Nonlinear Dose-response Relationship Research Articles

The association of serum albumin with 28 day mortality in critically ill patients undergoing dialysis: a secondary analysis based on the eICU collaborative research database

BackgroundThe relationship between serum albumin and prognosis in critically ill patients has been studied, however, there is a paucity of exploration into non-linear relationships, particularly in critically ill patients undergoing dialysis. This study intends to investigate the association between serum albumin (ALB) and 28 day mortality in critically ill patients undergoing dialysis.MethodsWe conducted a multi-center retrospective cohort study of patients undergoing dialysis by utilising data from the eICU Collaborative Research Database from 208 distinct ICUs across the United States between 2014 and 2015. The study focused on mortality within 28 days of ICU admission. We employed univariate analysis, multi-factor logistic regression, subgroup analysis, curve-fitting, and threshold effect analysis to examine the correlation between ALB levels and 28 day mortality.ResultsAmong the 2,315 patients with a median age of 63 years, 205 (8.86%) died within 28 days of ICU admission. When ALB level was < 2.7 g/dL, the mortality decreased with an adjusted odds ratio (OR) of 0.34 (95% CI 0.22–0.51, P < 0.0001) for every 1 increment in the ALB. However, no significant mortality changes were observed when ALB levels were at or above this threshold.ConclusionOur study identifies a nonlinear dose–response relationship between serum ALB levels and 28 day mortality in critically ill patients undergoing dialysis, with a specific turning point observed. This finding underscores a significant negative correlation between ALB levels and mortality risk, with lower ALB levels being associated with higher mortality risk in this particular population.

Dose-response effects of 8-week resistance training on body composition and muscular performance in untrained young women: A quasi-experimental design.

The purpose of this study was to investigate the effects of 8-week resistance training with different training volumes on body composition, maximum strength, peak power, and muscle thickness in non-training women. This was a 3-arm, prospectively designed, randomized controlled trial. A total of 45 adult women aged 20.7 ± 1 years, the mean heights of the participants were 166 ± 0.07 cm, body weight was measured as 54.5 ± 8.8 kg, and body mass index was 19.9 ± 2.1 kg/m2. They were randomized to low-volume training resistance training (LVT; n = 15, 3 sessions of 12 exercises per week), moderate-volume training resistance training (MVT; n = 15; 4 sessions of 12 exercises per week), and high-volume resistance training (HVT; n = 15; 5 sessions of 12 exercises per week) for 8 weeks. The muscle thickness (MT) of the vastus lateralis was assessed at baseline and 8 weeks later using a portable ultrasound device. A total of 39 adult women completed the study, with 2 participants from each group lost to follow-up. All experimental groups 1RM increased (P = .001, effect size (ES) = 0.463) All groups showed improved muscle thickness (MT) (P = .001) and CMJ (P = .004). The group × time interaction is statistically significant (P = .001) suggests that the changes in muscle thickness over time differ significantly between the different training volume groups (ηp²) is 0.368. In untrained young women, resistance training improved muscle hypertrophy, maximal strength, power, and body composition in untrained young women. However, 4 sessions MVT per week were superior to LVT and HVT sessions, suggesting a nonlinear dose-response relationship favoring moderate volume over low or high volumes, at least in previously untrained young women. ClinicalTrials.gov (NCT06449300).

Relationship between per-fluoroalkyl and polyfluoroalkyl substance exposure and insulin resistance in nondiabetic adults: Evidence from NHANES 2003–2018

