Modification Effects Of Age Research Articles

Associations of Sedentary Behavior with Risks of Cardiovascular Disease Events among Chinese Adults.

Evidence regarding the modification effects of age, sex, ethnicity, socioeconomic status, or weight status on the associations of sedentary behavior (SB) with cardiovascular diseases (CVDs) is limited. Moreover, the mechanisms for the associations also remain unclear. We aimed to investigate the possible influence of these factors on the associations of SB with CVD events and whether the associations are mediated by metabolic phenotypes. This study included 42,619 participants aged 20-74 years, recruited from the Shanghai Suburban Adult Cohort and Biobank study. SB was assessed at baseline and integrated with health information systems to predict future CVD events. Cox proportional hazards models, interaction analyses, restricted cubic splines and causal mediation analyses were used for assessments. Compared to those with ＜3 h/d sedentary time, participants having SB ≥ 5 h/d had significantly higher risks of CVD (HR[95%CI]: 1.27[1.12-1.44]), coronary heart disease (CHD, 1.35[1.14-1.60]), and ischemic stroke (IS, 1.30[1.06-1.60]). The association of CHD was more pronounced in the retired individuals than their counterparts (1.45[1.20-1.76] versus 1.06[0.74-1.52], pinteraction=0.046). When SB was expressed as a continuous variable, a 1 h/d increment in SB was positively associated with risks of CVD (1.03[1.01-1.05]), CHD (1.04[1.01-1.07]), and IS (1.05[1.01-1.08]). High-density lipoprotein cholesterol (HDL-C, proportion mediated: 12.54%, 12.23%, and 11.36%, all p＜0.001), followed by triglyceride (TG, 5.28%, 4.77%, and 4.86%, all p＜0.01) and serum uric acid (SUA, 3.64%, 4.24%, and 2.29%, all p＜0.05) were major mediators through metabolic phenotypes. Higher SB was associated with elevated risks of CVD events. The detrimental effect of SB on CHD risk was more pronounced among retired individuals. Moreover, HDL-C, TG and SUA partially mediated the relationships between SB and CVD events. Our findings may have implications for preventing and controlling CVD associated with SB.

Association between blood metals mixture and chronic kidney disease in adults: NHANES 2013-2016

BackgroundThe association between single metal exposure and chronic kidney disease (CKD) has been established. However, there is limited research on the effects of multi-metal mixtures and their potential age-specific associations with kidney injury. This study aimed to examine the relationship between metal mixtures and kidney function in adults, while also exploring the modifying effects of age. MethodsWe included a subset (n = 4250) of a nationally representative adult population in the National Health and Nutrition Examination Survey (NHANES) 2013–2016. Kidney function was assessed using the glomerular filtration rate (eGFR) and creatinine albumin ratio (ACR). The individual and combined effects of lead (Pb), cadmium (Cd), mercury, and manganese on kidney injury and the risk of CKD were evaluated. ResultsPb and Cd were found to be positively associated with decreased kidney function. For a one Ln-unit increase in lead and cadmium, the adjusted ORs of CKD were 1.60 (95% CI: 1.35, 1.90) and 1.41 (95% CI:1.12, 1.77), respectively. We also observed an interaction between lead and cadmium for ACR. We also observed the joint effect between Pb and Cd on eGFR, ACR and CKD. Stratified analysis found a higher risk of decreased kidney function among older individuals. The quantile-g calculation model further showed that metal mixture was associated with decreased kidney function and the risk of CKD (OR = 1.53, 95% CI: 1.22, 1.90). And lead and cadmium were the main contributors. And Pb and Cd were the major components that increased the risk of CKD. ConclusionCo-exposure to metal mixture were associated with reduced kidney function in adults, especially in older. Our findings support co-exposure to lead and cadmium as risk factors of CKD in adults.

Risk of major adverse limb events in patients with type 2 diabetes mellitus receiving sodium glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists: A population-based retrospective cohort study.

Background: Both sodium glucose cotransporter 2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have cardiovascular protective effects in patients with type 2 diabetes mellitus. However, the comparative risk of GLP-1RA versus SGLT-2i for major adverse limb events remains unknown. Materials and methods: We studied a nationwide cohort involving 123,048 diabetes patients 20–100 years of age who initiated a SGLT-2i or GLP-1RA during 2012 and 2017. The patients in the two groups were matched by propensity score (PS), and incidence rates for hospitalization for major adverse limb events, critical limb ischemia (CLI) and lower extremity amputation (LEA), were assessed. Cox proportional hazards regression was applied to estimate hazard ratios (HRs) between patients receiving SGLT-2i as compared with GLP-1RA. The modification effects of age, a history of established cardiovascular disease, and chronic kidney disease were examined. In addition, use of dipeptidyl peptidase-4 inhibitor (DPP-4i) was chosen as a second active comparator. Results: After PS-matching, a total of 13,378 SGLT-2i and 13,378 GLP-1RA initiators were identified. Use of SGLT-2i was not associated with an increased risk for hospitalization for CLI and LEA, either compared with GLP-1RA (HR, 1.13; 95% CI, 0.77–1.65 and 1.27; 95% CI, 0.63–2.55, respectively) or compared with DPP-4i use (HR, 1.06; 95% CI, 0.75–1.50 and HR, 0.80; 95% CI, 0.42–1.53, respectively). Although the study was underpowered to explore potential effect modification, a trend of higher risks for LEA was noted among SGLT-2i users with cardiovascular disease as compared with either GLP-1RA or DPP-4i. Conclusion: Use of SGLT-2i was not associated with higher risks for hospitalization for CLI and LEA as compared with reference drugs. Further large-scale studies are needed for a precise risk estimation.

