Lifestyle Risk Factors Research Articles

Genetic, sociodemographic, lifestyle, and clinical risk factors of heart failure aggravation events: data from the UK Biobank

Abstract Background Heart failure (HF) is the leading cause of readmission and hospitalization. Purpose This study examined the associations and clinical utilities of genetic, sociodemographic, lifestyle, laboratory, and clinical risk factors on HF aggravation. Methods Data were from 5,345 UK Biobank middle-aged adults with established HF at enrolment. We performed Cox proportional hazard regression analyses to investigate the associations related to HF admission after enrolment utilizing 24 variables encompassing sociodemographic, clinical, lifestyle, and laboratory data. To assess the impact of genetic factors, we additionally adjusted each polygenic risk score (PRS) for the three medical histories: hypertension, atrial fibrillation (AF), and coronary heart disease (CHD), where the hazard ratios were statistically significant. Results Over a median follow-up of 11.5 [10.9-12.2] years, 247 (4.6%) HF admission events occurred. Among the 24 variables, statistically significant hazard ratios were observed for 10 variables, with hypertension (3.31, 2.19-5.02), AF (2.06, 1.53-2.75), current smoking (1.63, 1.09-2.46), and coronary heart disease (1.58, 1.17-2.13) showing the highest hazard ratios, while female gender (0.65, 0.46-0.91) exhibited the smallest hazard ratio. After adjusting for each PRS individually, HTN PRS (HR 1.06, 0.94-1.21) and AF PRS (HR 1.02, 0.90-1.16) were not statistically significant, whereas CHD PRS (HR 1.15, 1.02-1.31) showed significance in relation to HF admission. In the HF admission prediction model, the C index was 0.859 (0.838-0.880) with clinical variables, and it marginally increased to 0.864 (0.843-0.885) when all factors, including the genetic factor, were applied. Conclusions Sociodemographic, clinical, laboratory, lifestyle, and genetic factors are each associated with HF aggravation with male gender, hypertension, AF, low eGFR, cigarette smoking, and CHD PRS.

Genetic and clinical risk factors for stroke recurrence with different impact by assessment age: data from the UK Biobank

Abstract Background The predictive utility of genetic risk factors added to clinical risk factors for stroke recurrence is unclear. Furthermore, whether those predictive utility change in different age groups is uncertain. This study aimed to compare the association of genetic and clinical risk factors with recurrent stroke. Methods Data were collected from 5,378 patients with a history of stroke from the UK Biobank. Cox proportional hazards regression models were used to assess the associations of genetic, demographic, lifestyle, and comorbidity risk factors with stroke recurrence, both in overall and three age-based groups. Results Over a median follow-up of 11.5 (interquartile range [IQR] 10.6–12.3) years, 417 patients had recurrent stroke. The hazard ratio (HR) for recurrent stroke was most pronounced for diabetes mellitus (HR 2.28, 95% confidence interval [CI] 1.83-2.86). Additionally, current smoking, hypertension, age, and polygenic risk score for ischemic stroke (stroke PRS) were also significantly associated with recurrent stroke. Based on concordance index (C-index, 95% CI), the strongest predictors were diabetes mellitus (0.578, 0.556-0.599) followed by age, hypertension and stroke PRS. However, the stroke PRS (0.577, 0.527-0.627) was the strongest predictor in the younger 1/3 patient group (median age 54, IQR 50-57). In addition to demographic, lifestyle, and comorbidity risk factors, genetic risk factor improved C-index of the prediction model from 0.640 (0.592-0.688) to 0.652 (0.602-0.703) in the younger group. Conclusions Recurrent stroke is significantly associated with genetic and clinical risk factors. Genetic risk factor enhances the predictive model`s accuracy, particularly in younger patients.Prediction of stroke recurrence

Farming and the risk of developing osteoarthritis in Alberta, Canada.

