Risk Of Major Chronic Diseases Research Articles

Association between walking pace and risks of major chronic diseases in individuals with hypertension based on a prospective study in UK Biobank: Involvement of inflammation

ObjectiveWalking pace is associated with risks of major chronic diseases including cancer, cardiovascular disease (CVD) and diabetes mellitus type 2 (T2DM) in the general population. However, whether increasing walking pace could reduce risks of major chronic diseases in individuals with hypertension remains to be explored, and the underlying mechanism potentially mediated by low-grade inflammation is also unclear. MethodsA total of 160,470 participants with hypertension were included based on the UK Biobank. The relationships of the walking pace and low-grade inflammation with risks of major chronic diseases in individuals with hypertension were assessed by the Cox proportional hazards model. Mediation analyses were performed to investigate the contribution of low-grade inflammation to the association between walking pace and risks of major chronic diseases. ResultsIndividuals with hypertension at the brisk walking pace had decreased risks of overall cancer and site-specific cancers (liver, lung, and endometrial cancers), all CVD events (angina, atrial fibrillation, heart failure, myocardial infarction, peripheral vascular disease and stroke), and T2DM (hazard ratios: 0.42–0.91). Increasing low-grade inflammation was associated with higher risks of aforementioned diseases except liver cancer and atrial fibrillation. Furthermore, low-grade inflammation partially mediated associations of the walking pace with risks of lung cancer, T2DM, and all CVD events (except atrial fibrillation), with mediation proportion of 2.0%–9.8%. ConclusionsBrisk walking pace was linked to reduced risks of major chronic diseases in individuals with hypertension, partially mediated by low-grade inflammation. Improving walking pace may be beneficial for health in individuals with hypertension.

High-quality fruit and vegetable characterized by cardiometabolic biomarkers and its relation to major chronic disease risk: results from 3 prospective United States cohort studies

BackgroundThe current guidelines recommend a specified total serving of fruits and vegetables (FV). However, how differences in their nutritional quality of specific FV influence overall health remains unclear. ObjectivesTo identify high-quality FV using 14 cardiometabolic biomarkers, and assess their consumption, alongside overall FV intake, with chronic disease risk. MethodsWe used data from 3 prospective cohorts, Health Professionals Follow-up Study, Nurses’ Health Study (NHS), and NHSII. Diet was assessed at baseline and updated every 4 y. Biomarker analysis was conducted on 41,714 participants using generalized linear models. Metabolic quality was ascertained by each FV’s association with biomarkers. Major chronic disease risk analysis involved 207,241 participants followed for 32 y with Cox proportional hazards models. We also analyzed atherosclerotic cardiovascular disease (ASCVD), type 2 diabetes (T2D), cancer, and chronic obstructive pulmonary disease (COPD) as secondary outcomes. ResultsOf 52 FV items, 19 were identified as high-metabolic quality (top 5: apples/pears, iceberg/head lettuce, raw spinach, alfalfa sprouts, and eggplant/summer squash). In disease risk analysis, 60,712 major chronic disease events were recorded. A higher proportion of high-metabolic quality FV intake was associated with lower chronic disease risk across total FV quantity levels. In each quantity level stratum (quartiles Q1–Q4), comparing the highest to the lowest quality proportion quartiles, the hazard ratio (HR) (95% confidence interval [CI]) were 0.85 (0.81–0.90), 0.86 (0.82–0.90), 0.84 (0.80–0.89), and 0.89 (0.84–0.94), all P-trend < 0.001. Patterns were similar for ASCVD, T2D, and COPD but less consistent for cancer. High total FV intake, if consisting mostly of neutral or low-metabolic quality items, was not associated with lower chronic disease risk. For diabetes specifically, these were associated with significantly higher risk [quantity-Q3, HR: 1.13 (1.05, 1.22); quantity-Q4, HR: 1.17 (1.07, 1.28)]. ConclusionsOur findings indicate the importance of considering both quality and quantity of FV for health, and support dietary guidelines to emphasize high-metabolic quality FV consumption alongside overall intake.

