Sarcopenia as a causal mediator in aging, obesity and central obesity related outcomes: A comprehensive analysis of NHANES, CHARLS and ELSA.

Global Patterns of Myopia, Age, Sex, and Vision Loss: A Comparative Analysis of US and South Korean National Surveys.

Lymphocyte-based inflammatory biomarkers during the postpartum period and postpartum depression symptoms in U.S. women.

This study assessednational trends in weight loss attempts, clinically meaningful weight loss, and associated strategies among US adolescents with overweight or obesity. We analyzed National Health and Nutrition Examination Survey (NHANES) 1999-2023 data for 2708 adolescents aged 16-19 years with overweight or obesity. Weight loss attempts and strategies were self-reported. Clinically meaningful weight loss was defined as ≥ 5% and ≥ 10% body weight reductions or a ≥ 0.2 reduction in body mass index (BMI) z-score over the prior year. Survey-weighted logistic regression assessed temporal trends and associations between strategies and weight loss success. The prevalence of weight loss attempts increased from 53.9% in 1999-2000 to 65.7% in 2021-2023 (p for trend < 0.001). Overall, 26.96% achieved a ≥ 5% weight loss and 12.58% achieved a ≥ 10% weight loss; 34.34% achieved a ≥ 0.2 BMI z-score reduction. Exercise and dietary changes were the most reported strategies. Reducing sugar intake (OR, 2.16) and prescription medication use (OR, 2.55) were associated with achieving a ≥ 5% weight loss, and prescription medication use (OR, 3.59) was also associated with achieving a ≥ 10% weight loss. Sugar intake reduction (OR, 1.89) and prescription medication use (OR, 2.73) were associated with achieving a ≥ 0.2 reduction in BMI z-score. Weight loss attempts increased over time, but clinically meaningful weight loss remained uncommon. Improved access to evidence-based, developmentally appropriate interventions is needed.

Phenotypic age acceleration and all-cause and cardiovascular mortality among U.S. adults at risk for heart failure.

Differential Effects of Cardiometabolic Risk Factors on All-Cause Mortality in United States Adults With Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).

Association between C-reactive protein and depression among alcohol users in the United States: A population-based analysis of National Health and Nutrition Examination Survey (NHANES) 2015-2020.

Comorbidity patterns of respiratory symptoms and diseases and their impact on all-cause and respiratory mortality: Prospective cohort study.

Associations of probiotics, prebiotics, synbiotics, and yogurt supplements with oxidative balance scores and all-cause and cardiovascular mortalities in neuropsychiatric disorders.

Association of Body Roundness Index with all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3: a cohort study.

Systemic inflammation increases the risk of cardiovascular events and is often present in patients with atherosclerotic cardiovascular disease (ASCVD), particularly in those who also have chronic kidney disease (CKD). However, the prevalence of systemic inflammation in patients with ASCVD and CKD is not well characterized. Here, we estimate the prevalence of ASCVD with CKD and systemic inflammation in the US population and describe the characteristics of people with ASCVD, CKD stages 3-4, and systemic inflammation, who are at high risk for cardiorenal events. Cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2015-2020 continuous cycles. Adults aged≥20years with ASCVD who had high-sensitivity C-reactive protein (hsCRP) measurements. Prevalence and characteristics of adults with systemic inflammation in groups with ASCVD, with ASCVD and CKD, and with ASCVD and CKD stages 3-4. Systemic inflammation was defined as hsCRP levels≥2mg/L. Our study sample included 238,164,067 adults. In total, 8.5% had ASCVD, of whom 55.5% had systemic inflammation. The prevalence of systemic inflammation in individuals with ASCVD and CKD stages 3-4 (1.6% of the US population) was 59.1%, equating to 0.9% or>2 million individuals in the general US adult population. In summary, over half of US adults with ASCVD and CKD stages 3-4 were estimated to have systemic inflammation. This group could benefit from weight loss strategies, lifestyle changes, and other approaches to improve cardiovascular outcomes.

