Linear Association Research Articles

The Association Between Obesity and Wet Overactive Bladder: Results from 2005-2020 National Health and Nutrition Examination Survey.

The association between obesity and wet overactive bladder (wet OAB) was few, and was also inconsistent and controversial in sex differences. This study aimed to ascertain the specific association between obesity and wet OAB for females and males using five obesity measures. This cross-sectional study included 29,041 participants from the 2005-2020 National Health and Nutrition Examination Survey database. The outcome was the risk of wet OAB. Five obesity measures were exposure using quintile, including body mass index (BMI), waist-to-stature ratio (WSR), body fat percentage (BFP), fat mass, and lean mass. The associations were elucidated using weighted logistic regression models and restricted cubic spline analysis. The elevated BMI, WSR, BFP, and fat mass were positively associated with the risk of wet OAB in both sexes, which was evident in females. Interestingly, lean mass was adversely associated with the risk of wet OAB in both sexes. In restricted cubic spline (RCS) analysis about BMI, WSR, BFP, and fat mass, monotonically increasing nonlinear associations were found in males, while positive linear associations were found in females. Besides, negative linear and nonlinear relationships were shown between lean mass and the risk of wet OAB in females and males, respectively. Obesity was positively associated with the risk of wet OAB in both sexes. Controlling BMI, WSR, BFP, fat mass, and strengthening lean mass may help prevent the development of wet OAB.

Negative association between body roundness index and constipation: insights from NHANES

BackgroundsThe relationship between body roundness index (BRI), a metric that distinguishes heterogeneity in fat distribution, and constipation is unclear. This study is the first to investigate the association between BRI and constipation based on the National Health and Nutrition Examination Survey (NHANES) in the United States, providing a new perspective on the mechanisms of obesity-related gastrointestinal dysfunction.MethodsThis cross-sectional study utilized data from the NHANES conducted between 2005 and 2010. Constipation was diagnosed based on the Bristol Stool Form Scale (BSFS). Weighted logistic regression models were employed to assess the association between BRI and constipation prevalence. Restricted cubic splines (RCS) and piecewise linear regression models were applied to evaluate non-linear relationships between BRI and constipation. Propensity score matching (PSM) was implemented to match constipated and non-constipated populations with similar baseline characteristics. Subsequent analyses were conducted to investigate the correlation between BRI and constipation.ResultsA total of 12,732 eligible participants were included. A negative correlation was observed between BRI and constipation prevalence, with an adjusted odds ratio (OR) of 0.87 (95% CI: 0.80, 0.95) after controlling for all covariates. When BRI was categorized into quartiles (Q1-Q4), both Q3 and Q4 groups exhibited significantly reduced constipation risk compared to Q1 (OR = 0.72, 95% CI: 0.54–0.97; OR = 0.63, 95% CI: 0.46–0.87). The RCS regression model revealed a linear inverse association between BRI and constipation risk (nonlinearity test P = 0.083). Subgroup analyses identified significant interaction effects of BRI with age, alcohol consumption status, and hypertension on constipation risk (interaction P < 0.05). Post PSM, constipation patients demonstrated higher BRI levels than non-constipation counterparts (P = 0.013).ConclusionAn inverse association was observed between BRI and constipation risk in U.S. adults, suggesting that lower BRI levels may correlate with raised constipation incidence. This underscores the critical importance of maintaining optimal BRI levels for constipation prevention. Further research is warranted to elucidate the underlying mechanisms governing this association.

