Poverty Income Ratio Research Articles

Relationship between Cardiometabolic index and endometriosis in a US nationally representative sample: results from NHANES 1999-2006

BackgroundEndometriosis is an estrogen-dependent gynecological endocrine condition and a systemic inflammatory disease associated to improper lipid metabolism and increased cardiovascular risk. The Cardiometabolic Index (CMI) is a novel indicator representing visceral adipose tissue distribution and metabolic dysfunction, integrating lipid metabolism indicators and the waist-to-height ratio. While anomalies in lipid metabolism are often associated with (BMI) Body Mass Index, literature consistently shows a negative link between endometriosis and female BMI, and some studies have found that endometriosis is one of the few reproductive diseases not persistently positively correlated with obesity. Given the limitations of BMI, a comprehensive index like CMI is crucial for exploring the incidence of endometriosis. Currently, research on the correlation between CMI and endometriosis is lacking, prompting this study to investigate this association.ObjectiveTo investigate the association between the CMI and the risk of having endometriosis in a sample representing the entire U.S. population.Study designA cross-sectional analysis was conducted using data from four cycles of the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999 to 2006. The study included individuals aged 20 to 54 with a documented history of endometriosis and complete CMI data. Logistic regression analysis, subgroup and interaction analyses, smooth curve fitting, and restricted cubic splines (RCS) were utilized to examine the association between CMI and endometriosis.ResultsThe study found that individuals with higher CMI had an increased probability of developing endometriosis. This relationship remained significant after adjusting for potential confounders such as age, ethnicity, Poverty Income Ratio (PIR), drinking, smoking, education level, and marital status. The fully adjusted model revealed a positive correlation between CMI and endometriosis (OR = 1.21; 95% CI, 1.04–1.40, p < 0.05). Subgroup and interaction analyses showed no significant effect modification by age, BMI, PIR, hypertension, drinking, smoking, or menarche age (all p-values for interaction > 0.05).ConclusionOur study shows a link between CMI and the chance of getting endometriosis.Due to the common occurrence of endometriosis and the lack of clarity surrounding their cause, more study is needed to confirm our results and find out if CMI could be used as a warning sign for endometriosis.

Association between triglyceride glucose-body mass index and depression among US adults: A cross-sectional study

ObjectivesThe triglyceride glucose-body mass index (TyG-BMI) is a well-established surrogate marker for insulin resistance. While an association between insulin resistance and depression has been identified, that between TyG-BMI and depression remains unclear. Therefore, we used data from the National Health and Nutrition Examination Survey (NHANES) database to investigate this. Study designThis cross-sectional study included 9673 adults (aged ≥20 years) from the NHANES in the United States from 2011 to 2020. MethodsDepressive symptoms were assessed using a nine-item version of the Patient Health Questionnaire. The covariates included age, sex, race/ethnicity, marital status, educational level, poverty-income ratio, smoking status, alcohol intake, diabetes status, cardiovascular disease, hypertension, physical activity, high-density lipoprotein, low-density lipoprotein, and total cholesterol. Multivariate logistic regression models, subgroup analyses, and threshold saturation effect analyses were conducted. ResultsAfter adjusting for age, sex, race/ethnicity, marital status, education level, poverty-income ratio, smoking status, drinking status, diabetes status, cardiovascular disease, hypertension, physical activity, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, the threshold saturation effect showed a TyG-BMI inflection point of 174.4. Below the inflection point, a 10-unit increase in TyG-BMI was associated with a 12 % lower prevalence of depression. Above the inflection point, each 10-unit increase in TyG-BMI was associated with a 4 % increase in prevalence of depression. ConclusionsTyG-BMI had a U-shaped relationship with prevalence of depression. There was a significant link between higher TyG-BMI levels and increased prevalence of depression. When the TyG-BMI value was below 174.4, any further increase in TyG-BMI was associated with a significantly lower prevalence of depression.

