Risk Of Disease In Adulthood Research Articles

Adverse childhood experiences and myocardial infarction: Analysis of United States Behavioral Risk Factor Surveillance System (BRFSS) data

Adverse childhood experiences (ACEs) have been linked to an increased risk of disease in adulthood and a range of other negative health outcomes, including cardiovascular disease (CVD). This study aims to build on previous research on ACEs and CVD by investigating the association between ACEs and heart attack or myocardial infarction diagnosis. Our analysis used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and ACE Module questionnaires. Responses included data from a national sample of 52,492 adults aged 18 years or older in the United States. ACEs value is a composite score of physical, emotional and sexual abuse, household dysfunction, neglect, and other childhood traumas. The study population had a mean number of 1.75 ACEs (SD 2.25), with 61% experiencing at least one ACE and 17% experiencing four or more ACEs. Almost 6% of adults in the sample reported a previous myocardial infarction (5.7%). Multiple logistic regression analysis demonstrated that, after adjusting for a variety of sociodemographic and health covariates, every one-event increase in the number of ACEs was significantly associated with 6% increased odds of myocardial infarction in adulthood (adjusted odds ratio [aOR] = 1.06, 95% confidence interval [CI] = 1.04 – 1.09, p <0.001). Efforts to decrease the incidence of myocardial infarction and reduce cardiac-related mortality in the U.S. should include policies that reduce the occurrence of ACEs and provide resources for adults to address their childhood traumas.

Correlation between triglyceride-glucose index and diabetic kidney disease risk in adults with type 1 diabetes mellitus

BackgroundThe triglyceride-glucose (TyG) index is identified as an alternative indicator of insulin resistance (IR) and is associated with macro- and micro-vascular diseases among patients with type 2 diabetes mellitus. The relationship between the TyG index and IR and its impact on diabetic kidney disease (DKD) remains unclear among adults with type 1 diabetes mellitus(T1DM).MethodsThis study comprised a cross-sectional analysis using data from the Guangdong T1DM Translational Medicine Study (GTT) and a longitudinal analysis using data from the type 1 diabetes (T1D) Exchange registry study. Correlation analysis was used to investigate the association between the TyG index and IR. Logistic regression and Cox proportional hazards regression were performed to explore the impact of the TyG index on DKD risk.ResultsThe GTT Study included 836 adults (216 with DKD and 620 without DKD). A significant correlation existed between the TyG index and the estimated glucose disposal rate (r=-0.64, p < 0.01). The TyG index was a risk factor for DKD after confounder adjustment (OR = 1.34, 95% CI:1.03–1.74). The T1D Exchange registry study included 8,771 adults (2,050 with DKD and 6,721 without DKD). After adjusting confounding factors, the TyG index was identified as an independent risk factor for DKD at enrollment, with the highest risk of DKD incidence observed in the highest TyG tertile group (OR = 1.92, 95%CI:1.67–2.20). During a median follow-up of 44.58(21.84, 67.09) months, the risk of developing DKD was increased by 32% at every 1 SD increase of the TyG index over time among participants without DKD at enrollment.ConclusionsThe TyG index could be used to assess IR and was identified as an independent risk factor of DKD among adults with T1DM.

Association between self-reported child maltreatment and risk of hospital-treated infectious diseases in middle-aged and older adults: A UK Biobank cohort study.