Association between visceral adiposity index and sleep disorders among the U.S. adults: a cross-sectional study

BackgroundThe visceral adiposity index (VAI) reliably measures body fat distribution and related dysfunctions. However, its association with sleep disorders among US adults remains unclear.MethodsThis study analyzed cross-sectional data from the 2005 to 2018 National Health and Nutrition Examination Survey (NHANES) for adults aged 18 and older. We used multivariable logistic regression to evaluate the association between VAI and sleep disorders and applied restricted cubic splines to assess potential non-linear relationships. Additionally, subgroup analyses by gender, age, and race were conducted to explore the VAI-sleep disorder association across different populations.ResultsThis study included 14,021 adults aged 18 +. In Model 1, adjusted for gender and age, each unit increase in VAI was associated with a 5% higher risk of sleep disorders (OR = 1.05; 95% CI = 1.02–1.07). In Model 2, which adjusted for all potential confounders, each unit increase in VAI was linked to a 3% higher risk (OR = 1.03; 95% CI = 1.00–1.05). When treating VAI as a categorical variable, those in the highest quartile (Q4) had a 21% higher risk of sleep disorders compared to those in the lowest quartile (Q1) (OR = 1.21; 95% CI 1.03–1.41). Restricted cubic spline analysis revealed a positive linear relationship between VAI and sleep disorder prevalence. Subgroup analysis found stronger associations in males and non-Hispanic white individuals.ConclusionWhile causality cannot be confirmed, this cross-sectional study shows a significant positive linear association between higher VAI and the risk of sleep disorders among U.S. adults.

Associations of Serum Vitamin D with Sarcopenia in Patients with Chronic Liver Disease: A Population-Based Cross-Sectional Study.

The association between vitamin D and sarcopenia in patients with chronic liver disease (CLD) has yet to be conclusively established, particularly in Western populations. We investigated the association between serum 25(OH)D levels and sarcopenia in adult CLD patients in the USA. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey III. Weighted logistic regression was used to determine the association between sarcopenia and serum 25(OH)D in participants with CLD. CLD was defined as chronic hepatitis B or C, non-alcoholic fatty liver disease, alcohol-related liver disease, and other liver diseases. A serum 25(OH)D level of less than 75 nmol/L was defined as vitamin D insufficiency. This study included 1402 participants with CLD. The serum 25(OH)D concentration was significantly lower in the sarcopenia group (45.3 nmol/l) compared to the non-sarcopenia group (50.6 nmol/l). The prevalence of vitamin D insufficiency was as high as 91.3% in participants with CLD, and the proportion of vitamin D insufficiency was higher in those with sarcopenia. In the full multivariate model, each 10-nmol/L increase in 25(OH)D concentration was significantly associated with a decreased risk of sarcopenia (OR 0.89; 95%CI 0.79-0.99). Conversely, participants with insufficient vitamin D levels had a significantly increased risk of sarcopenia (OR, 2.07; 95% CI 1.08-4.00). Subgroup analyses suggested a sex difference in the association between vitamin D levels and sarcopenia, with a significant association only observed in females. Restricted cubic spline curves indicated a linear inverse association between serum 25(OH)D concentration and risk of sarcopenia in all participants and in females. Low serum 25(OH)D levels were significantly associated with an increased risk of sarcopenia in individuals with CLD, with the observed gender differences in this association warranting further validation in future studies.

Association of obesity- and insulin resistance-related indices with subclinical carotid atherosclerosis in type 1 diabetes: a cross-sectional study

