Population-based Cross-sectional Study Research Articles

Medication use among the oldest old in the Faroe Islands-A national cross-sectional study.

Aging is often associated with an increasing number of comorbidities that warrant use of multiple drugs which increases the use of potentially inappropriate medications (PIMs), drug-drug interactions (DDIs) and drug-related problems (DRPs). The aim is to assess the prevalence of polypharmacy, PIMs, DDIs and DRPs among Faroese residents aged ≥90 years. In this population-based cross-sectional study, 494 individuals ≥90 years were invited and 298 (60%) participated. A pharmacist-led medication review was performed based on self-information, electronic patient journal and the Faroese Prescription Registry. The prevalence of polypharmacy was 74% with no sex-difference. Approximately 60% of participants used PIMs, primarily benzodiazepines and proton pump inhibitors, the latter being a frequently implicated medication in DRPs. Opioid use was low compared with other Nordic studies. DRPs were observed for 79% with discrepancies in the medication lists as the most common cause, and DDIs were identified for 47% of participants, mostly moderately clinically relevant DDIs. In conclusion, the medication use among the oldest old Faroese resembled that in other Nordic countries with a high prevalence of polypharmacy and use of PIMs, especially PPIs and benzodiazepines. However, no sex-difference was noted in medication use and the use of opioids was low.

Association of nightmares with cardio-cerebrovascular disease, hypertension and hyperlipidemia in older adults: A population-based cross-sectional study

ObjectiveThis cross-sectional study investigated the relationship of nightmares with cardio-cerebrovascular disease (CVD), hypertension and hyperlipidemia which are major preceding diseases of CVD in older adults. MethodsParticipants (n = 2824; mean age 63.6 ± 6.6 years, females 49.3%) completed the Disturbing Dream and Nightmare Severity Index (DDNSI), which was used to divide the sample into either the Nightmare or Non-Nightmare group (cut-off score ≥ 10). Demographic information, history of CVD (cerebrovascular disease, myocardial infarction, congestive heart failure, coronary artery disease, and arrhythmia), hypertension, hyperlipidemia, and self-report questionnaires about stress (Perceived Stress Scale), depression (Beck Depression Inventory), sleep quality (Pittsburgh Sleep Quality Index), and insomnia symptoms were also collected. ResultsAmong the sample, 379 participants (13.4%) reported experiencing nightmares more than once a year, and 73 participants (2.6%) were classified as having nightmare disorder based on DDNSI scores (≥10). 11.3% of participants (n = 319) reported having more than one CVD. Approximately half of the participants reported a history of hypertension (52.1%, n = 1471) and hyperlipidemia (47.7%, n = 1346). Logistic regression analysis indicated the Nightmare group was 2.04 times at higher risk for hyperlipidemia (OR = 2.04, 95% CI 1.22–3.40, p = .006) after controlling for covariates compared to the Non-Nightmare group. Although non-significant, there was a trend toward a higher risk of hypertension in the Nightmare group (OR = 1.67, 95% CI 0.99–2.84, p = .056). ConclusionsResults of this study indicate frequent nightmares in older adults may be associated with hyperlipidemia, which are risk factors for CVD. Further studies are needed to explore nightmares' directionality and health consequences in an aging population.

0885 Exploring Sleep Health in the Context of COPD and Obesity: Insights from a Population-Based Cross-Sectional Study

0885 Exploring Sleep Health in the Context of COPD and Obesity: Insights from a Population-Based Cross-Sectional Study

The Association between the Plasma Phospholipid Profile and Insulin Resistance: A Population-Based Cross-Section Study from the China Adult Chronic Disease and Nutrition Surveillance.

