Lower Odds Ratio Research Articles

The lean body mass to visceral fat mass ratio is negatively associated with cardiometabolic disorders: a cross-sectional study

The literature has documented conflicting and inconsistent associations between muscle-to-fat ratios and metabolic diseases. Additionally, different adipose tissues can have contrasting effects, with visceral adipose tissue being identified as particularly harmful. This study aimed to explore the relationship between the ratio of the lean mass index (LMI) to the visceral fat mass index (VFMI) and cardiometabolic disorders, including dyslipidemia, hypertension, and diabetes, as previous research on this topic is lacking. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States and included 10,867 individuals. Logistic regression was employed to explore the association between LMI/VFMI and cardiometabolic disorders. Generalized additive models were utilized to examine the nonlinear relationships between variables. Data analysis revealed a consistent inverse association between ln(LMI/VFMI) and dyslipidemia, hypertension, and diabetes. Each 2.7-fold increase in LMI/VFMI (one unit of ln[LMI/VFMI]) was associated with lower odds ratios (ORs) for these conditions. In men, the ORs were 0.21 (95% CI 0.17–0.25) for dyslipidemia, 0.37 (95% CI 0.30–0.45) for hypertension, and 0.16 (95% CI 0.10–0.23) for diabetes. Similarly, in women, the ORs were 0.22 (95% CI 0.19–0.26), 0.51 (95% CI 0.42–0.61), and 0.19 (95% CI 0.13–0.27). Quartile analysis showed that participants in the highest quartile (Q4) had significantly lower ORs compared to those in the lowest quartile (Q1). In men, Q4 ORs were 0.18 (95% CI 0.14–0.23) for dyslipidemia, 0.30 (95% CI 0.23–0.39) for hypertension, and 0.11 (95% CI 0.06–0.20) for diabetes. In women, Q4 ORs were 0.12 (95% CI 0.10–0.15), 0.39 (95% CI 0.29–0.52), and 0.12 (95% CI 0.06–0.25), respectively. Dyslipidemia and diabetes demonstrated nonlinear patterns, while a linear association was found for hypertension. Subgroup analyses across various characteristics confirmed these findings with no substantial directional changes. Maintaining an appropriate ratio of LMI to VFMI may be associated with favorable metabolic health.

P0863 Risk of colitis in patients with Inflammatory Bowel Disease exposed to checkpoint inhibitors – a national Danish cohort study

Abstract Background Patients with intestinal inflammatory diseases such as ulcerative colitis (UC), Crohn’s disease (CD) and microscopic colitis (MC) are excluded from clinical trials with immune checkpoint inhibitors (ICI) due to assumed increased risk of activation of the underlying immune mediated disease. Therefore, we aimed to evaluate the risk of developing disease activity or checkpoint inhibitor immune-mediated enterocolitis (IMEC) in patients with UC, CD or MC treated with ICI in a real-world cohort. Methods We performed a nation-wide Danish retrospective cohort study on patients with UC, CD and MC with cancer treated with checkpoint inhibitors from 2010 to 2024. Results Eighty-five patients were included in the study and IMEC was observed in 39 (46%) cases. IMEC was not severe in fifteen cases, and it was possible to continue ICI treatment in 61 patients (72%). When compared to a control cohort without intestinal disease (n=138), patients with UC, CD, and MC had a higher risk of IMEC if treated with anti-PD-1 or anti-PD-L1, hazard ratio (HR) 4.93, p<0.001. Not enough patients were treated with CTLA-4 alone or in combination with anti-PD-1/PD-L1 treatment to calculate these groups and therefore we can only describe the risk in patients treated with anti-PD-1/PD-L1. Multivariate logistic analysis showed that patients with CD had a lower odds ratio (OR) of IMEC compared to patients with UC and MC (OR 0.07, p=0.02). Conclusion Patients with CD appear to have a lower risk of IMEC compared to patients with UC and MC. Despite the high risk of developing IMEC in patients with UC, CD, and MC, 72% of the patients were able to continue first-line treatment with ICI after managing IMEC.

The association of agricultural and non-agricultural work on the healthy ageing of older adults in Japan: A 6-year longitudinal study from the Japan Gerontological evaluation study.

