Adult Levels Research Articles

Effects of PFAS on human liver transporters: implications for health outcomes.

Per- and polyfluoroalkyl substances (PFAS) have become internationally recognized over the past three decades as persistent organic pollutants used in the production of various consumer and industrial goods. Research efforts continue to gauge the risk that historically used, and newly produced, PFAS may cause to human health. Numerous studies report toxic effects of PFAS on the human liver as well as increased serum cholesterol levels in adults. A major concern with PFAS, also dubbed "forever chemicals," is that they accumulate in the liver and kidney and persist in serum. The mechanisms responsible for their disposition and excretion in humans are poorly understood. A better understanding of the interaction of PFAS with liver transporters, as it pertains to the disposition of PFAS and other xenobiotics, could provide mechanistic insight into human health effects and guide efforts toward risk assessment of compounds in development. This review summarizes the current state of the literature on the emerging relationships (eg, substrates, inhibitors, modulators of gene expression) between PFAS and specific hepatic transporters. The adaptive and toxicological responses of hepatocytes to PFAS that reveal linkages to pathologies and epidemiological findings are highlighted. The evidence suggests that our understanding of the molecular landscape of PFAS must improve to determine their impact on the expression and function of hepatocyte transporters that play a key role in PFAS or other xenobiotic disposition. From here, we can assess what role these changes may have in documented human health outcomes.

Exploring the Relationship Between Attachment Styles and Loneliness Levels in Young Adults

This study explores the relationship between attachment styles and loneliness levels. The study utilized correlation analysis to examine how different attachment styles might influence the experience of loneliness in this demographic. The findings provide insights into how attachment patterns can be linked to varying levels of loneliness among young adults, shedding light on the complex interplay between emotional bonds and feelings of isolation in this population. This research contributes to a better understanding of the factors that contribute to loneliness levels among young adults and may have implications for interventions aimed at addressing social isolation. Loneliness levels of individuals with secure attachment style was much lower as compared to Anxious and Avoidant styles.

Effect of an eight-week high-intensity interval training programme on circulating sphingolipid levels in middle-aged adults at elevated cardiometabolic risk (SphingoFIT)-Protocol for a randomised controlled exercise trial.

Evidence indicates that sphingolipid accumulation drives complex molecular alterations promoting cardiometabolic diseases. Clinically, it was shown that sphingolipids predict cardiometabolic risk independently of and beyond traditional biomarkers such as low-density lipoprotein cholesterol. To date, little is known about therapeutic modalities to lower sphingolipid levels. Exercise, a powerful means to prevent and treat cardiometabolic diseases, is a promising modality to mitigate sphingolipid levels in a cost-effective, safe, and patient-empowering manner. This randomised controlled trial will explore whether and to what extent an 8-week fitness-enhancing training programme can lower serum sphingolipid levels of middle-aged adults at elevated cardiometabolic risk (n = 98, 50% females). The exercise intervention will consist of supervised high-intensity interval training (three sessions weekly), while the control group will receive physical activity counselling based on current guidelines. Blood will be sampled early in the morning in a fasted state before and after the 8-week programme. Participants will be provided with individualised, pre-packaged meals for the two days preceding blood sampling to minimise potential confounding. An 'omic-scale sphingolipid profiling, using high-coverage reversed-phase liquid chromatography coupled to tandem mass spectrometry, will be applied to capture the circulating sphingolipidome. Maximal cardiopulmonary exercise tests will be performed before and after the 8-week programme to assess patient fitness changes. Cholesterol, triglycerides, glycated haemoglobin, the homeostatic model assessment for insulin resistance, static retinal vessel analysis, flow-mediated dilatation, and strain analysis of the heart cavities will also be assessed pre- and post-intervention. This study shall inform whether and to what extent exercise can be used as an evidence-based treatment to lower circulating sphingolipid levels. The trial was registered on www.clinicaltrials.gov (NCT06024291) on August 28, 2023.

Protracted development of stick tool use skills extends into adulthood in wild western chimpanzees.