Prevalence of and trends in hyperuricemia by race and ethnicity among US adolescents, 1999–2018

PurposeOur objective was to ascertain the most recent prevalence and trends of hyperuricemia among adolescents, stratified by sex and race/ethnicity subgroups, as well as to investigate potential risk factors associated with hyperuricemia in US adolescents.MethodsData were obtained from adolescents aged 12–17 years in the 1999–2018 NHANES cycles. Hyperuricemia for adolescents was defined as ≥ 5.5 mg/dL. The prevalence of hyperuricemia, along with 95% confidence intervals (CIs), was calculated for each four-year survey cycle, stratified by sex, race/ethnicity, body mass index (BMI), poverty income ratio (PIR), and parental education levels. Linear regression and logistic regression analyses were conducted independently to evaluate the linear trends in mean serum urate levels and the prevalence of hyperuricemia across the four-year cycles. Utilizing NHANES data from 2011 to 2018, we identified factors associated with mean serum urate levels and hyperuricemia through the application of linear regression and Poisson regression analyses.ResultsA total of 11 264 participants were included in the analysis. In 2015–2018, the overall hyperuricemia prevalence was 32.78%, 50.7% in males, and 13.51% in females. No significant trends were identified in the prevalence of hyperuricemia from 1999 to 2002 to 2015–2018. Between 2011 and 2018, hyperuricemia was significantly more prevalent among males compared to females (prevalence ratio [PR], 3.50 [95% CI, 2.83–4.33]), non-Hispanic Asians compared to non-Hispanic Whites (PR, 1.26 [95% CI, 1.04–1.53]), and individuals with overweight (PR, 1.63 [95% CI, 1.32–2.01]) or obesity (PR, 2.45 [95% CI, 2.08–2.88]) compared to those of normal weight. There was a stronger correlation between obesity and hyperuricemia among females (PR, 4.77 [95% CI, 3.08–7.39]) than in males (PR, 2.06 [95% CI, 1.82–2.34]). Furthermore, non-Hispanic Black adolescents with obesity exhibited higher PRs (PR, 3.40 [95% CI, 2.54–4.55]) for hyperuricemia in comparison to other ethnic groups.ConclusionsThis study has updated recent trends in hyperuricemia by sex and race/ethnicity among US adolescents. Our results suggest that hyperuricemia has a significant association with greater obesity in US adolescents, and the degree of correlation varies by sex and race/ethnicity.

Association between life’s essential 8 and hyperuricemia among adults in the United States: insights from NHANES 2005–2018

BackgroundHyperuricemia is a significant risk factor for various metabolic and cardiovascular conditions. Life’s Essential 8 (LE8), a comprehensive measure of cardiovascular health promoted by the American Heart Association, may have a protective role against hyperuricemia. This study aims to evaluate the association between LE8 scores and hyperuricemia in a representative sample of US adults.MethodsWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2018, encompassing 26,885 adults. LE8 scores were calculated based on diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Hyperuricemia was defined as serum uric acid levels ≥7.0 mg/dL in men and ≥ 6.0 mg/dL in women. Logistic regression and generalized additive models (GAMs) were used to analyze the relationship between LE8 scores and hyperuricemia, adjusting for potential confounders.ResultsHigher LE8 scores were significantly associated with lower odds of hyperuricemia (OR per 10-point increase: 0.73, 95% CI: 0.72–0.75, p < 0.001). Stratified analyses revealed consistent protective effects across subgroups defined by sex, age, race/ethnicity, PIR (poverty income ratio), education level, drinking status, eGFR, and CVD status. Logistic regression and GAM analyses both confirmed a linear relationship between increasing LE8 scores and reduced hyperuricemia risk. For example, in males, the OR was 0.81 (95% CI: 0.78–0.84), and in females, it was 0.66 (95% CI: 0.64–0.68).ConclusionThe findings suggest that higher LE8 scores are robustly associated with lower odds of hyperuricemia in US adults. These results support the promotion of comprehensive cardiovascular health behaviors encapsulated by LE8 to mitigate hyperuricemia risk. Further studies are needed to explore the causal pathways and potential interventions.