The dysfunction of phospholipid metabolism enzymes and the change in membrane phospholipid composition are associated with insulin resistance, indicating that phospholipids play an important role in the regulation of insulin sensitivity. The reflection of phospholipid changes in blood might provide clues for both mechanism understanding and intervention. Using a targeted phospholipidomic approach, 199 phospholipid molecular species were identified and quantified in the plasma of 1053 middle-aged participants from a national investigation. The associations of the phospholipid matrix, clusters, and molecular species with insulin resistance were investigated. A significant association was confirmed between the phospholipid matrix and the homeostatic-model assessment of insulin resistance (HOMA-IR) by a distance-based linear model. Furthermore, three clustered phospholipid modules and 32 phospholipid molecular species were associated with HOMA-IR with the strict control of demographic and lifestyle parameters, family history of diabetes, BMI, WC, and blood lipid parameters. The overall decline in lysophosphatidylcholines (LPCs), the decrease in saturated lysophosphatidylethanolamines (LPEs), the decrease in polyunsaturated/plasmenyl phosphatidylcholines (PCs), and the increase in polyunsaturated phatidylethanolamines (PEs) were the prominent characters of plasma phospholipid perturbation associated with insulin resistance. This suggested that PC- and PE-related metabolic pathways were widely involved in the process of insulin resistance, especially the disorder of LPC acylation to diacyl-PC.

Prevalence of Non-Communicable Chronic Morbidities (NCCMs) and Associated Factors Among Persons Aged 60 Years And Above in Bulambuli District, Eastern Uganda

Background The epidemiology of Non-Communicable Chronic Morbidities (NCCMs) is crucial in informing prevention and control initiatives for health systems in the developing world to handle the extra disease burden common in the aging population. Unfortunately, such evidence on the NCCMs and the associated factors remains scarce in Uganda and in Bugisu Sub-Region in particular just like in the rest of the Sub-Saharan Africa. Therefore, against this background, a study was undertaken to establish the prevalence of NCCMs and its associated factors among the elderly persons aged 60 years and above in Bulambuli District, Eastern Uganda. Methods A population-based cross sectional study design in which questionnaires and a key interview guide were administered to study subjects as part of the data collection process. Self-report, medical records and checklist of the typical symptoms were adopted in the diagnoses of NCCMs among elderly persons aged 60 years and above in Bulambuli district between late January and February 2020. SPSS software version 20.0 was used for data analysis and a Logistic Regression model was fitted to identify factors that independently influenced prevalence of NCCMs. Results A total of 317 subjects aged 60 years were recruited in the study and slightly more than half (55.0%) were less than 70 years and less than half (45.0%) were aged 70 years and above. The general prevalence rate of NCCMs was found to be 85.5%. The prevalence of the specific NCCMs was 71.0% for visual impairment, edentulousness (57.4%), Hypertension (33.4%), Diabetes mellitis (10.4%), Asthma (9.5%) and least common was Stroke at (9.1%). The statistically significant associated factors were family history of NCCMs (AOR = 4.80; 95% CI: 1.88-12.27; p = 0.001), poor state of housing (AOR = 3.22; 95% CI: 1.18-8.75; p = 0.022), cooking in a poorly ventilated kitchen (AOR = 4.53; 95% CI: 1.56-13.19; p = 0.006), and physical inactivity (AOR = 6.13; 95%CI: 2.04-18.46; p= 0.001). Conclusions There is generally a high burden of Non-Communicable Chronic Morbidities among elderly persons aged 60 years and above calling for more attention by the Ministry of Health and other ministries responsible for the elderly in Uganda and the developing world in general. There is need to pay attention to housing and kitchen conditions that were found to be significant influencing factors. Clear interventions are required to address the highly prevalent conditions among the elderly to improve on their quality of life.

Health inequalities in childhood diseases: temporal trends in the inter-crisis period

