis.

Inflammation plays a critical role in both the development and progression of heart failure (HF), which is a leading cause of morbidity and mortality worldwide. However, the causality between specific inflammation-related proteins and HF risk remains unclear. This study aims to investigate the genetically supported causality between inflammatory proteins and HF using a two-sample Mendelian randomization (MR) analysis. We utilized genome-wide association study (GWAS) data of 91 inflammation-related proteins as exposures from the SCALLOP Consortium (14,824 participants), alongside outcome GWAS summary statistics from FinnGen (29,218 cases/381,838 controls) and HERMES (47,309 cases/930,014 controls) for HF, to conduct a two-sample MR analysis. For each inflammatory protein, instrumental variables (IVs) were chosen following the three foundational assumptions of the MR analysis, requiring a minimum of three qualifying single nucleotide polymorphisms (SNPs) each with a P<5e-8. Associations between inflammatory proteins and HF were assessed through inverse-variance weighted (IVW), MR-Egger regression, weighted median and weighted mode analysis. The reliability and validity of the results were evaluated by examining heterogeneity, horizontal pleiotropy, leave-one-out analysis, meta-analysis and reverse MR analysis. Heterogeneity refers to the variation in results across different genetic variants. Horizontal pleiotropy occurs when a genetic variant influences multiple traits through different biological pathways. Addressing both heterogeneity and horizontal pleiotropy is crucial for ensuring the reliability and interpretability of MR results. Our analysis identified associations between three inflammatory proteins and HF risk. Matrix metalloproteinase-1 (MMP-1) (OR, 1.09; 95% CI, 1.00-1.18; P=0.04) and TNF-beta (OR, 1.05; 95% CI, 1.01-1.09; P=0.01) were positively associated with HF risk in FinnGen. In contrast, urokinase-type plasminogen activator (uPA) was inversely associated with HF risk in both FinnGen (OR, 0.85; 95% CI, 0.78-0.92; P=3.27e-5) and HERMES (OR, 0.93; 95% CI, 0.87-0.99; P=0.03). No evidence of heterogeneity and horizontal pleiotropy was observed in the MR analysis, indicating the robustness of our findings. A meta-analysis further supported this association, indicating a reduced risk (OR, 0.89; 95% CI, 0.81-0.98; P=0.02). No reverse causality was found between HF and these three inflammatory proteins (P>0.05 for all). This study provides genetically supported evidence of the causal association of specific inflammatory proteins with HF risk. The positive association of MMP-1 and TNF-beta with HF suggests their roles in disease pathogenesis, whereas the inverse association of the uPA indicates its potential protective effect. Our findings highlight the potential of targeting specific inflammatory pathways as a therapeutic strategy for HF.

Perceived social support and symptoms of depression and anxiety in emerging adulthood: A Swedish prospective cohort study.

The transition from adolescence to young adulthood, often referred to as 'emerging adulthood', is a challenging period in life, and mental health problems are common. Although a large number of studies have shown that social support is linked with fewer mental health problems, few longitudinal studies have examined these associations during this life phase. The aim of the current study was to examine the associations between perceived social support from different sources - family, friends and significant other - at age 17-18 and symptoms of depression and anxiety at age 20-21. Data were obtained from the cohort study Futura01 based on a Swedish national sample of adolescents attending grade 9 in 2016/2017. We used survey information from 2019 (age 17-18) and 2022 (age 20-21) and linked registry information (N=2722). Symptoms of depression and anxiety were measured by the Patient Health Questionnaire-4 (PHQ-4) at age 20-21. Perceived social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS) at age 17-18. Control variables included sociodemographic characteristics and indicators of mental health problems at age 17-18. Binary logistic regressions were performed. When mutually adjusting for all sources of perceived social support, family support at age 17-18 had inverse associations with symptoms of both depression and anxiety at age 20-21. Perceived support from friends was associated with subsequent symptoms of anxiety only. Perceived social support can be a protective factor against mental health problems in emerging adulthood. The family serves a particularly important source of social support.