BackgroundObesity and insulin resistance are well-established risk factors for atherosclerosis and cardiovascular disease (CVD). Although some obesity- and insulin resistance-related indices (OIRIs) have been linked to CVD, their associations with subclinical carotid atherosclerosis (SCA) in individuals with type 1 diabetes (T1D) remain unclear. This study aims to systematically explore and compare the associations of various common OIRIs with SCA in T1D population.MethodsA total of 418 adult inpatients with classic T1D admitted from October 2008 to June 2021 to the First Affiliated Hospital of Air Force Medical University in Xi’an, China were included in this study. Demographic, anthropometric, and laboratory data were collected. Studied OIRIs comprised body mass index, waist-to-height ratio, waist-to-hip ratio (WHR), a body shape index, abdominal volume index, body adiposity index, body roundness index, conicity index, triglyceride-glucose index, visceral adiposity index, Chinese visceral adiposity index (CVAI), lipid accumulation product, estimated glucose disposal rate (eGDR), triglyceride-to-HDL ratio, and cardiometabolic index. Binary logistic regression, restricted cubic spline (RCS), and receiver operating characteristic curves were used to examine the associations of these indices with SCA.ResultsIn multivariable logistic regression analyses, after adjusting for potential confounders, per 1.0-standard deviation (SD) increase in CVAI (OR, 95% CI: 1.68, 1.16–2.47), eGDRWHR (eGDR calculated with WHR; OR, 95% CI: 0.44, 0.22–0.82), and eGDRWC (eGDR calculated with waist circumference; OR, 95% CI: 0.49, 0.24–0.93) were significantly associated with SCA. CVAI exhibited the highest area under the curve (AUC) in diagnosing SCA, with a value of 0.73 (95% CI: 0.69–0.77). RCS analyses indicated a linear and positive association between CVAI and SCA in the overall population and the females. Subgroup analyses and sensitivity analyses further supported the association between CVAI and SCA. Additionally, adding CVAI to the Steno Type 1 Risk Engine (ST1RE) improved the reclassification, but did not enhance the overall discriminative ability of ST1RE to identify SCA.ConclusionAmong various OIRIs, CVAI shows the strongest association with SCA in adults with T1D. These findings suggest that CVAI may merit further longitudinal investigation as a potential marker for SCA assessment in this population.Graphical abstract

Association between relative fat mass and colorectal cancer: a cross-sectional study

AimsWe aimed to investigate the potential association between relative fat mass (RFM) and colorectal cancer (CRC).Design and methodsData from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2020 were analyzed. Associations between RFM and CRC were analyzed using multiple logistic regression. Smoothed curve fitting was performed to conduct the association by sex. The stability of associations was assessed using subgroup analyses and interaction tests.ResultsOverall, 52,281 participants over the age of 20 years were enrolled. The fully adjusted model observed a positive association between RFM and CRC, with one-unit increases in RFM linked to a 3% greater prevalence of CRC (OR = 1.03, 95%CI: 1.01, 1.06). A linear positive association was identified between RFM and CRC in male subjects, while a non-linear relationship was observed in females, with an inflection point at 42. Subgroup analysis revealed that age significantly modified the relationship between RFM and CRC (P for interaction = 0.0085).ConclusionRFM is strongly associated with CRC prevalence in US adults. Further large-scale prospective investigations are warranted to for verification.

Unveiling the role of stress hyperglycemia in predicting mortality for critically ill hemorrhagic stroke patients: insights from MIMIC-IV

BackgroundHemorrhagic stroke (HS), including intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), is associated with high mortality and morbidity. Stress hyperglycemia ratio (SHR), reflecting acute glycemic responses relative to baseline glucose levels, has been linked to poor outcomes in critical illnesses. However, research on its prognostic significance in HS patients admitted to the intensive care unit (ICU) is limited. This study aims to assess the association between SHR and all-cause mortality (ACM) in critically ill HS patients.MethodsPatients diagnosed with HS were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database using ICD-9/10 codes. SHR was calculated as [admission glucose (mg/dL)/(28.7 × HbA1c (%) − 46.7)]. Patients were stratified into tertiles. Primary outcomes were ICU, in-hospital, 30-day, 90-day, 180-day, and 1-year mortality. Cox regression and restricted cubic splines (RCS) evaluated the dose-response relationship between SHR and ACM. Kaplan-Meier (K-M) analysis assessed survival across tertiles, with subgroup analysis and interaction tests for effect modification.ResultsThe study included 1,749 patients, with a median age of 68 years (IQR: 57–79), and 53.2% were male. The observed mortality rates were 10.6% in the ICU, 15.2% in-hospital, 19.6% at 30 days, 24.2% at 90 days, 27.8% at 180 days, and 31.7% at 1 year. Multivariate Cox regression analysis indicated that elevated SHR was independently associated with increased ACM at 30 days (adjusted hazard ratio [aHR]: 1.41; 95% confidence interval [CI]: 1.10–1.81; P = 0.006), 90 days (aHR: 1.33; 95% CI: 1.08–1.65; P = 0.008), and 1 year (aHR: 1.27; 95% CI: 1.05–1.54; P = 0.014). RCS analysis demonstrated a linear association between SHR and ACM, with no evidence of non-linearity. Subgroup analysis revealed consistent associations across various patient characteristics.ConclusionSHR is significantly associated with ACM in critically ill patients with HS, supporting its potential role as a prognostic marker for risk stratification and guiding clinical management. Incorporating SHR into routine risk assessment may facilitate early identification of high-risk patients, enabling timely interventions and improved outcomes.