This study aimed to explore the association between child maltreatment and hospital-treated infectious diseases in middle-aged and older adults. 145,151 participants aged 38-72 years from the UK Biobank between 2006 and 2010 were enrolled and interviewed. Child maltreatment included five types: physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse. Patterns of maltreatment were identified using latent class analysis (LCA). Cox regression was employed to estimate the associations between child maltreatment (number of types, individual types, and patterns) and infectious diseases. Further, we evaluated potential mediators using mediation analysis. Over a median follow-up of 13.4 years, 22,688 participants (12.26 per 1000 person-years) were hospitalized for an infectious disease. Participants reporting any maltreatment had elevated infectious diseases risk (HR 1.18, 95 % CI: 1.15-1.21) than those without maltreatment. A dose-response relationship was observed between the number of maltreatment types and infectious disease (one, HR 1.09 [95 % CI 1.06-1.13]; two, HR 1.17 [95 % CI 1.12-1.23]; three to five, HR 1.48 [95 %CI 1.41-1.55]; Ptrend < 0.001). Each type of maltreatment was associated with increased infectious diseases risk. LCA identified four patterns (low maltreatment, child neglect, child abuse, and poly-maltreatment), with those experiencing poly-maltreatment exhibiting the highest infectious diseases risk (HR 1.51, 95 % CI: 1.43-1.59). The association between child maltreatment and infectious diseases was mediated by C-reactive protein, phenotypic age acceleration, loneliness, psychiatric disorders, and unhealthy lifestyles. Child maltreatment may increase susceptibility to a broad spectrum of infectious diseases in adulthood, highlighting the need for early-life maltreatment prevention policies.

Psychosocial Health and the Association Between Cerebral Small Vessel Disease Markers With Dementia: The ARIC Study.

Associations between magnetic resonance imaging markers of cerebral small vessel disease (CSVD) and dementia risk in older adults have been established, but it remains unclear how lifestyle factors, including psychosocial health, may modify this association. Social support and social isolation were assessed among participants of the community-based ARIC (Atherosclerosis Risk in Communities) Study, via self-reported questionnaires (1990-1992). Following categorization of both factors, participants were classified as having strong or poor mid-life social relationships. At visit 5 (2011-2013), participants underwent 3T brain magnetic resonance imaging quantifying CSVD measures: white matter hyperintensity volume, microbleeds (subcortical), infarcts (lacunar), and white matter integrity (diffusion tensor imaging). Incident dementia cases were identified from the time of imaging through December 31, 2020 with ongoing surveillance. Associations between CSVD magnetic resonance imaging markers and incident dementia were evaluated using Cox proportional-hazard regressions adjusted for demographic and additional risk factors (from visit 2). Effect modification by mid-life social relationships was evaluated. Of the 1977 participants with magnetic resonance imaging, 1617 participants (60.7% women; 26.5% Black participants; mean age at visit 2, 55.4 years) were examined. In this sample, mid-life social relationships significantly modified the association between white matter hyperintensity volume and dementia risk (P interaction=0.001). Greater white matter hyperintensity volume was significantly associated with risk of dementia in all participants, yet, more substantially in those with poor (hazard ratio, 1.84 [95% CI, 1.49-2.27]) versus strong (hazard ratio, 1.26 [95% CI, 1.08-1.47]) mid-life social relationships. Although not statistically significant, subcortical microbleeds in participants with poor mid-life social relationships were associated with a greater risk of dementia, relative to those with strong social relationships, in whom subcortical microbleeds were no longer associated with elevated dementia risk. The elevated risk of dementia associated with CSVD may be reduced in participants with strong mid-life social relationships. Future studies evaluating psychosocial health through the life course and the mechanisms by which they modify the relationship between CSVD and dementia are needed.

Interactive Support in The Tambak Wedi Village Area of Surabaya City to Avoid Stunting

ABSTRACT Stunting remains a serious challenge for Indonesian society. The 2018 basic health research reported that the prevalence of stunting among toddlers reached 30.8%. The impact of stunting is not only on physical growth but also on cognitive development and the risk of diseases in adulthood. Community service plays a crucial role in supporting government efforts to address stunting through nutrition education, infant and child feeding practices, sanitation, hygiene, and family economic empowerment. Based on this, the involvement of higher education institutions is necessary to improve public health through an approach of interprofessional collaboration and interprofessional education designed in community service activities that focus on empowering communities through integrative assistance. This community service is carried out in 2024, located in Tambak Wedi Village, Surabaya. The activities conducted include training and assistance in the production of processed foods based on moringa leaves and fish, health education on healthy living behaviors, guidance on parenting and breastfeeding/MPASI, training for early detection of high-risk pregnancies for families, and checking hemoglobin and protein levels for pregnant women in a state of chronic energy deficiency who receive supplementary feeding based on moringa leaves and fish. At the beginning of the community service activities, the results of health and laboratory examinations were as follows: several mothers were found to have a mid-upper arm circumference (MUAC) below 23.5 cm, which may indicate a risk of chronic energy deficiency (CED). Pregnant women were still found with hemoglobin levels below 11 g/dL, indicating anemia during pregnancy. Additionally, protein levels in pregnant women were found to be 6.2 g/dL, and there was one stunted child and seven children in a pre-stunting condition. Following up on the results of the initial health examination, interventions were carried out for pregnant women with chronic energy deficiency and toddlers at risk of stunting by providing snacks made from moringa and fish for two weeks. The Surabaya Hebat cadres also received a refresher on early detection screening for high-risk pregnant women INDEX TERMS Stunting, Moringa leaves and fish, Tambak Wedi