Because farming is a physically demanding occupation, farmers may be susceptible to developing osteoarthritis (OA). The aim of this study was to determine the risk of developing OA in Canadian farm, non-farm rural and urban residents. A retrospective cohort study of five Alberta health administrative databases examined the risk of developing OA among three groups: farm (n=143 431), non-farm rural (n=143 431) and urban (n=143 431) residents over the fiscal years 2000-2001 through 2020-2021. The algorithm for OA ascertainment defined cases based on criteria including one hospital admission, two physician visits within a 2-year interval, or two ambulatory care visits within 2 years. Incidence rates, lifetime risk, and mortality rates were calculated. Cox proportional hazard models compared the incidence of OA for the three groups over the 21 years. A total of 26 957 OA cases were identified among 1 706 256 person-years (PYs) in the farm cohort. The crude incidence rate of OA over a period of 21 years ranged from 19.1 (95% confidence interval (CI) 18.6-19.6) per 1000 PYs in 2001 to 10.0 (95% CI 9.6-10.5) per 1000 PYs in 2021. The overall incidence rate was higher in the farm group (15.8 (95%CI 15.6-16.0) per 1000 PYs) as compared to the non-farm rural (14.7 (95%CI 14.5-14.9) per 1000 PYs) and the urban groups (13.3 (95%CI 13.1-13.4) per 1000 PYs). After adjusting for age and sex, the farm (6%; 95%CI 4-8%), and non-farm rural (9%; 95%CI 7-12%) groups had higher incidence rates than the urban group. The unadjusted non-injury mortality rate for the farm group with OA was lower (13.2 (95%CI 12.9-13.5) per 1000 PYs) than both the urban (14.5; 95%CI 14.1-14.8) and rural (18.0; 95%CI 17.6-18.4) groups. After adjusting for mortality, the lifetime risk of developing OA was 27.7% for farm residents, 25.6% for the non-farm rural cohort, and 24.0% for the urban cohort. When accounting for age and sex, farm and non-farm rural residents have a higher risk of developing OA as compared to the urban population. The higher mortality-adjusted lifetime risk of developing OA among farm residents highlights the necessity of specific interventions aimed at reducing the impact of this condition in rural communities. Further research is required to identify specific occupational and lifestyle risk factors associated with OA among farmers and to develop effective strategies for prevention and management.

Anxiety, depression and distress outcomes from the Health4Life intervention for adolescent mental health: a cluster-randomized controlled trial

Mental disorders are a leading cause of disease burden worldwide. As onset typically occurs in adolescence, prevention during this period is critical. The Health4Life-school-based multiple health behavior change (MHBC) intervention targets six lifestyle risk factors: diet, sleep, physical activity, screentime, alcohol use and smoking. Health4Life has been evaluated in a cluster-randomized controlled trial in 71 Australian schools (6,639 grade seven students). This study presents intervention effects on secondary outcomes of depressive, anxiety and psychological distress symptoms. Generalized linear mixed-effect analyses of data from baseline, post-intervention (7 weeks), 12 months and 24 months showed that the Health4Life intervention was no more effective than an active control in reducing depressive, anxiety or psychological distress symptoms at a 24 or 12 month follow-up; however, there were short-term benefits for psychological distress and depressive symptoms immediately post-intervention. This study offers new evidence that multiple health behavior change interventions may improve adolescent mental health, but future research should explore methods to address anxiety and sustain effects over the longer term. A priori ANZCTR trial registration: ACTRN12619000431123.

Lifestyle and metabolic risk factors, and diabetes mellitus prevalence in European countries from three waves of the European Health Interview Survey

Population shift towards healthier lifestyles can help reduce the burden of type 2 diabetes mellitus (DM), therefore understanding and monitoring the lifestyle-related risk factors are crucial for setting up effective preventive strategies and disease management. The present study aimed to explore the changes in prevalence of DM and major risk factors including smoking, physical activity, fruit and vegetable consumption, as well as body mass index (BMI) over three waves of European Health Interview Survey, and to investigate the association between risk factors and presence of DM across 11 European Union member states. Poisson regression models were used to evaluate the association between risk factors and DM, adjusted for demographic and socioeconomic variables. The estimated age-standardized prevalence of DM increased from 7.01% in 2009 to 7.96% in 2019, with substantial increase in subgroups with higher BMI and unhealthy lifestyle including physically inactive people, or current smokers. Obesity and overweight and physical inactivity were significantly associated with DM in all survey waves. Our findings underline that obesity prevention and weight loss promotion along with physical activity promotion are the subject of lifestyle interventions to reduce the burden of DM in EU member states.

Lifestyle and sociodemographic risk factors for stillbirth by region of residence in South Australia: a retrospective cohort study