BackgroundStudies have linked per- and polyfluoroalkyl substances (PFAS) to chronic metabolic diseases. However, the relationship between PFAS exposure and insulin resistance (IR), a key pathophysiological basis of these metabolic diseases, in nondiabetic individuals have yet to be determined. MethodsThis study analyzed data from 3909 participants (aged ≥20) from the NHANES 2003–2018 to investigate the associations between serum levels of seven PFAS and and IR indicators, including including HOMA-IR, HOMA-β, fasting insulin, QUICKI, and TyG index. Linear and logistic regression models were used, along with a restricted cubic spline to assess dose-response. Weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) models were used to assess the association between mixed PFAS exposure and IR. ResultsLinear regression revealed that elevated exposure to PFOS [β (95 % CI): 0.04 (0.02, 0.06)], PFOA [0.04 (0.01, 0.06)], and Me_PFOSA_AcOH [0.04 (0.02, 0.06)] was associated with a higher TyG index in adults. Notably, Me_PFOSA_AcOH was negatively associated with IR when assessed by HOMA-IR >2.6 [OR (95 % CI): 0.88 (0.79, 0.98)], although this was not supported by linear regression findings. When IR was defined by a TyG index >8.6, exposure to the highest quartiles of PFOS, PFOA, and Me_PFOSA_AcOH was associated with an increased risk of IR by 63 %, 42 %, and 85 %, respectively [1.63 (1.21, 2.20); 1.42 (1.06, 1.92); 1.85 (1.37, 2.50)]. PFOS, PFOA, and Me_PFOSA_AcOH demonstrated a nonlinear dose-response relationship with IR risk. The WQS and qgcomp models revealed significant positive correlations with the TyG index. ConclusionMixed PFAS exposure in US nondiabetic adults was positively associated with IR, as indicated by the TyG index, particularly for PFOS, PFOA, and Me_PFOSA_AcOH. Further research is needed to establish causality, and reinforcing environmental risk mitigation strategies to reduce PFAS exposure is recommended.

The association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and non-alcoholic fatty liver disease in US adults: a cross-sectional study

The ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to HDL-C (NHHR) is a novel lipid parameter used to assess the risk of cardiovascular disease. Previous studies have demonstrated an association between the NHHR and risk of non-alcoholic fatty liver disease (NAFLD). Owing to the lack of research exploring this relationship in specific populations, this study aimed to determine the potential link between the NHHR and risk of NAFLD among American adults in the United States. Data were retrieved from the National Health and Nutrition Examination Survey (NHANES) spanning 2017–2020. After excluding individuals with other liver diseases, alcohol abuse, and missing lipid data, a total of 6809 eligible adults were included for analysis. The NHHR was calculated as the ratio of (non-HDL-C) to HDL-C, while NAFLD was identified by liver steatosis detected by transient elastography. Multivariable weighted logistic regression models and restricted cubic spline (RCS) models were employed to investigate the relationship between the NHHR and risk of NAFLD. Subgroup and sensitivity analyses were also conducted to test the robustness of the results. As the NHHR increased, the prevalence of NAFLD rose progressively (5.88% vs. 8.75% vs. 12.24% vs. 15.77%, p < 0.001). In the overall population, after adjusting for confounding factors, each unit increase in the NHHR was associated with a 25% increase in NAFLD risk (OR = 1.25, 95% CI: 1.03–1.53, p = 0.0372). When the NHHR was analyzed as a categorical variable (quartiles), participants in the highest quartile had a significantly higher risk of NAFLD than those in the lowest quartile (OR = 2.6, 95% CI: 1.75–3.85, p = 0.009). RCS analysis further indicated a nonlinear dose–response relationship between the NHHR and risk of NAFLD (p non-linearity < 0.0001). This association remained significant in both subgroup and sensitivity analyses. This study confirmed that the NHHR, particularly at higher levels, was an independent risk factor for NAFLD. As a comprehensive lipid indicator, the NHHR had the potential to predict NAFLD risk. These findings provided new insights for the prevention and clinical management of NAFLD.

