Poverty Income Ratio Research Articles

Association between blood ethylene oxide levels and the prevalence of periodontitis: evidence from NHANES 2013-2014.

The study aimed to establish a link between blood ethylene oxide (EO) levels and periodontitis, given the growing concern about EO's detrimental health effects. The study included 1006 adults from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) dataset. We assessed periodontitis prevalence across groups, used weighted binary logistic regression and restricted cubic spline fitting for HbEO-periodontitis association, and employed Receiver Operating Characteristic (ROC) curves for prediction. In the periodontitis group, HbEO levels were significantly higher (40.57 vs. 28.87 pmol/g Hb, P < 0.001). The highest HbEO quartile showed increased periodontitis risk (OR = 2.88, 95% CI: 1.31, 6.31, P = 0.01). A "J"-shaped nonlinear HbEO-periodontitis relationship existed (NL-P value = 0.0116), with an inflection point at ln-HbEO = 2.96 (EO = 19.30 pmol/g Hb). Beyond this, ln-HbEO correlated with higher periodontitis risk. A predictive model incorporating sex, age, education, poverty income ratio, alcohol consumption, and HbEO had 69.9% sensitivity and 69.2% specificity. The model achieved an area under the ROC curve of 0.761. These findings suggest a correlation between HbEO levels and an increased susceptibility to periodontitis.

The association between waist circumference and adult asthma attack using nationally representative samples

AimsThis study aims to explore the relationship between waist circumference and asthma attack in adults.MethodsIn this cross-sectional study, we analysed data from 5,530 U.S. adults diagnosed with asthma. Participants were categorized into two groups based on their experience of asthma attacks: with or without asthma attacks. We employed adjusted weighted logistic regression models, weighted restricted cubic splines, subgroup and sensitivity analyses to assess the association between waist circumference and asthma attack.ResultsThe median age of all participants was 43 years, and the median waist circumference was 98.9 cm, with a median BMI was 28.50 kg/m2. Participants in the asthma attack group had significantly higher waist circumferences than those in the non-attack group (P < 0.001). After full adjustment for body mass index-defined obesity, age, gender, race, education levels, poverty income ratio levels, smoking status, and metabolic syndrome, every 5 cm increase in waist circumference exhibited a 1.06 times higher likelihood of asthma attack probability. The weighted restricted cubic spline analysis demonstrated an increased risk of asthma attacks with rising waist circumference. Subgroup analyses confirmed this relationship across various groups differentiated by gender, age, and smoking status. When applying a stricter definition of asthma attack, the weighted logistic regression models showed robust association between waist circumference and asthma attack.ConclusionWaist circumference is an independent predictor of asthma attacks. Our findings underscore the importance of waist circumference measurement in evaluating the risk of asthma attacks.

Social determinants of health and emergency department visits among older adults with multimorbidity: insight from 2010 to 2018 National Health Interview Survey

BackgroundMultimorbidity is prevalent among older adults and is associated with adverse health outcomes, including high emergency department (ED) utilization. Social determinants of health (SDoH) are associated with many health outcomes, but the association between SDoH and ED visits among older adults with multimorbidity has received limited attention. This study aimed to examine the association between SDoH and ED visits among older adults with multimorbidity.MethodsA cross-sectional analysis was conducted among 28,917 adults aged 50 years and older from the 2010 to 2018 National Health Interview Survey. Multimorbidity was defined as the presence of two or more self-reported diseases among 10 common chronic conditions, including diabetes, hypertension, asthma, stroke, cancer, arthritis, chronic obstructive pulmonary disease, and heart, kidney, and liver diseases. The SDoH assessed included race/ethnicity, education level, poverty income ratio, marital status, employment status, insurance status, region of residence, and having a usual place for medical care. Logistic regression models were used to examine the association between SDoH and one or more ED visits.ResultsParticipants’ mean (± SD) age was 68.04 (± 10.66) years, and 56.82% were female. After adjusting for age, sex, and the number of chronic conditions in the logistic regression model, high school or less education (adjusted odds ratio [AOR]: 1.10, 95% confidence interval [CI]: 1.02–1.19), poverty income ratio below the federal poverty level (AOR: 1.44, 95% CI: 1.31–1.59), unmarried (AOR: 1.19, 95% CI: 1.11–1.28), unemployed status (AOR: 1.33, 95% CI: 1.23–1.44), and having a usual place for medical care (AOR: 1.46, 95% CI 1.18–1.80) was significantly associated with having one or more ED visits. Non-Hispanic Black individuals had higher odds (AOR: 1.28, 95% CI: 1.19–1.38), while non-Hispanic Asian individuals had lower odds (AOR: 0.71, 95% CI: 0.59–0.86) of one or more ED visits than non-Hispanic White individuals.ConclusionSDoH factors are associated with ED visits among older adults with multimorbidity. Systematic multidisciplinary team approaches are needed to address social disparities affecting not only multimorbidity prevalence but also health-seeking behaviors and emergent healthcare access.