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

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

The Impact of 24 h Urinary Potassium Excretion on High-Density Lipoprotein Cholesterol and Chronic Disease Risk in Chinese Adults: A Health Promotion Study.

Research into the pivotal role of potassium in chronic diseases and their comorbidities remains scarce. Our aim is to elucidate the relationship between potassium and chronic diseases, including comorbid conditions, and to provide evidence-based recommendations for potassium intake in patients. This study is anchored in a representative, population-based survey conducted in Zhejiang Province, China, in 2017, encompassing participants aged 18 to 69 years. Data collection included questionnaire responses, physical measurements, and biological samples, obtained through a multistage cluster random sampling method. A subset of 1496 participants provided complete 24 h urine samples. The median age of the participants was 48.0 years (interquartile range [IQR] 24.0), with 51.1% being female, and hypertension was identified in more than one third (35.6%) of the participants. The prevalence of diabetes was approximately 9.0%, dyslipidemia was found in 34.2%, and microalbuminuria in 8.8%. The 24 h urinary excretion levels were 3613.3 mg/24 h (IQR 2161.7) for sodium and 1366.0 mg/24 h (IQR 824.9) for potassium, respectively. Potassium excretion exhibited an inverse relationship with blood pressure. Furthermore, a positive correlation was observed between potassium excretion and high-density lipoprotein cholesterol (HDL-C) levels, with an elevation of 0.03 mmol/L (95% confidence interval [CI] 0.00 to 0.05). In binary logistic regression analysis, individuals in the fourth quartile of potassium excretion (Q4) exhibited an odds ratio (OR) of 0.56 (95% CI 0.36-0.87) for hypertension compared to those in the first quartile (Q1). Urinary potassium excretion was inversely associated with low HDL-C levels, with Q4 individuals having 0.62 times the odds of having low HDL-C levels (OR, 0.62; 95% CI 0.39-1.00) compared to Q1. Potassium excretion demonstrated a direct negative correlation with certain comorbidities. This study underscores the pivotal role of potassium in the management of chronic diseases and associated comorbidities, thereby highlighting the significance of potassium in both public health initiatives and clinical practice.

Carbohydrate quality index and risk of non-alcoholic fatty liver disease in Iranian adults

Background/aimIn the current study, we aimed to assess the association of carbohydrate quality index (CQI) with the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults.MethodsThis case-control study was conducted on 225 newly diagnosed NAFLD patients and 450 controls, aged 20–60 years. A food frequency questionnaire was used to calculate the CQI and its components, including fiber intake, glycemic index, whole grains: total grains ratio, and solid carbohydrates: total carbohydrates ratio. Multivariable logistic regression was used to estimate the odds ratio (OR) of NAFLD across the tertile of CQI and its components.ResultsThe participant’s mean ± SD of body mass index and age were 26.8 ± 4.3 kg/m2 and 38.1 ± 8.8 years, respectively. The median (interquartile) CQI score in participants of the case and control groups was 20 (15–25) and 23 (18–28), respectively. In the multivariable-adjusted model, the risk of NAFLD decreased significantly across the tertiles of the CQI [(OR: 0.20; %95CI: 0.11–0.39), Ptrend <0.001)]. Also, the odds of NAFLD decreased across tertiles of solid carbohydrates to total carbohydrates ratio [(OR: 0.39; 95%CI: 0.22–0.69), Ptrend <0.001)]. However, a high dietary glycemic index (GI) was associated with increased odds of NAFLD [(OR:7.47; 95%CI: 3.89–14.33, Ptrend<0.001)]. There was no significant relationship between other CQI components, including fiber intake and whole grain/total grains and the risk of NAFLD.ConclusionsOur results revealed that a diet with a high quality of carbohydrates, characterized by higher intakes of solid carbohydrates, whole grain, and low GI carbohydrates, can be related to a reduced risk of NAFLD.

