Significant Inverse Association Research Articles

Associations between serum per- and polyfluoroalkyl substances and thyroid hormones in Chinese adults: A nationally representative cross-sectional study

Disruption of thyroid homeostasis has been indicated in human studies on the effects of per- and polyfluoroalkyl substances (PFASs). However, limited research exists on this topic within the general Chinese population. Based on a substantial and representative sample of the Chinese adult population, our study provides insight into how PFASs specifically affect thyroid homeostasis. The study included 10 853 participants, aged 18 years and above, sampled from nationally representative data provided by the China National Human Biomonitoring (CNHBM). Weighted multiple linear regression and restricted cubic spline (RCS) models were used to explore the associations between eight individual PFAS concentrations and total thyroxine (T4), total triiodothyronine (T3), and the T4/T3 ratio. Bayesian kernel machine regression (BKMR) and quantile-based g-computation (qgcomp) were employed to explore the joint and independent effects of PFASs on thyroid homeostasis. Both individual PFASs and PFAS mixtures exhibited a significant inverse association with serum T3 and T4 levels, and displayed a positive association with the T4/T3 ratio. Perfluoroundecanoic acid (PFUnDA) [–0.07 (95 % confidence interval (CI): –0.08, –0.05)] exhibited the largest change in T3 level. PFUnDA also exhibited a higher weight compared to other PFAS compounds in qgcomp models. Additionally, a critical exposure threshold for each PFAS was identified based on nonlinear dose–response associations; beyond these thresholds, the decreases in T3 and T4 levels plateaued. Specifically, for perfluoroheptane sulfonic acid (PFHpS) and 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA), an initial decline in hormone levels was observed, followed by a slight increase when concentrations surpassed 0.7 ng/mL and 2.5 ng/mL, respectively. Sex-specific effects were more pronounced in females, and significant associations were observed predominantly in younger age groups. These insights contribute to our understanding of how PFAS compounds impact thyroid health and emphasize the need for further research and environmental management measures to address these complexities.

Dietary intake and visceral adiposity in older adults: The Multiethnic Cohort Adiposity Phenotype study.

There are established links between the accumulation of body fat as visceral adipose tissue (VAT) and the risk of developing obesity-associated metabolic disease. Previous studies have suggested that levels of intake of specific foods and nutrients are associated with VAT accumulation after accounting for total energy intake. This study assessed associations between a priori selected dietary factors on VAT quantified using abdominal magnetic resonance imaging. The cross-sectional Multiethnic Cohort Adiposity Phenotype Study included n=395 White, n=274 Black, n=269 Native Hawaiian, n=425 Japanese American and n=358 Latino participants (mean age=69years±3 SD). Participants were enrolled stratified on sex, race, ethnicity and body mass index. General linear models were used to estimate the mean VAT area (cm2) for participants categorized into quartiles based on their dietary intake of selected foods/nutrients adjusting for age, sex, racial and ethnic groups, the total percentage fat from whole-body dual energy X-ray absorptiometry and total energy. There were significant inverse associations with VAT for dietary intake of total vegetables, total fruits (including juice), cereals, whole grains, calcium, copper and dietary fiber (p-trend ≤0.04). Positive trends were observed for VAT for participants who reported higher intake of potatoes, total fat and saturated fatty acids (SFA) (p-trend ≤0.02). Foods/nutrients that met the multiple testing significance threshold were total fruits, whole grains, copper, dietary fiber and SFA intake. These results highlight foods and nutrients including SFA, total fruit, whole grains, fiber and copper as potential candidates for future research to inform dietary guidelines for the prevention of chronic disease among older adults.