Association of Stair Use With Risk of Major Chronic Diseases

Physical inactivity is associated with a higher risk of chronic diseases. Regular stair use can contribute to increasing physical activity in the population. This study aimed to investigate the association between flights of stairs used daily at home and all-cause mortality and cause-specific incidence and mortality. Of the 502,628 UK Biobank participants recruited between 2007 and 2010, 442,027 (mean age, 56±8 years) had available data and were included in the analyses conducted in 2023. Participants were categorized on the basis of flights of stairs climbed daily (1-5, 6-10, 11-15, >15). The disease-specific outcomes were cardiovascular disease, respiratory disease, cancer, type 2 diabetes, and all-cause dementia. Cox proportional hazard models, adjusted for sociodemographic, lifestyle, and health-related confounding factors, were used to analyze the associations between stair use frequency and health outcomes. Participants were followed up for a median of 10.9 years. Climbing stairs >15 times per day was associated with a lower risk of 8 of the 9 outcomes analyzed than not using stairs. The magnitude of association ranged from 3% (95% CI=0.94, 0.99) lower risk for all-cause cancer to 51% (95% CI=0.39, 0.60) lower risk of chronic obstructive pulmonary disease. Findings were similar for mortality outcomes, with the hazard ratios ranging from 0.82 (95% CI=0.77, 0.87) for all-cause cancer to 0.46 (95% CI=0.23, 0.92) for chronic obstructive pulmonary disease mortality. Stair use was associated with a lower risk of all-cause mortality and cause-specific incidence and mortality independent of confounding factors, including adiposity and multimorbidity.

Evaluation of Phytochemical Constituents of Fresh Roots Aqueous and Ethanolic Extracts of the Medicinal Plants of Uvaria chamae, Anthocleista djalonensis and Euadenia eminens

Phytochemicals are bioactive plant chemicals nutrients typically found in fruits, vegetables, grains, and other plant foods which may provide desirable health benefits beyond basic nutrition and can help reduce risks of major chronic diseases. This study was conducted to evaluate the phytochemical constituents of fresh roots ethanolic and aqueous extracts of medicinal plants of Uvaria chamae, Anthocleista djalonensis and Euadenia eminens using standard methods of phytochemical screening and Gas Chromatography - Mass Spectrometry (GC-MS) analysis. Phytochemical screening revealed a diverse array of phytochemical constituents such as alkaloids, flavonoids, phenols, tannins, saponins, isoprenoids, steroids, phlobatanins and cardiac glycosides. The results of GC-MS analysis of aqueous and ethanolic extracts of U. chamae revealed the presence of four and fourteen compounds respectively. Aqueous and ethanolic extracts of A. djalonensis had ten and seventeen compounds respectively while the aqueous and ethanolic extracts of E. eminens was found to have six and twenty compounds respectively. These results indicate U. chamae, A. djalonensis and E. eminens possess phytochemicals which have potential antioxidant, antidiabetic, anticancer, anti-inflammatory activity amongst others and as such, can be recommended as plants of phytopharmaceutical importance.

Optimal dietary patterns for prevention of chronic disease.

Multiple dietary patterns have been associated with different diseases; however, their comparability to improve overall health has yet to be determined. Here, in 205,852 healthcare professionals from three US cohorts followed for up to 32 years, we prospectively assessed two mechanism-based diets and six diets based on dietary recommendations in relation to major chronic disease, defined as a composite outcome of incident major cardiovascular disease (CVD), type 2 diabetes and cancer. We demonstrated that adherence to a healthy diet was generally associated with a lower risk of major chronic disease (hazard ratio (HR) comparing the 90th with the 10th percentile of dietary pattern scores = 0.58-0.80). Participants with low insulinemic (HR = 0.58, 95% confidence interval (CI) = 0.57, 0.60), low inflammatory (HR = 0.61, 95% CI = 0.60, 0.63) or diabetes risk-reducing (HR = 0.70, 95% CI = 0.69, 0.72) diet had the largest risk reduction for incident major CVD, type 2 diabetes and cancer as a composite and individually. Similar findings were observed across gender and diverse ethnic groups. Our results suggest that dietary patterns associated with markers of hyperinsulinemia and inflammation and diabetes development may inform on future dietary guidelines for chronic disease prevention.