Association Analysis of Telomere Length and Vision in a Large Community-Based Survey

ABSTRACT Purpose To investigate whether there is a direct, age-independent association between telomere length and visual acuity decline in a large community-based cohort study. Methods Participants older than 40 with linked leukocyte telomere length (LTL) were enrolled in NHANES. LTL was assayed using qPCR from the participants’ blood samples. Best corrected visual acuity (BCVA) of the better-seeing eye was analyzed, with visual impairment (VI) defined as BCVA ≥ 20/40. LTL was grouped into quartiles, and its association with BCVA and VI was evaluated after adjusting for covariates. Results Among the 4,480 enrolled participants, the weighted means of age, BCVA, and telomere length were 56.1 ± 11.9 years, 0.05 ± 0.08 logMAR, and 5,662 ± 36 base pairs, respectively. The proportion of VI was 2.6%. After adjusting for covariates including sex, ethnicity, education, family poverty income ratio, general health status, hypertension, diabetes, smoking, and body mass index, BCVA was significantly worse in participants with shorter LTL, with a significant trend (p = 0.002). However, after further adjusting for age, the association between LTL and BCVA was no longer significant, without a trend (p = 0.640). No significant association or trend between LTL and VI was found in the stepwise logistic model. Conclusions No age-independent association between LTL and BCVA was found. Our study indicates LTL may not serve as a biomarker for age-related visual acuity decline.

Associations between dietary nutrient intake and sleep disorders in cancer survivors base on NHANES 2005 to 2018.

Sleep disorders significantly impact the quality of life for many individuals, which remain largely unrecognized. It is widely believed that dietary nutrient intake plays a crucial role in promoting healthy sleep patterns. However, there is lack of research focusing on cancer survivors. This study utilized the National Health and Nutrition Examination Survey (NHANES) database to investigate the correlation between dietary nutrient intake and sleep disorders in cancer survivors. Analyzing data from 2882 cancer survivors in NHANES spanning from 2005 to 2018. Dietary nutrient intake was evaluated through two 24-h dietary recalls. Weighted multivariable logistic regression model was employed to further applied to explore the association between dietary fiber intake and sleep disorders while controlling for relevant confounding factors. Additionally, the nonlinear and dose-response relationships were explored using restricted cubic spline (RCS) regression along with smooth curve fitting and threshold effect analysis. Stratified analysis and interaction analysis were conducted to assess the consistency of the results. Univariable and multivariable analysis demonstrated that dietary fiber intake showed negative correlation with sleep disorders (P < 0.05). Treating dietary fiber intake as continuous variable. After accounting for all covariates, the study reaffirmed the protective role of dietary fiber (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.98-0.99, P = 0.044). Analysis of dietary fiber intake in quartiles further supported this trend (P < 0.001). Interestingly, further investigations indicated that dietary fiber intake was not associated with sleep apnea, insomnia, restless legs syndrome, or other types of sleep disorders (P > 0.05). Notably, no statistically significant interactions were observed in all subgroup analyses except poverty income ratio (PIR) (P for interaction < 0.05), indicating that the protective effect of dietary fiber on sleep disorders was more pronounced in individuals with PIR ≥2.5. Our results suggest that adequate dietary fiber intake may be beneficial dietary strategy to reduce sleep disorders in cancer survivors.

Association between platelet to high-density lipoprotein cholesterol ratio (PHR) and hypertension: evidence from NHANES 2005–2018

BackgroundThe Platelet to High-Density Lipoprotein cholesterol Ratio (PHR) is a novel indicator of inflammatory response and metabolic disorders, linked to various chronic diseases. This study aims to investigate the relationship between PHR and hypertension.MethodsData from the National Health and Nutrition Examination Survey (NHANES), collected across seven consecutive cycles from 2005 to 2018, were analyzed. The dataset included participants’ hypertension status as reported by a doctor, their use of antihypertensive medications, and the average of three blood pressure measurements to identify hypertensive adults, along with complete information for PHR calculation. PHR was calculated based on Platelet (PLT) count and High-Density Lipoprotein cholesterol (HDL-C) using the following formula: PHR = [PLT (1000 cells/µL) / HDL-C (mmol/L)]. A multivariable logistic regression model was employed to assess the association between PHR and hypertension, and subgroup analyses were conducted to explore potential influencing factors. Additionally, Restricted Cubic Spline (RCS) curves were applied for threshold effect analysis to describe nonlinear relationships.ResultsHigher PHR was associated with an increased prevalence of hypertension. After adjusting for various covariates, including race, education level, Family Poverty Income Ratio (PIR), smoking, alcohol consumption, sleep disturbances, waist circumference, diabetes, coronary heart disease, angina, heart attack, and stroke, the results remained significant (OR = 1.36; 95% CI, 1.32, 1.41, P < 0.001). Participants with the highest PHR levels had a 104% higher risk of hypertension compared to those with the lowest PHR levels (OR = 2.04; 95% CI, 1.89, 2.21, P < 0.001).ConclusionElevated PHR levels are strongly associated with an increased risk of hypertension. Specifically, when PHR is below 280, the risk of hypertension increases in proportion to PHR. This suggests that regular monitoring of PHR may help identify patients at risk of hypertension early, allowing for timely interventions to slow disease progression. Larger cohort studies are necessary to confirm these findings.