Many studies have examined the impact of employment on health, but few large-scale longitudinal studies specifically investigate the impact of agricultural labor on the health of older adults. This study aims to identify the health effects of employment on older Japanese adults, focusing on agricultural workers. This study uses longitudinal data collected by the Japan Gerontological Evaluation Study (JAGES) from 2013 to 2019. We selected 48,221 older adults out of a total of 65,751 respondents, excluding missing values. The objective variables included healthy ageing, such as dementia, functional disability, loss of healthy life expectancy, and death. Explanatory variables were used to categorize participants into four groups: non-agricultural workers, agricultural workers, retired, and those who have never worked. Seven adjustment variables, including sex, age, and socioeconomic status, were considered. Logistic and modified Poisson regression analyses were employed after imputing missing values. Incidence ranged from 2.6% (dementia) to 17.3% (any level of functional disability). Post-multiple imputation analysis showed significantly lower odds ratios and risk ratios for dementia, functional disability, loss of healthy life expectancy, and death among non-agricultural and agricultural workers compared to retirees. The odds and risk ratios for agricultural workers ranged from 0.45 (dementia) to 0.69 (loss of healthy life expectancy). Compared with retirees, non-agricultural and agricultural workers experience significantly reduced risks for dementia, functional disability, loss of healthy life expectancy, and death. These findings showed potential health benefits associated with continued employment in older age.

Decadal trends in the exclusive breastfeeding practices among working Indian mothers: a multi-level analysis

BackgroundExclusive breastfeeding (EBF) is defined as feeding infants only breast milk of the mother or a wet nurse for the first six months, without additional food or liquids except the oral rehydration solution or drops/syrups of vitamins, minerals or medicines. The working status of women in developed countries adversely affects the EBF rates, which calls for an assessment in rapidly developing countries like India. Therefore, the primary aim of the present study is to determine the prevalence of EBF using the data from the National Family Health Surveys (NFHS 3, 4, 5) conducted between 2005 and 06, 2015-16 and 2019-21 to estimate the likelihood EBF according to mothers’ employment status.MethodsWe did a secondary data analysis of the cross-sectional surveys. Exclusive breastfeeding was the primary dependent variable and defined as the percentage of youngest children under six months exclusively breastfed per last 24 h. The employment status of the mother was the primary independent variable and was coded dichotomously (yes/no). Chi-square analysis assessed the association of EBF with the outcome variable of interest. A multi-level modelling approach has been used for portioning variation in the prevalence of exclusive breastfeeding at different geographical levels.ResultsFrom NFHS rounds 3 to 5, the overall prevalence of exclusive breastfeeding was 47.45%, 54.85%, and 64.01% respectively. On segregating the women as per their employment status, the prevalence among employed women was 51.1%, 51.1%, and 60.3%, while in unemployed women the prevalence was 45.9%, 54.8%, and 67.3% respectively. The odds of practising EBF in NFHS-5 doubled since NFHS-3 (Adjusted Odds Ratio: 2; 95% Confidence Interval: 1.08, 3.67). Employed mothers had a significantly lower odds ratio (0.94, 0.91, 0.98) of practising exclusive breastfeeding. The likelihood increased when mothers were exposed to media, had normal BMI, and visited health centres > 4 times during pregnancy. The likelihood decreased in older mothers, birth of infant in a health facility, female gender of the child, and late initiation of breastfeeding.ConclusionsThe lower prevalence of exclusive breastfeeding among working mothers calls for an urgent need to improve policies around maternity benefits at workplaces.

The association between post-lunch napping duration and social participation among the Chinese older adults: a cross-sectional study

BackgroundSocial participation (SP) affects the physical and mental health of older adults. Post-lunch napping is a prevalent lifestyle practice observed among older adults, and it may have an impact on their SP. However, research that explores the association between these factors is limited, and we thus aimed to examine this association.MethodsWe conducted a cross-sectional study using data from the China Health and Retirement Longitudinal Study (CHARLS), focusing on participants aged 60 and older. SP was measured by both the number and frequency of activities based on participant self-reports. The duration of post-lunch napping was also self-reported. We explored the association between post-lunch napping duration and SP using logistic regression, subgroup analysis, and Restrictive Cubic Spline (RCS) analysis.ResultsWe included 4259 participants in the study. Post-lunch napping demonstrated a significant association with decreased odds ratio of poor SP in fully adjusted logistic regression models (odds ratio = 0.77, 95% CI: 0.66 ~ 0.90, p = 0.011). Subgroup analysis indicated consistent proportional effects across all subgroups (p > 0.05). RCS analysis revealed a non-linear "J"-shaped relationship between post-lunch napping duration and SP, with the lowest odds ratio corresponding to a duration of 34.37 min.ConclusionOur study suggests that a moderate duration of post-lunch napping, ideally around 34 min, might have the potential to enhance SP, whereas exceeding this duration could could potentially have a limiting effect. This observation implies that incorporating moderate post-lunch napping into health management strategies for older adults might offer some advantages.