BackgroundStillbirth rates remain a global priority and in Australia, progress has been slow. Risk factors of stillbirth are unique in Australia due to large areas of remoteness, and limited resource availability affecting the ability to identify areas of need and prevalence of factors associated with stillbirth. This retrospective cohort study describes lifestyle and sociodemographic factors associated with stillbirth in South Australia (SA), between 1998 and 2016.MethodsAll restigered births in SA between 1998 ad 2016 are included. The primary outcome was stillbirth (birth with no signs of life ≥ 20 weeks gestation or ≥ 400 g if gestational age was not reported). Associations between stillbirth and lifestyle and sociodemographic factors were evaluated using multivariable logistic regression and described using adjusted odds ratios (aORs).ResultsA total of 363,959 births (including 1767 stillbirths) were included. Inadequate antenatal care access (assessed against the Australian Pregnancy Care Guidelines) was associated with the highest odds of stillbirth (aOR 3.93, 95% confidence interval (CI) 3.41–4.52). Other factors with important associations with stillbirth were plant/machine operation (aOR, 1.99; 95% CI, 1.16–2.45), birthing person age ≥ 40 years (aOR, 1.92; 95% CI, 1.50–2.45), partner reported as a pensioner (aOR, 1.83; 95% CI, 1.12–2.99), Asian country of birth (aOR, 1.58; 95% CI, 1.19–2.10) and Aboriginal/Torres Strait Islander status (aOR, 1.50; 95% CI, 1.20–1.88). The odds of stillbirth were increased in regional/remote areas in association with inadequate antenatal care (aOR, 4.64; 95% CI, 2.98–7.23), birthing age 35–40 years (aOR, 1.92; 95% CI, 1.02–3.64), Aboriginal and/or Torres Strait Islander status (aOR, 1.90; 95% CI, 1.12–3.21), paternal occupations: tradesperson (aOR, 1.69; 95% CI, 1.17–6.16) and unemployment (aOR, 4.06; 95% CI, 1.41–11.73).ConclusionFactors identified as independently associated with stillbirth odds include factors that could be addressed through timely access to adequate antenatal care and are likely relevant throughout Australia. The identified factors should be the target of stillbirth prevention strategies/efforts. SThe stillbirth rate in Australia is a national concern. Reducing preventable stillbirths remains a global priority.

Sociodemographic and Lifestyle Risk Factors Associated with Fragility Hip Fractures: A Systematic Review and Meta-Analysis

Hip fractures inflict heightened morbidity and mortality upon older adults. Although previous studies have explored the impact of individual demographic factors on hip fracture risk, a comprehensive review can help reconcile disparities among these factors. This meta-analysis encompassed 69 studies involving 976,677 participants and 99,298 cases of hip fractures. We found that age ≥ 85 (OR = 1.75), BMI < 18.5 (OR 1.72), female sex (OR = 1.23), history of falls (OR = 1.88), previous fractures (OR = 3.16), menopause (OR 7.21), history of maternal hip fractures (OR = 1.61), single and unmarried status (OR = 1.70), divorced status (OR 1.38), residing in a residential care facility (OR = 5.30), and living alone (OR = 1.47) were significantly associated with an increased incidence of hip fracture. Conversely, BMI ranging from 25 to 30 (OR = 0.59), BMI > 30 (OR = 0.38), parity (OR = 0.79), non-Caucasian descent (overall OR = 0.4, Asian OR 0.36, Black OR = 0.39, and Hispanic OR = 0.45), and rural residence (OR = 0.95) were significantly associated with a diminished risk of hip fracture. Hip fracture patients exhibited significantly lower weight and BMI than the non-fracture group, while their age was significantly higher. However, age at menopause and height did not significantly differ between the two groups.

Estimated pulse wave velocity in metabolic dysfunction-associated steatotic liver disease and all-cause/cause-specific mortality.

Several reports show a significant association between metabolic dysfunction-associated steatotic liver disease (MASLD) and arterial stiffness (estimated pulse wave velocity [ePWV]) as a surrogate marker of vascular age. We investigate whether ePWV as arterial stiffness in MASLD is associated with all-cause/cause-specific mortality. This cohort study was based on the third National Health and Nutrition Examination Survey (NHANES, 1988-1994) and NHANES 2007-2014 and linked mortality datasets through 2019. Cox regression models assessed the association between ePWV categorized by quartile and all-cause/cause-specific mortality among individuals with MASLD. During the follow-up of a median of 26.3 years (interquartile range: 19.9-27.9), higher levels of ePWV among individuals with MASLD were associated with increased all-cause mortality, which remained significant after adjusting for demographic, lifestyle, clinical, and metabolic risk factors. Furthermore, higher ePWV in MASLD was associated with higher cardiovascular mortality. There was a 44% (hazard ratio: 1.44, 95% confidence interval: 1.32-1.58) increase in all-cause mortality and a 53% (hazard ratio: 1.53, 95% confidence interval: 1.32-1.77) increase in cardiovascular mortality for every 1 m/s increase in ePWV in MASLD. However, there was no significant association between ePWV and cancer-related mortality. Sensitivity analyses using the NHANES 2007-2014 dataset showed results identical to the original analysis. Higher ePWV in MASLD was associated with a higher risk of all-cause and cardiovascular mortality beyond traditional cardiovascular risk factors. Screening for ePWV in individuals with MASLD may be an effective and beneficial approach to reducing all-cause and cardiovascular mortality.

Personalized medicine and nutrition in hepatology for preventing chronic liver disease in Mexico.