COVID-19 Traumatic Stress, Working Memory Deficits, and Mindfulness

Stress is known to be a risk factor for deficits in working memory creating profound cognitive disturbances resulting in lingering impairments and losses in social and occupational functioning. Although a body of research has identified mindfulness as a potential means of mitigating deficits in working memory, there is a paucity of studies on the association between mindfulness and deficits in working memory among those who have experienced COVID-19 traumatic stress. This exploratory cross-sectional study sought to examine the mitigating effect of mindfulness on COVID-19 stress impacting working memory. The sample included 484 college students in Israel and the USA. Correlation and multiple regression analyses indicated that COVID-19 stress had a modest, inverse association with both a self-report and task-based indicator of working memory. In separate models predicting the different operationalizations of working memory, results revealed different effects for Israeli and USA students. Mindfulness was significantly associated with task-based but not self-reported working memory. The results offered evidence for a small but significant effect of mindfulness as moderating the impact of COVID-19 stress on working memory deficits. This exploratory, cross-­sectional study, used a convenience sample limiting the generalizability and its ability to test causal effects, calling for replication.

Untangling the role of tau in sex hormone responsive cancers: lessons learnt from Alzheimer's disease.

Tubulin associated unit has been extensively studied in neurodegenerative diseases including Alzheimer's disease (AD), whereby its hyperphosphorylation and accumulation contributes to disease pathogenesis. Tau is abundantly expressed in the central nervous system but is also present in non-neuronal tissues and in tumours including sex hormone responsive cancers such as breast and prostate. Curiously, hormonal effects on tau also exist in an AD context from numerous studies on menopause, hormone replacement therapy, and androgen deprivation therapy. Despite sharing some risk factors, most importantly advancing age, there are numerous reports from population studies of, currently poorly explained inverse associations between cancer and Alzheimer's disease. We previously reviewed important components of the phosphoinositide-3-kinase/protein kinase B (PI3K/Akt) signalling pathway and their differential modulation in relation to the two diseases. Similarly, receptor tyrosine kinases, estrogen receptor and androgen receptor have all been implicated in the pathogenesis of both cancer and AD. In this review, we focus on tau and its effects in hormone responsive cancer in terms of development, progression, and treatment and in relation to sex hormones and PI3K/Akt signalling molecules including IRS-1, PTEN, Pin1, and p53.

The Relationship Between Serum Cholesterol, Triglycerides, and Self-Reported Appetitive and Reactive Aggression, as Well as Violent Crimes in Male Forensic Patients with Substance Use Disorder

Numerous studies have linked lower levels of serum cholesterol with heightened aggression, violent crimes, and violent deaths across diverse populations, including forensic psychiatric patients, criminals, and the broad public. Interestingly, this association appears to be more pronounced in men than in women. Conversely, findings regarding serum triglycerides present a more nuanced picture, with some studies indicating heightened aggression with elevated levels and others suggesting the opposite. However, most studies have neglected to examine this phenomenon in conjunction with psychological traits. Additionally, no prior research has explored the association between serum lipid levels and different types of aggression, e.g., reactive, instrumental, or appetitive. Considering these gaps, our study aimed to assess serum cholesterol and triglyceride levels upon clinic admission and correlate them with scores from the Appetitive and Facilitative Aggression Scale (AFAS), a self-rating questionnaire assessing reactive and appetitive aggression. We conducted our investigation on a cohort of 135 forensic psychiatric patients undergoing drug addiction treatment under Section 64 of the German Criminal Code. This provision offers a nearly unique opportunity worldwide for individuals who have committed crimes under the influence of drugs or in the context of their addiction to receive specialized treatment. Using non-linear Spearman correlation analyses, we observed an inverse relationship between serum concentrations of both cholesterol and triglycerides and AFAS appetitive violence scores but not for reactive aggression. Additionally, triglyceride levels exhibited an inverse association with the prevalence of violent crimes as an index crime. In conclusion, blood lipids may affect numerous areas of health and disease beyond what is currently known, offering a potential shift in how we understand their role in aggression.