Exercise to Manage Fatigue During and After Chemotherapy in Adolescents and Young Adults With Cancer: A Systematic Review and Meta-Analysis.

There is a gap in knowledge about the efficacy of exercise in managing cancer-related fatigue (CRF) in adolescents and young adults (AYAs) during and after chemotherapy. A systematic search was conducted in Scopus®, PubMed®, and CINAHL®, as well as citation searching, for studies about the impact of exercise on CRF in the AYA population. Abstract and full-text screening of 2,234 studies produced 15 studies for systematic review and 13 for meta-analysis. Effect size was calculated using standardized mean difference and confidence intervals. Subgroup analysis was conducted to assess the impact of various exercise types on CRF. A meta-regression was performed using exercise frequency, intensity, and duration as predictors to determine relationships with effect size on CRF and adherence to exercise. Exercise had a large effect size on CRF in AYAs. No difference in effect size estimates for exercise type subgroups was observed. A linear association was found between exercise duration and CRF (p = 0.005), and exercise intensity and adherence (p = 0.037). Exercise is effective in managing CRF among AYAs, and efforts should be aimed toward including it in routine oncologic care.

Linear and Non-linear Association of Chronic Kidney Disease with Retina and Choroid Vessel Density in Diabetes: A Prospective Study.

Linear and Non-linear Association of Chronic Kidney Disease with Retina and Choroid Vessel Density in Diabetes: A Prospective Study.

Association of Body Mass Index and Abdominal Obesity with Incidence of Atrial Fibrillation in Heart Failure with Preserved Ejection Fraction

The association between obesity and atrial fibrillation (AF) incidence in heart failure with preserved ejection fraction (HFpEF) patients is currently unclear. Our analyses and results are based on the whole Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial (placebo and spironolactone). A total of 2138 subjects without baseline AF were included in the trial. Kaplan-Meier (K-M) curves and Cox regression with hazard ratios (HRs) and confidence intervals (CIs) were used to assess the incidence of AF with obesity. Of 2138 HFpEF patients without baseline AF, 1165 were obese (body mass index [BMI]≥ 30 kg/m2). The K-M curve showed obese patients developed AF more than overweight (25≤ BMI ≤29.9 kg/m2) patients (p=0.013), confirmed by multivariable analysis, while there’s no statistical difference between overweight and normal weight (18.5≤ BMI ≤24.9 kg/m2) patients. The occurrence of AF increased by 3% for every kg/m2 increase in BMI (adjusted HR, aHR: 1.03; 95% CI: 1.00-1.06), with a positive linear association (p for nonlinear: 0.145). Obesity was associated with AF incidence (aHR: 1.62; 95% CI: 1.05-2.50) compared with non-obesity (including overweight and normal-weight patients). Abdominal obesity was associated with increased AF incidence (aHR: 1.70; 95% CI: 1.04-2.77), and AF incidence rose by 18% per centimeter in circumference (aHR: 1.18; 95% CI:1.04-1.34). Obesity and abdominal obesity increase the incidence of AF in HFpEF patients. Further studies need to determine whether there is a difference in AF in response to spironolactone across obese HFpEF pheno groups. URL: https://clinicaltrials.gov. Unique identifier: NCT00094302. Registered on October 15, 2004

Circulating polyunsaturated fatty acids percentages and coronary artery disease incidence and mortality: Observational and Mendelian randomization analyses.