Association between atherogenic indexes and erectile dysfunction: a cross-sectional analysis of the National Health and Nutrition Examination Survey 2001-2004.

Elevated blood lipids are considered a risk factor for atherosclerosis, which can lead to erectile dysfunction. This study aimed to explore the relationship between the atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and erectile dysfunction. Based on the National Health and Nutrition Examination Survey (NHANES) data from 2001-2004, multivariable-adjusted logistic regression models were used to evaluate the association between AIP, AC, CRI-I, and CRI-II with ED. Smooth curve fitting was employed to assess the linear association. A total of 1806 male participants with complete data were enrolled in the study. In Model 1, those in the highest tertile of AIP had a 49% increased risk of ED compared to the lowest tertile (OR 1.49; 95% CI 1.15-1.91 p = 0.0021). After adjusting for the variables of age, race, education, body mass index, and poverty income ratio (PIR), significant positive correlations were found between ED and AIP, with each 1-unit increase in AIP associated with a 65% increase in the risk of developing ED (OR 1.65; 95% CI 1.03-2.64 p = 0.0361). AIP is positively associated with the development of ED in US adults. More prospective cohort studies are needed to confirm the link between AIP and ED.

A Comparative Study of the Breast Feeding Practice of Mothers between Rural Area and Urban Area in Bangladesh

The exclusive breast feeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months of life and the later age breastfeeding provides complete nutrition for infants and children. But it is not properly maintained in Bangladesh with limited resources, such as Sirajganj, where poverty and illiteracy are prevalent. Poor nutritional status during childhood can have long-lasting consequences in adulthood, including health, mortality, and human capital. It was a community based cross sectional comparative study which was conducted on 500 hundred mothers and their 500 hundred children in which 250 mothers and 250 children from each of Sirajganj and Dhaka City were selected. The target respondents were selecting randomly. χ 2 test, and Pearson’s correlation was performed as P&lt;0.05 level of significance. The study found that there was a higher number of female children and higher birth frequencies in Sirajganj and Dhaka City. The study assessed mothers' breast feeding practices, including knowledge of colostrums, first baby food feeding, initiation, and duration of exclusive breastfeeding. Sirajganj city mothers received more breastfeeding attention than Dhaka City mothers, with findings decreasing with child's birth order. Breast feeding privileges in Sirajganj City increase as mothers' education levels rise from low school to a bachelor's degree or higher. Breast-feeding prevalence in infants up to 12 months is influenced by factors like sex, maternal age, birth order, education, employment status, and mother's poverty income ratio. The sickness of children is also influence to stop breast-feeding. The child birth weight was found to comparatively lower in the Sirajganj city than Dhaka City.

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and kidney stones: a cross-sectional study