Prolonged exposure to air pollution and risk of acute kidney injury and related mortality: a prospective cohort study based on hospitalized AKI cases and general population controls from the UK Biobank

BackgroundPrevious investigations identified a connection between air pollution and kidney diseases. Nevertheless, there is a lack of comprehensive evidence on the long-term risks posed by air pollution with respect to acute kidney injury (AKI) and AKI-related death.MethodsThis prospective cohort analysis included 414,885 UK Biobank (UKB) participants who did not exhibit AKI at the study’s outset. AKI was defined based on ICD-10 codes recorded for hospitalized patients. Cox proportional hazards models were used to assess the association between prolonged exposure to air pollutants (particulate matter with diameters of 2.5 micrometers or less (PM2.5), between 2.5 and 10 micrometers (PM2.5−10), and 10 micrometers or less (PM10), along with nitrogen dioxide (NO2) and nitrogen oxides (NOx)) and the risk of AKI and AKI-related death, adjusting for potential confounders including sex, age, ethnicity, education, income, lifestyle factors, and relevant clinical covariates. Restricted cubic splines were applied to evaluate non-linear dose-response relationships, and stratified analyses were performed to explore potential effect modification across subgroups.ResultsOver an average follow-up duration of 11.7 years, 14,983 cases of AKI and 326 cases of AKI-related death were diagnosed. Quartile analysis showed individuals exposed to higher levels of these air pollutants had a significantly higher risk of developing AKI and AKI-related death compared to those in the lowest quartile (all P < 0.05). The RCS curves depicting the relationship between PM2.5, PM2.5−10, PM10, NO2, NOx, and the risk of AKI showed a significant departure from linearity (P for non−linearity < 0.05), while the relationships between PM2.5, NO2, NOx, and the risk of AKI-related death did not exhibit a significant departure from linearity (P for non−linearity > 0.05). Sensitivity analyses confirmed the robustness of our findings.ConclusionOur study reveals a direct association between prolonged air pollution exposure and elevated risks of both AKI and AKI-related death. These findings offer scientific validation for the adoption of environmental and public health measures directed towards the reduction of air pollution. Such initiatives could potentially ease the impact associated with AKI and AKI-related death.

Association of serum fatty acids with bone health in rural elderly population in Qingdao, China: A cross-sectional study.

As a type of macronutrient, fatty acids (FA) play significant roles in the bone health of elderly people. However, the specific association between different types of FA and bone health is not fully understood, especially in rural elderly populations. To address this gap, a study was conducted in rural areas of Qingdao, China. Participants aged 65 and older were randomly recruited from 11 rural villages in Licha town, Qingdao City. The levels of serum FA in their serum were measured to investigate the associations between FA and bone mass. The results showed that levels of saturated fatty acids (SFA), n-3 polyunsaturated fatty acids (n-3 PUFA), and n-6 polyunsaturated fatty acids (n-6 PUFA) were all significantly associated with bone mass. Specifically, higher levels of SFA were positively correlated with low bone mass (LBM), while PUFA levels were inversely correlated with LBM. Furthermore, the odds ratio (OR) for LBM exhibited a significant nonlinear dose-response relationship (pnonlinearity = 0.1989) with SFA levels, and a significant nonlinear dose-dependent relationship was also observed with the levels of n-3PUFA and n-6PUFA (pnonlinearity = 0.6183, 0.5808, respectively), indicating that increasing dietary PUFA intake appropriately and controlling SFA intake may benefit the bone health of elderly individuals in rural areas.

Association of serum gamma-glutamyl transferase levels with cardiovascular disease risk in type 2 diabetes patients: a prospective cohort study

To investigate the associations of serum gamma-glutamyl transferase (GGT) levels with the risk of cardiovascular disease (CVD) and its subtypes in patients with type 2 diabetes mellitus (T2DM) in Jiangsu Province. Methods: The participants were enrolled in the Comprehensive Research project regarding 'Prevention and Control of Diabetes' in Jiangsu Province. The baseline survey was conducted from 2013 to 2014, and follow-up until December 31, 2021. After excluding the participants who self-reported with chronic liver disease/stroke/coronary heart disease at baseline survey and those with incomplete information on GGT, a total of 16 147 T2DM patients were included in the final analysis. Cox proportional hazard regression models were used to calculate the hazard ratio (HR) and their 95%CI of GGT for CVD, myocardial infarction, and stroke. Restricted cubic spline models were applied to analyze the dose-response relationship between GGT and the risk of CVD and its subtypes. Results: During the median follow-up time of 8.02 years, 2 860 CVD cases were registered, including 196 cases of myocardial infarction and 2 730 cases of stroke. Multivariate Cox proportional risk regression model indicated that compared to the lowest serum GGT level group, the highest GGT level group had a 24% increased risk of CVD (HR=1.24, 95%CI: 1.09-1.41) and a 23% increased risk of stroke (HR=1.23, 95%CI: 1.08-1.40). The restricted cubic spline model showed a nonlinear dose-response relationship between GGT and the risk of CVD, myocardial infarction, and stroke in T2DM patients. Conclusions: High levels of GGT may be associated with an increased risk of cardiovascular disease in T2DM patients, which needs further exploration and validation in future clinical practice.