Circulating polyunsaturated fatty acids percentages and coronary artery disease incidence and mortality: Observational and Mendelian randomization analyses.

The association between life’s crucial 9 and all-cause, cancer-specific and cardiovascular mortality in US cancer survivors: a cohort study of NHANES

BackgroundLife’s Crucial 9 (LC9) is a recently proposed cardiovascular health (CVH) scoring system that integrates psychological well-being with Life’s Essential 8 (LE8). However, its prognostic value remains unclear. This study aims to investigate the association between LC9 and outcomes among cancer survivors.MethodsA total of 2,558 cancer survivors from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 were included in this study. LC9, representing a dimension of psychological health, was calculated as the average of the LE8 score and the depression score. Cox proportional hazards regression, restricted cubic spline (RCS) analysis, subgroup analysis, and Kaplan-Meier survival curves were employed to evaluate the association between LC9 and mortality risk, with adjustments for potential confounders.ResultsDuring an average follow-up period of 80 months, 640 deaths occurred, including 205 from cancer and 128 from cardiovascular disease. After adjusting for all covariates using Cox regression, a 10-point increase in the LC9 score was associated with a 24% reduction in all-cause mortality (HR: 0.76; 95% CI: 0.68–0.84), a 19% reduction in cancer-specific mortality (HR: 0.81; 95% CI: 0.68–0.97), and a 28% reduction in cardiovascular mortality (HR: 0.72; 95% CI: 0.58–0.90). Kaplan-Meier survival curves indicated lower rates of all-cause, cancer-specific, and cardiovascular mortality among participants with higher LC9 scores. RCS analysis revealed a linear inverse association between LC9 and all-cause and cancer-specific mortality and a nonlinear inverse association with cardiovascular mortality.ConclusionAmong cancer survivors in the United States, higher LC9 scores were independently associated with lower risks of all-cause, cancer-specific, and cardiovascular mortality. This finding highlights the potential link between cardiovascular health and survival outcomes in cancer survivors, suggesting that improving cardiovascular health may serve as an important preventive strategy to enhance survival rates in this population.

Sex-specific association between triglyceride-glucose index and all-cause mortality in patients with osteoporotic fractures: a retrospective cohort study

BackgroundOsteoporotic fractures (OPFs) pose a considerable global health burden and are linked with an elevated mortality risk. The triglyceride-glucose index (TyG-I) is a recognized marker of insulin resistance across various populations. The association between all-cause mortality (ACM) and the TyG-I has been widely investigated in a variety of clinical settings. The potential sex-specific differences in this association among OPF patients remain uncertain.MethodsIn this retrospective cohort study, 2,307 patients ≥ 50 years old admitted to the hospital between January 2018 and August 2023 for surgical treatment of OPFs were included. The TyG-I was determined using fasting triglyceride and glucose levels measured at admission. The association between ACM and the TyG-I was evaluated by Cox proportional hazards regression, adjusting for possible confounding variables. Analyses were categorized by sex, and subgroup analyses evaluated possible interaction effects. The ACM rates among TyG-I tertiles were compared via Kaplan–Meier curves.ResultsThis research study analyzed 2,307 patients, of whom 247 (10.71%) died from any cause during the follow-up period. In females, a linear association of the TyG-I with ACM was observed even after adjusting for confounders, with each unit increase in the TyG-I correlating with a 37% increased risk of death (HR: 1.37, 95% CI: 1.06-1.77, p = 0.02). However, in males, there was a non-linear correlation, where patients in the uppermost TyG-I tertile showed a substantially decreased mortality risk relative to those in the lowest tertile (HR: 0.53, 95% CI: 0.30–0.92, p = 0.02). TyG-I indicated a statistically significant relation with sex (P for interaction = 0.01).ConclusionIn patients diagnosed with OPFs, distinct sex-specific variations were observed in the relationship between ACM and the TyG-I. Among female patients, each unit increase in the TyG-I was linked to a 37% greater risk of mortality. Conversely, male patients within the highest TyG-I tertile indicated a lower mortality risk than those in the lowest tertile. Further research is required to confirm these sex-specific associations.

