National Health Examination Survey Research Articles

Association of plasma homocysteine with cardiovascular disease in American adults: a study based on the national health and nutrition examination survey database

ObjectiveThe purpose of this study was to investigate the correlation between plasma homocysteine (Hcy) levels and cardiovascular disease (CVD) in United States adults based on the National Health and Examination Survey (NHANES) database of the United States.MethodsData from two survey periods (2003–2006) in the NHANES database were used as the research data set. Plasma Hcy levels are considered an independent variable, while CVD is a dependent variable. Weighted logistic regression, linear trend analysis, subgroup analysis and limiting cubic spline plots were used for analysis. A total of 4,418 samples were included.ResultsIn the weighted logistic regression model, a significant positive correlation between Hcy level and CVD risk was observed (P for trend = 0.007).The subgroup analysis revealed that various characteristics such as age, race, education level, obesity, alcohol use, diabetes, and hypertension did not affect this positive correlation (P for interaction ≥0.05). The nonlinear association between Hcy level and CVD risk was explored by limiting cubic spline plots, revealing the overall significant trend (P for overall <0.0001) and the significant nonlinear trend (P for nonlinear <0.01).ConclusionIn this large cross-sectional study, an increase in Hcy levels leads to an increased risk of CVD. There is a nonlinearly positive correlation between Hcy levels and the risk of CVD.

The Association of Blood Lead with Cardiovascular Disease Incidence and Mortality: Findings from the Strong Heart Study Cohort.

Evidence on lead and the burden of cardiovascular disease (CVD) derived from National Health and Nutrition Examination Survey (NHANES) data, a general sample of the U.S. population, lacks sufficient representation of American Indians. Moreover, there is limited prospective evidence on lead and incident CVD outcomes. We evaluated if blood lead levels were associated with CVD mortality and incidence in American Indian adults from the Strong Heart Study (SHS). Whole blood samples collected in 1998-1999 among 1,818 participants was analyzed for lead using inductively coupled plasma mass spectrometry. CVD incidence and mortality were available through 2019. We used progressively adjusted multivariable Cox proportional hazards models to estimate the risk of composite CVD and coronary heart disease (CHD) mortality and incidence by baseline blood lead levels. The median (p20, p80) blood lead was 22.5 (14.2, 37.3) µg/L, similar to that of a representative sample of US adults in NHANES 1999-2000. During follow-up, 578 (31.8%) participants had a composite CVD event and 454 (25.0%) participants had a CHD event. After adjustment for demographic, lifestyle, and cardiovascular risk factors, the hazard ratio (95% CI) per change across the 80th to 20th quantiles in blood lead was 1.15 (1.02-1.30) and 1.22 (1.08- 1.37) for CVD and CHD mortality, respectively, and 1.13 (1.02-1.24) and 1.12 (0.99-1.25) for CVD and CHD incidence, respectively. In flexible dose-response models, the associations appeared to be non-linear, with a clear increased risk of CVD and CHD mortality at blood lead concentrations above 35 µg/L. Blood lead levels in American Indian adults, which are comparable to populations in the U.S. and globally, were associated with increased risk of CVD and CHD incidence and mortality. These findings highlight the importance of further reducing lead exposure, including American Indian communities. https://doi.org/10.1289/EHP16309.

Vitamin C intake and cognitive function in older U.S. adults: nonlinear dose–response associations and effect modification by smoking status

ObjectiveTo investigate the association between vitamin C intake and cognitive function in U.S. older adults, focusing on dose–response characteristics and effect modification of key subgroups.MethodsUtilizing data from the 2011–2014 National Health and Nutrition Examination Survey (NHANES), this cross-sectional study included 2,801 adults aged ≥ 60 years. Total vitamin C intake was assessed via standardized 24-h dietary recalls and supplement questionnaires. Cognitive function was evaluated using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning Test, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Multivariate adjusted linear regression models, smooth curve fitting, and stratified regression analyses were employed to examine associations and effect modification.ResultsOur analysis revealed a nonlinear dose–response relationship between vitamin C intake and cognitive performance. In fully adjusted models, participants in the highest intake quartile (Q4) showed significantly better performance on the Auditory Fluency Test (AFT; β = 1.11, 95% CI: 0.37–1.85) and the Digit Symbol Substitution Test (DSST; β = 3.35, 95% CI: 1.49–5.21) compared to those in the lowest quartile (Q1). Threshold analyses indicated that cognitive protection for DSST peaked at an intake of 500 mg/day, while AFT benefits plateaued at 120 mg/day. Stratified analyses further demonstrated that the cognitive benefits of vitamin C were more pronounced among smokers (DSST: β = 0.59 per 100 mg/day, p = 0.0009), with no significant associations observed in non-smokers.ConclusionVitamin C intake is associated with improved cognitive function in older U.S. adults, with distinct dose-dependent and domain-specific threshold effects. Smoking status significantly modifies this relationship, suggesting that personalized supplementation strategies targeting smokers may enhance cognitive protection.