Higher socioeconomic status is associated with higher ultra-processed food intake: a cross-sectional analysis

Objective: To explore the differences in ultra-processed food (UPF) consumption across different socioeconomic status (SES) levels. Methods: Data on UPF consumption (grams/day) were derived from the 2017–2018 National Health and Nutrition Examination Survey. The analysis controlled for age, marital status, race, and sex. A restricted cubic spline (RCS) model was applied to examine the nonlinear response curve. Results: UPF consumption increased with higher poverty income ratio (PIR), the ratio of household income to the established poverty line. Compared to the low PIR group, the medium group showed a non-significant increase (β = 34.23[95%CI: −28.81, 97.28], p = 0.287), while the high group exhibited a significant increase (β = 115.15[95%CI: 43.53, 186.76], p = 0.002). A linear positive correlation was observed in RCS analysis (p-nonlinear = 0.166, p-overall < 0.001). Conclusions: The study highlights that higher SES is associated with greater consumption of UPF in the US. The findings suggest that policy interventions should take SES into consideration.

Association between vegetable intake and major depressive disorder: results from National Health and Nutrition Examination Survey 2005-2018 and bidirectional two-sample Mendelian randomisation.

This study aimed to evaluate the association between vegetable intake and major depressive disorder (MDD) through cross-sectional analysis and bidirectional two-sample Mendelian randomisation (MR). Cross-sectional analysis was conducted on National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018 and the corresponding Food Patterns Equivalents Database (FPED). Genome-wide association study (GWAS) data were obtained from UK Biobank and Psychiatric Genomics Consortium (PGC) dataset. Logistic regression analysis was performed after calculating the weights of the samples. Inverse variance weighted, MR-Egger and weighted median methods were used to evaluate the causal effects. A Patient Health Questionnaire-9 score ≥ 10 was considered to indicate MDD. Low vegetable intake was defined as < 2 cups of vegetables per day. 30 861 U.S. adults from NHANES. The GWAS data sample size related to vegetable intake were comprised 448 651 and 435 435 cases respectively, while the GWAS data sample size associated with MDD encompassed 500 199 cases. There were 23 249 (75·33 %) participants with low vegetable intake. The relationship between vegetable intake and MDD was nonlinear. In the multivariate model adjusted for sex, age, education, marital status, poverty income ratio, ethnicity and BMI, participants with low vegetable intake were associated with an increased risk of MDD (OR = 1·53, 95 % CI (1·32, 1·77), P < 0·001). Bidirectional MR showed no causal effects between vegetable intake and MDD. Cross-sectional analysis identified a significant relationship between vegetable intake and MDD, whereas the results from bidirectional two-sample MR did not support a causal role.

The association between triglyceride glucose index and suicidal ideation in American adults: Results from NHANES 2005 to 2018.

Previous studies have shown a significant association between the triglyceride glucose index (TyG) and suicidal ideation in Korean women. However, this association has not yet been examined among American adults. This study aims to investigate the association between TyG and suicidal ideation using data from the National Health and Nutrition Examination Survey. The National Health and Nutrition Examination Survey database from 2005 to 2018 was used, including samples ≥20 years old. Suicidal ideation was assessed through questionnaires, and the TyG was derived from fasting triglyceride and glucose measurements. Weighted logistic regression models were used to analyze the relationship between the TyG and suicidal ideation. Generalized additive model curves explored the nonlinear relationship, while stratified and sensitivity analyses assessed potential interactions and the robustness of the findings. A significance level of P < .05 was considered statistically significant. A total of 15,694 participants were enrolled, of whom 3.67% participants showed suicidal ideation. The mean TyG index for participants with or without suicidal ideation was 8.82 ± 0.76, 8.65 ± 0.68, respectively (P < .001). Multivariable logistic regression showed that a higher level of TyG were associated with a higher likelihood of suicidal ideation (OR = 1.20; 95% CI, 1.05-1.38) after full adjustment. Subgroup analysis and interaction tests showed no significant correlation between gender, age, race, marital status, education, body mass index, poverty income ratio, smoking status, drinking status, diabetes, hypertension, stroke, and cancer (P > .05 for all interactions). Our findings confirm a significant and positive association between the TyG and suicidal ideation among American adults. Further large-scale prospective studies are needed to analyze the role of TyG in suicidal ideation.