Chronic liver disease is a global health issue. Patients with chronic liver disease require a fresh approach that focuses on the genetic and environmental factors that contribute to disease initiation and progression. Emerging knowledge in the fields of Genomic Medicine and Genomic Nutrition demonstrates differences between countries in terms of genetics and lifestyle risk factors such as diet, physical activity, and mental health in chronic liver disease, which serves as the foundation for the implementation of Personalized Medicine and Nutrition (PerMed-Nut) strategies. Most of the world's populations have descended from various ethnic groupings. Mexico's population has a tripartite ancestral background, consisting of Amerindian, European, and African lineages, which is common across Latin America's regional countries. The purpose of this review is to discuss the genetic and environmental components that could be incorporated into a PerMed-Nut model for metabolic-associated liver disease, viral hepatitis B and C, and hepatocellular carcinoma in Mexico. Additionally, the implementation of the PerMed-Nut approach will require updated medicine and nutrition education curricula. Training and equipping future health professionals and researchers with new clinical and investigative abilities focused on preventing liver illnesses in the field of genomic hepatology globally is a vision that clinicians and nutritionists should be concerned about.

The Gut Microbial Metabolite Trimethylamine N -oxide, Incident CKD, and Kidney Function Decline.

Trimethylamine N-oxide (TMAO) is a gut microbiota-derived metabolite of dietary phosphatidylcholine and carnitine. Experimentally, TMAO causes kidney injury and tubulointerstitial fibrosis. Little is known about prospective associations between TMAO and kidney outcomes, especially incident CKD. We hypothesized that higher plasma TMAO levels would be associated with higher risk of incident CKD and greater rate of kidney function decline. We included 10,564 participants from two community-based, prospective cohorts with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m2 to assess incident CKD. TMAO was measured using targeted mass spectrometry at baseline and one follow-up visit. Creatinine and Cystatin C were measured up to 4 times during follow-up and used to compute eGFR. Incident CKD was defined as an eGFR decline ≥ 30% from baseline and a resulting eGFR<60 ml/min/1.73 m2. Time-varying Cox models assessed the association of serial TMAO measures with incident CKD, adjusting for sociodemographic, lifestyle, diet, and cardiovascular disease risk factors. Linear mixed models assessed the association with annualized eGFR change in 10,009 participants with at least one follow-up eGFR measure without exclusions for baseline eGFR levels. During a median follow-up of 9.4 years (interquartile range: 9.1-11.6 years), 979 incident CKD events occurred. Higher TMAO levels associated with higher risk of incident CKD (2nd to 5th vs. 1st quintile HR[95%CI]= 1.65 [1.22-2.23], 1.68 [1.26-2.25], 2.28 [1.72-3.02], and 2.24[1.68-2.98], respectively) and greater annualized eGFR decline ( 2nd to 5th vs. 1st quintile annualized eGFR change= -0.21 [-0.32, -0.09], -0.17 [-0.29, -0.05], -0.35 [-0.47, -0.22], and -0.43[-0.56, -0.30], respectively) with monotonic dose-response relationships. These associations were consistent across different racial/ethnic groups examined. The association with eGFR decline was similar to or larger than that seen for established CKD risk factors including diabetes, per 10 mmHg of higher systolic blood pressure, per 10 years of older age, and Black race. In community-based US adults, higher serial measures of plasma TMAO were associated with higher risk of incident CKD and greater annualized kidney function decline.

ERGONOMIC AWARENESS SURVEY: EXAMINING MUSCULOSKELETAL PAIN PREVALENCE AND CONTRIBUTING FACTORS AMONG DENTAL PROFESSIONAL IN A SAMPLE OF INDIAN POPULATION

Background: Musculoskeletal pain (MSP) is a serious workplace hazard for dental professionals. Efforts have been made to investigate the prevalence of MSDs and risk factors in various Indian regions. However, these are primarily tied to workplace risk factors and overlook the impact of lifestyle and ergonomic awareness as risk factors for MSP in dentists. Therefore, this study aimed to assess the prevalence of MSP among dental professionals and its associated work, lifestyle, and awareness-related risk factors. Material and methods: A cross-sectional observational research design were conducted among dental professionals working in the clinical facilities. The snowball sampling technique was employed to choose participants. The data collection tool was administered via a Google Form survey. Categorical variables were reported as frequency and percentage. Chi-square was applied with a P-value &lt;0.05 as significant. Results: 120 dental practitioners were enrolled in the study. 53.3% of participants reported having work-related MSD. Male professionals had a greater incidence (55.6%) than their female counterparts (48.7%). The most commonly reported specific discomforts were back/neck pain (18.3%), isolated neck pain (15.8%), and back pain (12.5%). The number of hours worked each day (p=0.001), type of activity (p=0.022), work stress (p=0.001), and ergonomics in the curriculum (p=0.039) differed significantly between male and female participants. Medical problems (p=0.001) and their types (p=0.022), dental support during practice (p=0.005), and ergonomics in the dental curriculum (0.005) varied significantly among age groups. Conclusion: There is a significant prevalence of work-related MSP among Indian dentists, particularly in males over 40 years age. Factors such as physical activity, stress levels, co-existing medical conditions, and exposure to ergonomic education may influence the prevalence of MSDs. Thus, there is a need for continuing education programs and advocating for more comprehensive training in ergonomic practices to mitigate the risk of MSDs among dental professionals.