Association between the oxidative balance score with metabolic syndrome traits in US adults

ObjectiveTo explore the association between the Oxidative Balance Score (OBS), which represents the balance of multiple oxidative stress-related dietary and lifestyle exposures, and the risk of metabolic syndrome (MetS).MethodsA population-based cross-sectional study design was adopted and 16,850 participants in NHANES database were included in the statistics analysis stage. The OBS was constructed by combining information from 20 a priori selected pro- and antioxidant factors. Weighted logistic regression and restricted cubic splines (RCS) were used to estimate the association between OBS and MetS.ResultsParticipants in the highest OBS quartile, indicating low oxidative stress (OS) levels, exhibited a significantly lower risk of MetS (odds Ratio [OR] = 0.55, 95% confidence Interval [CI]: 0.47–0.64) compared to the lowest quartile. Specifically, higher OBS was inversely associated with abdominal obesity (OR = 0.61, 95% CI: 0.54–0.69), hypertension (OR = 0.69, 95% CI: 0.58–0.83), elevated triglycerides (OR = 0.68, 95% CI: 0.57–0.82), low high-density lipoprotein cholesterol (HDL-C) levels (OR = 0.60, 95% CI: 0.50–0.70) and fasting blood glucose (FBG) levels (OR = 0.74, 95% CI: 0.62–0.88). The observed inverse association between OBS and hypertension or FBG levels appeared to primarily influenced by BMI. The association between dietary OBS intervals and elevated FBG levels was not statistically significant in men, whereas the risk was lower by 25% in women.ConclusionsA higher OBS, representing a balance of multiple oxidative stress-related dietary and lifestyle exposures, is associated with a lower risk of MetS. Therefore, adhering to an antioxidant diet and lifestyle may help prevent the occurrence of metabolic disorders.

Diet-Wide Association Study for the Incidence of Type 2 Diabetes in Three Population-Based Cohorts

Background: Dietary factors are well-known modifiable risk factors for type 2 diabetes (T2D), but many studies overlook the interrelationships between these factors, even though foods are often consumed together and contain a variety of nutrients. Objectives: In this study, we employed a diet-wide association study approach to investigate the links between various dietary factors and T2D onset, taking into account complex dietary patterns. Methods: We analyzed 16,666 participants without T2D from three Korean population-based cohorts: the Multi-Rural Communities Cohort (n = 8302), the Atherosclerosis Risk of a Rural Area Korean General Population cohort (n = 4990), and the Kanghwa cohort (n = 3374). A two-step approach was employed. In the first step, robust Poisson regression analysis was used for the initial screening (false discovery rate-adjusted p-values &lt; 0.05). In the second step, a hierarchical cluster analysis was conducted of all dietary factors, followed by mutual adjustment of the screened factors within each cluster to account for interrelationships. Results: The 11 food clusters screened were cooked rice with beans, rice cakes, breads/spreads, bread products, cheese and pizza/hamburger, grain powder, snack/confections, nuts and roasted beans, soy milk, traditional beverages, and non-native fruit. These factors were similarly distributed across three of the seven clusters in each cohort. After mutual adjustment, cooked rice with beans (p-value ≤ 2.00 × 10−7 in all three cohorts) and non-native fruits (p-value ≤ 5.91 × 10−3 in two cohorts) remained significantly associated with lower T2D risk in more than one cohort. Conclusions: The inverse association of cooked rice with beans, not observed with other types of cooked rice, and that of non-native fruits, suggest that incorporating beans into rice and eating various fruits may be an effective strategy for preventing diabetes.

The relationship between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status in adolescents with overweight and obesity: results from a cross-sectional study in Iran.

Few studies investigated the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status, particularly among adolescents. The present study was designed to investigate the association of MIND diet with metabolic health status in Iranian adolescents with overweight/obesity. This cross-sectional study was done among 203 adolescents with overweight/obesity (12-18 years) in Isfahan, Iran. A validated FFQ was applied to collect dietary intakes. Anthropometric indices and blood pressure were also measured by standard procedures. Fasting blood samples were obtained to determine serum insulin, glucose and lipid profile. To categorise participants as being with metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO), two methods including International Diabetes Federation (IDF) criteria and IDF plus Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were applied. Participants had a mean age of 13·98 years and 50·2 % of them were girls. In fully adjusted models, participants with highest MIND diet adherence had lower odds of MUO status based on IDF (OR = 0·20; 95 % CI 0·08, 0·51) and IDF/HOMA-IR (OR = 0·22; 95 % CI 0·08, 0·59) criteria. Stratified analyses revealed that this association was stronger among girls and was only significant among individuals with overweight. An inverse association was also found between MIND diet score and odds of hyperglycaemia and insulin resistance (IR). Higher MIND diet adherence was associated with lower odds MUO in adolescents with overweight/obesity. Inverse associations were also found between MIND diet and odds of hyperglycaemia and IR. Future longitudinal prospective studies are necessary to confirm our results.