Micro- and nanoencapsulation of natural phytochemicals: Challenges and recent perspectives for the food and nutraceuticals industry applications.

Worldwide, there has been growing interest in the research, development, and commercialization of functional bioactive components and nutraceuticals. As a result of consumer awareness of the relationship between diet, health, and disease, the consumption of plant-derived bioactive components has recently increased in the past two decades. Phytochemicals are bioactive nutrient plant chemicals in fruits, vegetables, grains, and other plant foods that may provide desirable health benefits beyond essential nutrition. They may reduce the risk of major chronic diseases, cardiovascular diseases, cancer, osteoporosis, diabetes, high blood pressure, and psychotic diseases and have antioxidant, antimicrobial, and antifungal properties, cholesterol-lowering, antithrombotic, or anti-inflammatory effects. Phytochemicals have been recently studied and explored for various purposes, such as pharmaceuticals, agrochemicals, flavors, fragrances, coloring agents, biopesticides, and food additives. These compounds are known as secondary metabolites and are commonly classified as polyphenols, terpenoids (terpenes), tocotrienols and tocopherols, carotenoids, alkaloids and other nitrogen-containing metabolites, stilbenes and lignans, phenolic acids, and glucosinates. Thus, this chapter aims to define the general chemistry, classification, and essential sources of phytochemicals, as well as describe the potential application of phytochemicals in the food and nutraceuticals industry, explaining the main properties of interest of the different compounds. Finally, the leading technologies involving micro and nanoencapsulation of phytochemicals are extensively detailed to protect them against degradation and enhance their solubility, bioavailability, and better applicability in the pharmaceutical, food, and nutraceutical industry. The main challenges and perspectives are detailed.

Phytochemical Based Nano Design for Cancer: A Recent Update

Despite exponential advancements in medical research, various types of cancer are increasing day by day and becoming a leading cause of mortality worldwide. The worldwide cancer burden has increased to 19.3 million new cases and 10 million cancer deaths in 2020. Changes in food habits, lifestyle, different types of food additives, synthetic chemicals, environmental pollutants, different types of radiation, and limited physical activities have led to a severe increment in this disease. Healthy nutritive foods and phytochemicals play an essential role in supporting the immune system, which is beneficial in combating various types of cancer. Phytochemicals are natural bioactive non-nutrient compounds derived from various plant sources, reducing the risk of major chronic diseases. It can be easily classified and categorized into different groups based on its chemical nature and mode of biological action. These bioactive compounds are effective against various types of cancers. Recently the role of several novel phytochemicals and nanoformulations has been explored and extensively applied in cancer therapeutics. This review provides insight into various traditional phytochemicals and novel nanoformulations used in cancer management.

Red Fruits Composition and Their Health Benefits—A Review

The probability that fruit ingestion may protect human health is an intriguing vision and has been studied around the world. Therefore, fruits are universally promoted as healthy. Over the past few decades, the number of studies proposing a relationship between fruit intake and reduced risk of major chronic diseases has continued to grow. Fruits supply dietary fiber, and fiber intake is linked to a lower incidence of cardiovascular disease and obesity. Fruits also supply vitamins and minerals to the diet and are sources of phytochemicals that function as phytoestrogens, antioxidant and anti-inflammatory agents, and other protective mechanisms. So, this review aims to summarize recent knowledge and describe the most recent research regarding the health benefits of some selected red fruits.