Evaluation of a New Device for Clearing Secretions From Lower Airways.

Background: Endotracheal intubation promotes the retention of secretions in the lower airways, potentially leading to infections and obstructions. A novel endotracheal cuff controller, synchronized with the ventilator, is designed to remove secretions from both above and below the endotracheal tube (ETT) cuff by generating a semi-automatic "artificial cough" through brief ETT cuff deflation during the inspiratory phase of a ventilator breath. This study assessed, first, in vitro, the accuracy of a computation for estimating the cough flow and, subsequently, in subjects, the device's effectiveness in moving secretions from lower airways toward the mouth during invasive ventilation. Methods: In the in vitro study, the mean cough flow estimated by the ratio between the expiratory volume lost and the duration of the cuff deflation was compared with the actual cough flow measured using flow meters. In the clinical study, we enrolled subjects admitted to the ICU. Three artificial cough maneuvers were performed within 3 min during a sigh (inspiratory pressure of 35 cm H2O for ∼1.8 s). Aspiration of the oral cavity was conducted before the first maneuver and after the third maneuver. Results: A strong linear association was found between actual and computed cough flow (Pearson's correlation coefficient 0.991, 95% CI: 0.987-0.994). Twenty-eight subjects were enrolled. After device activation, oral secretions were detected in 78.6% of subjects (responders). Cough flow was similar in both responders and nonresponders, with a mean highest value of 23.3 ± 11.5 L/min. Demographic, physiological, and ventilatory parameters before and after the maneuvers were also similar. No relevant adverse events were recorded, except for one transient episode of hypotension. Conclusions: The cough flow can be accurately estimated from the expiratory volume lost. The device successfully generated effective cough flows in all subjects, clearing secretions from the trachea to the mouth in nearly 80% of cases.

Impact of the systemic inflammatory indices on birth weight: A prospective observational study.

Objectives Several studies explored the role of maternal systemic inflammation indices during pregnancy. Different conditions, such as gestational hypertension, preeclampsia, and gestational diabetes, are associated with abnormal systemic inflammation indices. However, there is a lack of research on the impact of systemic inflammation indices on fetal growth in physiological pregnancies. The objective of this study is to explore the potential associations between birth weight, length, and head circumference with a group of systemic inflammatory indices, namely Platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), the Mean Platelet Volume-to-Lymphocyte Ratio (MPVLR), Monocyte-Lymphocyte Ratio (MLR), Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI). Design Full-term, physiological pregnancies admitted to a tertiary center from November 2019 until February 2021 were included in a prospective observational study. We excluded pregnancies affected by gestational or pregestational diabetes, chronic hypertension, gestational hypertension, pre-eclampsia/eclampsia, fetal growth restriction, preterm delivery or premature rupture of membranes, multiple pregnancies, and malformed fetuses. Socio-demographic characteristics, clinical data, and complete blood count were recorded. Materials and methods: Continuous variables were reported as either the means and standard deviation or median and interquartile ranges (IQRs) according to their distribution, as assessed by the Shapiro-Wilk normality test. Categorical variables were reported as percentages. To measure the linear association between continuous variables, the Pearson correlation test was used if variables had a normal distribution. Otherwise, Spearman's rank correlation test was calculated. To obtain an inflammatory latent score a principal component analysis (PCA) was performed on NLR, PLR, MPVLR, MLR, SII and SIRI. Results: 264 pregnant women came to our observation before the delivery. After the exclusion criteria, 199 pregnant were included. The Spearman's rank correlation test showed a high correlation among the indices. Then, a PCA was performed to a composite indicator of inflammatory score. The first principal component was selected, with a proportion of explained variance equal to 73.11%. The contributions of variables suggested to exclude from the score the MLR index. From the linear regression models, results denoted that the inflammatory score negatively affects the birth weight (β=-42.60, 95%CI [-76.91, -8.28]) and the head circumference (β=-0.14, 95%CI [-0.24, -0.04]); whereas, the effect of the score on the birth length is not statistically significant at 5% (β=-0.12, 95%CI [-0.27,0.02]). Limitations This research's main limitation is the lack of data about the indirect inflammatory markers during the first and second trimesters of pregnancy. In addition, no neonatal outcomes were scheduled, such as NICU hospitalization for the different neonatal pathologies. Conclusions The results of our study revealed a negative direct correlation between the composite indicator of inflammatory score and the birth weight and fetal head circumference. This novel finding prompts further evaluation of the role of indirect inflammatory markers on fetal growth and neonatal outcomes and highlights the need for additional research to clarify the complex relationship between inflammation and pregnancy.