Hypertension is associated with an increased fracture risk. However, evidence on its association with bone mineral density (BMD) is conflicting, and data on bone microarchitectural quality are scarce. The in vivo effects of anti-hypertensive medications on bone quality are poorly explored. The primary aim of this study was to evaluate whether bone microarchitecture, non-invasively assessed by trabecular bone score (TBS), is altered in hypertensive patients. The association between anti-hypertensive medications and TBS was also evaluated as a secondary endpoint. We extracted individual data of 7053 subjects included in the 2005-2008 cycles of the National Health and Nutrition Examination Survey (NHANES), in which lumbar spine dual-energy X-ray absorptiometry (DXA) scans were acquired. TBS values were calculated from DXA images using dedicated software. The association between hypertension, anti-hypertensive medications, and bone outcomes was assessed by regression analyses, adjusted for relevant confounders. Hypertension was independently associated with lower TBS values (β = -0.010; 95%CI, [-0.016, -0.003]; p = 0.008); on the contrary, no association was observed between hypertension and BMD at any site (lumbar spine: p = 0.362; total hip: p = 0.481; femoral neck: p = 0.298). No class of anti-hypertensive medications was significantly associated with TBS. Thiazide diuretics and angiotensin receptor blockers were associated with higher BMD values, whereas loop diuretics and non-dihydropyridine calcium channel blockers were associated with lower BMD values. Hypertension is associated with degraded bone microarchitecture, while no association is observed with bone mass. No significant relationships between anti-hypertensive medications and TBS were found. Associations between anti-hypertensive medications and BMD were consistent with previous reports.

The primary objective of this study was to examine the association between the skeletal muscle mass-to-visceral fat area ratio (SVR) and cardiovascular disease (CVD) prevalence. This study employed data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) to derive the SVR using dual-energy X-ray absorptiometry (DXA) measurements. CVD status was ascertained using self-reported physician-diagnosed medical history. Subsequent multivariable logistic regression analyses were performed to examine the relationship between SVR and CVD prevalence. Restricted cubic spline regression was utilized to examine underlying non-linear associations between the SVR and CVD risk. Stratified subgroup analyses were ultimately performed to assess the robustness of the findings. Sensitivity analyses were conducted with additional adjustment for total body fat percentage, and sex-stratified restricted cubic spline analyses were also conducted to explore potential differences in nonlinear associations between men and women. This study included 9383 participants, among whom 348 were diagnosed with CVD. Multivariable logistic regression models demonstrated a statistically significant inverse relationship between SVR and CVD prevalence (OR = 0.093; 95% CI: 0.016-0.542; p = 0.011). The association persisted after adjustment for total body fat percentage. RCS analysis revealed a non-linear association between the SVR and CVD risk. Moreover, subgroup analyses confirmed that the protective effect of SVR remained consistent across various baseline characteristics. The findings indicate that lower SVR correlates with an elevated risk of CVD, and this association has been robustly demonstrated across multiple studies.

Smoking is associated with both systemic inflammation and depression, but few studies have examined inflammatory biomarkers as mediators of this relationship. Using 2021-2023 National Health and Nutrition Examination Survey (NHANES) data, we investigated whether White Blood Cell (WBC) count, Platelet Count (PLT), High-Sensitivity C-Reactive Protein (hs-CRP), Mean Platelet Volume (MPV), and Red Cell Distribution Width (RDW) mediate associations between smoking status and depressive symptoms. Data from 6029 adults (14.3% current smokers, 25.5% former smokers, 60.2% never smokers) were analyzed with survey-weighted structural equation models and multiple imputation, adjusting for age, sex, and race/ethnicity. Current smokers had higher depressive symptoms (M= 5.81, SD= 5.79) than former smokers (M= 4.08, SD= 4.71) and never smokers (M = 3.91, SD= 4.70). WBC, PLT, hs-CRP, and RDW were elevated in smokers and significantly predicted higher PHQ-9 scores. Mediation analyses showed that WBC explained 10.9% of the smoking-depression association in current smokers (β= 0.01, SE= 0.004, p< .001) and 7.6% in former smokers (β= 0.005, SE= 0.002, p= .008). PLT mediated 3.7% (current smokers: β= 0.005, SE= 0.002, p= .006) and 4.1% (former smokers: β= 0.003, SE= 0.001, p= .003). hs-CRP mediated 3.7% (current smokers: β= 0.005, SE= 0.002, p= .03) and 5.0% (former smokers β= 0.003, SE= 0.002, p= .05). RDW mediated 3.0% of the effect for current smokers (β= 0.004, SE= 0.002, p= .02). MPV showed no mediation. These findings indicate that systemic inflammation partly explains the link between smoking and depression, highlighting biological pathways that may inform integrated cessation and mental health strategies.