BackgroundThe relationship between the NHHR and kidney stone risk remains unknown. The purpose of this study was to evaluate the association between adult NHHR and kidney stone occurrence in USA.MethodsThis study used a variety of statistical techniques such as threshold effects, subgroup analysis, smooth curve fitting, multivariate logistic regression, and data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014. We aimed to clarify the relationship between the NHHR and kidney stone risk.ResultsThe average age of the 21,058 individuals in this research was 49.70 ± 17.64 years. The mean NHHR was 3.00 ± 1.47, and the overall prevalence of kidney stone occurrence was 9.05%. The prevalence within the quartile ranges (Q1–Q4) was 7.01%, 8.71%, 9.98%, and 10.49%, respectively. The overall average recurrence rate of kidney stones was 3.05%, demonstrating a significant increase with increasing NHHR (Q1: 1.92%, Q2: 2.92%, Q3: 3.35%, Q4: 4.00%, P < 0.01). The occurrence of kidney stones increased by 4% (95% CI: 1.00-1.08, P = 0.0373) and the chance of recurrence increased by 9% (95% CI: 1.03–1.14, P < 0.01) with each unit increase in NHHR. The interaction analysis results demonstrated that the relationship between the NHHR and the risk of kidney stones was not significantly impacted by the following factors: sex, body mass index, poverty income ratio, diabetes, or hypertension. Curve fitting and threshold effect analysis also demonstrated a non-linear association, with a breakpoint found at 3.17, between the NHHR and the risk of kidney stones.ConclusionsIn adults in the USA, there is a substantial correlation between elevated NHHR levels and a higher probability of kidney stones developing and recurring. Timely intervention and management of NHHR may effectively mitigate the occurrence and recurrence of kidney stones.

The Alcohol Harm Paradox in Periodontitis

Individuals of lower socioeconomic position (SEP) experience a greater rate of alcohol-related harms, yet they consume equal or lower amounts of alcohol than higher-SEP individuals. This phenomenon, called the “alcohol harm paradox” (AHP), gained attention recently, and different mechanisms have been proposed to explain it. Since both SEP and alcohol have been suggested to be associated with periodontitis risk, we conducted a secondary analysis using data from the National Health and Nutrition Examination Survey 2011 to 2012 and 2013 to 2014 cycles, aiming to examine 1) whether the association between alcohol consumption and periodontitis is modified by SEP and 2) the extent to which the effect of SEP inequalities on periodontitis is mediated by and/or interacts with alcohol consumption. We set educational attainment as the main SEP proxy and tested the poverty income ratio in subsequent sensitivity analyses. Effect measure modification analysis was employed, considering heavy drinking as exposure, and causal mediation analysis based on the potential outcome’s framework decomposed the effect of SEP on periodontitis in proportions attributable to mediation and interaction. Models were fitted using binary logistic regression and adjusted for sex, ethnicity, age, body mass index, smoking status, diabetes, binge drinking, and regular preventive dental visits. The analytical sample comprised 4,057 participants. After adjusting for covariates, less educated heavy drinkers presented 175% (odds ratio, 2.75; 95% confidence interval [CI], 2.04–3.72) higher odds of periodontitis than their counterparts, and super-additive associations were found (relative excess risk due to interaction: 1.35; 95% CI, 0.49–2.20). Additionally, −69.5% (95% CI, −122.1% to −16.8%) of the effects of education on periodontitis were attributable to interaction with heavy drinking, consistent with the AHP. No contribution was found for the mechanism of mediation. Heavy drinking disproportionately impacts the occurrence of periodontitis in lower-SEP individuals. Lower-SEP individuals seem to experience differential effects of heavy drinking on periodontitis.

Navigating the future of diabetes: innovative nomogram models for predicting all-cause mortality risk in diabetic nephropathy.

This study aims to establish and validate a nomogram model for the all-cause mortality rate in patients with diabetic nephropathy (DN). We analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016. A random split of 7:3 was performed between the training and validation sets. Utilizing follow-up data until December 31, 2019, we examined the all-cause mortality rate. Cox regression models and Least Absolute Shrinkage and Selection Operator (LASSO) regression models were employed in the training cohort to develop a nomogram for predicting all-cause mortality in the studied population. Finally, various validation methods were employed to assess the predictive performance of the nomogram, and Decision Curve Analysis (DCA) was conducted to evaluate the clinical utility of the nomogram. After the results of LASSO regression models and Cox multivariate analyses, a total of 8 variables were selected, gender, age, poverty income ratio, heart failure, body mass index, albumin, blood urea nitrogen and serum uric acid. A nomogram model was built based on these predictors. The C-index values in training cohort of 3-year, 5-year, 10-year mortality rates were 0.820, 0.807, and 0.798. In the validation cohort, the C-index values of 3-year, 5-year, 10-year mortality rates were 0.773, 0.788, and 0.817, respectively. The calibration curve demonstrates satisfactory consistency between the two cohorts. The newly developed nomogram proves to be effective in predicting the all-cause mortality risk in patients with diabetic nephropathy, and it has undergone robust internal validation.