Pregnancy associated plasma protein-A2 (PAPP-A2) and stanniocalcin-2 (STC2) but not PAPP-A are associated with circulating total IGF-1 in a human adult population

The pappalysins pregnancy associated plasma protein-A (PAPP-A) and -A2 (PAPP-A2) act as proteinases of insulin-like growth factor-1 (IGF-1) binding proteins, while stanniocalcin-2 (STC2) was identified as a pappalysin inhibitor. While there is some evidence from studies in children and adolescents, it is unclear whether these molecules are related to concentrations of IGF-1 and its binding proteins in adults. We investigated cross-sectionally the association of circulating PAPP-A, PAPP-A2 and STC2 with IGF-1 and its binding proteins (IGFBPs) in 394 adult pretest participants (20–69 years) of the German National Cohort Berlin North study center. Plasma PAPP-A, PAPP-A2, total and free IGF-1, IGFBP-1, IGFBP-2, IGFBP-3, IGFBP-5 and STC2 were measured by ELISAs. The associations of PAPP-A, PAPP-A2 and STC2 with IGF-1 or IGFBPs were investigated using multivariable linear regression analyses adjusting for age, sex, body mass index and pretest phase. We observed significant inverse associations of PAPP-A2 (difference in concentrations per 0.5 ng/mL higher PAPP-A2 levels) with total IGF-1 (− 4.3 ng/mL; 95% CI − 7.0; − 1.6), the IGF-1:IGFBP-3 molar ratio (− 0.34%; 95%-CI − 0.59; − 0.09), but not free IGF-1 and a positive association with IGFBP-2 (11.9 ng/mL; 95% CI 5.0; 18.8). PAPP-A was not related to total or free IGF-1, but positively associated with IGFBP-5. STC2 was inversely related to total IGF-1, IGFBP-2 and IGFBP-3 and positively to IGFBP-1. This first investigation of these associations in a general adult population supports the hypothesis that PAPP-A2 as well as STC2 play a role for IGF-1 and its binding proteins, especially for total IGF-1. The role of PAPP-A2 and STC2 for health and disease in adults warrants further investigation.

Abstract A017: Lipidomic biomarkers of usual alcohol use and their association with pancreatic ductal adenocarcinoma risk

Abstract There is suggestive epidemiologic evidence for an association between alcohol use and pancreatic ductal adenocarcinoma (PDAC). Previous studies reported alcohol use to be associated with high-density lipoprotein and fatty acyl ethyl esters. Lipidomic metabolites may improve assessment of self-reported alcohol use and provide mechanistic insights for the alcohol-PDAC association. We aimed to identify lipidomic signatures of self-reported alcohol use and evaluate their associations with PDAC risk using comprehensive lipidomic measures from nested case-control studies within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial cohorts (716 case-control sets). Controls were matched to cases (1:1) by age, sex, race, date of blood draw and cohort. Serum samples and self-reported alcohol use were collected at baseline up to 24 years before PDAC diagnosis. Absolute concentrations of 611 lipid species across 15 classes were measured on the Complex Lipid Panel (Lipidizer Sciex SelexIon-5500 QTRAP platform) and grouped into 161 class-specific fatty acids (FA) and 28 total FAs. We conducted cross-sectional analyses using linear regression to identify associations between log-transformed alcohol and 1-standard deviation (SD) increase in log-lipid concentrations among controls within each cohort. Conditional logistic regression and fixed-effects meta-analysis were used to calculate PDAC odds ratios (OR) per 1-SD increase in the log-concentration identified alcohol-lipidomic metabolites in common in both cohorts. All models were adjusted for age, smoking, BMI, height, diabetes, education, and diet quality. Alcohol was associated with 36 species, 13 class-specific FAs and 3 total FAs at Bonferroni thresholds <8.18 × 10−5, <3.11 × 10−4, and <1.79 × 10−3, respectively. These belonged to ceramides, cholesterylesters, diacylglycerols, hexosylceramides, lactosylceramides, lysophosphatidylcholines, phosphatidylcholines, phospatidylethanolamines, phosphatidylinositols, and triacylglycerols lipid classes, and mostly holding FA15:0 (pentadecanoic acid), FA17:0 (margaric acid) and FA18:2 (linoleic acid). Nine triacylglycerols (TAG(49:3-FA18:2), TAG(51:3-FA18:2), TAG(49:2-FA18:2), TAG(49:3-FA15:0), TAG(51:3-FA15:0), TAG(51:4-FA18:3), TAG(51:2-FA18:2), TAG(51:5-FA18:3), TAG(51:2-FA15:0)) and one phosphatidylcholine (PC(15:0/18:2)) lipid species and one total FA (FA15:0) showed significant inverse associations with PDAC with ORs ranging from 0.82 to 0.86 (FDR<0.10). There was no association between class-specific FAs and PDAC. Our results support the hypothesis that alcohol use is associated with serum lipid species from 10 lipid classes, mostly with FA15:0, FA17:0 and FA18:2. Nine triacylglycerols, one phosphatidylcholine and total FA15:0 showed inverse prospective associations with PDAC, the latter having been shown to decrease inflammation and regulate glucose metabolism in previous studies. These findings may help understand the inconsistent association between alcohol use and PDAC. Citation Format: Sabine Naudin, Paloma Mitra, Ting Zhang, Demetrius Albanes, Steven C. Moore, Rachael Stolzenberg-Solomon. Lipidomic biomarkers of usual alcohol use and their association with pancreatic ductal adenocarcinoma risk [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr A017.