Blood pressure status, quality of life, and emotional states in adults with different disease awareness and treatment adherence

This study aimed to examine the association between blood pressure (BP) with health-related quality of life (HRQoL) and emotional states, considering the disease awareness and commitment to treatment among the Iranian adult population. This cross-sectional study uses the data of 7257 and 2449 individuals aged ≥ 20 who had completed data on HRQoL and emotional states, respectively. Linear and logistic regression were used to evaluate the mentioned association. The results showed that commitment to treatment had an inverse association with physical HRQoL in both sexes, except for bodily pain in men. Concerning mental HRQoL, in women, poor medication adherence was linked to a decline in mental HRQoL and social functioning, while good treatment adherence was associated with a reduction in the mental health domain. However, except for a decrease in vitality of hypertensive males with high treatment adherence, no significant association was found between their mental HRQoL and BP. In women, increased commitment to treatment was associated with anxiety, whereas poor commitment was related to depression and stress. The undiagnosed disease was not associated with any HRQoL and emotional state deficits. This study highlights the significance of psychiatric assessment, counseling, and support services while taking into account gender-specific differences among hypertensive patients. It also emphasizes the necessity for customized interventions for both men and women to improve their mental well-being and adherence to treatment.

Day Care Attendance and Risk of Type 1 Diabetes

A meta-analysis published in 2001 suggested that exposure to infections measured by day care attendance may be important in the pathogenesis of type 1 diabetes. Several new studies on the topic have since been published. To investigate the association between day care attendance and risk of type 1 diabetes and to include all available literature up to March 10, 2024. Data from PubMed and Web of Science were used and supplemented by bibliographies of the retrieved articles and searched for studies assessing the association between day care attendance and risk of type 1 diabetes. Studies that reported a measure of association between day care attendance and risk of type 1 diabetes were included. Details, including exposure and outcome assessment and adjustment for confounders, were extracted from the included studies. The multivariable association with the highest number of covariates, lowest number of covariates, and unadjusted estimates and corresponding 95% CIs were extracted. DerSimonian and Laird random-effects meta-analyses were performed and yielded conservative confidence intervals around relative risks. The principal association measure was day care attendance vs no day care attendance and risk of type 1 diabetes. Seventeen articles including 22 observational studies of 100 575 participants were included in the meta-analysis. Among the participants, 3693 had type 1 diabetes and 96 882 were controls. An inverse association between day care attendance and risk of type 1 diabetes was found (combined odds ratio, 0.68; 95% CI, 0.58-0.79; P < .001; adjusted for all available confounders). When the 3 cohort studies included were analyzed separately, the risk of type 1 diabetes was 15% lower in the group attending day care; however, the difference was not statistically significant (odds ratio, 0.85; 95% CI, 0.59-1.12; P = .37). These results demonstrated that day care attendance appears to be associated with a reduced risk of type 1 diabetes. Increased contacts with microbes in children attending day care compared with children who do not attend day care may explain these findings. However, further prospective cohort studies are needed to confirm the proposed association.

Inverse Association between the Body Mass Index and the Incidence of Unruptured Intracranial Aneurysms-Insights from the Hamburg City Health Population Study.

Overweight/obese patients experience a lower incidence of subarachnoid hemorrhage (SAH) compared to non-overweight patients, even though elevated body mass index (BMI) has been associated with various SAH risk factors. Given that intracranial aneurysms are a primary cause of SAH, a potential protective effect of a high BMI on intracranial aneurysms is likely but remains insufficiently investigated. This population-based MRI study aims to conduct detailed analyses on risk factors associated with the incidence of unruptured intracranial aneurysms (UIA). Retrospective analysis of subjects enrolled in the prospective Hamburg City Health study who underwent intracranial magnetic resonance imaging (MRI) was done. MRI scans were screened for UIA using time-of-flight angiography. Subject data including medical history, laboratory examinations, and risk factors for UIA were collected, and a multivariable logistic regression model was used to investigate the relationship between risk factors and UIA incidence. 2688 subjects (mean (IQR) age, 65 (58-71); 1176 female (43.8%) were included. An UIA was detected in 214 subjects with an incidence of 10.6% (6.0%) in females (males). Determinants for UIA were female sex (OR 2.00, 95%CI 1.45-2.77, p < 0.001), hypertension (OR 1.48, 95%CI 1.08-2.04, p = 0.015), smoking (OR 1.41, 95%CI 1.03-1.95, p = 0.036), and BMI (OR 0.95, 95%CI 0.91-0.98, p = 0.004). Among subjects with UIA, 9.4% with a BMI > 25 had multiple aneurysms, compared to 21.6% with BMI ≤ 25 (p = 0.012). This study suggests that a high BMI exhibits a protective effect on UIA incidence and the development of multiple aneurysms. Additionally, the data confirms established risk factors for UIA development, such as female sex, hypertension, and smoking.