Protein Source, Dietary Fibre Intake, and Inflammation in Older Adults: A UK Biobank Study

Background: Chronic inflammation is linked to cardiovascular disease, cancer, and other non-communicable diseases. Dietary factors like fibre and protein may affect inflammation, but limited evidence exists exploring how they interact. This study investigated associations between dietary fibre, protein sources, and the inflammatory marker C-reactive protein (CRP) in older adults. Methods: This cross-sectional analysis included 128,612 UK Biobank participants aged 60+ years with CRP measurements and dietary data from multiple 24 h recalls. Fibre intake was reported as total fibre (g/day). Protein intake included total, animal, and vegetable protein (g/day). Robust regression analysis examined associations between quintiles of fibre, protein, and CRP, adjusted for demographics, lifestyle factors, and multimorbidity. Analyses were stratified by health status (with and without multimorbidity). Results: Higher fibre and vegetable protein intakes were inversely associated with CRP, while higher animal and total protein were positively associated with CRP in people with no multimorbidity. Specifically, participants in the highest quartile of dietary fibre had CRP levels that were 0.42 mg/L lower compared with the lowest quartiles. In contrast, those with the highest total protein and animal protein intakes had CRP levels that were 0.24 mg/L and 0.40 mg/L higher, respectively. In people with multimorbidity, fibre exhibited an inverted U-shaped association with the strongest association in participants in the highest quintile of intake. Vegetable protein had an inverse association with CRP. Animal and total protein had strong positive linear associations with CRP. Notably, high animal protein coupled with low dietary fibre intake resulted in CRP levels that were 0.65 mg/L higher compared with low animal protein and high dietary fibre intake. Conclusions: Higher fibre and vegetable protein intakes were associated with lower inflammation in older adults. In promoting protein intake to maintain muscle mass and function, future studies should investigate replacing animal with vegetable protein to concomitantly reduce age-related inflammation.

Restrained Eating Features and Brain Morphology: A Pediatric Population-Based Study.

Anorexia nervosa, a restrictive eating disorder that is most commonly seen in females, is associated with alterations in gray matter (GM) and white matter (WM) structures. However, little is known about how restrained eating (RE) and the body mass index-standard deviation score (BMI-SDS) are related to brain morphology and whether sex differences exist in the general pediatric population. Participants were 9-year-old girls and boys (n = 2729) from the population-based Generation R Study. BMI-SDS was calculated by adjusting BMI for sex and age, using Dutch growth curves. RE is measured with the Dutch Eating Behavior Questionnaire. All children underwent structural magnetic resonance imaging, and brain volumes were calculated using FreeSurfer. BMI-SDS in girls was positively associated with total intracranial volume and several regional brain volumes. In addition, BMI-SDS showed an inverted U-shaped association with total GM and WM. In girls, RE had a positive linear association with total intracranial, WM, and several regional brain volumes, corrected for BMI-SDS. Additionally, there was an inverted U-shaped association with the amygdala and insula volume. In boys, we found merely positive linear associations between BMI-SDS and brain volumes, and no associations between RE and brain volumes. Associations between BMI and brain volumes exist in typically developing children, but there are significant sex differences in the magnitude and shape of the associations. RE is associated with some differences in brain volumes in girls only. Longitudinal studies are needed to assess these associations over a longer period of time.