Impact of nomenclature as metabolic associated steatotic liver disease on steatotic liver disease prevalence and screening: a prospective population survey in Asians.

The introduction of the latest nomenclature, metabolic associated steatotic liver disease (MASLD), proposed by the multi-society without Asian society consensus statement, aims to redefine the diagnostic criteria for metabolic associated fatty liver disease (MAFLD). However, its effect on the epidemiology in Asia remains unclear. We conducted a population-based cross-sectional survey on fatty liver disease using multistage stratified random sampling of participants from Guangzhou, a representative area in China (ChiCTR2000033376). Demographic, socioeconomic, lifestyle, and laboratory data were collected. Hepatic steatosis and the severity of fibrosis were assessed using FibroScan. A total of 7388 individuals were recruited, the proportion of which meeting the definitions for nonalcoholic fatty liver disease (NAFLD), MAFLD, and MASLD were 2359 (31.9%), 2666 (36.1%), and 2240 (30.3%), respectively. One hundred and twenty (1.6%) patients had cryptogenic SLD, and 537 (7.3%) patients were diagnosed with MetALD. MASLD did not significantly differ from NAFLD and MAFLD, except that MAFLD patients had a lower proportion of males, hypertension, and diabetes and were less likely to consume tea (P<0.05). Both cryptogenic SLD and MASLD non-MAFLD patients exhibited milder hepatic steatosis and a lower frequency of liver injury than NAFLD, MAFLD, or MASLD patients (all P<0.05). An increased HOMA-IR (adjusted OR: 1.33, 95% CI: 1.10-2.03) was associated with higher risk of moderate-to-severe steatosis for MASLD non-MAFLD patients, while consuming more cups of tea (P for trend=0.015) showed inverse associations. Irrespective of terminology used is that fatty liver disease is highly prevalent in the Han Chinese population. Differences in insulin resistance and lifestyle risk factors are associated with redefinition disparities.

Abstract PO2-09-11: Breast Cancer Care Disparities in Sexual Minority Women: An Analysis of the National Institutes of Health All of Us Research Program

Abstract Background. Currently, sexual orientation data is not collected, nor is the language to study sexual orientation data defined by any national cancer database. Due to this limitation, little is known about breast cancer (BC) disparities in sexual minority women (SMW) despite several studies showing increased lifestyle risk factors. Our objective was to study this question in the All of Us database. Methods. We analyzed data from the All of Us research program, a national open enrollment database that registers diverse subjects through associated healthcare electronic medical records and collects survey data. We aimed to compare risk factors, as well as preventative and procedural healthcare utilization differences between SMW and straight women (StW) as they relate to BC care. Results were expressed as odds ratios (OR) with a 95% confidence interval [CI]. Results. Of 229,917 cisgender women who answered the sexual orientation question, 27,302 (11.9%) selected “non-straight orientation, prefer not to answer, or skipped” and thus were defined as SMW. In total, 6,905 (3.0%) women had received a BC diagnosis, including 423 (6.1%) SMW. SMW were less likely to have a BC diagnosis than StW (OR 0.48 [0.43-0.53]). Among all women, there were significant differences in frequency and types of visits and procedures performed. SMW women were less likely to undergo annual history and physical examination (0.79 [0.73-0.85]), mammography (0.61 [0.53-0.69]), and breast biopsy (0.55 [0.41-0.72]), as well as being less likely to undergo breast surgeries (mastectomy 0.53 [0.30-0.93]; lumpectomy 0.53 [0.38-0.74]). Survey data revealed differences in several lifestyle factors that relate to BC risk development. While StW were more likely to answer yes to being an “alcohol participant” (0.79 [0.77-0.82]), SMW reported higher rates of alcohol intake on a daily, weekly, and monthly basis, as well as being more likely to consume 6 or more drinks in one sitting. SMW also showed significantly increased history of smoking/nicotine usage. There were also significant differences in healthcare access and utilization: StW were more likely to receive health advice from a primary care provider (0.65 [0.65-0.69]), while SMW were more likely to utilize urgent and emergency care (1.44 [1.34-1.54]). SMW were also more likely to report being unable to afford care (1.82 [1.72-1.93]), medication (1.69 [1.61-1.76]), specialty care (1.98 [1.89-2.08]), and follow-up care (1.85 [1.75-1.95]), as well as to delay care due to cost concerns about the copay (2.13 [2.02-2.23]), deductible (1.64 [1.56-1.73]), paying out of pocket (1.70 [1.63-1.77]) or because they were nervous (2.80 [2.69-2.91]). SMW reported being more likely to experience healthcare discrimination based on questions about healthcare provider interactions (Table 1). Conclusions.Although likelihood of a breast cancer diagnosis in the All of Us database is significantly higher in StW than SMW, discrimination, lack of access, and underutilization of preventative and screening services by SMW likely creates an underrepresentation of the true number of SMW with BC. Further studies on characteristics at diagnosis, treatments, and survival are needed to address how these disparities affect BC outcomes in SMW. Table 1: Survey answers among sexual minority women (SMW) compared to straight women (StW) reporting on discrimination from healthcare provider interactions in the All of Us database. SMW: sexual minority women; StW: straight women; OR: odds ration; Lower 95 CI: lower 95% confidence interval; Upper 95 CI: upper 95% confidence interval; Sig. *: statistically significant with p &amp;lt; 0.05; OR&amp;gt;1: SMW most likely to answer; OR &amp;lt;1 StW most likely to answer. Citation Format: Lucas Houser, Collin Dougherty, Sean Figy, Jessica Maxwell, Juan Santamaria-Barria. Breast Cancer Care Disparities in Sexual Minority Women: An Analysis of the National Institutes of Health All of Us Research Program [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-09-11.