BackgroundSince 2008, children in Catalonia (Spain) have suffered a period of great economic deprivation. This situation has generated broad-ranging health inequalities in a variety of diseases. It is not known how these inequalities have changed over time. The aim of the present study is to determine trends in inequalities over this period in ten relevant diseases in children according to sex and age.MethodsA retrospective cross-sectional population-based study of all children under 15 years old resident in Catalonia during the 2014–2021 period (over 1.2 million children/year) and of their diagnoses registered by the Catalan Health System. Health inequalities were estimated by calculating the relative index of inequality and time trends using logistic regression models. Interaction terms were added to test for the effects of sex on time trends.ResultsIncreasing significant temporal trends in inequalities were shown for both sexes in almost all the diseases or adverse events studied (asthma, injuries, poisoning, congenital anomalies, overweight and obesity), in mood disorders in boys, and in adverse birth outcomes in girls. Adjustment and anxiety and mood disorders in girls showed a decreasing temporal trend in inequalities. More than half of the diseases and adverse events studied experienced significant annual increases in inequality. Poisoning stood out with an average annual increase of 8.65% [4.30, 13.00], p ≤ 0.001 in boys and 8.64% [5.76, 11.52], p ≤ 0.001) in girls, followed by obesity with increases of 5.52% [4.15, 6.90], p = < 0.001 in boys and 4.89% [4.26, 5.51], p ≤ 0.001) in girls.ConclusionsOur results suggest that inequalities persist and have increased since 2014. Policy makers should turn their attention to how interventions to reduce Health inequalities are designed, and who benefits from them.

Prevalence of Steinert's Myotonic Dystrophy and Utilization of Healthcare Services: A Population-Based Cross-Sectional Study.

Myotonic dystrophy type I (MDI) is the most common muscular dystrophy in adults. The main objectives of this study were to determine the prevalence of MDI in the Community of Madrid (CM) (Spain) and to analyze the use of public healthcare services; a population-based cross-sectional descriptive study was carried out on patients with MDI in CM and data were obtained from a population-based registry (2010-2017). A total of 1101 patients were studied (49.1% women) with average age of 47.8 years; the prevalence of MDI was 14.4/100,000 inhabitants. In the women lineal regression model for hospital admissions, being in the fourth quartile of the deprivation index, was a risk factor (regression coef (rc): 0.80; 95%CI 0.25-1.37). In the overall multiple lineal regression model for primary health care (PHC) attendance, being a woman increased the probability of having a higher number of consultations (rc: 3.99; 95%CI: 3.95-5.04), as did being in the fourth quartile of the deprivation index (rc: 2.10; 95%CI: 0.58-3.63); having received influenza vaccines was a protective factor (rc: -0.46; 95%CI: -0.66-(-0.25)). The prevalence of MDI in the CM is high compared to other settings. Moreover, having any level of risk stratification of becoming ill (high, medium or low) has a positive association with increased PHC consultations and hospital admissions.

Patellofemoral pain syndrome in children and adolescents: A cross-sectional study.

To assess the prevalence and associated factors of Patellofemoral Pain Syndrome (PFPS) in children and adolescents. A population-based cross-sectional study was conducted with children and adolescents aged 10 to 18 years, who presented a history of peripatellar and/or retropatellar pain, attending elementary or high school in urban public schools in Natal, Brazil. The sample size was calculated based on a minimum outcome prevalence of 22%. A prevalence of 24.7% of PFPS was found. There was a positive association of PFPS with active students (p < 0.01; PR: 2.5; CI: 1.4-4.5), low functional capacity (p < 0.01; PR: 8.0; CI: 5.0-12.8), and those classified as pubertal (p < 0.03; PR: 1.8; CI: 1.0-3.2). There was a considerable prevalence of PFPS in children and adolescents, as well as an association between the level of sexual maturation and adjustable determinants, such as the level of physical activity and low functional capacity in this group.

Sex Differences in the Association Between LDL/HDL with Cognitive Decline in Older Adults: National Health and Nutrition Examination Survey.

Lipids have a significant impact on the development and functioning of the nervous system, but the sex differences between the association of LDL/HDL, which reflects lipid metabolic status, and cognitive impairment remains unclear. We aimed to determine if there were sex differences between the association of LDL/HDL and cognitive function in US older adults. This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 cycles. The main outcome was poor cognitive performance defined by the Digit Symbol Substitution Test (DSST) < 34 based on published literature. A total of 1,225 participants were included in the study, with a cognitive impairment incidence of 25.6% (314/1,225). Multivariate regression models demonstrated a significant association between cognitive decline and each 1-unit increase in LDL/HDL, after adjusting for all covariates (adjusted odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.11-1.67). Furthermore, subgroup analysis revealed an interaction between LDL/HDL and cognitive impairment in sex subgroups. LDL/HDL was associated with cognitive impairment in the US older adult population in adjusted models, although the significance of this association was not observed in females.