Association between the neutrophil-to-lymphocyte ratio and cancer in adults from NHANES 2005–2018: a cross-sectional study

Inflammation plays a crucial role in cancer development. The neutrophil-to-lymphocyte ratio (NLR), a measure of inflammation, is obtained from a complete blood count. However, little is known about the association between NLR and cancer in the general adult population in the United States. This study aimed to evaluate whether NLR is associated with cancer in American adults. This retrospective cross-sectional study included 28,016 adult participants from the National Health and Nutrition Examination Survey (NHANES) dataset spanning 2005 to 2018. Data on demographics (age, sex, race, marital status, Poverty-Income Ratio, education level), lifestyle factors (smoking, alcohol consumption, body mass index), medical conditions (hypertension, diabetes, cardiovascular disease), and laboratory parameters (hemoglobin, platelet count, alanine aminotransferase, creatinine, albumin, and lactate dehydrogenase), were collected. Logistic regression analysis was used to investigate the research objectives. Of the total 28,016 participants, 2639 had cancer. The mean age was 49.6 ± 17.6 years, and 50% were male. A positive association between NLR and cancer risk was observed after multivariate adjustment (OR = 1.20, 95% confidence interval (CI) = 1.05–1.36, p = 0.006). Similar patterns were observed in subgroup analyses (all p-values for interaction > 0.05). A higher NLR was directly correlated with an increased risk of developing cancer in adults.

Trends and key disparities of obesity among US adolescents: The NHANES from 2007 to 2020.

This study aimed to estimate the trends in the body mass index (BMI) and prevalence of obesity among United States (U.S.) adolescents (10-19 years) and to examine the associations between sociodemographic factors and both BMI and obesity prevalence. The 2007-2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative repeated cross-sectional survey data (n = 9,826) were used. Outcomes included: 1) Mean BMI and 2) obesity (yes/no; defined as BMI ≥95% percentile). Sociodemographic variables included age, sex, race/ethnicity, and poverty income ratio (PIR; low-income <1.3, middle-income ≥1.3 and <3.5, high-income ≥3.5). By accounting for the complex survey design, weighted generalized linear/Poisson models were used to conduct the analyses. Girls constituted 49% of the sample. From 2007-2008 to 2017-2020, there was an increase in BMI and obesity prevalence, particularly among Black and Hispanic adolescents, and those from low- and middle-income families. Additionally, there was an increase in obesity prevalence among both boys and girls. However, there were no significant changes in BMI and obesity prevalence in the other race and ethnic adolescents. Girls had a 12% (Adjusted Prevalence Ratio [APR] = 0.88; 95% CI, 0.81-0.96) lower likelihood of being obese than boys. Compared to White adolescents, Black and Hispanic adolescents had 22% (APR = 1.22; 95% CI, 1.06-1.40) and 19% (APR = 1.19; 95% CI, 1.05-1.36) greater risk of being obese. Compared to high-income families, adolescents from low- and middle-income families had 62% (APR = 1.62; 95% CI, 1.39-1.90) and 47% (APR = 1.47; 95% CI, 1.24-1.76) greater risk of being obese, respectively. The results indicated persistent disparities in obesity prevalence among different race/ethnic and sociodemographic groups. Future obesity intervention should address key disparities by targeting specific race/ethnic adolescents from low-income families and promoting health equality.

Gender differences in the relationship between the systemic immune-inflammation index and all-cause and cardiovascular mortality among adults with hypertension: evidence from NHANES 1999-2018.