Association of air purifier usage during pregnancy with adverse birth outcomes: the Japan Environment and Children’s Study

ObjectivePrevious studies have reported that ambient air pollutants such as PM2.5 can increase the risk of adverse birth outcomes. The objective of this study was to ascertain whether air purifier usage during pregnancy is associated with a lower risk of adverse birth outcomes in a large Japanese birth cohort.MethodsWe conducted a prospective cohort analysis using data from the Japan Environment and Children’s Study. Use of air purifiers during pregnancy was assessed using a self-administered questionnaire. Primary outcomes were the prevalence of preterm birth (PTB), small for gestational age (SGA), and low birth weight (LBW). Logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe prevalence of outcomes was 4.5% for PTB, 7.4% for SGA, and 8.1% for LBW. The crude model analysis revealed that PTB, SGA, and LBW showed lower ORs in the group that used an air purifier, although the association disappeared in the adjusted model except for SGA (OR: 0.94; 95% CI: 0.89, 1.00, p = 0.048) and LBW (OR: 0.93; 95% CI: 0.88, 0.98, p = 0.003). Subgroup analysis stratified by infant sex revealed that the lower OR for LBW was observed only in male infants.ConclusionsOur results suggest that avoiding maternal air pollution exposure during pregnancy may be useful in preventing adverse birth outcomes. These findings provide evidence supporting the development of protective measures against air pollutants in the gestational period by relevant health agencies.

Influence of Type of Dental Visit on the Incidence of COVID-19 and Related Hospitalisation Among Older People in Japan.

In 2020, the coronavirus disease 2019 (COVID-19) pandemic began worldwide. We examined the association between dental visit status and the incidence of COVID-19 and hospitalisation for it among older people based on medical claims data to help reduce COVID-19 severity. The study included 170,232 people who were 75-85 years old in fiscal 2019, with fiscal 2020 and 2021 serving as the follow-up period to ascertain the status of COVID-19. Using medical claims data, we investigated four types of dental visit (no visit, only periodontal treatment, periodontal and other treatment, and only other treatment) during fiscal 2019 and the incidence of COVID-19 and hospitalisation for COVID-19 during the follow-up period. Logistic regression analyses were performed with the incidence of COVID-19 and hospitalisation for COVID-19 as the dependent variables. Of the participants, 3206 (1.9%) developed COVID-19, of whom, 559 (17.4%) were hospitalised. There was not a significant association between the incidence of COVID-19 and type of dental visit. Participants with dental visits for periodontal treatment during the baseline year had a significantly lower odds ratio (OR) for hospitalisation due to COVID-19 compared to those without dental visits (OR: 0.71, 95% confidence interval: 0.58-0.78). The results suggest that dental visits for periodontal treatment including maintenance are important not only for maintaining oral health but also for preventing severe COVID-19.

IL4 and TLR3 gene polymorphism in infectious complications in patients with acute myeloid leukemia

Background. Patients with acute myeloid leukemia (AML) are predisposed to infectious complications (IC). Single nucleotide polymorphisms in genes can affect the function and/or expression of the proteins they encode. Since the functioning of the innate immune system is under genetic control, identifying polymorphic variants that reduce the effectiveness of the immune response is a promising method for identifying patients at high risk of severe infections.Aim. To evaluate the relationship between presence of single nucleotide polymorphisms TLR3 C1234G and IL4 C589T with IC frequency in AML patients.Materials and methods. TLR3 C1234G and IL4 C589T polymorphisms were genotyped in 93 patients with AML, of which 77 (82.80 %) – de novo AML, 16 (17.20 %) – AML with previous myelodysplastic syndrome. Patients received 263 chemotherapy courses. Median age was 58 (Q1–Q3: 38–66) years, 50 (53.76 %) were men, 43 (46.24 %) were women. Sepsis and pneumonia were considered severe IC. Allele-specific polymerase chain reaction with detection of amplification products in a 3 % agarose gel was used to genotype single nucleotide polymorphisms in immune response genes.Results. Severe IC were developed in 57 (21.67 %) chemotherapy courses. It was found that in patients with the TLR3 1234GG genotype, compared with carriers of the TLR31234CC genotype, the frequency of severe IC is 4.8 times lower (odds ratio 0.21; p = 0.022). Severe IC occurred 2.3 times more often in heterozygous carriers of the IL4 C589T polymorphism than in homozygous carriers of the C allele (odds ratio 2.29; p = 0.025). In multivariate analysis, taking into account age, gender and severity of neutropenia, the TLR31234GG and IL4 589CT genotypes variants remained independent predictors of IC.Conclusion. The TLR3 1234CC and IL4589CT genotypes are associated with the risk of severe IC in AML patients.