Association of combined healthy lifestyle with general and abdominal obesity.

Data linking joint healthy lifestyle factors to general and abdominal obesity are scarce, in particular in the Middle East. The aim of this study was to examine the association of combined healthy lifestyle factors with general and abdominal obesity in a large population of Iranian adults. This cross-sectional study was done on 3,172 Iranian adults aged ≥18 years. We constructed healthy lifestyle score using information on dietary intakes, physical activity, smoking status, and psychological distress. To evaluate components of healthy lifestyle, we applied a validated 106-item semi-quantitative Food Frequency Questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ), and other pre-tested questionnaires. General obesity was defined as having a body mass index (BMI) ≥30 kg/m2 and abdominal obesity as a waist circumference (WC) of ≥102 cm in men and ≥88 cm in women. Mean age of participants was 36.54 ± 7.97 years. General and abdominal obesity were prevalent among 8.7% and 21.5% of study participants, respectively. Linear analysis showed a significant positive relationship between healthy lifestyle score and BMI among men (β: 0.30, 95% CI: 0.05, 0.54). However, no significant association was found between healthy lifestyle and abdominal obesity in men. Among women, one score increase in healthy lifestyle score was associated with a reduction of 0.65 cm in WC. In terms of individual components of healthy lifestyle, we found that low-distressed women had lower odds of abdominal obesity compared with high-distressed women. We found a significant inverse association between healthy lifestyle and WC among women. However, healthy lifestyle was positively associated with BMI among men.

Adherence to Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay Diet in Relation to Serum Brain-Derived Neurotrophic Factor Concentrations and Metabolic Health Status in Adults

BackgroundThere is a lack of data regarding the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet and metabolic health. ObjectivesThis study assessed the relation between MIND diet and metabolic health status relative to serum brain-derived neurotrophic factor (BDNF) concentrations. MethodsThis was a cross-sectional study of 527 adults (286 males and 241 females) recruited from 20 schools in 6 different educational districts of Isfahan, Iran. Dietary intakes of participants were collected by a validated 168-item food frequency questionnaire, and MIND diet score was estimated. Anthropometric indices, blood pressure, biochemical parameters, and BDNF concentrations were assessed for all participants. The metabolically unhealthy (MU) phenotype was determined based on blood pressure, glycemic and lipid profiles, chronic inflammation, and insulin resistance. ResultsThe frequency of MU phenotype among obese/overweight and normal-weight individuals was 79.5 % and 20.5 %, respectively. After adjustment for confounders, individuals in the top tertile of the MIND diet scores had 58 % lower odds of having the MU phenotype than individuals in the bottom tertile (odds ratios [ORs]: 0.42; 95 % confidence interval [CI]: 0.20, 0.90). In the fully adjusted model, females and normal-weight individuals had 81 % (OR: 0.19; 95 % CI: 0.04, 0.83) and 89 % (OR: 0.11; 95 % CI: 0.02, 0.69) lower chance of developing the MU phenotype, respectively. In addition, significant inverse associations between adherence to the MIND diet and high-blood pressure and hypertriglyceridemia were found. No significant association was found between adherence to MIND diet and odds of low BDNF concentrations. ConclusionsAdherence to MIND diet is inversely associated with odds of MU phenotype, especially among women and normal-weight individuals. BDNF concentration is not associated with MIND diet and MU status.