Association of residential environment with depression and anxiety symptoms among older adults in China: A cross-sectional population-based study

This study, grounded in environmental psychology, investigated the correlation between residential environments and the prevalence of depression and anxiety among older adults in China. Utilizing data from the Chinese Longitudinal Healthy Longevity Survey, it evaluated the incidence of depression and anxiety among 11,614 participants aged 65 and above across 23 provinces in China and examined how residential factors affect mental health. The findings revealed that 26.9 % of the participants had symptoms of depression and 11.7 % had symptoms of anxiety. A logistic regression analysis highlighted a significant relationship between various aspects of the residential environment and depression and anxiety among older adults. The influence risk factors from the residential environment included, but were not limited to, not house ownership, having no one's own bedroom, living in high-rise apartment, water leakage or a musty smell in the home and having no kitchen ventilation. The study makes a novel theoretical contribution by identifying key environmental factors affecting the well-being of the elderly, thereby filling a gap in the literature regarding the influence of physical living conditions on older adults' mental health. This pioneering research, with its nationwide scope and focus on Chinese older adult population, not only advances academic understanding but also has practical implications for urban planning and public health policies that aim to improve the quality of life for the elderly through interventions targeting residential environments.

Avaliação do estado nutricional em idosos com diabetes mellitustus

Objective: To analyze the nutritional status of elderly individuals with diabetes mellitus. Methods: Cross-sectional population-based study. Part of the Longitudinal Study of Health of the Elderly of Alcobaça – ELSIA, including 465 elderly people. Data analysis was performed using a structured questionnaire containing sociodemographic, health and behavioral information. Nutritional status was assessed using the Mini Nutritional Assessment – MNA. Results: There was a prevalence of risk of malnutrition/malnutrition of 47,1% (15,7% in men and 30,1% in women) in the group with diabetes. The MNA analysis revealed that the individuals in the group with diabetes, when compared to the group without diabetes, presented greater weight loss in the last three months (p=0,017), took more than three different medications per day (p=≤0,0001), believed they were malnourished (p=0,003) and considered their own health as not very good (p=0,027). When comparing genders, the male diabetes group showed differences in relation to the use of multiple medications (p=≤0,0001), mobility (p=≤0,0001), and neuropsychological problems (p=0,029). While females showed a statistically significant difference in relation to use of multiple medications (p=≤0,0001). Conclusion: The findings showed a significant prevalence of risk of malnutrition/malnutrition in elderly with diabetes mellitus, especially in females. However, the presence of the disease in males has been shown to have a significant impact on nutritional status when analyzing MNA parameters.

Prevalence of and factors influencing Hikikomori in Osaka City, Japan: A population-based cross-sectional study.

Hikikomori is commonly defined as a social condition in which individuals avoid social participation and relationships beyond their family members by confining themselves to a room or their house for 6 months or longer. Hikikomori has been predominantly considered a problem among young people; however, as the population is ageing, hikikomori has also emerged as a social issue among adults. Nevertheless, no comparative studies have examined the differences in the factors associated with hikikomori among teenagers/young adults and middle-aged/older adults. Thus, this phenomenon has not been thoroughly examined, and it remains unclear whether the risk factors vary between teenagers/young adults and middle-aged/older adults. Based on the Japan Cabinet Office's definition of hikikomori, this cross-sectional study evaluated the prevalence and related factors of hikikomori among the working age population (15-64 years), utilising univariate and multivariate analyses. The study also compared differences in the prevalence of and factors related to hikikomori between teenagers/young adults and middle-aged/older adults. We distributed self-administered questionnaires to individual participants and their families between 24 December 2020 and 18 January 2021. Data from an anonymised sample of 3,092 individuals (split into two groups of 15-39 and 40-64 years) were subjected to analysis. The results revealed a hikikomori prevalence of 2.3% in the target population; the prevalence rate was 2.12% among individuals aged 15 to 39 years and 2.42% among those aged 40 to 64 years. The analysis demonstrated strong correlations between hikikomori and several factors, including unemployment, truancy, a history of psychiatric consultation or hospitalisation, being male and the absence of ibasho, which is defined as a place where individuals can feel peace, security, acceptance and belonging. The factors associated with hikikomori differed between teenagers/young adults and middle-aged/older adults. Our findings, thus, contribute to existing research by providing a comparative analysis of risk factors across different age groups.