There are gender differences in hypertension and the effect of gender on the relationship between systemic immune-inflammation index (SII) and mortality in hypertensive patients is unclear. Hypertensive patients (n=7444) from ten cycles of the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018 were enrolled in this study. The maximally selected rank statistics method was employed to identify the optimal cut-off value for the SII. Survey-weighted Cox regression analysis was utilized to explore the links between SII and all-cause and cardiovascular mortality. Kaplan-Meier method and time-dependent receiver operating characteristic curve analysis was conducted to assess the predictive accuracy of SII for mortality. Whether SII was considered as a numerical variable or as a binary variable (higher- and lower-SII groups), higher SII levels were associated with a higher risk of all-cause and cardiovascular mortality in female hypertensive patients (all P < 0.001), but no such association was observed in the males. The area under the curve of the SII was 0.602, 0.595, and 0.569 for 3-, 5-, and 10-year all-cause mortality, respectively, in females, but was 0.572, 0.548, and 0.554 in males. High SII levels interacted with the poverty income ratio and physical activity to affect mortality in the male population (P for interaction < 0.05), and there was an interaction between race and SII in the female cardiovascular mortality rate (P for interaction < 0.05). Higher levels of SII may be closely related to the high risk of all-cause and cardiovascular mortality in hypertensive patients, and the results showed that this relationship is more significant and stable in the female group. High SII interacts with PIR, physical activity, and race to affect the mortality rate in different gender populations.

Associations between exposure to multiple environmental chemicals and metabolic syndrome: A mixture analysis

Exposure to environmental chemicals is prevalent. While previous studies reported associations between multiple chemical exposures and metabolic syndrome (MetS), they did not comprehensively account for correlations among exposures. We used machine learning methods including Boruta algorithm and least absolute shrinkage and selection operator (LASSO) regression, combined with weighted quartiles sum (WQS) regression to investigate the associations of phenols, polycyclic aromatic hydrocarbons (PAHs), metals, and phthalates with MetS and its components. Data were drawn from the 2005–2012 National Health and Nutrition Examination Survey (NHANES). The mean (standard deviation (SD)) age of 2596 participants was 48.4 (17.9) years. After adjusting for age, sex, body mass index, race/ethnicity, marital status, education, poverty income ratio, physical activity, smoking, and alcohol, higher 2-Phenanthrene (2-PHE) and mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) concentrations were associated with a higher odds of the MetS (odds ratio (OR) = 4.26, 95 % confidence interval (CI) 2.40–7.58 per ng/mL, and 3.24, 1.75–6.02 per ng/L, respectively). WQS index for environmental chemicals was positively associated with the MetS (OR = 1.31, 95 % CI 1.09–1.57). Moreover, we observed consistent and stronger positive associations with MetS (OR = 1.54, 95 % CI 1.04–2.30) in current smokers. Exposure to phenols, PAHs, metals, and phthalates was positively associated with an increase in metabolic syndrome and its components, which was more pronounced in current smokers.

Association Between Family Income, Subclinical Myocardial Injury, and Cardiovascular Mortality in the General Population.

Both low family income and subclinical myocardial injury (SCMI) are risk factors for cardiovascular disease (CVD) mortality. However, the impact of their joint association on CVD mortality is unclear. This analysis from the third National Health and Nutrition Examination Survey included 6805 participants (age 59.1 ± 13.4 years, 52.3% women, and 49.8% White) free of CVD at baseline. Family income was assessed using the poverty-income ratio (PIR) and categorized into low (PIR < 1), middle (PIR = 1-4), and high (PIR > 4) income. A validated ECG-based cardiac infarction injury score (CIIS) ≥ 10 was considered positive for SCMI. CVD mortality was determined using the National Death Index. Cox-proportional hazard analysis was used to evaluate the associations of family income and SCMI, separately and jointly, with CVD mortality. A total of 1782 (26.2%) participants had SCMI at baseline. During a median follow-up of 18.2 years, 856 (12.6%) events of CVD mortality occurred. In separate multivariable Cox models, SCMI (vs. no SCMI) and middle- and low-income (vs. high-income) were each associated with a higher risk of CVD mortality (HR [95% CI]: 1.34 [1.16-1.54], 1.44 [1.16-1.78], and 1.59 [1.22-2.07], respectively). Compared to high-income participants without SCMI, those with low-income and SCMI had an increased risk of CVD mortality (HR [95% CI]: 2.17 [1.53-3.08]). The multiplicative interaction between PIR and SCMI was not significant (p = 0.054). Lower family income and SCMI are associated with CVD mortality, and their concomitant presence is associated with the highest risk. Family income and SCMI may help in the individualized assessment of CVD risk.