Baseline absolute monocyte count predicts lung function decline among patients with systemic sclerosis-associated interstitial lung disease: A post hoc analysis from the focuSSced trial

ObjectiveInterstitial lung disease (ILD) is the leading cause of death in adults with systemic sclerosis (SSc). The identification of biomarkers to predict progression of SSc-ILD is an important unmet need. The purpose of this study was to determine whether an elevated baseline absolute monocyte count (AMC) is associated with a decline in forced vital capacity (FVC) at 48 weeks among participants with SSc-ILD enrolled in the phase 3 focuSSced trial. MethodsWe performed a post-hoc analysis of the focuSSced trial, a multicenter, double-blind, randomized, placebo-controlled trial of adults with diffuse cutaneous SSc for ≤ 60 months. Participants received subcutaneous tocilizumab 162 mg or placebo weekly for 48 weeks. We examined the relationship between baseline AMC and FVC at 48 weeks using a General Linear Model adjusted for potential confounders. ResultsThe 136 participants with SSc-ILD in focuSSced were included in this study. Among participants assigned to the placebo group, there was a statistically significant inverse association between baseline AMC and change in FVC from baseline at week 48 in both unadjusted (β coefficient -0.539, 95 % CI -1.032 to -0.047, p-value=0.032) and multivariable-adjusted (β coefficient -0.573, 95 % CI -1.086 to -0.060, p-value=0.029) models. Among participants with SSc-ILD assigned to the tocilizumab group, there was no statistically significant association between baseline AMC and change in FVC from baseline at week 48 in unadjusted or fully adjusted models. ConclusionAMC may be a biomarker of disease progression in SSc-ILD, especially in those with early SSc with elevated circulating inflammatory markers. These results should be validated in other SSc-ILD cohorts.

Dietary oily fish intake is inversely associated with moderate-to-severe intracranial artery stenosis in older adults of indigenous Ecuadorian ancestry

Background and aimsInformation on the association between dietary oily fish intake and intracranial atherosclerosis is limited and contradictory. Inconsistencies might be in part related to heterogeneous designs and differences in race/ethnicity of study populations. We aim to assess whether oily fish intake is inversely associated with intracranial artery stenosis (ICAS) in frequent fish consumers of indigenous ancestry living in coastal Ecuador. MethodsThe study included 384 participants aged ≥60 years enrolled in the Atahualpa Project Cohort. Dietary oily fish intake was quantified systematically via validated surveys and all participants received a time-of-flight MRA of intracranial vessels. Poisson regression models, adjusted for demographics, level of education, traditional risk factors and severe tooth loss, were fitted to assess the association between amounts of oily fish intake and the number of intracranial arteries with moderate-to-severe (≥50 %) stenosis. ResultsParticipants had a mean age of 67.7 ± 7 years, and 56 % were women. The mean oily fish intake was 8.9 ± 5.2 servings/week; 283 (74 %) participants consumed ≥5.2 servings/week (2nd to 4th quartiles of fish intake). Forty-three (11 %) participants had at least one major intracranial artery with moderate-to-severe stenosis. Both univariate and multivariate models showed a significant inverse association between consumption of oily fish in the 2nd to 4th quartiles and ≥50 % stenosis in at least one artery (β: 0.46; 95 % C.I.: 0.27–077, and β: 0.52; 95 % C.I.: 0.30–0.90, respectively). ConclusionsConsumption of more than five oily fish servings/week is associated with lower prevalence of moderate-to-severe ICAS in indigenous Ecuadorians.

Association of phase angle with sarcopenia and muscle function in patients with COPD: a case-control study

Background and aimsThe predictive value of phase angle for sarcopenia diagnosis has been discussed for years. The present investigation was conducted to determine the association between phase angle and sarcopenia in patients with COPD.MethodsIn this case-control study, 222 smoker men were divided into healthy and COPD groups. COPD was diagnosed by a pulmonologist through spirometry. Anthropometric indices, phase angle, muscle function, sarcopenia, and dietary intake were assessed.ResultsA significant inverse association was observed between phase angle and sarcopenia after adjustment for age and energy intake (OR: 0.31, 95% CI 0.18–0.52) and after adjustment for BMI (OR: 0.31, 95% CI 0.18–0.52). A significant decrease was detected in anthropometric indices and indicators of sarcopenia and muscle function in COPD cases compared to the healthy controls.ConclusionsAlthough further studies are suggested, phase angle might be considered an indicator of sarcopenia and muscle function in COPD patients.