Different types and numbers metabolic abnormalities and risk of gallbladder stone disease in adults.

Metabolic abnormalities in the body increase the risk of gallbladder stones and their complications, which brings a great economic and social burden. The relationship between different types and amounts of metabolic abnormalities and gallstone risk in different sexes is poorly documented and controversial. Based on the baseline survey data of the Chinese Multi-Ethnic Cohort (CMEC) study, 4,075 Chinese adults aged 30-79 years with complete abdominal ultrasound results and metabolic index data. Logistic regression model was used to evaluate the correlation between five metabolic abnormalities and gallstones, and to explore the gender difference. The detection rate of gallbladder stones was found to be 7.0%, with a higher rate in women (8.6%) than in men (4.1%). Logistic results showed adjustment odds ratio (ORs) and 95% confidence interval (95% CI) of dysglycemia + hypertension + central obesity in 3 metabolic combinations was 4.459 (1.653, 12.029). The four metabolic combinations, dysglycemia + dyslipidemia + hypertension + central obesity, dysglycemia + dyslipidemia + hypertension + abnormal blood uric acid and dysglycemia + dyslipidemia + central obesity + abnormal blood uric acid adjusted OR and 95%CI were 3.342 (1.459, 7.659), 5.439 (1.555, 19.018) and 2.971 (1.187, 7.435), respectively. Gender-stratified analysis found that "any three or more metabolic abnormalities and their components were associated with gallstone risk, more significantly in women. Different types and amounts of five metabolic abnormalities were associated with the risk of gallstone development, and the differences were more significant in women than men.

Heavy metal contamination in soil and food crops and associated human health risks in the vicinity of Iringa Municipal dumpsite, Tanzania

Heavy metal contamination and potential risks to human health related to consuming major food crops near Iringa Municipal dumpsite are presented. Soil samples, maize (Zea mays L.) and common beans (Phaseolus vulgaris L.) were collected downslope around the dumpsite during wet season. Soil samples were analyzed using Energy-Dispersive X-Ray Fluorescence (EDXRF) while crop (maize and beans) samples were analyzed using Flame Atomic Absorption Spectrophotometer (FAAS). The potential health risks associated with human exposure to heavy metals in maize and common beans was evaluated according to the method prescribed by the United States Environmental Protection Agency. The concentrations Cd (3.25–10.78 mg/kg), As (1.84–10.98 mg/kg) and Ni (71.74–55.10 mg/kg) in soil samples exceed the maximum allowable limits set by Tanzania Bureau of Standards (TBS). The average heavy metal concentration in food crops followed the trend Cd, As < Cr, Pb < Ni < Cu < Mn < Zn with Pb in maize (0.96 mg/kg) and common beans (0.81 mg/kg) above FAO/WHO regulatory standards of 0.3 mg/kg. This implied health concerns to consuming food crops grown in the vicinity of the dumpsite. Further, lifetime–incremental cancer risk (ILCR) assessment suggest that consuming maize and common beans from the study area could increase the risk of both cancer and non-cancerous diseases in both adults and children. However, the degree of ILCR in children was noticeably higher (1.0 × 10–2) than in adults (5.10. × 10–6) for Pb in common beans. Therefore sustainable waste management should be stressed and continuous monitoring of environments around dumpsites is crucial to mitigate the negative impacts on public and environments.

Sex differences in sympathetic transduction in black and white adults: implications for racial disparities in hypertension and cardiovascular disease risk.