Association between oxidative balance score and abdominal aortic calcification among middle-aged and elderly population

BackgroundThe Oxidative Balance Score (OBS) was created to evaluate an individual’s overall antioxidant status. The objective of this study was to examine the association between OBS and abdominal aortic calcification (AAC) among individuals aged ≥ 40 years.MethodsThis population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2013–2014 and included adults aged ≥ 40 years. Survey-weighted multivariable logistic and restricted cubic spline models were used to assess the association between OBS and AAC.ResultsAmong 2520 participants, 744 were diagnosed with AAC (weighted percentage, 28.13%). Survey-weighted multivariable logistic revealed an inverse association between OBS and AAC [0.98 (0.96, 1.00)], and the nonlinear dose-response relationship was observed. Subgroup analysis and interaction tests revealed that this inverse relationship was consistent across different populations (all P for interaction > 0.05).ConclusionsOBS was inversely associated with the prevalence of AAC among individuals aged ≥ 40 years. Maintaining a higher OBS may be beneficial in reducing the burden of AAC.

Association of niacin intake and metabolic dysfunction-associated steatotic liver disease: findings from National Health and Nutrition Examination Survey

AimThis study aims to explore the relationship between niacin intake and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) within a large, multi-ethnic cohort.MethodsA total of 2946 participants from the National Health and Nutrition Examination Survey (NHANES) were carefully selected based on strict inclusion and exclusion criteria. Participants meeting the eligibility criteria underwent two dietary recall interviews, and niacin intake was calculated using the USDA’s Food and Nutrient Database for Dietary Studies (FNDDS). Liver steatosis was diagnosed using a Controlled Attenuation Parameter (CAP) of 248 dB/m, and MASLD diagnosis was based on metabolic indicators. Weighted multivariate logistic regression was utilized to analyze the correlation between niacin intake and MASLD prevalence, with potential nonlinear relationships explored through restricted cubic spline (RCS) regression.ResultsAnalysis of baseline data revealed that MASLD patients had lower niacin intake levels and poorer metabolic biomarker profiles. Both RCS analysis and multivariate logistic regression indicated a U-shaped association between niacin intake and MASLD prevalence. Specifically, there was a non-linear dose-response relationship, with the odds of MASLD gradually decreasing with increasing niacin intake until reaching a threshold of 23.6 mg, beyond which the odds of MASLD began to increase.ConclusionThis study confirms a U-shaped nonlinear relationship between niacin intake and MASLD prevalence within the diverse American population.

L-shaped association of thiamine intake and risk for peripheral artery disease in US adults: a cross-sectional study.