Association of endometriosis with asthma: a study of the NHANES database in 1999–2006

ObjectiveAsthma is a chronic inflammatory disease of the airways with a gender differences in the prevalence after puberty. Recent studies have reported a relationship between asthma and endometriosis, possibly related to the immune response mechanisms, but the evidences are limited and inconsistent. Herein, this research aimed to investigate the association of endometriosis with asthma based on the representative population in the United States (U.S.) to provide some reference for further exploration on mechanism of gender difference in asthma.MethodsIn this cross-sectional study, data of women aged ≥ 20 years old were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 1999–2006. Weighted univariate and multivariate logistic regression analyses were utilized to explore the association of endometriosis with asthma. The multivariate models adjusted for covariates including age, race, education level, marital status, poverty income ratio (PIR), body mass index (BMI), waist circumference, smoking, estrogen and progesterone hormones use, uterine fibroids, at least one ovary removed, and birth control pills intake. The evaluation indexes were odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age, race, BMI, and pregnancy history were also performed.ResultsAmong 5,556 eligible women, 782 had asthma, and 380 had endometriosis. The average age of participants was 37.19 years old, and more than half of them were non-Hispanic White (68.44%). After adjusting for covariates, endometriosis was associated with higher odds of asthma compared with non-endometriosis [OR = 1.48, 95%CI: (1.10–1.99)]. This relationship was also found in 40–49 years old [OR = 2.26, 95%CI: (1.21–4.23)], BMI of 25-29.9 kg/m2 [OR = 2.87, 95%CI: (1.52–5.44)], and pregnancy history [OR = 1.44, 95%CI: (1.01–2.06)] subgroups.ConclusionEndometriosis had a positive association with asthma in adult women. Females aged 40–49 years old, with BMI of 25-29.9 kg/m2 and had a history of pregnancy should take care about monitoring endometriosis to reduce the potential risk of asthma. Further studies are still needed to clarify the causal association between endometriosis and asthma.

Association of the Controlling Nutritional Status (CONUT) score with all-cause and cause-specific mortality in patients with diabetic kidney disease: evidence from the NHANES 2009–2018

ObjectiveTo investigate the association between the Controlling Nutritional Status (CONUT) score and all-cause and cause-specific mortality in patients with diabetic kidney disease (DKD).DesignA retrospective cohort study.Setting and participantsData on patients...

The association between serum copper concentration and prevalence of diabetes among US adults with hypertension (NHANES 2011-2016).

The objective of this study was to examine the association between the serum copper concentration and the prevalence of diabetes among US adults with hypertension using the data from the National Health and Nutrition Examination Survey (NHANES). The study population was selected from adults aged over 20 years old in the three survey cycles of NHANES from 2011 to 2016. Logistic regression model analyses were applied to determine the independent risky effect of copper to the prevalence of diabetes. Also, a restricted cubic spline (RCS) model was performed to explore the potential nonlinear association between serum copper concentration and the prevalence of diabetes. A total of 1786 subjects (742 cases and 1044 controls) were included, and 924 were men (51.7%), and 742 (41.5%) were diabetic. Compared with non-diabetic individuals, the concentration of serum copper in diabetic patients with hypertension was higher. After adjusting for age, sex, race, education, marital status, body mass index (BMI), family poverty income ratio (PIR), smoking, alcohol drinking, physical activity, systolic blood pressure (SBP), diastolic blood pressure (DBP), and hyperlipidemia, the highest quartile of serum copper concentration significantly increased the risk of diabetes as compared with the lowest quartile (OR: 1.38, 95% CI: 1.01-1.92, ptrend = 0.036). The results of RCS analysis showed significant non-linear relationship between serum copper concentration and prevalence of diabetes (p-non-linear = 0.010). This study finds that serum copper concentration are significantly associated with risk of diabetes in hypertensive patients, which suggests copper as an important risk factor of diabetes development.