The prevalence of hypertension in non-Hispanic black (BL) individuals is the greatest of any racial/ethnic group. Whereas women generally display lower rates of hypertension than men of the same background, BL women display a similar if not greater burden of hypertension compared with BL men. The risk for cardiovascular disease and related events is also highest in BL individuals. Given the importance of the sympathetic nervous system for the regulation of the cardiovascular system, a growing body of literature has investigated sympathetic function in BL and non-Hispanic white (WH) individuals. Here, we are focused on emerging evidence indicating that sympathetic function may be altered in BL individuals, with particular emphasis on the process by which bursts of muscle sympathetic nerve activity (MSNA) are transduced into vasoconstriction and increases in blood pressure (sympathetic vascular transduction). To synthesize this growing body of literature we discuss sex and race differences in 1) sympathetic outflow, 2) sympathetic vascular transduction, and 3) adrenergic receptor sensitivity. Sex differences are discussed foremost, to set the stage for new data indicating a sex dimorphism in sympathetic regulation in BL individuals. Specifically, we highlight evidence for a potential neurogenic phenotype including greater adiposity-independent sympathetic outflow and enhanced sympathetic vascular transduction in BL men that is not observed in BL women. The implications of these findings for the greater hypertension and cardiovascular disease risk in BL adults are discussed along with areas that require further investigation.

Association of asthma with the risk of cardiovascular disease: A Mendelian randomization study

BackgroundAssociation of asthma with the risk of cardiovascular disease has not been fully elucidated. So, this study tried to explore the genetic effect of asthma on five cardiovascular diseases and 90 peripheral cardiovascular proteins to answer the above topic. MethodsInstrumental variables predicting asthma was extracted from its genome-wide association study data. Two-sample and multivariate MR approaches were used to assess the genetic association of exposure factor (i.e., asthma) with outcome factors (i.e., hypertension, atrial fibrillation, angina pectoris, myocardial infarction, heart failure, and 90 peripheral cardiovascular proteins). ResultsFirst, asthma nominally increased the risk of hypertension and atrial fibrillation (OR = 1.009, 95%CI = 1.003–1.016, P = 0.004; OR = 1.074, 95%CI = 1.024–1.127, P = 0.003). Second, of the 90 cardiovascular proteins, asthma was associated with the increased levels of tumor necrosis factor ligand superfamily member 14 and CC motif chemokine 4 (β = 0.145, 95%CI = 0.077–0.212, P = 2.936e-05; β = 0.128, 95%CI = 0.063–0.193, P = 1.036e-04). Third, CC motif chemokine 4 increased the risk of hypertension (P = 0.043); and after adjusting for this protein, asthma still increased the risk of hypertension, but the strength of its P-value changed from 0.004 to 0.011. ConclusionAsthma was a risk factor for hypertension and atrial fibrillation at the genetic level, and CC motif chemokine 4 might play a mediating role in the mechanism by which asthma promoted hypertension. Thus, effective control of asthma may help reduce the risk of some cardiovascular diseases in older adults.

Association between plasma Maresin 1 and the risk of atherosclerotic cardiovascular disease in Chinese adults: A community-based cohort study

Association between plasma Maresin 1 and the risk of atherosclerotic cardiovascular disease in Chinese adults: A community-based cohort study

Dietary intake of potassium, vitamin E, and vitamin C emerges as the most significant predictors of cardiovascular disease risk in adults.

Prediction models were developed to assess the risk of cardiovascular disease (CVD) based on micronutrient intake, utilizing data from 90,167 UK Biobank participants. Four machine learning models were employed to predict CVD risk, with performance evaluation metrics including area under the receiver operating characteristic curve (AUC), accuracy, recall, specificity, and F1-score. The eXtreme Gradient Boosting (XGBoost) model was utilized to rank the importance of 11 micronutrients in cardiovascular health. Results indicated that vitamin E, calcium, vitamin C, and potassium intake were associated with a reduced risk of CVD. The XGBoost model demonstrated the highest performance with an AUC of 0.952, highlighting potassium, vitamin E, and vitamin C as key predictors of CVD risk. Subgroup analysis revealed a stronger correlation between calcium intake and CVD risk in older adults and those with higher BMI, while vitamin B6 intake showed a link to CVD risk in women. Overall, the XGBoost model emphasized the significance of potassium, vitamin E, and vitamin C intake as primary predictors of CVD risk in adults, with age, sex, and BMI potentially influencing the importance of micronutrient intake in predicting CVD risk.