Natriuretic peptides, body mass index and heart failure risk: Pooled analyses of SAVOR-TIMI 53, DECLARE-TIMI 58 and CAMELLIA-TIMI 61.

N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations are lower in patients with obesity. The interaction between body mass index (BMI) and NT-proBNP with respect to heart failure risk remains incompletely defined. Data were pooled across three randomized clinical trials enrolling predominantly patients who were overweight or obese with established cardiometabolic disease: SAVOR-TIMI 53, DECLARE-TIMI 58 and CAMELLIA-TIMI 61. Hospitalization for heart failure (HHF) was examined across strata of baseline BMI and NT-proBNP. The effect of dapagliflozin versus placebo was assessed for a treatment interaction across BMI categories in patients with or without an elevated baseline NT-proBNP (≥125 pg/ml). Among 24 455 patients, the median NT-proBNP was 96 (interquartile range [IQR]: 43-225) pg/ml and the median BMI was 33 (IQR 29-37) kg/m2, with 68% of patients having a BMI ≥30 kg/m2. There was a significant inverse association between NT-proBNP and BMI which persisted after adjustment for all clinical variables (p < 0.001). Within any range of NT-proBNP, those at higher BMI had higher risk of HHF at 2 years (comparing BMI <30 vs. ≥40 kg/m2 for NT-proBNP ranges of <125, 125-<450 and ≥450 pg/ml: 0.0% vs. 0.6%, 1.3% vs. 4.0%, and 8.1% vs. 13.8%, respectively), which persisted after multivariable adjustment (adjusted hazard ratio [HRadj] 7.47, 95% confidence interval [CI] 3.16-17.66, HRadj 3.22 [95% CI 2.13-4.86], and HRadj 1.87 [95% CI 1.35-2.60], respectively). In DECLARE-TIMI 58, dapagliflozin versus placebo consistently reduced HHF across BMI categories in those with an elevated NT-proBNP (p-trend for HR across BMI = 0.60), with a pattern of greater absolute risk reduction (ARR) at higher BMI (ARR for BMI <30 to ≥40 kg/m2: 2.2% to 4.7%; p-trend = 0.059). The risk of HHF varies across BMI categories for any given range of circulating NT-proBNP. These findings showcase the importance of considering BMI when applying NT-proBNP for heart failure risk stratification, particularly for patients with low-level elevations in NT-proBNP (125-<450 pg/ml) where there appears to be a clinically meaningful absolute and relative risk gradient.

Impacts of body weight change on treatment outcomes in patients with multidrug-resistant tuberculosis in Northwest Ethiopia

Measuring body weight during therapy has received insufficient attention in poor resource settings like Ethiopia. We aimed to investigate the association between weight change during therapy and treatment outcomes among patients with multidrug-resistant tuberculosis (MDR-TB) in northwest Ethiopia. This retrospective cohort study analysed data from patients with MDR-TB admitted between May 2015 to February 2022 at four treatment facilities in Northwest Ethiopia. We used the joint model (JM) to determine the association between weight change during therapy and treatment outcomes for patients with MDR-TB. A total of 419 patients with MDR-TB were included in the analysis. Of these, 265 (63.3%) were male, and 255 (60.9%) were undernourished. Weight increase over time was associated with a decrease in unsuccessful treatment outcomes (adjusted hazard ratio (AHR): 0.96, 95% CI: 0.94 to 0.98). In addition, patients with undernutrition (AHR: 1.72, 95% CI: 1.10 to 2.97), HIV (AHR:1.79, 95% CI: 1.04 to 3.06), and clinical complications such as pneumothorax (AHR: 1.66, 95% CI: 1.03 to 2.67) were associated with unsuccessful treatment outcomes. The JM showed a significant inverse association between weight gain and unsuccessful MDR-TB treatment outcomes. Therefore, weight gain may be used as a surrogate marker for good TB treatment response in Ethiopia.