Association of socioeconomic status and overactive bladder in US adults: a cross-sectional analysis of nationally representative data.

Socioeconomic status inequality is an important variable in the emergence of urological diseases in humans. This study set out to investigate the association between the prevalence of overactive bladder (OAB) and the poverty income ratio (PIR) that served as a more influential indicator of socioeconomic status compared to education and occupation. Data from the National Health and Nutrition Examination Survey (NHANES) conducted from 2007 to 2020 were used in this cross-sectional study. The association between the PIR and OAB was examined using weighted multivariate logistic regression and weighted restricted cubic splines (RCS). Additionally, interaction analysis was used for investigation to the connections between PIR and OAB in various covariate groups in order to confirm the stability of the results. We observed a noteworthy inverse association between PIR and OAB after adjusting for potential confounding variables (OR = 0.87, 95% CI, 0.84-0.90, p < 0.0001). PIR was transformed into categorical variables, and the association held steady after that (1.0 < PIR <4.0 vs. PIR ≤ 1.0, OR = 0.70, 95% CI =0.63-0.77, p < 0.0001; PIR ≥ 4.0 vs. PIR ≤ 1.0, OR = 0.56, 95% CI =0.48-0.65, p < 0.0001). Additionally, RCS analysis showed that PIR and OAB had a negative nonlinear response relationship. Subgroup analyses showed that the inverse association between PIR and prevalence of OAB was stronger in obese than in nonobese individuals (P for interaction < 0.05). In our study, we observed a significant negative association between the PIR and the prevalence of OAB. In the future, PIR could be used as a reference standard to develop strategies to prevent and treat OAB.

Abstract P416: Higher Household Income is Protective Against Chronic Kidney Disease Among White but Not Black Adults: An Analysis of 2017-2020 NHANES

Introduction: Chronic kidney disease (CKD) disproportionately affects Black adults in the U.S. Prior work suggests that lower income is a risk factor for CKD among Black but not White adults; however, this has not been examined in a nationally representative population, using the updated, race-free kidney function equation. Objective: To examine the relationship between household income and CKD between Black and White adults. Methods: We used data from the 2017-2020 NHANES. CKD was defined as an estimated glomerular filtration rate (eGFR) &lt; 60 mL/min/1.73m 2 based on the race-free CKD-EPI equation and/or a urine albumin-creatinine ratio &gt;30 mg/g. The poverty income ratio (PIR) (ranging from 0 to ≥5) was reported in NHANES (calculated as a multiple of interviewees self-reported income in dollars as compared to the federal poverty line). We examined the association between PIR and CKD using survey-weighted Poisson regression models, adjusted for age, sex, education, marital status, and medical comorbidities. We also examined how this association differed between Black and White adults aged ≥18 years old in separate subgroup analyses via interaction terms. Results: The weighted sample was 51.7% female, 15.5% Black, and 84.5% White with mean age (±SE) of 47.5±0.3 years. In the total sample, and among White adults, higher household income was associated with a lower prevalence of CKD ( Table ). A one-unit higher PIR was associated with a 11% (95% CI: 5%, 16%) lower prevalence of CKD in the total sample and a 12% (95% CI: 6%, 18%) lower prevalence of CKD among White adults. However, this association was not significant for Black adults. The interaction term for race and income was significant ( P = 0.001). Conclusion: Higher income was associated with a lower risk of CKD among White, but not Black adults. Further work is needed to characterize the complex relationship between socioeconomic status and race to address disparities in CKD.

Abstract P213: Examining Sociodemographic Disparities in Physical Activity and Diabetes: Preliminary Findings From 2007-2020 National Health and Nutrition Examination Survey