Childhood Adiposity and Risk of Major Clinical Heart Diseases in Adulthood: A Mendelian Randomization Study.

The causal relationship between childhood adiposity and adult risk of heart diseases has not been clearly demonstrated. This study aims to ascertain whether genetically predicted childhood body mass index (BMI) and childhood obesity are causally associated with adult coronary heart disease, myocardial infarction, heart failure, atrial fibrillation, hypertrophic cardiomyopathy, and pulmonary heart disease. To investigate the causative relationships and underlying mechanisms between childhood adiposity and adult heart diseases, 3 main methods of Mendelian randomization were used: 2-sample Mendelian randomization, multivariable Mendelian randomization with controlling for several cardiometabolic risk variables, and mediation analysis. Every 1-SD rise in genetically predicted childhood body mass index was associated with 24% (odds ratio [OR], 1.24 [95% CI, 1.12-1.37]), 28% (OR, 1.28 [95% CI, 1.14-1.42]), 28% (OR, 1.28 [95% CI, 1.14-1.42]), and 27% (OR, 1.27 [95% CI, 1.04-1.49]) higher risk of coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation, respectively. Every 1-unit increase in log-odds in childhood obesity was associated with 11% (OR, 1.11 [95% CI, 1.06-1.16]), 14% (OR, 1.14 [95% CI, 1.04-1.23]), 10% (OR, 1.10 [95% CI, 1.03-1.18]), and 20% (OR, 1.20 [95% CI, 1.08-1.32]) higher risk of coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation, respectively. The link between childhood adiposity and adult heart diseases was found to be mediated by high-density lipoprotein cholesterol, triglyceride, hypertension, and type 2 diabetes. Our findings support the causal relationships between childhood adiposity and risk of adult coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation. Blood lipids, hypertension, and type 2 diabetes are factors that mediate the aforementioned associations.

Child Maltreatment and Metabolic Syndrome: A Systematic Review.

Evidence suggests that child maltreatment (CM) is associated with an elevated risk of adult diseases in later life. Emerging evidence shows that CM in childhood is associated with metabolic syndrome (MetS) in adulthood. However, no study has systematically examined the evidence. Hence, this review aims to synthesise the evidence on the association between forms of CM and MetS in adulthood. Electronic databases of CINAHL, Medline, PsychInfo, SOCINDEX, and Scopus were systematically searched using predefined key terms to identify relevant published studies on the association between CM and MetS from the beginning of indexing to 1st January 2024. Studies were included if they met the selection criteria. The quality of studies was appraised using suitable criteria for cross-sectional and prospective studies. The search revealed a total of 2411 studies. Five studies met the inclusion criteria and were included in the review. The findings revealed that there was an association between physical abuse and MetS in women across two studies and one study in men. In addition, one study reported an association between emotional abuse and the risk of MetS in men, while two studies revealed increased odds with CM. However, no significant associations were reported between MetS and childhood sexual abuse and neglect, respectively. These findings suggest that some forms of CM may increase a person's risk of having MetS. However, there is a need for methodological improvements due to heterogeneity in studies, mainly on the assessment and definition of CM. Further research is needed on forms of CM and MetS to understand the underlying mechanisms of the associations found and to identify targeted strategies to prevent the impact of CM on MetS and subsequent future health.

AI-based abdominal CT measurements of orthotopic and ectopic fat predict mortality and cardiometabolic disease risk in adults.