Genetic and Lifestyle Risk Factors of Metabolic Dysfunction-Associated Fatty Liver Disease and Its Relationship with Premature Coronary Artery Disease: A Study on the Pars Cohort.

The main objective of this study is to identify the risk factors of metabolic dysfunction-associated fatty liver disease (MAFLD) in coronary artery disease (CAD) patients. The present retrospective cohort study is part of the Pars Cohort Study (PCS). The participants were categorized as having MAFLD or not. The pattern of independent variables in patients was compared with those who did not have MAFLD. All variables were retained in the multivariable logistic regression model. Totally, 1862 participants with CAD were enrolled in this study. MAFLD was diagnosed in 647 (40.1%) participants. Gender, diabetes, hypertension, tobacco, opium, alcohol, age, weight, waist circumference, cholesterol, HDL, triglyceride, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly different in MAFLD and non-MAFLD patients. Also, the results of multivariable logistic regression show male gender (OR=0.651, 95% CI: 0.470‒0.902, P value=0.01) and opium consumption (OR=0.563, 95% CI: 0.328‒0.968, P value<0.001) to be negative risk factors of MAFLD occurrence in CAD patients. Having diabetes (OR=2.414, 95% CI: 1.740-3.349, P value<0.001), high waist circumference (OR=1.078, 95% CI: 1.055‒1.102, P value<0.01), high triglyceride (OR=1.005, 95% CI: 1.001‒1.008, P value=0.006), and high ALT (OR=1.039, 95% CI: 1.026‒1.051, P value<0.01) were positive risk factors of MAFLD in CAD patients. Our study found that consuming opium decreases the likelihood of MAFLD in CAD patients, since these patients have decreased appetite and lower body mass index (BMI). On the other hand, female gender, having diabetes, high waist circumference, high triglyceride levels, and high ALT levels increase the probability of MAFLD in CAD patients.

Non-alcoholic fatty liver disease among patients undergoing ultra-sonography abdomen and its associated factors in a tertiary care hospital, Kakinada

Background: Non-alcoholic fatty liver disease (NAFLD) presents a growing global health concern, characterized by the accumulation of hepatic lipids in the absence of significant alcohol consumption. Its prevalence has surged worldwide, including in India, where it has reached alarming levels. Despite its silent progression, NAFLD can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma. Objectives of the study to assess prevalence and its associated factors, which are essential for effective management and prevention strategies. Methods: An observational, analytical cross-sectional study was conducted in a tertiary care hospital in Kakinada, Andhra Pradesh, from June to July 2022. Among 100 subjects, chosen through the simple random sampling. Ethical approval was granted before conducting study. Data on demographics, lifestyle risk factors, anthropometry, and ultrasound findings were collected using a pretested and validated case record form. Statistical analysis was carried out using SPSS software, employing appropriate tests to explore associations between NAFLD and various variables. Results: Among 100 participants, the prevalence of NAFLD was found to be 41%. Significant associations were observed between NAFLD and variables such as BMI (p=0.034), waist-hip ratio (p=0.002), and history of diabetes mellitus (p=0.000). Lifestyle factors, including increased cooking oil consumption, were identified as significant risk factors. Conclusions: The study highlights the high prevalence of NAFLD among subjects undergoing ultrasound abdomen in Kakinada. Significant associations were observed with BMI, waist-hip ratio, and diabetes mellitus history. Promoting healthy behaviours is crucial for NAFLD prevention and management.