Sex-specific associations of the Dietary Inflammatory Index with cardiovascular and non-cardiovascular mortality in hypertensive adults: a cohort study

ObjectiveThis study aimed to investigate the associations between the Dietary Inflammatory Index (DII) and cardiovascular (CV)/non-CV mortality in hypertensive individuals, and to explore sex-specific differences.MethodsSixteen thousand six hundred twenty-three individuals with hypertension were selected from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018 and divided into groups of males and females. We used multivariate Cox proportional hazards models, competing risk regression, restricted cubic splines (RCS), propensity score matching (PSM), and decision curve analysis (DCA) to evaluate the associations between the DII and CV/non-CV mortality.ResultsAfter fully adjusting for potential confounders, individuals with the highest DII score had a 35 percent higher CV mortality than those with the lowest DII score, observed in females but not in males. Across the cohort, there was a significant association between DII and non-CV mortality. RCS results showed that DII had an S-shaped association with CV mortality and a J-shaped association with non-CV mortality in hypertensive individuals.ConclusionsIn patients with hypertension, we found sex differences in the association between DII and CV mortality. High DII was only associated with increased CV mortality in females with hypertension, but not in males. Higher DII was also associated with increased non-CV mortality.

Association between anemia and mortality in patients with rheumatoid arthritis: A retrospective cohort study of the National Health and nutrition examination survey (NHANES) database.

Association between anemia and mortality in patients with rheumatoid arthritis: A retrospective cohort study of the National Health and nutrition examination survey (NHANES) database.

Association between HALP and all-cause and specific mortality in US adult with nonalcoholic fatty liver disease cirrhosis: a cohort study of National Health and Nutrition Examination Survey 2005-2018.

Nonalcoholic fatty liver disease (NAFLD) cirrhosis is a significant health concern with a major impact on global morbidity and mortality. This study investigates the association of hemoglobin, albumin, lymphocyte, and platelet (HALP) with all-cause mortality, cardiovascular disease mortality, and cancer-related mortality in patients with NAFLD cirrhosis. This retrospective cohort study used data from the National Health and Nutrition Examination Survey, assessing 11 550 adults. NAFLD cirrhosis was defined by a hepatic steatosis index greater than 36 and a NAFLD fibrosis score greater than 0.676 in participants without viral hepatitis or excessive alcohol use. The HALP score was categorized into low (<32), moderate (32-48.3), and high (>48.3). Logistic and weighted Cox regression analyses were conducted, along with subgroup and restricted cubic spline analyses. Higher HALP scores were associated with lower all-cause mortality. Subgroup analyses revealed significant interactions with gender and age, showing a decreased risk of all-cause mortality in males and individuals aged 40 and above with higher HALP scores. A U-shaped relationship between HALP scores and all-cause mortality was observed. The study demonstrates that HALP is associated with a lower risk of all-cause mortality in the NAFLD cirrhosis population, suggesting that HALP may be a useful predictor of mortality risk.

Correlation between serum uric acid to serum creatinine ratio and infertility in reproductive-age female of American: data from national health and nutrition examination survey (NHANES), 2013-2016.

Correlation between serum uric acid to serum creatinine ratio and infertility in reproductive-age female of American: data from national health and nutrition examination survey (NHANES), 2013-2016.

Association Between Visceral Fat Metabolism Score and Cataract Risk in US Adults: National Health and Nutrition Examination Survey 1999 to 2008.

Association Between Visceral Fat Metabolism Score and Cataract Risk in US Adults: National Health and Nutrition Examination Survey 1999 to 2008.