To evaluate the utility of CT-based abdominal fat measures for predicting the risk of death and cardiometabolic disease in an asymptomatic adult screening population. Fully automated AI tools quantifying abdominal adipose tissue (L3 level visceral [VAT] and subcutaneous [SAT] fat area, visceral-to-subcutaneous fat ratio [VSR], VAT attenuation), muscle attenuation (L3 level), andliver attenuation were applied to non-contrast CT scans in asymptomatic adults undergoing CT colonography (CTC). Longitudinal follow-up documented subsequent deaths, cardiovascular events, and diabetes. ROC andtime-to-event analyses were performed to generate AUCs andhazard ratios (HR) binned by octile. A total of 9223 adults (mean age, 57 years; 4071:5152 M:F) underwent screening CTC from April 2004 to December 2016. 549 patients died on follow-up (median, nine years). Fat measures outperformed BMI for predicting mortality risk-5-year AUCs for muscle attenuation, VSR, and BMI were 0.721, 0.661, and 0.499, respectively. Higher visceral, muscle, and liver fat were associated with increased mortality risk-VSR > 1.53, HR = 3.1; muscle attenuation < 15 HU, HR = 5.4; liver attenuation < 45 HU, HR = 2.3. Higher VAT area and VSR were associated with increased cardiovascular event and diabetes risk-VSR > 1.59, HR = 2.6 for cardiovascular event; VAT area > 291 cm2, HR = 6.3 for diabetes (p < 0.001). A U-shaped association was observed for SAT with a higher risk of death for very low and very high SAT. Fully automated CT-based measures of abdominal fat are predictive of mortality and cardiometabolic disease risk in asymptomatic adults and uncover trends that are not reflected in anthropomorphic measures. Fully automated CT-based measures of abdominal fat soundly outperform anthropometric measures for mortality and cardiometabolic risk prediction in asymptomatic patients. Abdominal fat depots associated with metabolic dysregulation and cardiovascular disease can be derived from abdominal CT. Fully automated AI body composition tools can measure factors associated with increased mortality and cardiometabolic risk. CT-based abdominal fat measuresuncover trends in mortality and cardiometabolic risk not captured by BMI in asymptomatic outpatients.

Associations of body mass index and waist circumference with risk of chronic kidney disease in adults in China

Objective: To examine the associations of BMI and waist circumference (WC) with the risk of chronic kidney disease (CKD) and its subtypes in adults in China. Methods: The data from the China Kadoorie Biobank were used. After excluding those with cancer, coronary heart disease, stroke, or CKD at baseline survey, 480 430 participants were included in this study. Their body height and weight, and WC were measured at baseline survey. Total CKD was defined as diabetic kidney disease (DKD), hypertensive nephropathy (HTN), glomerulonephritis (GN), chronic tubulointerstitial nephritis (CTIN), obstructive nephropathy (ON), CKD due to other causes, and chronic kidney failure. Cox proportional hazards regression model was used to estimate the associations between exposure factors and risks of outcomes. Results: During a follow-up period of (11.8±2.2) years, 5 486 cases of total CKD were identified, including 1 147 cases of DKD, 340 cases of HTN, 1 458 cases of GN, 460 cases of CTIN, 598 cases of ON, 418 cases of CKD due to other causes, and 1 065 cases of chronic kidney failure. After adjusting for socio-demographic factors, lifestyle factors, baseline prevalence of hypertension and diabetes, and WC and compared to participants with normal BMI (18.5-23.9 kg/m2), the hazard ratios (HRs) of total CKD for underweight (<18.5 kg/m2), overweight (24.0-27.9 kg/m2), and obese (≥28.0 kg/m2) were 1.42 (95%CI: 1.23-1.63), 1.00 (95%CI: 0.93-1.08) and 0.98 (95%CI: 0.87-1.10), respectively. Stratification analysis by WC showed that BMI was negatively associated with risk for total CKD in non-central obese participants (WC: <85.0 cm in men and <80.0 cm in women) (HR=0.97, 95%CI: 0.96-0.99), while the association was positive in central obese participants (≥90.0 cm in men and ≥85.0 cm in women) (HR=1.03, 95%CI: 1.01-1.05). The association between BMI and GN was similar to that of total CKD. BMI was associated with an increased risk for HTN, with a HR of 1.12 (95%CI: 1.06-1.18) per 1.0 kg/m2 higher BMI. After adjusting for potential confounders and BMI, compared to participants with non-central obesity, the HRs for pre-central obesity (WC: 85.0-89.9 cm in men and 80.0-84.9 in women) and central obesity were 1.26 (95%CI: 1.16-1.36) and 1.32 (95%CI: 1.20-1.45), respectively. With the exception of HTN and CTIN, WC was positively associated with risks for all CKD subtypes. Conclusions: BMI-defined underweight and central obesity were independent risk factors for total CKD, and BMI and WC had different associations with risks for disease subtypes.