Tool use is considered a driving force behind the evolution of brain expansion and prolonged juvenile dependency in the hominin lineage. However, it remains rare across animals, possibly due to inherent constraints related to manual dexterity and cognitive abilities. In our study, we investigated the ontogeny of tool use in chimpanzees (Pan troglodytes), a species known for its extensive and flexible tool use behavior. We observed 70 wild chimpanzees across all ages and analyzed 1,460 stick use events filmed in the Taï National Park, Côte d'Ivoire during the chimpanzee attempts to retrieve high-nutrient, but difficult-to-access, foods. We found that chimpanzees increasingly utilized hand grips employing more than 1 independent digit as they matured. Such hand grips emerged at the age of 2, became predominant and fully functional at the age of 6, and ubiquitous at the age of 15, enhancing task accuracy. Adults adjusted their hand grip based on the specific task at hand, favoring power grips for pounding actions and intermediate grips that combine power and precision, for others. Highly protracted development of suitable actions to acquire hidden (i.e., larvae) compared to non-hidden (i.e., nut kernel) food was evident, with adult skill levels achieved only after 15 years, suggesting a pronounced cognitive learning component to task success. The prolonged time required for cognitive assimilation compared to neuromotor control points to selection pressure favoring the retention of learning capacities into adulthood.

Factors Predicting Mental Health Literacy in Older Adults: A Community-Based Cross-Sectional Study.

To determine mental health literacy (MHL) levels of older adults and the predictive factors of MHL. This cross-sectional study was conducted between October and December 2022, with 410 older adults aged ≥65 years. A Personal Information Form and the Mental Health Literacy Scale were used for data collection. Independent samples t test, analysis of variance, and multiple linear regression were used to analyze the data. Significant predictors of MHL in older adults were being aged 65 to 69 years, being female, being a university graduate, having an income more than expenses, receiving information from a health professional, interest in mental health, having friends or family members with mental illness, and good perception of health. Older adults were found to have low levels of MHL. Mental health professionals should focus on community-based education and interventions to increase the MHL levels of older adults. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Effect of oral urea on copeptin levels in healthy adults: a double-blind, randomized, placebo-controlled cross-over study

Effect of oral urea on copeptin levels in healthy adults: a double-blind, randomized, placebo-controlled cross-over study

Association between patient activation level and functional outcomes in older adults with hip fractures

BackgroundHip fractures can significantly impact older adults' mobility and function. Effective rehabilitation is crucial to help them regain independence and quality of life. However, little is known about the association between patient activation and hip fracture rehabilitation. This study aims to assess the association between the PAM-13 scores and the level of physical function, mobility, and activities of daily living in older adults following a hip fracture rehabilitation program. MethodAn exploratory outcome study from a cluster-randomized stepped-wedge clinical controlled trial. Two hundred thirty-nine patients were classified into four Patient Activation Measure-Levels (PAM-13) according to their PAM-13 scores, reflecting their confidence and preparedness to manage their health. Level 1 represents the lowest level of confidence. The patient's mobility, function, and daily activities were evaluated at discharge and after 12 and 24 weeks. ResultsThe cohort had a median age of 78; 67% were female, and 50% lived alone. There were no significant differences in demographics between the PAM-Levels. PAM-Level 1 patients had longer hospital stays and lower mobility scores than PAM-Level 4 patients. However, all patients improved over time, and higher initial PAM levels resulted in better outcomes. PAM-Level 1 patients improved in Time Up and Go score from a median score of 54 seconds to 14 seconds at 24 weeks, while PAM-Level 4 patients improved from 26 to 9 seconds. ConclusionOur study found an association between PAM levels and functional outcomes in hip fracture rehabilitation. Patients with higher activation levels had better mobility and functional outcomes.

The Effect of Early Beta-Blockade with Esmolol on Therapy Intensity Level in Adults with Severe Traumatic Brain Injury.