The impact of occupational sitting time and occupation on cardiometabolic health in Japanese workers.

Prolonged sitting time (ST) has been suggested as a risk factor for CVD. Particularly, occupational ST (OST) is determined by occupation-specific activities and can impact the health status of workers. However, there is limited information on the impact of OST across different occupations among Japanese workers. This study aimed to examine how OST and occupation associate to CVD risks. Using a cross-sectional design, a total of 1874 workers were included in this study. ST was assessed using the Worker's Living Activity-time Questionnaire during working and non-working days. CVD risks were evaluated using a combination of questionnaires and medical checkup records. We conducted multivariable-adjusted logistic regression analyses to assess the associations between occupations (clerical support, professionals, service, and sales) and OST (categorized as long, middle, or short) with CVD risks. All analyses were adjusted for sex, age, smoking status, alcohol consumption, exercise habits, and either OST or occupation, depending on the primary exposure. The results indicated that workers in services and sales had significantly lower odds ratios (ORs) for hypertension (OR = 0.52, 95% CI: 0.40-0.69) and CVD risk (OR = 0.61, 95% CI: 0.47-0.78) compared to clerical support, while professionals showed higher ORs for dyslipidemia (OR = 1.49, 95% CI: 1.16-1.91). When analyzed by OST categories, the short OST group showed reduced risks for obesity (OR = 0.77, 95% CI: 0.59-1.00) compared to the long OST group. This study emphasizes the need to consider both occupation and OST when assessing health risks, highlighting the importance of targeted interventions for specific occupational groups.

The Independent Association Between Changes in Physical Activity Participation Time and Dyslipidemia Risk

Background and AimThis study aimed to examine the independent association between changes in participation time across different types of physical activities and dyslipidemia. Methods and ResultsThe study utilized data from a large-scale cohort survey of Koreans, comprising a total of 2,543 participants recruited during 2011-2012 and 2013-2014. Physical activity participation times by type were assessed using validated questionnaires, and changes in these participation times over two years were categorized into four groups(Consistently Inactive, Formerly Active, Newly Active, and Consistently Active). Dyslipidemia was classified according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Multiple logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) to assess the association between changes in physical activity participation times and dyslipidemia. The analysis revealed that, when adjusting for sex and age, the Consistently Active group had a 40% lower odds ratio (OR=0.60, 95% CI=0.45, 0.81) of dyslipidemia compared to the Consistently Inactive group. Similar results were observed after adjusting for various confounding factors. Also, being newly active(OR=0.75, 95% CI=0.58, 0.97) or consistently active(OR=0.63, 95% CI=0.41, 0.97) in moderate-intensity physical activity, as well as being consistently active(OR=0.76, 95% CI=0.61, 0.95), in walking, independently reduced the risk of dyslipidemia after adjusting for various confounding variables. ConclusionsMaintaining a high level of physical activity was associated with a reduced risk of dyslipidemia. Therefore, national recommendations should focus on sustaining and increasing physical activity levels to manage dyslipidemia effectively.

HoLEP Safety and Efficacy in Octogenarians: A Retrospective ACS-NSQIP Analysis (2011-2020)

ObjectiveTo evaluate the safety of Holmium laser enucleation of the prostate (HoLEP) in octogenarian compared to non-octogenarian patients. MethodsA retrospective cohort analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2020. We assessed baseline demographic data, American Society of Anesthesiologists (ASA) score, functional status, and medical comorbidities. Our primary outcome was the incidence of postoperative complications, the need for re-operation, and re-admission within 30 days following the procedure between octogenarians and non-octogenarians. A multivariate logistic model was utilized to identify predictors for postoperative complications. ResultsA total of 5305 patients were included. Octogenarians had higher rates of hypertension (69.9% vs. 55.5%, p < 0.001), and bleeding disorders (5.1% vs. 2.6%, p < 0.001). The absolute risk for postoperative complications was low in the two groups. However, the octogenarians had higher rates for readmitted (6.1% vs 3.6% p = 0.006) and to receive perioperative blood transfusion (3.3% vs 0.9% p-value <0.001). Multivariable regression analysis showed a significantly lower odds ratio to develop complications in non-octogenarians (OR: 0.698) [95% CI: 0.537, 0.908, (p=0.007)]. ConclusionThere was a significant association between octogenarians and the risk of post-operative complications of HoLEP however the absolute risk remained low. We believe that operative outcomes for octogenarians can be optimized with careful selection given the low incidence of complications.