Prospective association study of sleep status and risk of coronary heart disease in adults in Suzhou

Objective: To investigate the association between sleep status and the risk for coronary heart disease in adults in Suzhou. Methods: Using the baseline and follow up information of 53 269 local residents aged 30-79 years in China Kadoorie Biobank conducted in Wuzhong District, Suzhou, 51 929 subjects were included in this study after excluding those reporting coronary heart disease, stroke and cancer at the baseline survey. A Cox proportional hazards regression model was used to analyze the association of healthy sleep score (0-3 points) and sleep factors (snoring, insomnia, long sleep duration and nap) with the risk for coronary heart disease. Results: The median follow-up time was 11.12 years, and 1 304 individuals were diagnosed with coronary heart disease during the follow-up. After adjusting for potential confounders, occasional snoring (HR=1.20, 95%CI: 1.04-1.38), usual snoring (HR=1.17, 95%CI: 1.02-1.33), insomnia disorder (HR=1.41, 95%CI: 1.12-1.78), daytime dysfunction (HR=1.56, 95%CI: 1.20-2.03) and perennial nap (HR=1.37, 95%CI: 1.19-1.59) were associated with increased risk of coronary heart disease. Compared with those with sleep score of 0 - 1 (low sleep quality), the people with sleep score of 3 had reduced risk of coronary heart disease by 26% (HR=0.74, 95%CI: 0.63-0.87). Stratified analysis showed that the association of healthy sleep score 3 with risk of coronary heart disease was stronger in low physically active individuals (interaction P<0.05). Conclusions: Snoring, insomnia disorders, daytime dysfunction, and perennial napping were all associated with increased risk for coronary heart disease, and keep healthy sleep mode might reduce the risk for coronary heart disease in adults.

Relationship Between Serum Thyrotropin Levels and Metabolic Diseases in Older Adults.

Subclinical hypothyroidism is associated with metabolic diseases; however, it remains controversial in older individuals. This work aimed to investigate the relationship between thyrotropin (TSH) levels and metabolic diseases. In this cross-sectional study, sampling was conducted from nationally representative general communities from 31 provinces in mainland China. A total of6791 older (aged ≥65 years) and 55 303 young participants (aged 18-64 years) were selected after excluding individuals with overt hyperthyroidism or overt hypothyroidism. According to the kit, TSH reference range (0.27-4.2 mU/L) and the age-specific TSH range previously formulated (an upper limit of 8.86 mU/L for older adults and 6.57 mU/L for young adults), the older adults and young adults were separately divided into 4 groups based on their TSH levels. Main outcome measures included anthropometric assessments, serum concentrations of thyroid functions, and various metabolic parameters. In contrast to young adults, there was no significant increase in the prevalence of any metabolic disorders assessed in the slightly elevated TSH group (TSH 4.21-8.86 mU/L) compared to the euthyroid group (TSH 0.27-4.2 mU/L) among older adults. After adjusting for interference factors, a TSH level higher than 8.86 mU/L was found to be an independent risk factor for low high-density lipoprotein cholesterol (OR, 1.84; 95% CI, 1.14-2.98) and dyslipidemia (OR, 1.49; 95% CI, 1.09-2.04) when compared to the euthyroid group in older adults. Slightly elevated TSH levels are not associated with an increased risk of metabolic diseases in older adults. Therefore, we recommend raising the upper limit of the TSH range for individuals aged 65 years and older.