Following severe traumatic brain injury (TBI), elevated catecholamine levels are associated with worsened secondary brain injury and poorer clinical outcomes. The mechanisms are uncertain but may include cerebral ischemia and blood-brain barrier disruption, with consequent cerebral edema manifesting as intracranial hypertension. Early beta-blockade (EBB) may mitigate these detrimental hyperadrenergic effects. Therapy Intensity Level (TIL) is a validated score that quantifies intracranial pressure (ICP)-lowering interventions, with higher TIL being a surrogate for more severe intracranial hypertension. In this post hoc secondary analysis of a dose-finding study of EBB with esmolol in adults with TBI, we compared summary TIL (TIL24) and domain TIL between patients who received esmolol and those who did not. The primary outcome was TIL24 for each 24-h epoch of the esmolol intervention period of 96 h. Baseline characteristics were comparable in the esmolol (E) and non-esmolol (NE) groups. Mean TIL24 was similar in both groups up to 48 h but then diverged. The mean (standard deviation) TIL24 score between 48 and 72 h was 4.8 (1.5) in group E versus 6.6 (5.4) in group NE and at 72-96 h 4.5 (1.5) in group E versus 7.0 (4.0) in group NE. TIL domain scores were lower in group E for hyperosmolar therapy, targeted temperature management, and surgical management (cerebrospinal fluid drainage, evacuation, or decompressive craniectomy). The association between esmolol use after TBI and the reduction in ICP-directed interventions is consistent with an effect of beta-blockade on reduction of cerebral edema. Further research is necessary to determine causality and mechanism.

Level of Depression in Older Adults Related to Functional Capacity

Introduction: It is expected that by the year 2050, the number of people aged 60 or over will be higher than that of adolescents and young people aged 15 to 24, and nearly 65 % of older people will live in low- and middle-income countries.1 In this regard aging will become a very important object of study. This process, combined with the lack of physical activity, become conclusive factors in the progressive loss or alteration of physical and mental abilities (for example, depression).2, 3 Hypothesis: Worse functionality is related to depressive levels in older adults. Objective: To determine the level of depression (geriatric depression scale Yesavage) related to the functionality (Barthel Index/scale) of the elderly patients. Methodology: A convenience sample of 40 elderly patients (>60 years) was selected at the “Centro de Salud con Servicios Ampliados (CESSA) Romero Vargas” (Puebla, Mexico) who constantly attended follow-up consultations. During the period August-October 2023, the Yesavage and Barthel scale4 were applied. In addition, some additional data were also obtained from the identification sheet. Data analysis The final information was processed with Excel and Minitab software, the data were analyzed using simple descriptive statistics of frequencies, obtaining absolute and percentage distributions of the variable under study. For the relationship and significance of the variables level of depression and physical dependence, the variable correlation model (Spearman's Rho) was used, with a p <0.05. Results: Of the total sample (n= 40), 78% were female and 23% were male. 37.5% of the patients were classified as without depression and independent, 2.5% without depression with moderate dependence, 12.5% with mild depression and independent, 5% with depression and mild dependence, 15% with mild depression and moderate dependence, 10% with mild depression and severe dependence, 7.5% with mild depression and total dependence, and finally 5% for the categories of “severe and independent depression” and “severe depression and severe dependence”. In addition, a statistically significant correlation (p <0.05) was found with the following variables: economic dependency and health services, level of depression and health services and finally functional capacity and level of depression. Conclusion: Disability in the elderly encompasses functional deficiencies, limitations in activity and restrictions that transcend their autonomy, as well as the patient's own socialization; causing depression in the majority of this population. This is the reason why senile patients need to have close follow-up. In this study, it was demonstrated that the Barthel and Yesavage scale are useful tools for the assessment of depression and functionality. In addition, it was proven that there is a statistically significant correlation between the variables functional capacity and level of depression (p= 0.001).

Subcutaneous Administration of a Monoclonal Antibody to Prevent Malaria.