Herpes simplex virus type 2 (HSV-2) infection is a lifelong sexually transmitted infection with substantial disease and economic burdens. Despite its global impact, key features of its transmission dynamics-including sex-specific biological susceptibility (the inherent likelihood of acquiring infection upon exposure, independent of behavioral factors) and sexual mixing patterns (how individuals form sexual partnerships across age and risk groups)-remain poorly quantified. A population-level mathematical model of HSV-2 transmission dynamics was applied to heterosexual transmission in the USA and calibrated to nationally representative data from the National Health and Nutrition Examination Surveys (NHANES) conducted between 1988 and 2016. Bayesian inference was used to estimate: (1) relative biological susceptibility of women compared to men, (2) degree of assortativity in age group mixing, and (3) degree of assortativity in sexual risk behavior group mixing. Assortativity reflects the tendency of individuals to form partnerships with others who share similar characteristics, such as age or level of sexual risk behavior, and was quantified on a scale from 0 (no preferential mixing) to 1 (exclusive within-group mixing). The model demonstrated robust fits to sex-specific, age-specific, and temporal trends in HSV-2 prevalence across NHANES rounds, supporting the validity of the inferred transmission dynamics. Women were estimated to be 7.12 times (95% credible interval (Crl) 4.36-10.17) more biologically susceptible to HSV-2 infection than men, indicating a substantially higher likelihood of acquiring infection upon exposure. The degree of assortativity in age group mixing was high at 0.83 (95% Crl 0.75-0.88), indicating that most transmission occurs between individuals of similar age. In contrast, assortativity in sexual risk behavior group mixing was moderate at 0.49 (95% Crl 0.43-0.55), indicating that transmission frequently occurs across different risk groups rather than being confined within the same group. Women are much more biologically susceptible to HSV-2 infection than men. HSV-2 transmission mostly occurs within similar age groups but often crosses different sexual risk groups, reflecting strong age-assortative and moderate risk-assortative mixing patterns.

Evidence concerning total dietary selenium intake in the US pediatric population remains sparse and inconsistent. This study employs a nationally representative dataset to investigate the association between selenium intake and asthma prevalence, addressing this critical knowledge gap. The National Health and Nutrition Examination Survey (NHANES) (2011-2020) furnished data on asthmatic individuals aged < 20 years with quantified dietary selenium intake. Utilizing rigorous statistical methodologies - multivariable logistic regression, restricted cubic spline (RCS) modeling, and subgroup analyses - the authors evaluated the selenium-asthma association. In this study encompassing 7780 pediatric participants, multivariable logistic regression with comprehensive covariate adjustment revealed progressively higher asthma risk with increasing selenium exposure. Compared to the lowest intake tertile (Q1: ≤ 73.3 mg/day), adjusted ORs were 1.15 (95% CI: 0.98-1.35; p = 0.082) for Q2 (73.4-112.6 mg/day) and 1.24 (95% CI: 1.00-1.54; p = 0.048) for Q3 (≥ 112.7 mg/day). Subsequent restricted cubic spline modeling quantitatively established a significant dose-response relationship (p = 0.042) between dietary selenium levels and asthma risk. Dietary selenium intake demonstrated a significant dose-dependent association with asthma prevalence among US pediatric populations.