The relationship between thiamine intake and risk for peripheral artery disease (PAD) is unknown. We aimed to clarify the role of thiamine intake on risk for PAD and the implications of this relationship. The secondary objective of this study is to explore the potential non-linear dose-response relationship between exposure to thiamine intake and outcome risk for PAD. We conducted a cross-sectional study involving 6,112 participants with US adults from the National Health and Nutrition Examination Survey (1999-2004). Logistic regression and restricted cubic spline were utilized to substantiate the research objectives. The overall prevalence of risk for PAD was 7.9, 51% in males and 49% in females. After multivariable adjustment, lower thiamine intake was significantly and nonlinearly associated with higher risks of PAD among participants. Furthermore, we discovered L-shaped associations (p = 0.082) between thiamine intake and the risk of PAD, with an inflection point at 0.66 mg/day. Accordingly, in the threshold effect analysis, there was an inverse association between dietary thiamine intake and the risk in participants with dietary thiamine intake <0.65 mg/day. Compared to participants with thiamine intake below the inflection points, those with higher levels had a 31% lower risk for PAD (OR, 0.69; 95% CI: 0.51, 0.95). Further subgroup analysis showed no significant interactions between the subgroups (all p values for interaction were > 0.05). A non-linear association was revealed, showing that low and high levels of thiamine intake were associated with an increased the risk of peripheral artery disease in American adults. The inflection point at 0.66 mg/day and lower risk of PAD at 0.65-1.13mg/day of dietary thiamine intake may represent intervention targets for lowering the risk of PAD. The findings of this study require further validation and confirmation.

Association Between Nickel Exposure and Metabolic Syndrome: Data from NHANES 2017-2018.

Previous studies have found a possible association between nickel and metabolic syndrome (MetS), but with conflicting results. No studies have determined whether nickel exposure increases the prevalence of MetS in the general U.S. population. Therefore, we used data from the National Health and Nutrition Examination Survey (NHANES) to assess the association between urinary nickel and MetS. Since urinary nickel levels were presented as a skewed distribution, they were normalized using a logarithmic transformation. Weighted multivariate logistic models, restricted cubic spline, threshold effect analysis, and subgroup analyses were used to examine the association between urinary nickel concentration and the risk of MetS and its components. Based on data from 1577 participants, individuals in the second, third, and fourth quartiles of urinary nickel had an adjusted OR for MetS of 1.42 (95% CI: 0.88, 2.28), 2.00 (95% CI: 1.22, 3.28), and 1.68 (95% CI: 1.05, 2.70), respectively, representing an inverted "L"-shaped nonlinear dose-response relationship with an inflection point at 0.2141ng/L. Patients over the age of 40, males, less educated, and smokers are more susceptible to nickel exposure. In addition, there were significant associations between nickel and most components of the MetS, with the strongest to weakest correlations being high fasting glucose, reduced high-density lipoprotein, abdominal obesity, and elevated blood pressure; however, there was no significant correlation between nickel and hyperlipidemia. In conclusion, environmental nickel exposure increases the prevalence of MetS in U.S. adults, particularly in males over 40years of age, those with less education, and smokers.

Association between nut consumption and mortality risk: a 20-year cohort study in Korea with a stratified analysis by health-related variables.

Although nuts are a well-known healthy food group, the relationship between nut consumption and mortality remains unclear, particularly among Asians. This prospective cohort study examined the association between nut consumption and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in Korean adults. Data from two cohorts (the Ansan-Ansung and Health-Examinees) from the Korean Genome and Epidemiology Study were used. A total of 114,140 individuals aged 40-79 years were included in the data analyses. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized into four groups: non-consumers, less than 1 serving/week, 1-2 servings/week, and 2 or more servings/week (one serving was 15g of nuts). Mortality outcomes were determined based on the 2001-2021 death records from Statistics Korea. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across nut consumption categories. A stratified subgroup analysis by health-related variables was also performed. During a mean follow-up of 12.3 years, 4,559 deaths were recorded. After adjusting for covariates, the HR for all-cause mortality was 0.877 (95% CI = 0.772-0.996, p for trend = 0.006) in individuals with a nut consumption of 2 or more servings/week compared with that in non-consumers. Multivariable HRs for CVD mortality were 0.800 (95% CI = 0.681-0.939) in individuals consuming less than 1 serving/week, 0.656 (95% CI = 0.469-0.918) in those consuming 1-2 servings/week, and 1.009 (95% CI = 0.756-1.347) in those consuming 2 or more servings/week compared with that in non-consumers (p for trend = 0.080). No association was observed between nut consumption and cancer mortality. Stratified analysis identified significant interactions in the association between nut consumption and all-cause mortality by age, body mass index, and physical activity. Nut consumption was linearly associated with the reduced risk of all-cause mortality and showed a non-linear dose-response relationship with CVD mortality in Koreans, but had no association with cancer mortality. The effects of nut consumption, which have been inadequately investigated in this population, varied across different subgroups. These findings suggest that incorporating nuts into the diet should be encouraged for long-term health of Korean adults.