Polygenic risk score for breast cancer in the Thai population: Addressing genetic disparities in underrepresented populations.

10572 Background: Effective breast cancer prevention and management require accurate risk prediction tools. Polygenic risk scores (PRS) have shown promise but are often less effective in non-European populations due to differences in genetic architecture. This study evaluates PRS performance and adaptation for breast cancer in the Thai population, addressing disparities in underrepresented groups. Methods: We retrospectively analyzed breast cancer cases from the Genomics Thailand project at Siriraj Hospital and general population controls from the National Health Examination Survey (NHES) in Thailand. Whole-genome sequencing was performed for cases, and genotyping with imputation was done for controls using the TOPMed r2 reference panel. Clinical data were extracted from electronic medical records. PRS were constructed using SBayesRC, incorporating variants from publicly available genome-wide association study (GWAS) summary statistics and variant functional annotations. Logistic regression and area under the receiver operating characteristic curve (AUC) analyses were conducted using R. Results: The discovery cohort included 975 cases and 1,502 controls, with 230 cases and 265 controls in the validation cohort. Of the 330 previously reported GWAS loci, only 231 lead variants were identified in our dataset. We further analyzed variants near these lead variants within the 330 loci, identifying nominal associations with breast cancer for 329 loci (p&lt;0.05). Four PRS models were tested: (1) 231 variants, (2) ~7 million functional variants based on European (EUR) data, (3) East Asian (EAS) models, and (4) combined EUR and EAS models. The EUR-based model (AUC 0.66) outperformed the 231-variant model (AUC 0.59) and the population-specific EAS model (AUC 0.58) at p&lt;0.05. The combined EUR and EAS models showed no significant improvement over the EUR model alone (AUC 0.66 for both, p=0.69). Individuals in the highest PRS risk group (above the 90 th percentile) had an odds ratio (OR) of 3.34 for breast cancer compared to the rest of the population (95% confidence interval: 2.54–4.42, p&lt;0.05). Among 249 patients with pathology data, PRS was not associated with tumor size, estrogen receptor status, or nodal metastasis. Conclusions: In the Thai population, PRS derived from large-scale European GWAS provided the highest prediction accuracy for breast cancer risk. The limited transferability of a top-variant PRS (e.g., 330-variant model) underscores the challenge posed by variant availability in this population. Validation in prospective studies is essential to optimize PRS utility and address disparities in genetic risk prediction.

Age at menarche and risk of non-alcoholic fatty liver disease: Insights from the NHANES 2017-2020 and Mendelian randomization analyses.

Age at menarche and risk of non-alcoholic fatty liver disease: Insights from the NHANES 2017-2020 and Mendelian randomization analyses.

Association between hemoglobin, albumin, lymphocyte, and platelet score and all-cause and cardiovascular mortality among population with diabetes: Evidence from the NHANES 2003-2016.

Association between hemoglobin, albumin, lymphocyte, and platelet score and all-cause and cardiovascular mortality among population with diabetes: Evidence from the NHANES 2003-2016.

Association between dietary cholesterol, serum lipids, and cancer-specific mortality in U.S. adults.