Purpose: Physical activity (PA) plays a crucial role in preventing diabetes, but few studies have examined whether sociodemographic factors were associated to PA, and PA and sociodemographic factors were related to diabetes. We aimed to 1) examine associations between sociodemographic factors and PA, and 2) investigate whether PA and sociodemographic are related to the prevalence of diabetes. Methods: Data came from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), a series of cross-sectional cohort studies (total sample=30,788, Female: 49.1%, mean age =49.6). Two binary outcomes included: 1) Meeting PA guidelines (≥500 MET minutes/week) and 2) diabetes (yes/no). Sociodemographic variables included age group (20-44 [referent], 45-64, 65-79), sex, race/ethnicity (White [referent], Black, Hispanic, and other adults), and poverty income ratio (low, middle, high-income [referent]). PA guideline was also considered as exposure for diabetes analysis. By accounting for the complex survey design, two weighted generalized Poisson models were used to conduct the analyses, adjusting for covariates. Results: Model 1 showed that participants aged 45-64 and 65-79 had 14% and 16% lower likelihood of meeting PA guidelines than those aged 20-44. Females had an 18 % lower likelihood of meeting PA guidelines than males. Furthermore, Black, Hispanic, and other racial/ethnic adults were 7%, 8%, and 12% less likely to meet the PA guidelines than White adults. Adults with low- and middle-income had 13% and 8% lower likelihood of meeting PA guidelines than those with high income. Model 2 showed that participants from 2017-2020 were 22% more likely to have diabetes (AOR = 1.22) than those from 2007-2008. Adults aged 45-64 and 65-79 years had a 4.35- and 7.36-times higher likelihood of having diabetes than those aged 20-44. Females had a 25% lower likelihood of having diabetes than males. Black, Hispanic, and other groups were 49%, 35%, and 73% more likely to have diabetes than White adults, respectively. Adults with low- and middle-income had a 52% and 32% higher likelihood of having diabetes than those with high income. Adults meeting PA guidelines had a 28% lower likelihood of having diabetes than those not meeting the PA guidelines. Conclusion: The study highlights persistent disparities in PA levels and diabetes across different sociodemographic groups within the U.S. population. Future interventions targeting diabetes should prioritize addressing these disparities among vulnerable populations who do not meet PA guidelines. Emphasis should be placed on promoting PA as an integral component of diabetes prevention.

Abstract P528: Associations Between Sleep Duration and Sedentary Behavior Among Racial/Ethnic Minorities: Analysis of NHANES 2011-2018

Underlying mechanisms linking sleep to cardiovascular disease (CVD) risk are unclear, though they may be partially explained by movement behavior (e.g., sedentary time, moderate-vigorous physical activity [MVPA]). However, large-scale studies among racial/ethnic minorities are scant, which is important to address, given existing racial/ethnic disparities in CVD risk. National Health and Nutrition Examination Survey (NHANES) data was used to address these gaps. Adults 20-80 years from NHANES 2011-2018 were included in this cross-sectional study. After excluding those &lt; 20 years, those with depression, and those with missing data on sleep duration, sedentary time or MVPA, or putative confounders, 13,024 participants were included in the analysis. Sleep duration (hr./night), sedentary time (hr./day), and MVPA (hr./day) were self-reported, with sedentary time and MVPA obtained from the validated Global Physical Activity Questionnaire (GPAQ). Multivariate linear regression was used to evaluate the association between sleep duration and sedentary time, adjusted for MVPA, age, gender, race/ethnicity, body mass index, smoking history, education, and poverty income ratio. Additionally, we examined if associations between sleep duration and sedentary time varied by MVPA. Finally, we used stratification to assess whether the association between sleep duration and sedentary time varied by race/ethnicity. Median (Q1, Q3) age was 45.2 (31.1, 58.9) years and 52.3% of the sample were male. Median (Q1, Q3) sleep duration, sedentary time, and MVPA were 7.0 (6.1, 7.8) hr./night, 5.6 (3.8, 7.8) hr./day, and 2.9 (1.0, 6.1) hr./day), respectively. In the full sample, sleep duration was inversely associated with sedentary time (β = -5.5 min [95% CI: -9.3, -1.8] p = .0047), with each additional hr. of sleep duration associated with a 5.5-min decrease in sedentary time. MVPA did not change the association between sleep duration and sedentary time. After stratifying by race/ethnicity, differences in the sleep duration-sedentary time association were observed. Among multi-racial participants, every 1-hr. increase in sleep duration was associated with a 21.0-min. decrease in sedentary time (β = -21.0 min. [95% CI: -35.6, -6.5] p = .0053), a similar pattern was observed among Non-Hispanic (NH)-Asian participants (β = -12.6 min. [95% CI: -21.1, -4.0] p = .0047) and participants that identified as Mexican American or other Hispanic (β = -6.8 min. [95% CI: -11.2, -2.4] p = .0029). Associations between sleep and sedentary behavior may differ according to race/ethnicity. Findings indicate that researchers designing physical activity and sedentary behavior reduction interventions for racial/ethnic minorities should consider how sleep health may be affected. However, prospective studies with repeated measures are needed to confirm the temporality of these associations.