Near vision impairment and effective refractive error coverage for near vision in Andhra Pradesh, India – The Akividu Visual Impairment Study (AVIS)

ABSTRACT Clinical relevance Near Vision Impairment (NVI) is common in developing countries. A substantial proportion of NVI can be addressed by providing spectacles. Innovative eye care programmes are needed to address NVI. Population-based epidemiological studies can provide vital data to plan such eye care service delivery models. Background To report the prevalence of NVI and effective Refractive Error Coverage (eREC) for near vision in West Godavari and Krishna districts in Andhra Pradesh, south India. Methods A population-based cross-sectional study was carried out using a Rapid Assessment of Visual Impairment methodology. Presenting and pinhole distance visual acuity were assessed followed by near vision assessment using a N notation chart at a fixed distance of 40 cm. If the presenting near vision was worse than N8, the best corrected near visual acuity was recorded with age appropriate near vision correction. NVI was defined as presenting near vision worse than N8 among those without distance vision impairment (6/18 or better in the better eye). Effective Refractive Error Coverage for near was calculated as the proportion of individuals with an adequate correction to the total participants, including those with inadequate, adequate, and no correction for near vision. Results Data of 2,228 participants aged ≥40 years were analysed. The mean age of these participants was 54.0 ± 10.4 years; 53.8% were women; 44.5% had no formal education. The prevalence of NVI was 27.1% (95% CI: 25.2–29.0%). NVI significantly associated with 70 and above age group (adjusted OR: 1.97; 95% CI: 1.45-3.70). Participants with formal education had lower odds for NVI (adjusted OR: 0.75; 95 % CI: 0.68-0.83). The eREC for near vision was 48.0%. Conclusion NVI affects over a quarter of people aged ≥40 years in the West Godavari and Krishna districts of Andhra Pradesh. However, eREC is under 50% and there is scope for improving this by establishing eye care services to achieve universal eye health for all.

Prevalence and risk evaluation of cardiovascular disease in the newly diagnosed prostate cancer population in China: A nationwide, multi-center, population-based cross-sectional study.

Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China. Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher's exact test was used for comparison of categorical variables. A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received gonadotropin releasing hormone antagonists, in stark contrast to the grim situation of CVD prevalence and risk. PCa patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.

Occupational inequalities and gender differences: work accidents, Brazil, 2019.

To analyze the distribution and association of sociodemographic and occupational factors with self-reported work accidents (WA) in a representative sample of the Brazilian population, with emphasis on occupational class, and to examine gender differences in this distribution. A population-based cross-sectional study, using data from the 2019 National Health Survey (PNS), analyzed the responses of a sample of adults aged 18 or over. Factors associated with WA were investigated using binary logistic regression and hierarchical analysis using blocks (sociodemographic and occupational variables). The final model was adjusted by variables from all blocks, adopting a significance level of 5%. The values of odds ratios (OR) and respective confidence intervals were obtained. Among the participants, 2.69% reported having suffered a WA, with a higher prevalence in men (3.37%; 95%CI 2.97-3.82%) than in women (1.86%; 95%CI 1.55-2.23%). The analysis identified that age group, night work, working hours, and exposure to occupational risks were associated with WA, with emphasis on gender differences. The class of manual workers, both qualified (ORwomen = 2.87; 95%CI 1.33-6.21 and ORmen = 2.46; 95%CI 1.37-4.40) and unskilled (ORwomen = 2.55; 95%CI 1.44-4.50 and ORmen = 3.70; 95%CI 1.95-7.03), had a higher chance of WA than the class of managers/professionals. Occupational factors contributed significantly to the increase in the probability of WA for men and women, with greater magnitude among those positioned in the lower strata of the occupational structure. The results obtained are clues for working out WA prevention actions.