Association between dietary copper intake and bone mineral density in children and adolescents aged 8-19 years: A cross-sectional study.

Some studies showed the possible role of copper intake on bone mineral density (BMD) in adults or the elderly, but the association remained uncertain in children and adolescents. Our research explored the association between copper intake and BMD in individuals aged 8-19 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. In the present study, 6,965 individuals aged 8-19 (mean age 13.18 ± 3.38 years) were enrolled from the NHANES 2011-2016. Copper intake was evaluated by averaging two 24-hour copper dietary intake recalls. Multivariate linear regression analyses were used to explore the association between copper intake and total BMD, subtotal BMD, and total spine BMD in children and adolescents. Stratified analyses and interaction tests were performed by age, gender, and race. Participants of the higher quartile of copper intake were more likely to be older, men, Non-Hispanic White, and Other Hispanic. They have higher values of poverty income ratio (PIR), serum phosphorus, blood urea nitrogen, serum vitamin D, and BMD and lower values of body mass index (BMI), cholesterol, total protein, and serum cotinine. In the fully adjusted model, we found positive associations between copper intake and total BMD (β = 0.013, 95CI: 0.006, 0.019)), subtotal BMD (β = 0.020, 95CI: 0.015, 0.024), and total spine BMD (β = 0.014, 95CI: 0.009, 0.019). Stratified analyses showed that the association was stronger in men, individuals aged 14-19, Non-Hispanic White, and Other Hispanic. Our study suggests that copper intake is positively associated with BMD in U.S. children and adolescents. The study emphasizes the role of copper intake on bone health in the early stages of life. However, more investigations are needed to verify our findings and their underlying mechanisms.

High ratio of epi-25-(OH)-vitamin D3 to 25-(OH)-vitamin D3 increases the risk of asthma attack in American asthma adults: a population study.

The relationship between vitamin D3 and asthma remains controversial. However, previous studies have largely overlooked the impact of epi-25-(OH)-vitamin D3. This study aims to investigate the effects of different forms of vitamin D3 on asthma attack in adults. In this cross-sectional study, a total of 3,873 eligible adult participants were extracted from the national health and nutrition examination survey (NHANES) database from 2007 to 2018. Based on quartiles method, different levels of vitamin D were divided into four groups (Quartile 1-4). Bivariate correlation analysis was performed for vitamin D and covariates to avoid multicollinearity. Multivariate logistic regression was used to investigate the association between serum levels of vitamin D3 (epi-25-(OH)-vitamin D3 and 25-(OH)-vitamin D3) and asthma attack, adjusting for covariates including age, gender, race, length of time in the U.S., house poverty income ratio (PIR), education level, smoking history, hypertension history, and diabetes history. The ratio of epi-25-(OH)-vitamin D3 to 25-(OH)-vitamin D3 was used for secondary analysis of its association with asthma attack. The outcomes were assessed by odds ratios (ORs) and 95% confidence intervals (CIs). Among the 3,873 eligible adults American with asthma, 1,508 (38.94%) had experienced at least one acute asthma attack in the past year. There was no significant correlation between vitamin D and covariates. After adjusting for covariates including age, gender, race, length of time in the U.S., house poverty income ratio (PIR), education level, smoking history, hypertension history and diabetes history, we found a positive correlation between the ratio of epi-25-(OH)-vitamin D3 to 25-(OH)-vitamin D3 and asthma attack. Additionally, a high ratio of epi-25-(OH)-vitamin D3 to 25-(OH)-vitamin D3 was more common among elder, male, of normal weight, non-Hispanic American, have a long time stay in the U.S., a high house PIR, and a history of hypertension individuals. Our findings suggest that attention should be given to asthma attack associated with a high ratio of epi-25-(OH)-vitamin D3 to 25-(OH)-vitamin D3 in American adults who are elderly, male, of normal weight, non-Hispanic Americans, have long-term residence in the U.S., a high house PIR, and a history of hypertension.