Potential and toxicity effects of fish omega-3 fatty acid as a chemopreventive agent in colorectal cancer: A scoping review

Colorectal cancer (CRC), a malignancy that affects the colon and rectum, is influenced by gene mutations, epigenetic changes, local inflammation, and lifestyle risk factors. New cases of CRC globally account for 10%, with mortality at 9.4%, while Indonesia occupies the top four incidence and mortality cases. A family history of CRC requires preventive measures, including consuming functional foods to maintain the colon microenvironment. This article aims to review the potency and toxicity effects of omega-3 fish fatty acids as a chemopreventive agent against CRC. The data sources were original articles about omega-3 fish fatty acids as CRC chemopreventive agents, published in 2012-2022 and in English or Indonesian. Databases used are Ovid, ScienceDirect, ProQuest, PubMed, Springer Link, EBSCO, and Google Scholar using Boolean search. The selection of studies followed the PRISMA-ScR method. Of the nine articles selected, fish omega-3 fatty acids had the potential as a chemopreventive agent against CRC, with several variations in daily dose ranges accompanied by a good lifestyle. Oral omega-3 fish supplementation gave benefits in the range of 96 mg–2,000 mg of eicosapentaenoic acid (EPA) and between 360 mg–1,000 mg of docosahexaenoic acid (DHA), with a daily intake varying between 0–14 grams/day. One study reported a toxic effect of fish omega-3 fatty acids, which raised the risk of post-operative infection after parenteral (intravenous) administration. There are no reported side effects across eight studies following oral preparation administration. The omega-3 fish fatty acid shows potential as a chemopreventive therapy for CRC; further studies are required to explore the parenteral administration-associated toxic effects.

Role of Lifestyle Risk Factors for Azoospermia: Insights from Ebenezer Clinical Laboratory - Kampala Capital City, Uganda

Background: Azoospermia is one of the social problems affecting families/countries today in the whole world, which has resulted in an involuntary declining birth rate [1]. Worldwide, more than 70 million couples suffer from infertility, and it is estimated that azoospermia is found in up to 10 to 20 percent of the men who present to an infertility clinic [2]. Uganda is among the countries where male infertility is assumed to be a big challenge, with an estimated 5,000,000 people facing infertility, where 10 to 15% of the couples are unable to have children. Hence the current study aimed at establishing the risk factors associated with azoospermia among patients attending Ebenezer Clinical Laboratory, Kampala, Uganda. Methods: A retrospective case-control study design was conducted on men who had visited the Microbiology Department for semen analysis from 1st January to 31st December 2015. Cases were azoospermic participants in the ECL database with no sperm cells in the ejaculate whereas controls were normozoospermic participants in the ECL database with normal sperm cells in the ejaculate. Systematic sampling was employed in the selection of respondents using their clinical records. The sample size was 204 (102 cases and 102 controls) clients, determined using a formula from the OpenEpi software package for Kelsey. The sample involved 102 cases and 102 with a ratio of cases to controls being 1:1. The study used a data abstraction structured questionnaire for data collection. Data was analyzed using descriptive statistics to generate frequencies and percentages. Chi-square test and logistic regression analyses were used to determine whether there was a significant association between risk factors and azoospermia with about 0.05 statistical significance. Results: The study found out that tobacco use [AOR = 11.245, (CI 95% = 3.913 – 32.312), p = 0.000], marijuana use [AOR = 21.975, (CI 95% = 5.710 -44.571), p = 0.000], type of underwear [AOR = 9.366, (CI 95% = 4.360 – 19.9471), p = 0.000] were statistically significant factors associated with azoospermia among patients Conclusions: Interventions should be focused on improving these factors, such as minimizing tobacco and marijuana usage among the populations, as well as sensitizing the males on the dangers of wearing tight underwear.

The Minhang Pediatric Biobank cohort study: protocol overview and baseline characteristics

BackgroundLittle has been done to establish biobanks for studying the environment and lifestyle risk factors for diseases among the school-age children. The Minhang Pediatric Biobank (MPB) cohort study aims to identify factors associated with health and diseases of school-aged children living in the urban or suburban area of Shanghai.MethodsThis population-based cohort study was started in all sub-districts/towns of Minhang district of Shanghai in 2014. First-grade students in elementary school were enrolled during the time of their routine physical examinations, with self-administered questionnaires completed by their primary caregivers. Additional information was extracted from multiple health information systems. Urine and saliva samples were collected during the baseline survey and follow-up visits.ResultsAt the end of 2014 academic year, a total number of 8412 children and their parents were recruited, including 4339 boys and 4073 girls. All the participants completed the baseline survey and physical examination, and 7128 urine and 2767 saliva samples were collected. The five most prevalent childhood diseases in this population were dental caries, bronchitis, pneumonia, asthma and overweight/obese.ConclusionsThe MPB cohort has been successfully established, serving as a useful platform for future research relating to the genetic, environmental and lifestyle risk factors for childhood diseases.