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and preserved ratio impaired spirometry: NHANES 2007–2012

BackgroundPreserved ratio impaired spirometry (PRISm) refers to a form of lung function deterioration, and previous studies have established the association with Chronic Obstructive Pulmonary Disease (COPD). Research has also shown the association between COPD and lipid metabolism disturbances. Despite these findings, the association between lipid metabolism markers and PRISm remains poorly understood.MethodsThis analysis was conducted on the 2007–2012 data from the National Health and Nutrition Examination Survey (NHANES), including a total of 9,431 participants. The Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio (NHHR) was calculated based on lipid profiles, and PRISm patients were classified according to pulmonary function tests. To explore the association between NHHR and PRISm, multivariable logistic regression analysis was used.ResultsA strong linear association was observed between NHHR and PRISm. In Adjusted Model 2, the weighted multivariable logistic regression analysis revealed that each unit increase in NHHR increased the chance of developing PRISm by 8% (OR:1.08, 95%CI:1.01–1.16, P = 0.039).Participants within the highest NHHR tertile demonstrated a 1.36-fold increased likelihood of presenting with PRISm compared to those in the lowest NHHR tertile (OR:1.36, 95% CI: 1.01–1.83, P = 0.048). Additionally, weighted Restricted Cubic Spline affirmed a linear association between NHHR and PRISm (P for non-linearity = 0.637), while clear non-linear associations were found between NHHR and FEV1% predicted (P for non-linearity = 0.010) and FEV1/FVC (P for non-linearity = 0.023). Subgroup analysis and interaction tests revealed a significant interaction effect among different waist circumference categories (P for interaction = 0.020). Notably, in individuals without abdominal obesity, NHHR showed a strong positive association with PRISm (OR = 1.23, 95% CI: 1.07–1.42, P = 0.01).ConclusionThese results indicate that NHHR is positively associated with PRISm and is significantly associated with the decline in lung function. This study offers distinctive perspectives that may contribute to the avoidance and management of early-stage pulmonary dysfunction.

Prenatal exposure to manganese and objectively measured sleep disturbances in early childhood.

Prenatal exposure to manganese and objectively measured sleep disturbances in early childhood.

Associations of maternal serum transthyretin concentration with pregnancy and birth outcomes

ObjectiveThis study aims to explore the association of maternal serum transthyretin (TTR) concentrations with adverse pregnancy and birth outcomes, as well as the variations in TTR concentrations across different gestational weeks in relation to these outcomes.MethodsThis retrospective cohort study included 6,584 women who delivered at The Second Affiliated Hospital of Wenzhou Medical University between January 1, 2022 and January 30, 2024. Logistic regression and Restricted cubic spline (RCS) models were applied to evaluate the association between TTR levels and the risk of complications, based on TTR quartile analyses. Locally estimated scatter plot smoothing (LOESS) curves were performed to provide a graphical representation of the relationship between TTR levels and gestational weeks.ResultsSignificant negative correlations were observed between maternal TTR levels and the risk of gestational diabetes mellitus (GDM), preeclampsia (PE), liver disease, anemia during pregnancy, and preterm delivery (all P < 0.001). The RCS models revealed a non-linear relationship between TTR levels and maternal comorbidities, including anemia (adjusted OR 0.992 [95% CI 0.990–0.994]; P = 0.017), liver disease (adjusted OR 0.991 [95% CI 0.988–0.994]; P < 0.001), hypothyroidism (adjusted OR 0.999 [95% CI 0.996–1.001]; P = 0.023) and preterm delivery (adjusted OR 0.986 [95% CI 0.983–0.989]; P < 0.001). The LOESS curves indicated a declining trend in TTR concentrations during the third trimester of pregnancy.ConclusionMaternal TTR concentrations showed an inverse linear association with the incidence of GDM and PE. Moreover, complex non-linear relationships were identified with TTR levels and comorbidities such as liver disease, anemia, hypothyroidism during pregnancy, and preterm delivery.