Association of caffeine and caffeine metabolites with obesity among children and adolescents: National Health and Nutrition Examination Survey (NHANES) 2009-2014.

The effect of caffeine exposure on children's health remains poorly understood. We aimed to characterize the associations of caffeine and caffeine metabolites with adiposity outcomes among children and adolescents. We performed cross-sectional analyses of 1,447 children and adolescents aged 6-19years from the 2009-2014 National Health and Nutrition Examination Survey. The linear regression and weighted quantile sum (WQS) regression were used to explore the associations of urinary caffeine and 14 caffeine metabolites with adiposity outcomes, including body mass index (BMI) z-score, waist circumference (WC), obesity, and overweight. In linear regression models, compared with the participants who consumed low caffeine, higher BMI z-score, WC, and risks of obesity and overweight were more likely among those who consumed high caffeine (P < 0.05). In WQS regression models, an interquartile range increase in the weighted caffeine index was significantly associated with increased BMI z-score (β = 0.10, 95% CI = 0.01, 0.17) and WC (β = 1.20, 95% CI = 0.31, 2.09), and risks of obesity (OR = 1.09, 95% CI = 1.02, 1.17). Totally, no modification effect of age or gender was observed in the linear regression model. Nonetheless, in WQS models, the positive associations of caffeine exposure with WC and risks of obesity and overweight were significant in children aged 6-11years rather than 12-19years. When stratified by gender, caffeine exposure was significantly associated with BMI z-score and WC in both boys and girls. These results add novel evidence that caffeine exposure might be associated with adverse adiposity outcomes among children and adolescents.

0713 Association Between Obesity Indices And Obstructive Sleep Apnea Is Modified By Age In A Sex-specific Manner

Abstract Introduction The beneficial effects of weight loss on obstructive sleep apnea (OSA) are highly variable. Whether the variability is associated with the effects of age and sex remains unclear. This study examined this issue with large cross-sectional data. Methods A total of 4600 adult males and 1156 females with suspected OSA were included in the study. Anthropometric measurements, polysomnographic variables, biochemical indicators, and medical history were collected for each subject. Multivariable linear regression with interaction terms was used to estimate the modification effect of age on the associations between OSA severity (assessed by apnea-hypopnea index, AHI) with obesity indices (body mass index, BMI; neck circumference, NC; waist circumference, WC) in a sex-specific manner, and vice versa. Results BMI, NC, and WC were all positively correlated with AHI after adjusting for potential confounders in all populations. In males, these associations were much stronger and more significant in younger than older individuals (P for interaction &amp;lt; 0.001). For example, a 10% increase in BMI was independently associated with a 31.6% increase in AHI for males &amp;lt; 40 years old, whereas the corresponding increases were 20.8% and 16.7% for males 40-60 and &amp;gt;60 years old, respectively. By contrast, no modification effect of age was observed in females (P for interaction &amp;gt; 0.05). A 10% increase in BMI was associated with 25.6%, 26.8%, and 23.8% increases in AHI for females &amp;lt; 40, 40-60, and &amp;gt;60 years old, respectively. Conclusion Age modifies the associations between obesity indices and OSA severity in a sex-specific manner, and vice versa. These findings may broaden the understanding of age- and sex-related heterogeneities in the pathogenic role of obesity in OSA, and may be beneficial for individualized risk evaluation and treatment management for patients with OSA. Support This study was funded by Shanghai Municipal Commission of Science and Technology (grant number.18DZ2260200); the National Key R&amp;D Program of China (grant number: 2017YFC0112500); Multi-Center Clinical Research Project from the School of Medicine, Shanghai Jiao Tong University (grant number: DLY201502); and the Shanghai Shen-Kang Hospital Management Center Project (grant number: SHDC12015101 and 16CR3103B).

Effect of apparent temperature on daily emergency admissions for mental and behavioral disorders in Yancheng, China: a time-series study

BackgroundVery few studies have focused on the relationship between ambient apparent temperature (AT) and admission of mental and behaviour disorders (MDs). Therefore, a time-series study was conducted in Yancheng, China, to explore the effects of AT on the daily emergency admissions of patients with MDs over the period of 2014–17.MethodsA quasi-Poisson generalized linear model (GLM) combined with a distributed lag non-linear model (DLNM) was adopted to explore the associations after adjusting for time trend, day of the week, humidity, sunshine duration, rainfall, holidays and air pollutants. In the subgroup analysis, the modification effects of age and sex were also examined.ResultsOverall, 8438 cases of MDs emergency admissions were identified. With the apparent temperature with the minimum number of admissions (− 3.4 °C) serving as a reference, a positive correlation emerged between high AT and daily emergency admissions of patients with MDs in Yancheng, China, with the lagged effect of 1 to 5 days. The subgroup analysis demonstrated a positive relationship between AT and MDs emergency admissions among males and individuals younger than 45 years old, with no lagged effect.ConclusionsThe results will provide important scientific evidence for mental health policy-makers and practitioners for possible intervention, especially among the vulnerable populations.