Subcutaneous administration of the monoclonal antibody L9LS protected adults against controlled Plasmodium falciparum infection in a phase 1 trial. Whether a monoclonal antibody administered subcutaneously can protect children from P. falciparum infection in a region where this organism is endemic is unclear. We conducted a phase 2 trial in Mali to assess the safety and efficacy of subcutaneous administration of L9LS in children 6 to 10 years of age over a 6-month malaria season. In part A of the trial, safety was assessed at three dose levels in adults, followed by assessment at two dose levels in children. In part B of the trial, children were randomly assigned, in a 1:1:1 ratio, to receive 150 mg of L9LS, 300 mg of L9LS, or placebo. The primary efficacy end point, assessed in a time-to-event analysis, was the first P. falciparum infection, as detected on blood smear performed at least every 2 weeks for 24 weeks. A secondary efficacy end point was the first episode of clinical malaria, as assessed in a time-to-event analysis. No safety concerns were identified in the dose-escalation part of the trial (part A). In part B, 225 children underwent randomization, with 75 children assigned to each group. No safety concerns were identified in part B. P. falciparum infection occurred in 36 participants (48%) in the 150-mg group, in 30 (40%) in the 300-mg group, and in 61 (81%) in the placebo group. The efficacy of L9LS against P. falciparum infection, as compared with placebo, was 66% (adjusted confidence interval [95% CI], 45 to 79) with the 150-mg dose and 70% (adjusted 95% CI, 50 to 82) with the 300-mg dose (P<0.001 for both comparisons). Efficacy against clinical malaria was 67% (adjusted 95% CI, 39 to 82) with the 150-mg dose and 77% (adjusted 95% CI, 55 to 89) with the 300-mg dose (P<0.001 for both comparisons). Subcutaneous administration of L9LS to children was protective against P. falciparum infection and clinical malaria over a period of 6 months. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT05304611.).

“Adopting unsuitable solutions constitutes an additional risk factor”: Context-informed social work practice with at-risk young adult Arabs in Israel

Although previous studies regarding professional interventions with at-risk minority young adults have focused on the challenges in providing support, few have examined these needs through the perceptions of social service providers. The aim of the current study is to learn about the needs of at-risk young adult Arabs in Israel in their intersecting contexts, as well as about the challenges in addressing these needs, so as to promote context-informed practice. We conducted a qualitative study of 39 social service providers. The findings are organized according to two main themes: (1) context-informed needs, which consists of three sub-themes: personal needs, social needs, and systemic needs, and (2) challenges in addressing these needs, consisting of three sub-levels: personal, social, and systemic. The findings shed light on a significant issue concerning the context-informed approach. At the micro level, social workers are able to implement a context-informed practice, whereas at the macro level of policy formulation and implementation, social workers seem to have less control over determining the nature of policies and resource allocation. We discuss the implications of the findings for social work practice, with the aim of promoting a context-informed practice in the intersecting levels of at-risk minority young adults’ lives.

Readability of Trauma-related Patient Education Materials From the American Academy of Orthopaedic Surgeons and Orthopaedic Trauma Association Websites.

Web-based resources serve as a fundamental educational platform for orthopaedic trauma patients; however, they are frequently written above the recommended sixth-grade reading level, and previous studies have demonstrated this for the American Academy of Orthopaedic Surgeons (AAOS) web-based articles. In this study, we perform an updated assessment of the readability of AAOS trauma-related educational articles as compared with injury-matched education materials developed by the Orthopaedic Trauma Association (OTA). All 46 AAOS trauma-related web-based ( https://www.orthoinfo.org/ ) patient education articles were analyzed for readability. Two independent reviewers used (1) the Flesch-Kincaid Grade Level (FKGL) and (2) the Flesch Reading Ease (FRE) algorithms to calculate the readability level. Mean readability scores were compared across body part categories. A one-sample t -test was done to compare mean FKGL with the recommended sixth-grade readability level and the average American adult reading level. A two-sample t -test was used to compare the readability scores of the AAOS trauma-related articles with those of the OTA. The average (SD) FKGL and FRE for the AAOS articles were 8.9 (0.74) and 57.2 (5.8), respectively. All articles were written above the sixth-grade reading level. The average readability of the AAOS articles was significantly greater than the recommended sixth-grade reading level ( P < 0.001). The average FKGL and FRE for all AAOS articles were significantly higher compared with those of the OTA articles (8.9 ± 0.74 versus 8.1 ± 1.14, P < 0.001 and 57.2 ± 5.8 versus 65.6 ± 6.6, P < 0.001, respectively). Excellent agreement was observed between raters for the FKGL 0.956 (95% confidence interval, 0.922 to 0.975) and FRE 0.993 (95% confidence interval, 0.987 to 0.996). Our findings suggest that after almost a decade, the readability of the AAOS trauma-related articles remains unchanged. The AAOS and OTA trauma patient education materials have high readability levels and may be too difficult for patient comprehension. A need remains to improve the readability of these commonly used trauma education materials.