Associations Between HbA1c and Glucose Time in Range Using Continuous Glucose Monitoring in Type 1 Diabetes: Cross-Sectional Population-Based Study.

Continuous glucose monitoring (CGM) introduces novel indicators of glycemic control. This cross-sectional study, based on the Swedish National Diabetes Register, examines 27,980 adults with type 1 diabetes. It explores the relationships between HbA1c (glycated hemoglobin) and various CGM-derived metrics, including TIR (time in range, representing the percentage of time within the range of 4-10mmol/l for 2weeks), TAR (time above range), TBR (time below range), mean glucose, standard deviation (SD), and coefficient of variation (CV). Pearson correlation coefficients and linear regression models were utilized for estimation. The analysis included 46% women, 30% on insulin pump, 7% with previous coronary heart disease and 64% with retinopathy. Mean ± SD values were age 48 ± 18years, diabetes duration 25 ± 16years, HbA1c 58.8 ± 12.8mmol/mol, TIR 58.8 ± 19.0%, TAR 36.3 ± 20.0%, TBR 4.7 ± 5.4%, mean sensor glucose 9.2 ± 2.0mmol/l, SD 3.3 ± 1.0mmol/l, and CV 36 ± 7%. The overall association between HbA1c and TIR was -0.71 (Pearson's r), with R2 0.51 in crude linear regression and 0.57 in an adjusted model. R2values between HbA1c and CGM mean glucose were 0.605 (unadjusted) 0.619 (adjusted) and TAR (unadjusted 0.554 and fully adjusted 0.568, respectively), while fully adjusted R2values were 0.458, 0.175 and 0.101 between HbA1c and CGM SD, CGM CV and TBR, respectively. This descriptive study demonstrates that the degree of association between HbA1c and new and readily available CGM-derived metrics, i.e., time in range (TIR), time above range (TAR), and CGM mean glucose, is robust in assessing the management of individuals with type 1 diabetes in clinical settings. Metrics from CGM that pertain to variability and hypoglycemia exhibit only weak correlations with HbA1c.

Association of serum soluble α‑klotho with risk of kidney stone disease: a population-based cross-sectional study.

The aim of the study was to explore the association of serum soluble klotho with kidney stone disease (KSD) in the general population over the age of 40years in the United States. We integrated the data in National Health and Nutrition Examination Survey from 2007 to 2016years. The relationship between serum soluble α‑klotho and prevalence of KSD was analyzed by constructing weighted multivariable logistic regression model, restricted cubic spline (RCS) curve, and subgroup analyses. In the study, a total of 13,722 individuals were included in our study. A U-shaped association between serum soluble klotho and the risk of KSD was shown by the RCS curve (P value for nonlinear < 0.05). In the full adjusted model, compared with the lowest quartile of serum soluble α‑klotho, the adjusted odd ratios (95% confidence intervals) for KSD across the quartiles were (0.999 (0.859, 1.164), 1.005 (0.858, 1.176), and 1.061 (0.911, 1.235)). Subgroup analyses also showed that the U-shaped association of serum soluble α‑klotho with KSD was found among subjects who were age < 60years, female or male, with or without hypertension, and BMI ≥ 30kg/m2. Our findings suggested that serum klotho levels had a U-shaped correlation with risk of KSD. When the Klotho level is at 818.66pg/mL, prevalence of KSD is lowest. Therefore, maintaining a certain level of serum soluble α‑klotho could prevent the occurrence of KSD.

Higher oxidative balance score is associated with lower kidney stone disease in US adults: a population-based cross-sectional study.