A Trifecta-Based Evaluation of Patients Treated with Percutaneous Thermal Ablation of Small Renal Masses.

Background: Scoring metrics are important to compare outcomes of different percutaneous treatments for small renal masses (RMs). The concept of trifecta (no complications, kidney function preservation, and absence of local recurrence) has been recently introduced in percutaneous thermal ablation of RM. In this context, previous studies have shown that cryoablation (CA) and microwave ablation (MWA) have similar outcomes. We aimed to validate the trifecta in CA and MWA and factors associated with treatment success. Materials and Methods: A retrospective comparative analysis of two cohorts was carried out on 190 consecutive patients with RMs treated using percutaneous CA or MWA. Nephrometry scores described RM complexity. Postoperative complications were categorized according to the Clavien-Dindo system. Glomerular filtration rate (GFR) at the last follow-up was calculated through the chronic kidney disease-epidemiology collaboration (EPI) formula, whereas detection of contrast enhancement during follow-up defined local recurrence. Last, trifecta was defined by the combination of no major (Clavien >2) complications, estimation of GFR (eGFR) decline <10%, and absence of local recurrence. Descriptive statistics and logistic regression models tested the association between predictors and trifecta achievement. Factors associated with recurrence were compared by the log-rank test. Results: Of 175 patients, 121 (69.1%) and 54 (30.8%) patients underwent CA and MWA, respectively. Median (interquartile range [IQR]) age and RM diameter were 75 years (66-80) and 2.4 cm (1.8-3.0). The CA group had a lower preoperative GFR but also had a lower rate of comorbidities (both p = 0.01). Other demographics and tumor characteristics were comparable between groups. In the CA and MWA groups, major complications occurred after 1.6% and 4.8% of procedures (p = 0.33), whereas an eGFR decline >10% was found in 31.5% and 38.8% of cases (p = 0.40), respectively. Similarly, in the CA and MWA groups, at a median follow-up of 21 (8-39) and 24 (9.5-36) months, local recurrence was observed after 10 (8.3%) and 5 (9.3%) cases (p = 0.78), trifecta was accomplished after 72 (59.5%) and 32 (59.3%; p = 1.00) procedures, respectively. Of note, recurrence-free survival (RFS) was comparable among groups (p = 0.57). Moreover, trifecta achievement was comparable when stratifying for demographics and tumor characteristics in the whole cohort and in the CA group (p > 0.05). Conversely, logistic regression showed a lower odds ratio (OR) of trifecta for lesions close to renal collecting system treated by MWA, even when accounting for maximum diameter and preoperative GFR (OR 0.21, confidence interval 0.60-0.72, p = 0.010). Of note, this factor was also associated with a significantly lower RFS (log-rank p = 0.002). Conclusions: Both percutaneous CA and MWA of RM can safely accomplish good oncological outcomes while preserving renal function. Approximately 6 out of 10 patients achieved trifecta after each procedure. Patient selection should account for tumor proximity to the collecting system, as this factor seems to impact the outcomes of MWA.

The association between Chinese adapted MIND diet and cognitive function in Chinese middle-aged and older adults: results from the Chinese Square Dance Cohort.

This study aimed to assess the relationship between Chinese adapted MIND diet and cognitive functioning and performance in different cognitive domains across a cross-section of Chinese middle-aged and older adults. This cross-sectional study used baseline data from the Lifestyle and Healthy Ageing in Chinese Square Dancers study. Chinese adapted MIND diet scores were calculated from a detailed retrospective semi-quantitative food frequency questionnaire assessment. By averaging the z-scores of Auditory Verbal Learning Test (AVLT), Verbal Fluency Test (VFT), Digital Symbol Substitution Test (DSST), and Trail Making Test-B (TMT-B), a comprehensive z-score is obtained to represent global cognition. Mild cognitive impairment (MCI) was diagnosed based on Petersen's criteria. Multiple linear regression models were used to analyze the relationship between Chinese adapted MIND diet scores and z-scores of cognitive functions, and multiple logistic regression models were used to assess the association between diet scores and MCI. In this study, a total of 4335 participants were included, whose mean age was 63.61 years (SD = 5.15), 85.07% were female, and 13.33% (578/4335) of them had MCI. In the fully adjusted model, the group with the highest diet scores had the best cognitive function compared to the group with the lowest diet scores (P < 0.05), including global cognitive function (β = 0.10, 95% CI: 0.05, 0.15), AVLT (β = 0.12, 95% CI: 0.03, 0.20), VFT (β = 0.12, 95% CI: 0.03, 0.20), DSST (β = 0.07, 95% CI: 0.00, 0.14), and TMT-B (β =-0.10, 95% CI: -0.18, -0.01). In addition, compared to the lowest group, the highest diet scores group were associated with lower odd ratio of MCI (OR = 0.69, 95% CI: 0.51, 0.93). Our findings support that higher adherence to Chinese adapted MIND diet is associated with better cognitive function and lower prevalence odds ratio for MCI in a Chinese middle-aged and older population.