The effectiveness of the TRACE online nutrition intervention in improving dietary intake, sleep quality and physical activity levels for Australian adults with food addiction: a randomised controlled trial.

Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three-arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian-led telehealth intervention at 3 months. Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non-core foods were reported. The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) -0.0 to 12.9], p = 0.049), non-core foods (-6.4%/day [95% CI -12.9 to 0.0], p = 0.049), sweetened drinks (-1.7%/day [95% CI -2.9 to -0.4], p = 0.013), takeaway foods (-2.3%/day [95% CI -4.5 to -0.1], p = 0.045) and sodium (-478 mg/day [95% CI -765 to -191 mg], p = 0.001). A dietitian-led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change.

The association between short-term ozone exposure and fasting blood glucose levels in non-diabetic adults was more obvious in rural residents: the evidence from a typical “urban–rural dual structure” province in southwestern China

The association between short-term ozone exposure and fasting blood glucose levels in non-diabetic adults was more obvious in rural residents: the evidence from a typical “urban–rural dual structure” province in southwestern China

Prevalence and Risk Factors of Low Vitamin D Level in Adults with Epilepsy: A Cross-sectional Study at a Single Tertiary Neurological Center in Thailand

Background: Epilepsy has a wide-ranging impact on the quality of life in patients of all age groups. Reduced levels of active vitamin D contribute to various bone diseases and may influence seizure control. Nevertheless, the risk factors for low vitamin D levels in patients with epilepsy remain inconclusive and are not well-established. The limited number of studies in Thailand may not be sufficient to provide guideline recommendations for screening vitamin D levels in adults with epilepsy. Objective: To evaluate the prevalence and risk factors of low vitamin D levels in Thai adults with epilepsy taking long-term antiepileptic drugs. To provide supporting recommendations for screening vitamin D levels in patients with epilepsy for early diagnosis and appropriate vitamin supplementation. Materials and Methods: The present study was a cross-sectional study conducted on 87 adults with epilepsy aged 18 to 76 years who were followed up at the Neurological Institute of Thailand between March and October 2023. Patients with comorbidities affecting vitamin D metabolism were excluded from the study. Baseline demographic data, epilepsy-related information, and anti-seizure medication information were analyzed. Blood tests for vitamin D for 25-hydroxyvitamin D [25(OH)D], calcium, phosphorus, and albumin were performed. Results: The prevalence of low vitamin D levels was 85%, including deficiency at 37% and insufficiency at 48%, with the mean (±SD) of serum 25(OH)D being 21.9±7.60 ng/mL. Multivariate analyses revealed that female was significantly associated with low vitamin D levels, adjusted OR 4.97 (95% CI 1.23 to 20.05). There was no significant association among epilepsy-related information, anti-seizure medications, and low vitamin D levels. Conclusion: The prevalence of low vitamin D levels in the present study was significantly higher than that observed in the previous studies, which is consistent with the findings of the recent studies in many countries. The authors strongly recommend screening for vitamin D levels in Thai adults with epilepsy, particularly in females. Early diagnosis and management of this condition are beneficial for patients with epilepsy and can help mitigate the various complications resulting from low vitamin D levels. Keywords: Epilepsy; Low vitamin D level; Vitamin D deficiency; Vitamin D insufficiency; Antiseizure medications; Prevalence; Risk factors

Cluster analysis dissecting cognitive deficits in older adults with major depressive disorder and the association with neurofilament light chain