Polygenic risk score: a useful clinical instrument for disease prediction and risk categorization

Genetic information is one of the essential components of precision medicine. Over the past decade, substantial progress has been made, such as low-cost, high-throughput genotyping arrays, advances in statistical techniques, and progressively larger discovery datasets, enabling the discovery of alleles contributing to common diseases, such as coronary artery disease and type 2 diabetes. The polygenic risk score (PRS) represents the aggregate contribution of numerous common genetic variants, individually conferring small to moderate effects, and can be used as a marker of genetic risk for major chronic diseases. PRSs can be obtained from early childhood, and only one measurement is needed to determine the score. PRSs can potentially be used for triage of further investigations to confirm disease susceptibility and to optimize individualized preventive strategies for high-risk disease groups. We provide an overview and commentary on important advances in deriving and validating PRSs, as well as the implementation of PRSs for clinically useful purposes.

Ginger nanoparticles mediated induction of Foxa2 prevents high-fat diet-induced insulin resistance.

Rationale: The obesity epidemic has expanded globally, due in large part to the increased consumption of high-fat diets (HFD), and has increased the risk of major chronic diseases, including type 2 diabetes. Diet manipulation is the foundation of prevention and treatment of obesity and diabetes. The molecular mechanisms that mediate the diet-based prevention of insulin resistance, however, remain to be identified. Here, we report that treatment with orally administered ginger-derived nanoparticles (GDNP) prevents insulin resistance by restoring homeostasis in gut epithelial Foxa2 mediated signaling in mice fed a high-fat diet (HFD).Methods: Ginger-derived nanoparticles (GDNP) were added into drinking water to treat high-fat diet fed mice for at least one year or throughout their life span. A micro array profile of intestinal, liver and fat tissue of GDNP treated mice was used to analyze their gene expression profile. Genes associated with metabolism or insulin signaling were further quantified using the real time polymerase chain reaction (RT-PCR). Surface plasmon resonance (SPR) was used for determining the interaction between Foxa2 protein and phosphatic acid lipid nanoparticles.Results: HFD-feeding inhibited the expression of Foxa2; the GDNPs increased the expression of Foxa2 and protected Foxa2 against Akt-1 mediated phosphorylation and subsequent inactivation of Foxa2. Increasing expression of Foxa2 leads to altering the composition of intestinal epithelial cell (IEC) exosomes of mice fed a HFD and prevents IEC exosome mediated insulin resistance. Collectively, oral administration of GDNP prevents insulin resistance in HFD mice. Interestingly, oral administration of GDNP also extended the life span of the mice and inhibited skin inflammation.Conclusion: Our findings showed that GDNP treatment can prevent HFD-induced obesity and insulin resistance via protecting the Foxa2 from Akt-1 mediated phosphorylation. GDNP treatment provides an alternative approach based on diet manipulation for the development of therapeutic interventions for obesity.

Ageing, Age-Related Cardiovascular Risk and the Beneficial Role of Natural Components Intake.

Ageing, in a natural way, leads to the gradual worsening of the functional capacity of all systems and, eventually, to death. This process is strongly associated with higher metabolic and oxidative stress, low-grade inflammation, accumulation of DNA mutations and increased levels of related damage. Detrimental changes that accumulate in body cells and tissues with time raise the vulnerability to environmental challenges and enhance the risk of major chronic diseases and mortality. There are several theses concerning the mechanisms of ageing: genetic, free radical telomerase, mitochondrial decline, metabolic damage, cellular senescence, neuroendocrine theory, Hay-flick limit and membrane theories, cellular death as well as the accumulation of toxic and non-toxic garbage. Moreover, ageing is associated with structural changes within the myocardium, cardiac conduction system, the endocardium as well as the vasculature. With time, the cardiac structures lose elasticity, and fibrotic changes occur in the heart valves. Ageing is also associated with a higher risk of atherosclerosis. The results of studies suggest that some natural compounds may slow down this process and protect against age-related diseases. Animal studies imply that some of them may prolong the lifespan; however, this trend is not so obvious in humans.

Nutritional and Antioxidant Value of Horticulturae Products

The recent growing interest towards the nutraceutical and antioxidant value of fruit and vegetables has arisen from their content of phytochemicals, which provide desirable health benefits, beyond basic nutrition, to reduce the risk of major chronic diseases [...]