e22609 Background: The relationship between dietary cholesterol and its impact on serum lipids and health outcomes remains a topic of debate. This study aims to investigate whether dietary cholesterol intake is associated with lipid abnormalities and cancer-specific mortality in a nationally representative U.S. adult population. Methods: We included adults &gt; 20 years from the 1999-2018 National Health and Nutrition Examination Surveys, excluding those consuming &lt; 500 or &gt; 4000kcal/day, or taking anti-lipid agents. Dietary cholesterol intake was categorized into ≤100, 101-200, 201-300, 301-400, &gt;400mg/day based on two 24-hour dietary recalls. Outcomes were abnormal serum lipids (triglycerides &gt;150, HDL &lt;40 for men, &lt;50 for women, and LDL &gt;160mg/dl) and cancer-specific determined via linkage to the 2019 National Death Index. Odds of abnormal lipids were estimated using logistic regression, adjusting for demographics, comorbidities, &amp; dietary intake. Cancer mortality risk was estimated using Cox regression in adults without cancer. Analyses accounted for survey design &amp; weights for nationally representative estimates. Results: Our cohort included 1,909 cancer survivors (mean age 62y, 61% female, 84% White) and 23,238 adults without cancer (mean age 47y, 51% female, 70% White). Adults consuming &gt; 400mg/day of dietary cholesterol vs. &lt; 100mg/day were more likely to have higher protein intake (men: 117 vs. 50g/day, women: 93 vs. 43g/day), higher % saturated fat (men: 12% vs. 8.1%, women: 13% vs. 9.0%), higher total caloric intake (men: 2,708 kcal vs. 1,619kcal, women: 2,186 vs. 1,322kcal) and similar fiber intake (men: 18.7g vs. 20.0g, women: 16.1g vs. 14.7g; p = 0.15). In adults without cancer, higher dietary cholesterol was associated with high triglycerides (adjusted OR [95% CI], 400mg/day vs. &lt;100mg/day: 1.22 [1.01, 1.49]; p-trend = 0.019) but not with low HDL (1.03 [0.84, 1.25]) or high LDL (0.89 [0.63, 1.24]). These associations were similar in cancer survivors. Over a median follow-up of 8 years (IQR, 4-11), there were a total of 564 cancer-specific deaths. Protein intake &gt; 0.8g/kg/day modified the association between dietary cholesterol and cancer-specific mortality (p-interaction = 0.01). In those consuming protein &gt; 0.8g/kg/day, there was no association between dietary cholesterol and cancer mortality (adjusted HR [95% CI]; &gt; 400mg, 0.97 [0.48, 1.96]; 301-400mg, 1.13 [0.54, 2.36]; 201-300mg, 0.65 [0.32, 1.30]; 101-200mg, 0.95 [0.45, 2.02]); however, in those consuming &lt; 0.8g/kg/day, dietary cholesterol did increase risk of cancer mortality ( &gt; 400mg, 1.18 [0.53, 2.65]; 301-400mg, 2.32 [1.21, 4.44]; 201-300mg, 2.02 [1.18, 3.48]; 101-200mg, 1.80 [1.11, 2.91]). Conclusions: Dietary cholesterol &gt;400mg/day was associated with higher triglyceride levels but not HDL or LDL in both adults with &amp; without cancer. Dietary cholesterol only increased cancer mortality risk in those with protein intake &lt; 0.8g/kg/day. Further studies on sources of cholesterol and impact on health outcomes are needed.

Sexual behavior characteristics in breast cancer patients: NHANES study analysis.

e24071 Background: Breast cancer is the most common malignancy among women, excluding skin cancer, with one in eight women diagnosed in their lifetime in the United States. Advances in early detection have improved survival rates, yet many patients experience distressing symptoms and a decline in quality of life. Sexual health is often affected by both the cancer diagnosis and its treatment but remains inadequately addressed during routine follow-up care. Factors influencing sexual health include health, relationships, communication, sexual history, self-esteem, medications, and menopausal status. Understanding sexual health in breast cancer patients helps healthcare providers assess needs and promote comprehensive care. Methods: Used National Health and Nutrition Examination Survey data 1999–2016 to identify females who completed the sexual behavior questionnaire, separating them by breast cancer status. Descriptive analyses calculated proportions of categorical variables. T-tests and ANOVA compared continuous variables, and chi-square tests compared categorical variables. Survey-weighted regressions evaluated associations. Statistical significance was defined as p &lt; 0.05. Results: 16,631 females without breast cancer and 245 with breast cancer. Breast cancer patients were older (56.5 vs 40.7 years, p &lt; 0.05) and higher rates of diabetes (13.5% vs 8.3%), hypertension (46.5% vs 26.4%), and smoking (45.6% vs 36.8%, p &lt; 0.05), more likely to have had a hysterectomy (32.6% vs 19.1%, p &lt; 0.05), used hormones (27.7% vs 15.2%, p &lt; 0.05), and total oophorectomy (23% vs 11.7%, p &lt; 0.05). Sexually active status was similar in both groups (96% vs 98%, p &lt; 0.05). Homosexual identity slightly higher breast cancer patients (13% vs 16%, p = 0.6). Mean lifetime male sex partners was higher for non breast cancer patients (18 vs 8.3, p = 0.5). Mean last year male partners was lower for breast cancer patients (3.6 vs 2, p &lt; 0.05). Mean female partners was higher for non breast cancer patients (9 vs 4, p &gt; 0.05). Age at first sexual intercourse similar (17.7 vs 18.7, p = 0.99). Genital herpes (5.1% vs 6.7%, p &gt; 0.5), genital warts (5.4% vs 4.5%, p = 0.7), gonorrhea (0.39% vs 0%, p = 0.9), and chlamydia (1.46% vs 0.75%, p = 0.7) rates were similar between the groups. Menopausal status and hormone use did not significantly affect lifetime male partners (p = 0.34). Sexual activity was lower in postmenopausal breast cancer patients (p &lt; 0.05). Hysterectomy status was associated with fewer male partners (p &lt; 0.05). Conclusions: Study highlights differences in sexual behavior between breast cancer and non-breast cancer patients. Breast cancer status impacts behaviors such as recent sexual partnerships but does not significantly affect lifetime partners or STI prevalence. The potential impact of surgical interventions on sexual health was noted. These findings emphasize the need to explore causal pathways linking sexual behavior, comorbidities, and breast cancer to better understand the impact on sexual function and quality of life.