Impact of in-hospital cardiac rehabilitation on hospital-associated disability after transcatheter aortic valve implantation.

Hospital-associated disability (HAD), a decline in the ability to perform activities of daily living (ADL) during hospitalization, is a modifiable target in integrated care for older adults. The aim of this study was to determine the impact of inpatient cardiac rehabilitation (CR) on the development of HAD in older patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Older patients undergoing TAVI were extracted from the Japanese nationwide database (JROAD-DPC) from April 2014 to March 2021 and were divided into patients receiving inpatient CR (CR group) and a non-CR group. HAD was defined as a decrease in the Barthel Index (BI) score ≥5 points at discharge compared with the score at admission. Of 19,789 eligible patients, 17,066 (86%) underwent inpatient CR. The overall prevalence of HAD was 9.6%, with a lower incidence in the CR group than in the non-CR group (8.8% vs. 14.2%, p < 0.001). Random forest analysis revealed key features associated with HAD risk including BI score at admission, inpatient CR participation, age, body mass index (BMI), and chronic kidney disease. The results of multivariate logistic regression analysis showed that participation in inpatient CR was associated with a lower odds ratio (OR) of HAD (OR, 0.62; 95% confidence interval, 0.54-0.70), with similar results in inverse probability of treatment weighting-adjusted logistic regression analyses (OR, 0.82; 95% confidence interval, 0.77-0.88). Analyses in subgroups of interest showed heterogeneity in the effects of inpatient CR with possible loss in patients with a BMI of <18.5 kg/m2 or a BI score of less than 60 points at admission. The data suggest a beneficial effect of inpatient CR participation on the prevention of HAD in older patients undergoing TAVI, but the effect may be limited in lean patients with disability for ADL before TAVI.

Malignancy risk in diabetes; A population study based on electronic health records

Objective: To document the risk of the most common types of malignancies in people with diabetes compared to the people without diabetes. Methods: The data source of this study is the national electronic health records system of Turkey (e-Nabız). We analysed only the data of people over 14 years old in 2019. All the people with ICD-O-3 codes recorded for the first time in 2019 were accepted as new tumour cases. Tumours with /3 behaviour codes were accepted as malignant. Results: We detected 6,775,054 (10.6%) people with diabetes and 57,167,598 people without diabetes in our database. There were 63,696 new malignant cases in the group with diabetes and 123,662 new malignant cases in the group without diabetes. The total number of malignant tumours was 187,358. All types of major tumours seem to have increased risk. Pancreas cancer has the highest OR (odds ratio), 4.02 (3.71-4.36, 95% confidence interval), and larynx cancer has the lowest OR, 1.29 (1.19-1.41). OR for the presence of any malignancy in a person with diabetes is 1.87 (1.85-1.89). Conclusion: All major types of malignant tumours have an increased incidence in people with diabetes. The results confirm the presence of a relationship between diabetes and malignancy.

Abstract 4145873: Optimal Timing for Coronary Artery Bypass Grafting in NSTEMI Patients: A Retrospective Cohort Analysis of In-Hospital Mortality and Stroke Prevalence Over 2017 to 2021