Risk of major chronic diseases in transport, rescue and security industries: a longitudinal register-based study

ObjectiveTo investigate the risk of hospitalisation for major chronic diseases across representative transport, rescue and security industries.MethodsWe performed a register-based study of 624 571 workers from six industries in Denmark...

Muscle-strengthening activities and risk of cardiovascular disease, type 2 diabetes, cancer and mortality: A review of prospective cohort studies.

The benefits of aerobic moderate-to-vigorous physical activity (MVPA) on major non-communicable diseases (NCDs) are well established. However, much less is known whether muscle-strengthening activities (i.e., resistance/weight/strength training) confer similar benefits. Herein, we conducted a narrative literature review and summarized the existing evidence from large prospective cohort studies on muscle strengthening activities and risk of major chronic diseases and mortality in adults generally free of major NCDs at baseline. Current epidemiologic evidence suggests that engagement in muscle-strengthening activities over 1-2 sessions (or approximately 60-150 min) per week was associated with reduced risk of cardiovascular disease (seven studies; approximately 20%-25% reduction), type 2 diabetes (four studies; approximately 30% reduction), cancer mortality (four studies; approximately 15%-20% reduction) as well as all-cause mortality (six studies; approximately 20%-25% reduction). For diabetes, the risk appears to lower further with even higher levels of muscle-strengthening activities, but some studies for cardiovascular and all-cause mortality suggest a reversal whereby higher levels (≥2.5 h/week) have less benefit, or are even harmful, relative to lower levels of activity. The likely mechanisms contributing to a benefit include improvement in body composition, lipid profile, insulin resistance and inflammation. The evidence supports engaging in 1-2 sessions (up to 2.5 h) per week, preferably performed complementary to the recommended levels of aerobic MVPA. Although data are limited, caution is suggested for training exceeding 2.5 h per week. Further studies are required to better understand the influence of frequency, duration and intensity of muscle-strengthening activities on major NCDs and mortality in diverse populations.

Nutritional epidemiology and the Women’s Health Initiative: a review

The dietary modification (DM) clinical trial, within the Women's Health Initiative (WHI), studied a low-fat dietary pattern intervention that included guidance to increase vegetables, fruit, and grains. This study was motivated in part from uncertainty about the reliability of observational studies examining the association between dietary fat and chronic disease risk by using self-reported dietary data. In addition to this large trial, which had breast and colorectal cancer as its primary outcomes, a substantial biomarker research effort was initiated midway in the WHI program to contribute to nutritional epidemiology research more broadly. Here we review and update findings from the DM trial and from the WHI nutritional biomarker studies and examine implications for future nutritional epidemiology research. The WHI included the randomized controlled DM trial (n = 48,835) and a prospective cohort observational (OS) study (n = 93,676), both among postmenopausal US women, aged 50-79 y when enrolled during 1993-1998. Also reviewed is a nutrition and physical activity assessment study in a subset of 450 OS participants (2007-2009) and a related controlled feeding study among 153 WHI participants (2010-2014). Long-term follow-up in the DM trial provides evidence for intervention-related reductions in breast cancer mortality, diabetes requiring insulin, and coronary artery disease in the subset of normotensive healthy women, without observed adverse effects or changes in all-cause mortality. Studies of intake biomarkers, and of biomarker-calibrated intake, suggest important associations of total energy intake and macronutrient dietary composition with the risk for major chronic diseases among postmenopausal women. Collectively these studies argue for a nutrition epidemiology research agenda that includes major efforts in nutritional biomarker development, and in the application of biomarkers combined with self-reported dietary data in disease association analyses. We expect such efforts to yield novel disease association findings and to inform disease prevention approaches for potential testing in dietary intervention trials. This trial was registered at clinicaltrials.gov as NCT00000611.