Exposure to volatile organic compounds and suicidal ideation: Insights from a U.S. population-based study.

Exposure to volatile organic compounds (VOCs) has been increasingly linked to mental health disorders, but the relationship between VOCs exposure and suicidal ideation (SI) remains unclear. This study aims to investigate the link between VOCs exposure and the prevalence of SI. We analyzed data from 6966 participants in the 2005-2020 National Health and Nutrition Examination Survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. Key urinary metabolites of VOCs (mVOCs) associated with SI were identified using elastic net regression models. Multivariate logistic regression and restricted cubic spline were used to explore associations between individual mVOCs and SI. To evaluate the impact of mVOCs mixtures on SI, we applied Environmental Risk Score and Weighted Quantile Sum models. Mediation analysis was conducted to determine whether inflammation and oxidative stress pathways contribute to the observed associations. Among the participants, 253 reported SI. Across various models, only the urinary N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) consistently showed a significant linear association with SI. Mixture analyses indicated a significant positive association between mVOCs mixtures and SI prevalence. Mediation analysis suggested that inflammation and oxidative stress are unlikely to be the primary mechanisms linking mVOCs exposure to SI. This study provides the first epidemiological evidence of an association between mVOCs exposure and SI. CYMA was identified as the most critical mVOCs influencing SI. The findings suggest that the link between mVOCs exposure and SI does not primarily involve inflammation or oxidative stress pathways.

Neutrophil to albumin ratio as a novel associated factor for depression; results from NHANES 2017-2018.

Neutrophil to albumin ratio as a novel associated factor for depression; results from NHANES 2017-2018.

Association Between Ultra-Processed Food Intake and Self-Reported Arthritis.

Ultra-processed foods are typically high in fat, salt, sugar, and food additives, which may contribute to the development of arthritis. This study examined the association between ultra-processed food intake and the presence of self-reported arthritis. The 2001-2018 U.S. National Health and Nutrition Examination Survey data was used to analyze the association between ultra-processed food intake and arthritis in 2025. Ultra-processed foods were identified by applying Nova classifications to 24-hour dietary recall data and expressed as a percentage of daily total energy intake. The outcomes were self-reported physician's diagnosis of arthritis, osteoarthritis, and rheumatoid arthritis. Survey-weighted logistic regressions were conducted to analyze associations between ultra-processed food intake and outcomes, controlling for age, gender, race/ethnicity, smoking status, health insurance status, and poverty-to-income ratio. UPFs contributed 55.2% of the daily total energy intake in the U.S. After adjusting for covariates, a positive association was found between daily total energy intake from ultra-processed foods and self-reported arthritis (AOR associated with each 10-percentage point increase in intake: 1.04; 95% CI=1.02, 1.06). For the second, third, and fourth quartiles of ultra-processed food intake, the AOR of arthritis was 1.14 (95% CI=1.04, 1.25), 1.22 (95% CI=1.10, 1.35), and 1.27 (95% CI=1.14, 1.41), respectively (p for linear trend <0.001). A positive association was also observed between ultra-processed food intake and rheumatoid arthritis (AOR=1.05; 95% CI=1.02, 1.09) but not for osteoarthritis. In this nationally representative sample of U.S. adults, higher consumption of ultra-processed foods was associated with overall arthritis and rheumatoid arthritis.