Background: Recent studies have suggested performing coronary artery bypass grafting (CABG) within 24 hours of acute myocardial infarction increases mortality risk. However, the ideal timing after the first day remains unclear. This study aims to suggest an optimal timing of CABG in NSTEMI patients using the large National Inpatient Sample (NIS) database over a 5-year period. Methods: This retrospective cohort study analyzed survey-weighted NIS data over 2017-2021, including adult-age admissions with NSTEMI as the principal diagnosis who underwent CABG without prior transfer from another hospital. Patients were categorized into eight groups based on days from admission to CABG (0, 1, 2, 3, 4, 5, 6, and ≥7 days). Baseline characteristics were compared across groups. Multivariate regression analysis adjusted for multiple confounders to assess the association between Time-to-CABG and in-hospital mortality and stroke prevalence. Results: Table 1 presents the baseline characteristics across the eight groups, encompassing 142,200 included admissions (mean age 65.24 years; 26.78% female). In-Hospital Mortality: The adjusted odds ratios (OR) were less than one for groups 1 through 7 compared to group 0, indicating that immediate CABG (day 0) is associated with higher mortality risk. While the reduced odds in the day 1 group were not statistically significant, substantial and statistically significant reductions in mortality were observed between days 2 and 5 (OR: 0.624 - 0.609; p&lt;0.05). After day 5, the OR for mortality trended up, reaching 0.667 (p&lt;0.05) on day 6 and 0.692 (p&lt;0.05) for surgeries performed on day 7 or later. Stroke Prevalence: The adjusted ORs for stroke prevalence were significantly lower for groups 1 through 7 compared to the CABG within 24-hour group (all p-values &lt;0.05). The lowest ORs were observed between days 2 and 4 (OR: 0.654 and 0.542, p&lt;0.05, respectively). After day 4, the ORs increased, reaching 0.672 (p&lt;0.05) for surgeries performed on day 5 and 0.609 (p&lt;0.05) on day 7 and beyond. Conclusion: The mortality risk in NSTEMI patients remained higher if CABG was performed in the first 48 hours of admission (end of day 1) compared to later. This risk also increased if CABG was done after day 5. Combined with the possible risk of stroke being increased from day 5, we suggest the optimal time-to-CABG is between admission day 2 and day 4 in NSTEMI patients. Future prospective studies are warranted to confirm these findings and guide clinical practice.

Association between total antioxidant capacity and prevalence of depression: NHANES 2007–2018

BackgroundGlobally, depression is a serious public health problem with high incidence and recurrence rate. Although studies analyzed the association between different oxidative stress components and depression, few of them have explored the effect of total antioxidant capacity on depression. We aimed to explore the cross-sectional association of total antioxidant capacity with depression prevalence by sex group, and whether there was an interaction between the total antioxidant capacity and other exposures. MethodsThis study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. A total of 24,375 participants were included. The Composite Dietary Antioxidant Index (CDAI) and the Oxidative Balance Score (OBS) were used to estimate the antioxidant capacity. The association between total antioxidant capacity and depression were analyzed using binary logistic regression. ResultsBoth CDAI and OBS were inversely associated with the prevalence of depression (P < 0.05). There was an interaction between OBS and hypertension (P-interaction = 0.043), and none of the other variables (including sex) had a statistically significant interaction with OBS. Higher levels of OBS were strongly associated with lower odds ratio of depression, especially in the non-hypertensive group. There were three subgroups that had lower odds ratio of depression compared with the OBS 1 combined hypertension subgroup (P < 0.05). ConclusionHigher total antioxidant capacity was significantly associated with lower odds ratio of depression. An interaction existed between OBS and hypertension in the whole sample. The inverse association between OBS and depression was clearer in individuals without hypertension than in individuals with hypertension.

Income Inequality in Dental Visits Among Chinese Children: Analysis of Longitudinal Data.

This study aimed to explore whether income inequality exists in dental visits among children when children/parents were informed they had caries. This study used data from a prior longitudinal study carried out in Liaoning Province, China, involving 772 children under the age of five from local kindergartens. Children were clinically assessed for dental caries at baseline, data on dental visits were collected a year later.Logistic regression model was used to analyze the association betweendental caries and household income at baseline and dental visits at follow-up, a year later. In the logistic regression analysis accounting for age and sex, the results showed that household income and dental caries had significant association with dental visits among Chinese children. Lower household income was negatively associated with dental visits, with those at the lowest income level having lower odds ratio (OR) of 0.27 (95% confidence interval (CI):0.16, 0.47), and the second lowest income level, with OR of 0.39 (95% CI: 0.22, 0.71) compared to highest-income group. There was a statistically significant association between dental caries at baseline and dental visits in the following year (OR: 1.08, 95% CI: 1.02, 1.15). There were income inequalities in dental visits among children in China, even when they were diagnosed with dental caries. Socioeconomic inequality appears to be a major barrier to dental visits among Chinese children with dental needs.