Weight Gain After Smoking Cessation and Risk of Major Chronic Diseases and Mortality

Smoking cessation is frequently followed by weight gain; however, whether weight gain after quitting reduces the health benefits of quitting is unclear. To examine the association between weight change after smoking cessation and the risk of cardiovascular diseases (CVD), type 2 diabetes, cancer, chronic obstructive pulmonary disease (COPD), and all-cause mortality. This cohort study analyzed data from a nationally representative sample of Australian adults aged 18 years or older who were studied between 2006 and 2014. Smoking status and anthropometric measurements were self-reported annually. Cox proportional hazards regressions were used to determine the hazard ratios (HRs) for the association between changes in weight and body mass index (BMI) and the risk of CVD, type 2 diabetes, cancer, COPD, and mortality. Data were analyzed in January 2019. Annual self-reported smoking status; years since quitting. Weight gain after quitting, incident CVD, type 2 diabetes, cancer, COPD, and all-cause mortality. Of a total 16 663 participants (8082 men and 8581 women; mean [SD] age, 43.7 [16.3] years), those who quit smoking had greater increases in weight (mean difference [MD], 3.14 kg; 95% CI, 1.39-4.87) and BMI (MD, 0.82; 95% CI, 0.21-1.44) than continuing smokers. Compared with continuing smokers, the HRs for death were 0.50 (95% CI, 0.36-0.68) among quitters who lost weight, 0.79 (95% CI, 0.51-0.98) among quitters without weight change, 0.33 (95% CI, 0.21-0.51) among quitters who gained 0.1 to 5.0 kg, 0.24 (95% CI, 0.11-0.53) among quitters who gained 5.1 to 10 kg, and 0.36 (95% CI, 0.16-0.82) among quitters who gained more than 10 kg. The HRs for death were 0.61 (95% CI, 0.45-0.83) among quitters who lost BMI, 0.86 (95% CI, 0.51-1.44) among quitters without change in BMI, 0.32 (95% CI, 0.21-0.50) among quitters who gained up to 2 in BMI, and 0.26 (95% CI, 0.16-0.45) among quitters who gained more than 2 in BMI. This cohort study found that smoking cessation was accompanied by a substantial weight gain; however, this was not associated with an increased risk of chronic diseases or an attenuation of the mortality benefit of cessation.

Eating Habits Associated with Overweight and Obesity: Case - Control Study in 11-14 year old Adolescents in Hanoi in 2020

Eating Habits Associated with Overweight and Obesity: Case - Control Study in 11-14 year old Adolescents in Hanoi in 2020

A nutrient pattern characterized by vitamin A, C, B6, potassium, and fructose is associated with reduced risk of insulin\u2010related disorders: A prospective study among participants of Tehran lipid and glucose study

BackgroundInsulin-related disorders, including insulin resistance, insulin insensitivity, and insulinemia, is considered early predictors of major chronic disease risk. Using a set of correlated nutrient as nutrient patterns to explore the diet-disease relationship has drawn more attention recently. We aimed to investigate the association of nutrient patterns and insulin markers’ changes prospectively among adults who participated in the Tehran Lipid and Glucose Study (TLGS).Methods For the present study, 995 men and women aged 30–75 years, with complete information on insulin and dietary intake in survey III TLGS, were selected and followed three years until survey IV. Dietary intakes at baseline were assessed using a valid and reliable food frequency questionnaire (FFQ). Nutrient patterns were derived using principal component analysis (PCA). We extracted five dominant patterns based on the scree plot and categorized them into quartiles. Linear regression analysis was conducted to investigate the association between Nutrient patterns and three-year insulin markers changes, including fasting insulin, HOMA-IR, and HOMA-S.ResultsThe mean (SD) age and BMI of participants (43.1 % male) were 46.2(10.9) year and 28.0(4.7) kg/m2, respectively. The median (IQR, 25, 75) of 3 years changes of insulin, HOMA-IR and HOMA-S were 0.35 (− 1.71, 2.67) mU/mL, 0.25 (− 0.28, 0.84) and − 6.60 (− 22.8, 7.76), respectively. In the fully adjusted model for potential confounders, per each quartile increment of the fifth nutrient pattern, the β coefficients (95 % CI) of changes in insulin, HOMA-IR, and HOMA-S were − 0.36 (− 0.62, − 0.10); P value = 0.007, -0.10 (-0.19, -0.01); P value = 0.022, and 1.92 (0.18, 3.66); P value = 0.030, respectively. There were no significant association between other nutrient patterns and insulin related indices.ConclusionsPresent study showed that high adherence to a nutrient pattern rich in vitamin A, vitamin C, pyridoxine, potassium, and fructose is inversely associated with 3-years changes in insulin, HOMA-IR, and directly associated with HOMA-S.