BackgroundCognitive impairment is a growing problem with increasing burden in global aging. Older adults with major depressive disorder (MDD) have higher risk of dementia. Neurofilament light chain (NfL) has been proven as a potential biomarker in neurodegenerative disease, including dementia. We aimed to investigate the association between cognitive deficits and NfL levels in older adults with MDD.MethodsIn this cross-sectional study, we enrolled 39 MDD patients and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer’s type, as controls, from a tertiary psychiatric hospital. Both groups were over age 65 and with matched Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and each cognitive domain.ResultsIn the MDD group, participants had higher rate of family psychiatry history and current alcohol use habit compared with controls. Control group of neurocognitive disorders showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits clustered with that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster.ConclusionsWe noted the negative correlation between NfL levels and cognition in MDD patients clustered with neurodegenerative disorder, Alzheimer’s type. NfL could be a promising candidate as a biomarker to predict subtype of patients in MDD to develop cognitive decline. Further longitudinal studies and within MDD cluster analysis are required to validate our findings for clinical implications.

Association Between Iodine Status and Prevalence of Hypothyroidism, Autoimmune Thyroiditis, and Thyroid Nodule: a Cross-Sectional Study in Shandong Province, China.

In this study, the aim was to investigate the correlation between varying levels of urinary iodine concentration (UIC) in adults and the occurrence of thyroid diseases, with the additional objective of determining the optimal iodine status level for adults. A cross-sectional study was conducted on adults from six areas with different drinking water iodine concentrations (WIC) without eating iodized salt in Heze and Jining counties, Shandong Province, China. A total of 1336 adults were included in this study, and drinking water samples, blood samples, urine samples, thyroid ultrasound, and a questionnaire were collected. UIC, free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) were detected. There were no significant differences in the detection rates of hypothyroidism and thyroid autoimmunity (TAI) among the different median UIC groups (UIC < 100μg/L, 100-199μg/L, 200-299μg/L, ≥ 300μg/L). However, the detection rates of hypothyroidism were higher in the UIC < 100μg/L group (16.67%) and the UIC ≥ 300μg/L group (16.51%) compared to the other groups. The detection rate of TAI increased as UIC levels increased. The detection rate of thyroid nodule (TN) in the UIC < 100μg/L group was significantly higher than that in the UIC 200-299μg/L UIC group (χ2 = 10.814, P = 0.001). After adjusting confounding factors, it was found that low UIC (< 100μg/L) was a risk factor for TN (OR 1.83, 95% CI [1.04-3.22]). Meanwhile, there no statistical difference between UIC 200 and 299μg/L and UIC 100 and199 μg/L for OR of hypothyroidism, TAI, and TN. This study identified associations between different UIC levels and the prevalence of thyroid disorders, with low UIC (< 100μg/L) posing a risk for TN, and the detection rate of TN and hypothyroidism was the lowest in UIC (200-299μg/L) group. Therefore, the acceptable UIC range of 'adequate' iodine intake among adults can be widened from 100-199µg/L to 100-299µg/L.

Association between Homocysteine and Vitamin D Levels in Asymptomatic Korean Adults.

An increased homocysteine level is a risk factor for cardiovascular disease, venous thromboembolism, cerebrovascular disease, and chronic kidney disease. In addition, vitamin D deficiency is associated with coronary artery disease and metabolic disorders. The present study included data from 1375 adults (895 men and 480 women) with a mean age of 52.62 ± 9.94 years who visited the Health Promotion Center of the University Hospital in Gyeonggi-do, Republic of Korea from January 2018 to December 2022 for routine checkups that included assessments of their homocysteine and vitamin D levels. Homocysteine levels were positively associated with age, a history of hypertension, a history of diabetes, current smoking habits, and levels of low-density lipoprotein cholesterol, creatinine, uric acid, and high-sensitivity C-reactive protein. By contrast, vitamin D levels were negatively associated with serum levels of homocysteine after adjusting for covariates (β = -0.033, p < 0.001). Additional long-term prospective studies are needed to elucidate the presence of a causal relationship between vitamin D status and serum levels of homocysteine in asymptomatic Korean adults. An intervention trial is warranted to determine whether the administration of vitamin D is helpful for the primary prevention of cardiovascular disease by lowering the homocysteine level in this population.