Association of aerobic and muscle-strengthening physical activity with chronic kidney disease in participants with hypertension

BackgroundIn Korea, chronic kidney disease (CKD) is increasingly prevalent among adults with hypertension, of which approximately 30% of the population is affected. Despite the recognized benefits of adherence to physical activity (PA) recommendations, including aerobic and muscle-strengthening activities (MSA), the impact of such adherence on the prevalence of CKD in individuals with hypertension has not been extensively studied. This study aimed to investigate the association between aerobic PA and MSA levels, and the prevalence of CKD in individuals with hypertension.MethodsThis study included 5,078 individuals with hypertension using data from the Korean National Health and Nutrition Examination Survey (2019–2021). PA levels were measured as min/week of moderate-to-vigorous PA (MVPA) based on self-reports, and MSA was quantified as the number of days per week. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Logistic regression analysis evaluated the association between meeting PA guidelines and CKD after adjusting for potential confounders. Additionally, a joint analysis was conducted to assess the combined effects of MVPA and MSA on CKD.ResultsAfter adjusting for all covariates, higher MVPA was associated with a lower prevalence of CKD. Compared to the group with inactive, the group with MVPA 1–149 min/week had an odds ratio (OR) of 0.80 (95% confidence interval [CI], 0.61–1.05), the group that met the MVPA 150–299 min/week criteria had an OR of 0.85 (95% CI, 0.62–1.17), and the group that met the MVPA ≥ 300 min/week criteria had an OR of 0.53 (95% CI, 0.37–0.76). MSA alone did not show a significant association with CKD. In the joint analysis, the group that met the MVPA and MSA guidelines had the lowest OR of 0.54 (95% CI, 0.34–0.86), compared to the group that did not meet either.ConclusionsMVPA was associated with the prevalence of CKD in participants with hypertension but not in those with MSA alone. However, compared with the group that did not meet both guidelines, the group that met both guidelines showed the lowest prevalence of CKD.

Effect of DASH vs. Mediterranean diet on metabolic syndrome and cardiometabolic profile in adults with high normal blood pressure or grade 1 hypertension: the DASH-MedDiet randomized controlled trial

Abstract Background Lifestyle interventions are recommended as the first-line treatment to control metabolic syndrome components and improve cardiometabolic profile. However, studies directly comparing the effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) on metabolic syndrome prevalence and cardiometabolic risk factors are currently lacking. Purpose We aimed to assess the effects of a 3-month intensive dietary intervention implementing salt restriction either alone or on top of the DASH and MedDiet compared to no/ minimal intervention on metabolic syndrome prevalence and cardiometabolic profile in never drug-treated adults with high normal blood pressure (BP) or grade 1 hypertension. Methods We randomly assigned individuals to the control group (CG, n = 60), salt restriction group (SRG, n = 60), DASH diet with salt restriction group (DDG, n = 60), or MedDiet with salt restriction group (MDG, n = 60). All patients were followed monthly for 3 months in individual sessions coordinated by the clinical dietician. For the patients of all four study groups, the goal was to maintain the initial body weight unchanged. Patients in the CG received general advice on dietary principles for BP control. For the patients in all three intervention groups, the goal was to limit sodium intake to 2,000 mg/ day (equivalent to 5,0g salt/ day). In addition, patients in the DDG and the MDG received an individualized dietary plan with six daily sample menus to facilitate the adoption of the assigned dietary pattern. Anthropometric indices, dietary intake, office BP, and fasting blood samples were evaluated pre- and post-intervention. Results According to the intention-to-treat analysis, at 3 months post-intervention, the DDG and the MDG had lower odds ratio (OR) (95% CI) of metabolic syndrome [0.29 (0.12, 0.72), and 0.15 (0.06, 0.41), respectively] compared to the CG. Moreover, the MDG had lower odds of elevated BP levels compared to both the DDG and the SRG [0.08 (0.03, 0.19), and 0.13 (0.05, 0.34), respectively], and lower odds of metabolic syndrome compared to the SRG [0.25 (0.09, 0.67)]. In addition, the DDG and the MDG had lower odds of elevated fasting glucose compared to both the CG and the SRG, whereas the study groups did not differ regarding the odds of elevated waist circumference, elevated triglycerides, and reduced HDL- cholesterol. Regarding cardiometabolic indices, total and LDL-cholesterol, fasting glucose, HbA1c, and systolic/ diastolic BP were reduced in all three intervention groups compared to the CG. Conclusions On a background of salt restriction, the MedDiet was superior in BP reduction, but the DASH and MedDiet reduced the prevalence of metabolic syndrome to the same extent.