Oxidative balance stress (OBS) was an important indicator for assessing exposure to oxidative stress related to diet and lifestyle. The purpose of this study was to explore the relationship between OBS and kidney stone disease (KSD). Secondary dataset analysis was performed by the study from six survey cycles (2007-2018) in the National Health and Nutrition Examination Survey (NHANES). OBS was the exposure factor and ever had kidney stone (yes or no) was the outcome. Weighted univariate or multivariate logistic regression models were used to estimate the associations. The prevalence of KSD among participants was 8.6%. OBS showed a significant negative correlation with KSD (OR: 0.98, 95% CI 0.96-0.999), 35% reduction in KSD in the highest OBS quartile compared to the lowest OBS quartile. Dietary OBS was significantly negatively correlated with KSD (OR: 0.98, 95% CI 0.96-0.9998), but not with lifestyle OBS. In addition, OBS had a negative correlation with KSD in females (OR: 0.97, 95% CI 0.94-0.996), non-diabetic participants (OR: 0.98, 95% CI 0.96-0.99), and hypertensive participants (OR: 0.96, 95% CI 0.93-0.99), but OBS was not observed to be associated with KSD in gout participants. Interestingly, this relationship existed in participants aged 30-60years and a ratio of family income to poverty (PIR) of 1.3-3.5 (all P value < 0.05). Our study revealed that OBS was negative associated with KSD, and high OBS might be a protective factor in KSD. Targeting one of the components of OBS might be beneficial.

The role of interaction between vitamin D and VDR FokI gene polymorphism (rs2228570) in sleep quality of adults

To evaluate association of vitamin D with sleep quality in adults and the influence of VDR-gene polymorphism FokI (rs2228570;A > G). Cross-sectional population-based study in adults, conducted in Brazil. The outcome was sleep-quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D was determined by indirect electrochemiluminescence and classified as deficiency (VDD), 25(OH)D < 20 ng/mL in a healthy population or 25(OH)D < 30 ng/mL for groups at risk for VDD. FokI polymorphism in the VDR-gene was genotyped by qPCR and classified as homozygous wild (FF or AA), heterozygous (Ff or AG), or homozygous mutant (ff or GG). Multivariate logistic analysis was used to estimate the association between vitamin D and FokI polymorphism with sleep-quality. In a total of 1674 individuals evaluated, 53.6% had poor-sleep-quality, 31.5% had VDD, and the genotype frequency of the FokI polymorphism was 9.9% FF, 44.6% Ff, and 45.5% ff. In multivariate analysis, individuals with VDD had 1.51 times the chance of poor-sleep-quality, and individuals with the ff genotype had 1.49 times the chance of poor-sleep-quality (OR:1.49;95%CI:1.05–2.12) when compared to individuals with the FF or Ff genotype. In the combined analysis, individuals with VDD and ff genotype had more chance of poor-sleep-quality than individuals with sufficient vitamin D and genotype Ff or FF (OR:2.19;95%CI:1.27–3.76). Our data suggest that VDD and VDR FokI gene polymorphism are associated with poor-sleep-quality, and combining the two factors increases the chance of poor-sleep-quality compared to separate groups.

Assessing the evolution of hypertension management in Gansu, China: A comparative study of prevalence, awareness, treatment, and control in 2012 and 2022.

The aim of this study is to evaluate the developments in the treatment and prevalence of hypertension by demographic subgroups in least developed area of China in 2012 and 2022. This population-based cross-sectional study was conducted in 2012 and 2022, we applied stratified multistage random sampling to investigate residents aged 18 years or older in Gansu, the least developed province in the northwest of China. Questionnaires and anthropometric measurements were given to all respondents. The standardized prevalence of hypertension in adults in Gansu increased from 26.1% in 2012 to 28.8% in 2022. Compared with 2012, the control rate remains decreased despite the significantly improved awareness and treatment rates of hypertension in 2022. Apart from the reversal of the control rate, the trend of higher prevalence in men and higher awareness and treatment rates in women has not changed. There was an obviously increase in the proportion of participants who had received health education and hypertension management services from medical workers. The treatment was still primarily monotherapy, and there was no significant improvement in the prescription of medication. The prevalence of hypertension has increased mildly in the least developed region of China over the past decade, and the challenge of hypertension management has shifted from increasing awareness and treatment rates to increasing control rates. The onset and control of hypertension are affected by education methods, BMI, local economic conditions and other factors, and targeted strategies can be adopted to strengthen the management of hypertension in economically underdeveloped areas of China.