Identifying reliable obesity indices for hyperuricemia among middle-aged and elderly populations: a longitudinal study

BackgroundGiven the established link between obesity and hyperuricemia (HUA), the research want to investigate the relationship between different obesity indices and HUA, and further analyze which obesity index can better predict HUA.MethodsThe data were obtained from a longitudinal study involving middle-aged and elderly populations in Dalian, China. The research encompassed individuals who exhibited typical uric acid levels initially and tracked their progress over a three-year period. 8 obesity indices were evaluated retrospectively. Subgroup analyses were conducted to identify susceptible populations. Restricted cubic splines (RCS) were utilized to model the dose-response relationships between obesity indices and HUA. Receiver operating characteristic (ROC) curves were applied to visualize and compare the predictive value of both traditional and new obesity indices for HUA.ResultsAmong 4,112 individuals with normal baseline uric acid levels, 950 developed HUA. Significant associations with HUA were observed for body mass index (BMI), waist circumference (WC), body roundness index (BRI), cardiometabolic index (CMI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), and abdominal volume index (AVI). Subgroup analysis indicated that all obesity indices proved more effective in assessing the onset of HUA in women without Metabolic Syndrome (MetS). Further analysis using RCS revealed non-linear dose-response relationships between LAP, CMI, VAI, and HUA in males, with similar non-linear relationships observed for all indices in females. The results from the ROC curves indicate that LAP may serve as a better predictor of HUA in males, and CVAI may serve as a better predictor in females.ConclusionHUA is closely associated with obesity indices. Among females, CVAI emerges as the preferred predictive index for HUA. In males, LAP emerges as the preferred predictive index for HUA.

Type 2 diabetes mellitus modifies and mediates the association between the visceral adiposity index and depression: A cross-sectional study using NHANES 2005–2018 data

BackgroundThe objective of this investigation was to explore the correlation between the visceral adiposity index (VAI) and depression, and to analyze how type 2 diabetes mellitus (T2DM) may influence this relationship. MethodsThis study included data of 12,378 participants sourced from the National Health and Nutrition Examination Survey (NHANES) 2005–2018. Utilizing multivariate logistic regression and restricted cubic spline (RCS) regression, we examined the correlation between VAI and depression. Additionally, we investigated the interactive and mediating effects of T2DM on the association between VAI and depression. ResultsControlling for all potential confounders, the Ln logarithmic transformation of VAI showed a significant positive correlation with depression [odds ratio (OR) = 1.16, 95 % confidence interval (CI): 1.01–1.35, P = 0.041]. T2DM exhibited a notable interaction effect on the relationship connecting lnVAI and depression (P for interaction = 0.013). Specifically, the T2DM group exhibited a notable positive correlation between lnVAI and depression (OR = 1.46, 95 % CI: 1.17–1.82, P < 0.001), whereas such correlation didn't reach statistical significance within the non-T2DM group. The RCS model revealed a J-shaped nonlinear link between lnVAI and depression, with an inflection point value of 0.052. Mediation analysis indicated that diabetes accounted for 8.0 % of the correlation between lnVAI and depression. Furthermore, sensitivity analysis confirmed the consistency of these findings. ConclusionsA J-shaped nonlinear dose-response relationship was observed between lnVAI and depression among American adults, with a threshold of 0.052. T2DM not only served as a mediator between the two variables but also modified their association.

Association of healthy eating index-2015 and overactive bladder: a cross-sectional study.