Logistic regression was as good as machine learning for predicting major chronic diseases

ObjectiveTo evaluate the performance of machine learning (ML) algorithms and to compare them with logistic regression for the prediction of risk of cardiovascular diseases (CVDs), chronic kidney disease (CKD), diabetes (DM), and hypertension (HTN) and in a prospective cohort study using simple clinical predictors. Study Design and SettingWe conducted analyses in a population-based cohort study in Asian adults (n = 6,762). Five different ML models were considered—single-hidden-layer neural network, support vector machine, random forest, gradient boosting machine, and k-nearest neighbor—and were compared with standard logistic regression. ResultsThe incidences at 6 years of CVD, CKD, DM, and HTN cases were 4.0%, 7.0%, 9.2%, and 34.6%, respectively. Logistic regression reached the highest area under the receiver operating characteristic curve for CKD (0.905 [0.88, 0.93]) and DM (0.768 [0.73, 0.81]) predictions. For CVD and HTN, the best models were neural network (0.753 [0.70, 0.81]) and support vector machine (0.780 [0.747, 0.812]), respectively. However, the differences with logistic regression were small (less than 1%) and nonsignificant. Logistic regression, gradient boosting machine, and neural network were systematically ranked among the best models. ConclusionLogistic regression yields as good performance as ML models to predict the risk of major chronic diseases with low incidence and simple clinical predictors.

Alanine Aminotransferase and 20-Year Risk of Major Chronic Diseases and Death in a Healthy Cohort Aged 30 to 49 Years.

PurposeAlanine aminotransferase is the most frequently used marker of liver cell injury. We examined the association between alanine aminotransferase levels and long-term absolute risks of morbidity and mortality in healthy Danish people aged 30–49 years.Patients and MethodsWe divided 671 healthy participants from the Ebeltoft Health Promotion Project into four categories based on their baseline alanine aminotransferase values: low (≤10U/l), medium-low (men: 11–34U/l, women: 11–22U/l), medium-high (men: 35–69U/l, women: 23–44U/l) and high (men: ≥70U/l, women: ≥45U/l), and followed them through Danish healthcare registries for up to 20 years. We examined mortality and absolute risks of liver disease, overall cancer, ischemic heart disease, and diabetes.ResultsThe risk of any cancer was highest for participants with “low alanine aminotransferase” or “high alanine aminotransferase” (20-year risk: 17.2% [95% confidence interval (CI): 6.3–32.7%] and 18.2% [95% CI: 5.7–36.3%], respectively). The risk of diabetes was highest for participants with “medium-high alanine aminotransferase” or “high alanine aminotransferase” (20-year risk: 12.1% [95% CI: 7.3–18.3%] and 9.1% [95% CI: 1.6–25.1%], respectively). Participants with “high alanine aminotransferase” had the highest 20-year risk of liver disease (20-year risk: 13.6% [95% CI: 3.4–30.9%], while it was 1.0% or less in the other groups). The chance of being alive after 20 years without having been diagnosed with liver disease, cancer, ischemic heart disease, or diabetes was lowest in the “high alanine aminotransferase” group (50% [95% CI: 28–68%]) and 72–79% in the other groups.ConclusionOur findings suggest that persons with high or abnormally low alanine aminotransferase measurements are at increased long-term risk of several chronic diseases.