Visual Impairment as a Marker of Systemic Vulnerability and Cause-Specific Mortality in U.S. Adults.

Association of the neutrophil percentage-to-albumin ratio with sarcopenia in U.S. adults: Evidence from NHANES 2011-2018 and machine learning-based analyses.

Obesity has become a significant global public health issue that seriously threatens the health of more than one billion individuals worldwide. The weight-adjusted waist index (WWI) is a novel adiposity indicator calculated as waist circumference (cm) divided by the square root of body weight (kg). However, the association between WWI and thyroid function has not been reported to date. This study aims to investigate the relationship between WWI and thyroid function among U.S. adults. A total of 7,642 participants were enrolled in this study based on the National Health and Nutrition Examination Survey (NHANES) dataset from 2007 to 2012. Weighted statistical analyses were performed and three regression models were constructed sequentially, namely Model 1 (unadjusted), Model 2 (adjusted for age, sex, race, and survey cycle), and Model 3 (further adjusted for educational level, marital status, smoking status, alcohol consumption, diabetes mellitus, urinary iodine concentration, and poverty income ratio [PIR]). Stratified analyses and interaction effect tests were also conducted. Additionally, a retrospective validation cohort comprising 60 health check-up patients was extracted from Zhongshan Hospital Affiliated to Xiamen University between December 2024 and December 2025 to evaluate the association between WWI and free triiodothyronine (FT3) across WWI quartiles. The thyroid function indicators assessed included free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg). A total of 7,642 participants were included in this study. A positive correlation between WWI and FT3 levels was observed in Models 2 and 3, and this positive association persisted in both models after stratifying WWI into quartiles. The only exception was the WWI Q2 stratum in Model 3 where the 95% confidence interval (CI) for the association between WWI and FT3 included zero, indicating no statistical significance. Further stratified analyses revealed that the positive WWI-FT3 association was primarily evident in males, individuals under 50 years of age, and those of other Hispanic ethnicity. The positive WWI-FT3 correlation identified in NHANES was successfully replicated in our institutional validation cohort. A positive association between WWI and FT3 is suggested; however, further investigations are warranted to confirm this observation.

Despite growing recognition of stress-related health inequities, the role of nativity and acculturation in shaping the relationship between chronic stress and cancer outcomes among Hispanic populations remains poorly understood. The purpose of this study was to examine whether nativity factors (United States (US) citizenship status and length of time residing in the US modify the association between allostatic load (AL), a measure of chronic physiologic stress, and cancer mortality among Hispanic adults. We performed a prospective cohort analysis using data from the National Health and Nutrition Examination Survey (NHANES) 1999 - 2010, linked to National Death Index with follow-up through December 31, 2019. Survey-weighted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for cancer mortality, including interaction and age-stratified analyses by US citizenship status, length of time in the US, and country of birth. Fully adjusted models included age, sex, education, year interviewed, smoking status, history of heart attack, and congestive heart failure. Among 7,299 Hispanic adults, 2,835 (33.4% weighted) had high AL. Among Hispanic adults aged ≥ 60years, individuals with US citizenship and low AL (HR = 3.13; 95% CI = 1.37-7.12), as well as those with US citizenship and high AL (HR = 3.32; 95% CI = 1.18-9.35), experienced more than a three-fold increased risk of cancer mortality compared with non-US citizens with low AL. When examining AL by length of time residing in the US among Hispanic adults aged ≥ 60years, those with low AL and more than 10years in the US (HR = 6.32; 95% CI = 1.33-29.90) and those with high AL and more than 10years in the US (HR = 6.34; 95% CI = 1.17-34.43) had approximately a six-fold increased risk of cancer mortality compared with adults with low AL and less than 10years in the US. Cancer mortality risk among Hispanic adults appears to be driven primarily by older age and nativity-related factors rather than AL risk. These findings highlight the need for future research to more fully examine how structural, social, and immigration-related contexts intersect with aging to influence cancer outcomes among Hispanic populations.