Cancer incidence following non-neoplastic medical conditions: a prospective population-based cohort study.

Many non-neoplastic diseases have been established to be tumorigenic, and cancers are sometimes misdiagnosed as non-neoplastic diseases. We conducted a comprehensive registry-based study of site-specific cancer diagnosis risk following the diagnosis of any preceding medical condition (PMC) encoded by the International Classification of Diseases (ICD)-10 classification. We analyzed healthcare data and cancer data for a random population-based sample of 2.5 million individuals living in Finland on January 1, 2000. Hazard ratios for each PMC and cancer pair were estimated using piecewise constant hazard regression models. P-values were corrected for multiple testing with the Bonferroni method. Several lifestyle-related PMCs were associated with the risk of cancer diagnosis, exemplified by chronic obstructive pulmonary disease and subsequent lung cancer diagnosis risk (female hazard ratio [HR] = 9.91, 95% confidence interval [CI]: 9.18-19.7, p-adj. < 0.0001; male HR = 5.69, 95% CI: 5.43-5.96, p-adj. < 0.0001). Diagnosis risk of ill-defined cancers appeared to increase following diagnosis of Alzheimer's disease (AD). We identified rare PMCs of potential interest. A considerable proportion of the statistically significant associations were explainable by tobacco smoking and alcohol use. The enrichment of ill-defined cancer diagnoses in persons with AD, together with the overall inverse association between AD and cancer, may reflect underdiagnosis of cancer in this patient population. Our results provide a useful resource for research on the prevention and early detection of cancer.

Glucocorticoid Receptor Isoforms in Breast Cancer Raise Implications for Personalised Supportive Therapies

Glucocorticoid receptor (GR) activation may promote metastasis in oestrogen receptor-negative and triple-negative breast cancer (TNBC). However, the role of the GRβ isoform, which has opposing effects to the main isoform, has not been studied in clinical samples. We aimed to analyse the intracellular localisation of total GR and GRβ in vitro using plasmid constructs and fluorescent immunocytochemistry. Additionally, our goal was to perform immunostaining for total GR and GRβ on two cohorts: (i) on 194 clinical breast cancer samples to compare the expression in different molecular subtypes, and (ii) on 161 TNBC samples to analyse the association of GR with survival. We supplemented our analysis with RNA data from 1097 TNBC cases. We found that in the absence of the ligand, GR resided in the cytoplasm of breast cancer cells, while upon ligand activation, it translocated to the nucleus. A negative correlation was found between cytoplasmic GRtotal and Ki67 in luminal A tumours, while the opposite trend was observed in TNBC samples. Tumours with strong lymphoid infiltration showed higher cytoplasmic GRtotal staining compared to those with weaker infiltration. Patients with high nuclear GRtotal staining had shorter progression-free survival in univariate analysis. High cytoplasmic GRβ was a marker for better overall survival in multivariate analysis (10-year overall survival HR [95% CI]: 0.46 [0.22–0.95], p = 0.036). As a conclusions, this study is the first to investigate GRβ expression in breast tumours. Different expression and cellular localisation of GRtotal and GRβ were observed in the context of molecular subtypes, underscoring the complex role of GR in breast cancer. An inverse association between cytoplasmic GRtotal and the Ki67 proliferation index was observed in luminal A and TNBC. Regarding the impact of GR on outcomes in TNBC patients, while cytoplasmic GRβ was associated with a better prognosis, patients with nuclear GRtotal staining may be at a higher risk of disease progression, as it negatively affects survival. Caution should be exercised when using glucocorticoids in patients with nuclear GR staining, as it may negatively impact survival.