Non–High-Density Lipoprotein Cholesterol Levels From Childhood to Adulthood and Cardiovascular Disease Events

Elevated non-high-density lipoprotein cholesterol (non-HDL-C; a recommended measure of lipid-related cardiovascular risk) is common in children and increases risk of adult cardiovascular disease (CVD). Whether resolution of elevated childhood non-HDL-C levels by adulthood is associated with reduced risk of clinical CVD events is unknown. To examine the associations of non-HDL-C status between childhood and adulthood with incident CVD events. Individual participant data from 6 prospective cohorts of children (mean age at baseline, 10.7 years) in the US and Finland. Recruitment took place between 1970 and 1996, with a final follow-up in 2019. Child (age 3-19 years) and adult (age 20-40 years) non-HDL-C age- and sex-specific z scores and categories according to clinical guideline-recommended cutoffs for dyslipidemia. Incident fatal and nonfatal CVD events adjudicated by medical records. Over a mean length of follow-up of 8.9 years after age 40 years, 147 CVD events occurred among 5121 participants (60% women; 15% Black). Both childhood and adult non-HDL-C levels were associated with increased risk of CVD events (hazard ratio [HR], 1.42 [95% CI, 1.18-1.70] and HR, 1.50 [95% CI, 1.26-1.78] for a 1-unit increase in z score, respectively), but the association for childhood non-HDL-C was reduced when adjusted for adult levels (HR, 1.12 [95% CI, 0.89-1.41]). A complementary analysis showed that both childhood non-HDL-C levels and the change between childhood and adulthood were independently associated with the outcome, suggesting that from a preventive perspective, both childhood non-HDL-C levels and the change into adulthood are informative. Compared with those whose non-HDL-C levels remained within the guideline-recommended range in childhood and adulthood, participants who had incident non-HDL-C dyslipidemia from childhood to adulthood and those with persistent dyslipidemia had increased risks of CVD events (HR, 2.17 [95% CI, 1.00-4.69] and HR, 5.17 [95% CI, 2.80-9.56], respectively). Individuals who had dyslipidemic non-HDL-C in childhood but whose non-HDL-C levels were within the guideline-recommended range in adulthood did not have a significantly increased risk (HR, 1.13 [95% CI, 0.50-2.56]). Individuals with persistent non-HDL-C dyslipidemia from childhood to adulthood had an increased risk of CVD events, but those in whom dyslipidemic non-HDL-C levels resolve by adulthood have similar risk to individuals who were never dyslipidemic. These findings suggest that interventions to prevent and reduce elevated childhood non-HDL-C levels may help prevent premature CVD.

Assessment of oral hypofunction and its association with age among Korean community-dwelling older adults

BackgroundDue to the increasing proportion of older adults in Korea and growing interest in aging, the concepts of oral aging and oral hypofunction have recently been introduced. Thus, it is necessary to investigate the age-specific oral function levels of Korean older adults and develop expert intervention methods for healthy aging.MethodsDysphagia, independence of daily living, and oral hypofunction were assessed in 206 older adults living in Wonju, Gangwon State, South Korea. Subjective dysphagia was assessed through self-report questionnaires using the Dysphagia Handicap Index (DHI), the Korean version of Eating Assessment Tool-10, and the Korean version of the Modified Barthel Index. In addition, the oral hypofunction assessment items included decreased chewing ability, occlusal pressure, tongue pressure, oral dryness, and oral cleanliness.ResultsDHI increased significantly with age, with those in their 80 s reporting the most difficulty swallowing. Oral function in terms of chewing ability (maximum occlusal pressure and number of remaining teeth), maximum occlusal pressure, and maximum tongue pressure also declined with increasing age. While there was no significant difference in oral dryness by age, those in their 80 s had dry mouth according to the criteria of the oral moisture checking device.ConclusionsIn an assessment of oral function in community-dwelling, independent Korean older adults, the number of items that were assessed as oral hypofunction increased with age. The findings can be used to standardize the oral hypofunction assessment item and develop age-based individualized intervention plans for the early management of oral health and individual oral myofunctional rehabilitation in Korean community-dwelling older adults.