The aim of this cross-sectional study was to investigate the association of HEI-2015 and overactive bladder (OAB) in a large population. Data were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2005-2020 datasets. Univariate and multivariate logistic regression were performed to evaluate the association between HEI-2015 and OAB. The restricted cubic spline (RCS) model was conducted to investigate the dose-response relationship. Totally, this study included 29,206 participants with 6,184 OAB patients among them. The higher continuous HEI-2015 value was independently associated with lower OAB incidence (OR: 0.87; 95%CI: 0.78, 0.98). Similarly, the highest quartile categorical HEI-2015 was significantly associated with a lower OAB odds (OR: 0.72; 95%CI: 0.52, 0.99) when compared with the lowest quartile. The RCS curve also showed a favorable non-linear dose-response relationship between HEI-2015 and OAB. A higher HEI-2015 had a favorable association with OAB and there was a non-linear dose-response relationship between them. We suggest adherence to the United States diet recommendation as a potential behavioral prevention of OAB. Large-scale long term prospective cohort studies across various regions are needed to verify the findings of this paper.

Dietary mineral intake and risk of bladder cancer: a systematic review and meta-analysis.

This meta-analysis aimed to investigate the association between dietary mineral intake and the risk of bladder cancer. Relevant studies on bladder cancer and dietary mineral intake, including sodium, calcium, iron, magnesium, phosphorus, potassium, and zinc, were systematically identified through searches in Scopus and PubMed up to July 2024. Data from 12 studies were pooled using odds ratios (OR) and 95% confidence intervals (CI) with a random-effects model. The meta-analysis of 12 studies indicated a positive association between higher dietary sodium intake and bladder cancer risk (OR = 1.62, 95% CI: 1.04-2.55), with significant heterogeneity observed. No clear linear or nonlinear dose-response relationship was found for sodium intake. However, no significant associations were found between the intake of other minerals and the risk of bladder cancer. This study suggests that a high intake of sodium is significantly associated with an increased risk of bladder cancer. Further research is needed to explore the potential mechanisms underlying this relationship.

Aerobic exercise training and obstructive sleep apnea: dose-response meta-analyses.

Several studies have shown that aerobic exercise training improves obstructive sleep apnea (OSA) severity. However, a dose-response relationship has never been shown. This study aimed to quantify any dose-response relationships between time spent per week in aerobic exercise and key sleep apnea outcomes. Randomized controlled trials (RCT) were selected from literature search studying the effects of supervised aerobic exercise training on patients with OSA. Dose-response meta-analyses were performed, where the 'dose' was the total weekly duration of aerobic exercise training. Primary outcomes were apnea hypopnea index (AHI), cardiorespiratory fitness (maximum oxygen consumption or VO2peak) and Epworth Sleepiness Scale (ESS). Analysis of data from 11 RCTs showed a non-linear dose-response relationship between the total weekly duration of aerobic exercise training and mean differences in AHI. Maximum effects on AHI (-10.92 (95%CIs: -15.57; -6.27)) were observed when the weekly duration of aerobic exercise reached 100min/week. Similar non-linear dose-response trend was observed in the mean differences in VO2peak. Studies in which aerobic exercise training lasted ≥ 12 weeks showed greater proportional changes in mean AHI differences with maximal effects reaching a peak at ∼ 70min/week of aerobic exercise training. ESS and total weekly duration of aerobic exercise training showed a linear dose-response relationship based on 4 RCTs. Based on these analyses, aerobic exercise training of 70-100min/week over 3 or 5 days a week should be recommended as adjunctive treatment for patients with OSA.

Relationship between sleep quality and duration and the incidence rate of arthritis: A prospective cohort study.