Acute effects of ambient particulate matter pollution on hospital admissions for mental and behavioral disorders: A time-series study in Shijiazhuang, China

Until now, few epidemiological studies have focused on the association between ambient particulate matter pollution and mental and behavioral disorders, especially in developing countries. Thus, a time-series study on the short-term association between both fine and inhalable particles (PM2.5 and PM10) and daily hospital admissions for mental and behavioral disorders in Shijiazhuang, China was conducted, from 2014 to 2016. An over-dispersed, generalized additive model was used to analyze the associations after controlling for time trend, weather conditions, day of the week, and holidays. In addition, the modification effects of age, sex, and season were estimated. A total of 9156 cases of hospital admissions for mental and behavioral disorders were identified. A 10 μg/m3 increase in a 3-day average concentration (lag02) of PM2.5 and PM10 correspond to an increase of 0.48% (95% confidence interval (CI): 0.18–0.79%) and 0.32% (95% CI: 0.03–0.62%) in daily hospital admission for mental and behavioral disorders, respectively. We found stronger associations of PM2.5 and PM10 with mental and behavioral disorders in male and elder individuals (≥45 years) than in female and younger individuals (<45 years). Further, results indicated a generally stronger association of PM2.5 with mental and behavioral disorders in the cool season than in the warm season. This research found a significant association between ambient PM2.5 and PM10 and hospital admission for mental and behavioral disorders in Shijiazhuang, China.

Serum uric acid and prehypertension among Chinese adults

Raised blood pressure is emerging as an independent risk factor for cardiovascular diseases and diabetes. We examined the relation between serum uric acid and prehypertension and the modification effects of age, obesity, fasting glucose, and lipids in Chinese adults. The study samples are from a community-based health examination survey in China. A total of 14 451 patients with normal range of blood pressure were included. The odds ratios [ORs, 95% confidence interval (CI)] of prehypertension across increasing quintiles of serum uric acid were 1.00, 1.04 (0.92-1.18), 1.21 (1.06-1.38), 1.26 (1.09-1.45), and 1.36 (1.17-1.58) (P for trend < 0.0001), adjusting for age, sex, body mass index, glucose, and lipids. The regression splines suggested a possible threshold effect for serum uric acid of approximately 200 micromol/l on prehypertension risk. The associations were significant in both men and women, but was not significant in older individuals aged above 60 years. In addition, fasting glucose significantly interacted with uric acid (P for interaction < 0.0001). The associations were more evident in patients with low (P = 0.0005) and median glucose levels (P = 0.002) than in those with high glucose levels. Serum uric acid was associated with prehypertension, independent of metabolic risk factors. The associations were not significant in old individuals. Fasting glucose may modify the associations.

DEPRESSIVE SYMPTOMS IN WOMEN LIVING NEAR A 735 KV LINE

Objectives 735 kV powerlines increase residential exposure to electric and magnetic fields (EMF) for people living nearby. Some studies have suspected effect of EMF on depressive symptoms and there is plausibility for such an effect via the melatonin pathway. Recently, we found that aged and overweight women living near high power lines had lower sulfatoxymelatonin excretion (Levallois et al 2001). The objective of this study was to compare symptoms of depression in women living near and far away from a high transmission line. Methods In the Quebec city area, 221 women living within 200 meters of a 735 kV line and 195 women living at least 400 meters from any power lines were recruited. Participants, aged between 20 and 74, were required to wear an EMDEX Lite meter for at least 36 hours to measure personal exposure to extremely low frequency magnetic field. Residential exposure to extremely low frequency electric field was assessed by spot measurements. Depressive symptoms in the last week were evaluated with the Center for Epidemiologic Depression scale (CESD) and, for a subsample of participants, with the Diagnostic Intervention Schedule (DIS). Information on risk factors for depression and lifestyle was gathered by questionnaire. Results Mean magnetic field exposure over 24 hours was three times higher for women living near a power line than women living farther away (p < 0.001) and residential electric field intensity was nearly twice in those living near the line (p < 0.001). Proportion of participants with high CESD score (>16) was similar in the two groups (p = 0.63) and the adjusted Odds Ratio for the presence of depressive symptoms in the exposed group was 1.01 (95%Cl: 0.61–1.66). Results were similar when considering higher CESD cut-off scores (19 and 25). In addition, there was no dose response relationship with either electric or magnetic field measurements. There was no modification effect of age or BMI. The DIS results will available at the conference. Acknowledgements Hydro-Québec and Electricité de France supported the melatonin study from which these results are derived.