Prevalence and secular trends in premetabolic syndrome in the United States: Findings from 1999-2020 nationally representative data of adults

PurposeAlthough Premetabolic syndrome (PeMetSyn) is a precursor for metabolic syndrome (MetSyn), its prevalence and trends are unknown. This study examined the prevalence and trends in PreMetSyn and its association with sociodemographic risk factors in American adults. MethodsThe 1999–2000 to 2017–2020 United States National Health and Nutritional Health Surveys (NHANES) data were used. PreMetSyn was defined as co-occurrence two cardiometabolic risk factors consisting of abdominal obesity, elevated triglycerides, reduced HDL-C, elevated blood pressure, and fasting plasma glucose. We calculated sex-specific overall prevalence of PreMetSyn and by race/ethnicity, age, education, poverty, and body mass index (BMI) categories. Sex-specific logistic regression models were used to test the association between sociodemographic risk factors and PreMetSyn. ResultsFrom 1999 − 2000 to 2017–2020, the age-adjusted overall prevalence of PreMetSyn increased by 155.4% (from 9.2% to 23.5%) in men and by 131.3% (from 11.2% to 25.9%) in women. Increases in prevalence of PreMetSyn were observed by race/ethnicity, age, education, poverty and BMI levels in men and women from 1999–2000 to 2017–2020. Survey cycle, race/ethnicity, age, education, poverty-income ratio, and BMI were independently associated with greater odds of PreMetSyn in males and females. During this period, the co-occurrence of abdominal obesity and elevated blood pressure was the most common comorbidity and increased from 20.6% to 30.8% in men and from 27.8% to 36.1% in women. ConclusionsThis nationally representative study indicates a rapid increase from 1999–2000 to 2017–2020 in the proportion of American adults who meet the criteria for PreMetSyn. Early identification of subjects with PreMetSyn in the U.S. is a public health priority for initiating effective strategies to prevent the development of MetSyn and its associated chronic diseases.

Role of remnant cholesterol in the relationship between physical activity and diabetes mellitus: an intermediary analysis.

The purpose of this investigation was to evaluate the potential link between physical activity (PA) and the heightened susceptibility to diabetes mellitus (DM), by examining whether remnant cholesterol (RC) might act as a mediator in this correlation. The research utilized data from the National Health and Nutrition Examination Survey, spanning from 2005 to 2018. Various statistical analyses were conducted for continuous and categorical variables, including the t-test, ANOVA, and χ2 test. Logistic regression was employed to analyze the association between PA and DM across three distinct models. Mediation analysis was also conducted to assess the potential mediation effects of RC. The study encompassed a total of 9,149 participants, and it was observed that individuals with DM exhibited lower levels of PA. Furthermore, PA levels were found to be associated with all participant characteristics except poverty income ratio, fasting blood glucose, and HOMA-IR (p < 0.05). After adjusting for covariates (Model 3), individuals with high PA levels demonstrated a decreased likelihood of developing DM compared to those in the low PA group (OR: 0.73, 95%CI: 0.54-0.99). A significant dose-response relationship was identified (p < 0.05). No interaction between PA and RC in relation to DM risk was detected, and RC was found to serve as a mediator in the connection between PA and DM. After considering covariates, the mediating effect of RC between PA and DM weakens. Our findings suggest that higher levels of PA are linked to a reduced risk of DM in U.S. adults, with RC likely playing a mediating role.

Prevalence, trends, and characteristics of metabolic dysfunction-associated steatotic liver disease among the US population aged 12-79 years.