Association of cardiovascular-kidney-metabolic syndrome with all-cause and cardiovascular mortality: A prospective cohort study.

Association of cardiovascular-kidney-metabolic syndrome with all-cause and cardiovascular mortality: A prospective cohort study.

Evaluating the association between dietary zinc intake and cancer risk: Insights from NHANES 2021–2023 with stratified and multivariate analyses.

e22589 Background: Various studies have examined the relationship between dietary zinc (Zn) intake and cancer risk. While some have shown no substantial link, others have proposed an inverse association with colorectal and pancreatic cancers. Given these inconsistencies, we aimed to assess the relationship between dietary Zn intake and cancer diagnosis while adjusting for demographic variables. Methods: A retrospective analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) of the U.S. population from 2021 to 2023. Participants' Zn intake and cancer diagnoses were assessed through surveys. Chi-square tests were used to examine the association followed by logistic regression analyses to adjust for potential confounders, including age, gender, and smoking status. A stratified analysis by age groups was conducted to explore potential age-related differences, with a p-value &lt;0.05 being significant. Results: A total of 11,933 respondents' data was analyzed consisting of a majority of females(53.28%). Non-Hispanic whites(52.10%) were the most common ethnicity and 60–79 years(33.75%) represented the most common age group. 61.35% had low Zn intake with the mean ± SD value being 8.12 ± 2.5 mg/day. The chi-square test showed a significant association between Zn intake and cancer diagnosis(χ²=223.5478, p&lt;0.0001). Logistic regression analysis revealed that age was the strongest predictor of cancer diagnosis with individuals aged 60–79 years having significantly higher odds compared to those under 20(OR&lt;0.001, p&lt;0.0001). Zn intake and smoking were not significantly associated, although light smokers showed a marginally protective effect(OR=0.431, 95% CI=0.190–0.979). Stratified analysis showed an inverse association between Zn intake and cancer among the 41-60 age group(p=0.0114). The ROC curve analysis indicated poor predictive ability of Zn intake for cancer diagnosis(c-statistic of 0.520). Conclusions: Unlike previous studies showing a protective effect of Zn intake against various cancers, our findings indicate no overall significance. A notable inverse relationship was observed in the 41–60 age group, suggesting potential age-dependent effects. These findings challenge existing data and the complex relationship between Zn and cancer risk. Further studies are needed to explore the findings.

Association between coronary heart disease and risk of advanced liver fibrosis: results of the 2017-2018 national health and nutrition examination survey.

Studies have shown that advanced liver fibrosis is strongly associated with cardiovascular risk factors (including age and smoking status). Nevertheless, the exact mechanism is not yet clear. Hence, this study aimed to investigate the relationship between coronary heart disease (CHD) and advanced liver fibrosis and to reveal the developmental processes. In this study, we included 9254 participant data from the National Health and Nutrition Examination Surveydatabases in 2017-2018 to explore the association between risk factors and advanced liver fibrosis. First, the baseline characteristics of the participants were examined using Student's t -test and chi-squared test. Moreover, the association between CHD and advanced liver fibrosis was assessed using logistic regression analysis. Thereafter, the receiver operating characteristic curve was used to further evaluate the diagnostic performance of model 3 for advanced liver fibrosis. In total, 3624 participants were included in this study after removing samples with missing information. Baseline statistics showed that CHD, age, sex, BMI, alcohol consumption, smoking, diabetes, and physical activity were all remarkably discrepancies between nonadvanced and advanced liver fibrosis groups ( P < 0.05). Of these, CHD was shown to have a strong association with advanced liver fibrosis (95% confidence interval (CI), 1.84-7.27, P = 0.0063, odds ratio (OR) = 3.6587). Moreover, the effect of CHD on advanced liver fibrosis was not confounded by other confounders in model 3, in which confounders were corrected. Eventually, with an area under the curve greater than 0.7, the receiver operating characteristic curve confirmed the good diagnostic performance of Model 3 for advanced liver fibrosis. This study suggested that having CHD was a risk factor for patients with advanced liver fibrosis, which provides a basis for the study of advanced liver fibrosis.

Machine learning-based prediction of hearing loss: Findings of the US NHANES from 2003 to 2018.

Machine learning-based prediction of hearing loss: Findings of the US NHANES from 2003 to 2018.