Little is known about the relationship between sleep duration and quality and the risk of arthritis in the older adult population of China. The participants were a prospective cohort of adults aged 65 years and over who had not had arthritis at baseline and had participated in follow-up surveys from 2011 to 2018 in the Chinese Longitudinal Health and Longevity Survey (CLHLS). A Cox proportional-hazards regression model was established. The dose-response relationship between sleep duration and the incidence of arthritis was analyzed. The results of a Cox proportional-risk regression model revealed that sleep duration and quality were associated with the risk of arthritis in the participants. Specifically, compared with participants with good sleep quality, those with poor sleep quality had a 38% higher risk of developing arthritis (hazard ratio [HR] = 1.38, 95% confidence interval [CI] = 1.09-1.74), and compared with participants with a sleep duration of 5 to 10 hours, those with a sleep duration shorter than 5 hours had a higher risk of developing arthritis (HR = 1.56, 95% CI = 1.27-1.91). Moreover, the results of a restricted cubic spline Cox proportional-hazards regression model showed that there was an approximately non-linear dose-response relationship between sleep duration and the incidence rate of arthritis (P nonlinear < .0001). Participants with poor sleep quality and a sleep duration shorter than 5 hours had a higher risk of developing arthritis than those with better sleep quality and a longer sleep duration.

Soluble suppression of tumorigenicity 2 associated with contrast-induced acute kidney injury in patients with STEMI.

Contrast-induced acute kidney injury (CI-AKI) is a common complication after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Soluble suppression of tumorigenicity 2 (sST2) is associated with AKI. However, the relationship between sST2 and CI-AKI is unclear. This study aimed to investigate the relationship between sST2 and CI-AKI in patients with STEMI. This was a single-center retrospective observational study. Patients diagnosed with STEMI in the Yichun People's Hospital from February 2020 to May 2024 were continuously included. CI-AKI was defined as an increase in serum creatinine of at least 50% or 0.3mg/dL from baseline within 48-72h after contrast exposure. The incidence of CI-AKI after PCI was 12.4% (98/791). Univariate analysis showed that age, fasting plasma glucose, diabetes mellitus, Killip class, left ventricular ejection fraction, estimated glomerular filtration rate, high sensitivity troponin T, N-terminal pro-B-type natriuretic peptide, and sST2 were associated with CI-AKI. The above factors were included in a multivariate analysis, which showed that sST2 was an independent factor for CI-AKI after PCI. The restricted cubic splines showed a nonlinear dose-response relationship between sST2 and CI-AKI (P < 0.001). The integration of the sST2 could significantly improve the ability of the model to identify CI-AKI (NRI 0.681, 95% CI 0.474-0.887; IDI 0.063, 95% CI 0.038-0.099). Elevated sST2 is an independent risk factor for CI-AKI after PCI in patients with STEMI. Integration of sST2 can significantly improve the risk model for CI-AKI.

Association of dietary fiber intake with epileptic seizures in U.S. adults: A Population-base study of 13,277 participants

ObjectiveEpilepsy, a neurological disorder, is identified by the presence of recurrent seizures. We aimed to detect dietary fiber intake and its association with epilepsy prevalence in U.S. adults. MethodsThis cross-sectional study obtained data from the 2013–2018 National Health and Nutrition Examination Survey database. Univariate and multivariate logistic regression models were employed to estimate the association between dietary fiber intake and epilepsy prevalence. The restricted cubic spline (RCS) model was also applied to investigate the dose-response relationships between dietary fiber intake and epileptic seizure events(ESEs). ResultsOur final sample included 13,277 NHANES participants, with the average prevalence of ESEs being 1.09 % (145/13277). After adjusting for all confounding factors, the third quartile of dietary fiber intake levels remained significantly associated with a decreased risk of ESEs[odds ratios (OR) 0.54,95 % confidence interval (CI) 0.33–0.88, P = 0.014)] compared to the first quartile. Higher fiber intake indicated a stable negative association with ESEs in the multivariate logistic regression analysis, weighted generalized additive model. A nonlinear dose-response relationship was observed between dietary fiber intake levels and decreased ESEs risk (P for overall=0.017, P for nonlinear=0.155). Interaction tests showed no significant effect of demographic and disease status on the association between dietary fiber intake and ESEs. ConclusionIn this cross-sectional study, people with a high dietary fiber intake were at a reduced risk of ESEs. However, further prospective studies are needed to investigate the effect of dietary fiber intake in epilepsy events and to determine causality.