Clinical observation revealed an increase in metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence among adults and adolescents and young adults (AYA). However, its prevalence trend in specific subgroups and its characteristics are unclear. This cross-sectional study included adults and AYA aged 20-79 and 12-19 years, respectively, from the National Health and Nutrition Examination Survey from 1999 to 2018. MASLD was defined as US Fatty Liver Index ≥30 in adults and alanine amino transaminase elevation and obesity in AYA. Joinpoint and logistic regression were used to evaluate the MASLD prevalence trend and its associated characteristics. MASLD was diagnosed in 17 156 892 of 51 109 914 (33.6%) adults and 1 705 586 of 29 278 666 AYA (5.8%). During the study period, MASLD prevalence significantly increased from 30.8% to 37.7% ( P < 0.01) in adults and in subgroups of female participants, individuals aged 20-45 and 61-79 years, and non-Hispanic white individuals. Conversely, MASLD prevalence did not significantly change in AYA (from 5.1% to 5.2%, P = 0.139), except in the subgroup of Mexican Americans (from 8.2% to 10.8%, P = 0.01). Among adults, high MASLD prevalence was associated with male sex, Mexican American ethnicity, age >50 years, being unmarried, poverty income ratio <130, poor or fair health condition, obesity or overweight, and chronic conditions. Among AYA, high MASLD prevalence was associated with male sex, poverty income ratio <130, and education. Accordingly, we concluded that health care providers should prevent and treat conditions associated with MASLD by raising awareness of the increasing trend of MASLD.

Nomogram for Predicting the Risk of Short Sleep Duration in Myocardial Infarction Survivors.

Research on post-infarction insomnia, particularly short sleep duration following myocardial infarction (MI), remains limited. Currently, there are no existing guidelines or risk prediction models to assist physicians in managing or preventing short sleep duration or insomnia following MI. This study aims to develop a nomogram for predicting the risk of short sleep duration after MI. We conducted a retrospective study on 1434 MI survivors aged 20 and above, utilizing data from the National Health and Nutrition Examination Survey (NHANES) database spanning from 2007 to 2018. Among them, 710 patients were assigned to the training group, while 707 patients were allocated to the testing group. We utilized logistic regression, least absolute shrinkage and selection operator (LASSO) regression, and the elastic network for variable selection. The stability and accuracy of the prediction model were assessed using receiver operator characteristics (ROCs) and calibration curves. We included five variables in the nomogram: age, poverty income ratio (PIR), body mass index (BMI), race, and depression. The ROC curves yielded values of 0.636 for the training group and 0.657 for the testing group, demonstrating the model's good prediction accuracy and robustness through a calibration curve test. Our nomogram can effectively predict the likelihood of short sleep duration in MI survivors, providing valuable support for clinicians in preventing and managing post-MI short sleep duration.

Association of dietary live microbe intake with diabetic kidney disease in patients with type 2 diabetes mellitus in US adults: a cross-sectional study of NHANES 1999-2018.

Several studies have reported dietary microorganisms' beneficial effects on human health. We aimed to detect the potential association between dietary live microbe intake and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM) through a cross-sectional analysis of the National Health and Nutrition Examination Survey from 1999 to 2018. According to the Sanders classification system of dietary live microbes, the study participants were divided into three groups: low, medium, and high live microbe groups. In patients with T2DM, DKD was assessed by glomerular filtration rate (< 60mL/min/1.73m2 using the Chronic Kidney Disease Epidemiology Collaboration algorithm), proteinuria (urinary albumin to creatinine ratio ≥ 30mg/g), or both. Weighted univariate and multivariate logistic regression and subgroup analyses were conducted to investigate the independent association between dietary live microbe and DKD. The study included 3836 participants, of whom 1467 (38.24%) had DKD for the diagnosis. Our study demonstrated that participants in the high dietary live microbe group were more likely to be older, female, non-Hispanic White, have higher education levels, have a lower prevalence of smoking, have a high poverty-income ratio, have higher energy intake, lower haemoglobin (HbA1c) and serum creatinine levels, and lower risk of progression. After adjustment for covariates, patients in the high dietary live microbe group had a low prevalence of DKD, whereas no significant association with DKD was found between the medium and low dietary live microbe groups. No statistically significant interaction was observed in all subgroup analyses except for HbA1c (p for interaction < 0.05). Our results indicate that high dietary live microbe intake was associated with a low DKD prevalence.