Lifestyle and genetic risk of chronic liver disease in metabolically healthy and unhealthy individuals from the general population

Background & AimsIt is unclear to what extent lifestyle and genetic factors affect incidence of chronic liver disease (CLD) in a general population and if lifestyle affects CLD independently of underlying cardiometabolic perturbations and genetic predisposition. MethodsWe examined 27,991 men and women aged 44-73 years from the Malmö Diet and Cancer Study recruited between 1991-1996 and followed until end of 2020 using registry-linkage (median follow-up time 25.1 years; 382 incident first-time CLD events). Associations between cardiometabolic factors, polygenic risk scores (PRSs), and lifestyle factors in relation to CLD were examined using multivariable Cox proportional hazards regression models. ResultsIncidence of CLD increased with number of cardiometabolic risk factors (the hazard ratio (HR) per each additional cardiometabolic risk factor was 1.33 (95% CI: 1.21-1.45; p= 5.1 x 10-10). Two novel polygenic risk scores (PRS) for metabolic dysfunction-associated steatotic liver disease (MASLD) and a PRS for liver cirrhosis associated with higher risk of CLD but provided marginal predictive utility on top of other risk factors and compared to the PNPLA3 rs738409 genetic variant. An unhealthy lifestyle (high alcohol intake, current smoking, physical inactivity and unhealthy diet) markedly increased risk of CLD (HR=3.97, 95% CI: 2.59-6.10). Observed associations between examined lifestyle factors and CLD were largely independent of cardiometabolic perturbations and polygenic risk. ConclusionsWe confirmed the importance of cardiometabolic dysfunction in relation to risk of CLD in a general population. Lifestyle risk factors were shown to independently associate with CLD and added predictive information on top of cardiometabolic risk factors. Information on the polygenic risk of liver disease does not currently add to prediction of CLD in a general population. Lay summaryIn this large longitudinal study of a general population, we found that cardiometabolic, genetic and lifestyle risk factors all contribute to the development of chronic liver disease (CLD). Our results suggest that an unhealthy lifestyle, including alcohol consumption, smoking, physical inactivity, and an unhealthy diet, substantially increase risk of CLD independently of underlying genetic risk or cardiometabolic health. This suggest that a large proportion of CLD cases are potentially preventable through adoption of healthy lifestyle changes. Impact and implicationsThis large population-based prospective study suggests largely independent roles of cardiometabolic, lifestyle, and genetic risk factors in the development of chronic liver disease. Findings strengthen the evidence base for a beneficial effect of modification of high-risk lifestyle behaviors in the primary prevention of chronic liver disease in the general population.

Lifestyle for brain health and cognitive functioning in midlife to early late-life New Zealanders: Utility of the LIBRA index.

There is enormous potential to improve brain health and reduce the risk of cognitive decline and dementia based on modifiable risk factors. The Lifestyle for Brain Health (LIBRA) index was developed to quantify modifiable dementia risk or room for brain health improvement. The objective of the study was to investigate the utility of the LIBRA index in relation to cognitive functioning in a midlife to early late-life sample of New Zealanders. A subsample (n=1001) of the longitudinal New Zealand Health, Work and Retirement (NZHWR) study completed face-to-face cognitive assessments using the 'Kiwi' Addenbrooke's Cognitive Examination-Revised (ACE-R)in 2010 and again in 2012, in addition to completing biennial NZHWR surveys on socioeconomic, health and wellbeing aspects. The LIBRA index was calculated incorporating information on 8 out of 12 modifiable health and lifestyle factors for dementia. Unadjusted and adjusted regression models and mixed effects models were used to inspect associations of LIBRA with cognitive functioning, cognitive impairment, and cognitive decline. The analytical sample (n=881 [88.0%], after considering exclusion criteria and missing data) had a mean age of 63.1 (SD=6.5) years, 53.3% were female, 26.2% were Māori, and 61.7% were highly educated. Higher LIBRA scores (indicating higher modifiable dementia risk) were associated with lower cognitive functioning (B=-0.33, 95% CI=-0.52;-0.15, p<0.001) and a higher likelihood of cognitive impairment (OR=1.22, 95% CI=1.04; 1.42, p=0.013), but did not predict cognitive decline over 2years (B=-0.03, 95% CI=-0.22; 0.16, p=0.766), adjusted for age, age2, gender, education, and ethnicity. The LIBRA index indicated promising utility for quantifying modifiable dementia risk in midlife and early late-life New Zealanders. For local use, refinement of the LIBRA index should consider cultural differences in health and lifestyle risk factors, and further investigate its utility with a wider range of modifiable factors over a longer observation period.