Association of systemic immune-inflammation index with body mass index, waist circumference and prevalence of obesity in US adults

This study aims to investigate the potential relationships between the systemic immune-inflammation index (SII) and body mass index (BMI), waist circumference, and the prevalence of obesity. A cross-sectional analysis was conducted on 7,645 individuals aged 20 and above from the NHANES 2017–2020. Multivariate linear regression analyses were conducted to evaluate the association of the logarithmically transformed SII (lgSII) with BMI and waist circumference. Additionally, multivariable logistic regression was utilized to explore the relationship between lgSII and the prevalence of obesity. Fitted smoothing curves and threshold-effect analysis were applied to elucidate nonlinear relationships. In the fully adjusted model, a positive relationship was observed between lgSII and BMI, waist circumference, and obesity prevalence (β = 3.13, 95% CI 2.10–4.16; β = 7.81, 95% CI 5.50–10.13; OR = 1.44, 95% CI 1.12–1.86). The variables of gender, age, race, education, marital status, poverty income ratio (PIR), energy intake, sleep disorder, smoking status, and alcohol use did not significantly modify the positive association between lgSII and obesity. However, physical activity appeared to influence the positive correlation between lgSII and obesity. Using a two-segment linear regression model, an inverted U-shaped relationship was observed between lgSII and both BMI and waist circumference. Furthermore, lgSII demonstrated a linear positive correlation with obesity prevalence. When stratified by physical activity, lgSII showed a non-significant negative correlation with obesity in the physically active group. Our findings underscore a robust association between the logarithmically transformed SII and BMI, waist circumference, and the prevalence of obesity.

α-Klotho: the hidden link between dietary inflammatory index and accelerated ageing.

Recent studies suggest an association between greater dietary inflammatory index (DII) and higher biological ageing. As α-Klotho has been considered as a longevity protein, we examined whether α-Klotho plays a role in the association between DII and ageing. We included 3054 participants from the National Health and Nutrition Examination Survey. The associations of DII with biological and phenotypic age were assessed by multivariable linear regression, and the mediating role of α-Klotho was evaluated by mediation analyses. Participants' mean age was 58·0 years (sd 11·0), with a median DII score of 1·85 and interquartile range from 0·44 to 2·79. After adjusting for age, sex, race/ethnicity, BMI, education, marital status, poverty income ratio, serum cotinine, alcohol, physical activity, a higher DII was associated with both older biological age and phenotypic age, with per DII score increment being associated with a 1·01-year increase in biological age (1·01 (95 % CI: 1·005, 1·02)) and 1·01-year increase in phenotypic age (1·01 (1·001, 1·02)). Negative associations of DII with α-Klotho (β = -1·01 pg/ml, 95 % CI: -1·02, -1·006) and α-Klotho with biological age (β= -1·07 years, 95 % CI: -1·13, -1·02) and phenotypic age (β= -1·03 years, 95 % CI: -1·05, -1·01) were found. Furthermore, α-Klotho mediated 10·13 % (P < 0·001) and 9·61 % (P < 0·001) of the association of DII with biological and phenotypic age, respectively. Higher DII was associated with older biological and phenotypic age, and the potential detrimental effects could be partly mediated through α-Klotho.

Association between physical activity and sedentary behavior and depression in US adults with cardiovascular disease: NHANES 2007–2016

BackgroundPrevious studies reported the effect of physical activity (PA) or sedentary behavior (SB) on increasing occurrence of depression in patients with cardiovascular disease, leading to a higher risk of adverse clinical outcomes. However, the association between the combination of PA and SB and depression in patients with cardiovascular disease remained unstudied. MethodsPatients with cardiovascular disease (aged ≥18 years) who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Multivariable logistic regression was used to investigate the association between PA, SB, and depression. ResultsAmong the 2585 patients (mean age 64.43 years; 54.65 % male) in this study, the prevalence of depression was 16.40 %. After adjustment for age, gender, race, education level, marital status, poverty income ratio, employment status, smoking, alcohol use, BMI, hypertension, and number of cardiovascular diseases, depression was negatively associated with higher PA (adjusted OR = 0.567, 95 % CI 0.403, 0.799) and positively associated with higher SB (adjusted OR = 1.472, 95 % CI 1.089, 1.990), respectively. The risk of depression associated with higher PA and lower SB was significantly lower (adjusted OR = 0.464, 95 % CI 0.307, 0.702) compared to those with lower PA but higher SB. LimitationsThis was a cross-sectional study with limited ability to make causal inferences. ConclusionsOur findings indicate that patients with higher PA and lower SB have a lower risk of depression than those with low PA levels and high SB levels. Moving more and sitting less is a potential preventive measure against depression in patients with cardiovascular disease.