Fatty acid composition in erythrocytes and coronary artery disease risk: a case-control study in China.

Background and aims: There is limited and conflicting evidence about the association of erythrocyte fatty acids with coronary artery disease (CAD), particularly in China where the CAD rates are high. Our study aimed to explore the association between erythrocyte fatty acid composition and CAD risk in Chinese adults. Methods: Erythrocyte fatty acids of 314 CAD patients and 314 matched controls were measured by gas chromatography. Multivariable conditional logistic regression and restricted cubic spline models were used to explore the odds ratio with 95% confidence interval (OR, 95% CI) and potential association between erythrocyte fatty acids and CAD risk. Principal component analysis (PCA) was used to analyze further the potential role of various erythrocyte fatty acid patterns in relation to CAD risk. Results: Significant inverse associations were observed between high levels of erythrocyte total n-3 polyunsaturated fatty acids (n-3 PUFA) [ORT3-T1 = 0.18 (0.12, 0.28)], monounsaturated fatty acids (MUFA) [ORT3-T1 = 0.21 (0.13, 0.32)], and the risk of CAD. Conversely, levels of saturated fatty acids (SFAs) and n-6 polyunsaturated fatty acids (n-6 PUFAs) were positively associated with CAD risk [ORT3-T1 = 3.33 (2.18, 5.13), ORT3-T1 = 1.61 (1.06, 2.43)]. No significant association was observed between CAD risk and total trans fatty acids. Additionally, the PCA identifies four new fatty acid patterns (FAPs). The risk of CAD was significantly positively associated with FAP1 and FAP2, while being negatively correlated with FAP3 and FAP4. Conclusion: The different types of erythrocyte fatty acids may significantly alter susceptibility to CAD. Elevated levels of n-3-PUFAs and MUFAs are considered as protective biomarkers against CAD, while SFAs and n-6 PUFAs may be associated with higher CAD risk in Chinese adults. The risk of CAD was positively associated with FAP1 and FAP2, and negatively associated with FAP3 and FAP4. Combinations of erythrocyte fatty acids may be more important markers of CAD development than individual fatty acids or their subgroups.

Association between overall quality of macronutrients and incidence of overweight and obesity in the SUN (Seguimiento Universidad de Navarra) cohort.

Introduction: no previous large prospective studies have assessed the global quality of macronutrients in association with the risk of overweight/obesity. Objective: to prospectively assess the association of an overall macronutrient quality index (MQI) with weight change and the incidence of overweight/obesity in the Seguimiento Universidad de Navarra (SUN) cohort. Methods: the diet of 9,344 Spanish university graduates free of overweight/obesity (mean age: 36.5 [SD, 11.1]) was assessed through a validated 136-item food frequency questionnaire. The MQI was calculated as the sum of the Carbohydrate Quality Index, the Fat Quality Index, and the Healthy Plate Protein Quality Index. Participants were classified into groups (G) according to MQI. Incident overweight/obesity was defined if follow-up questionnaires indicated BMI was ≥ 25 kg/m2. Multiple linear regression models and Cox proportional hazard models were used to assess the average yearly weight change and the risk of overweight/obesity over follow-up time. Results: 2,465 cases of incident overweight/obesity were identified (median follow-up: 10.7 years). Increasing MQI was significantly associated with lower annual weight gain (g): ß coefficient: -99.0, (95 % CI: -173.6 to -24.5) in the G4 vs G1, p for trend = 0.007. In the fully adjusted model the incidences of overweight/obesity in G4 and G1 were 21.7 % (431 cases) and 29.3 % (954 cases), respectively. The adjusted HR was 0.87 (95 % CI, 0.77-0.98, p for trend = 0.036). When we used repeated analyses updating the MQI after 10 years of follow-up, results remained similar. Conclusions: a significant inverse association between a multidimensional MQI and the risk of overweight/obesity was found in this Mediterranean cohort of adults.

Association between serum carotenoids and hyperuricemia: a cross-sectional study based on NHANES 2001-2006.

This study aims to investigate the association between serum carotenoids and hyperuricemia. Data were sourced from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2006. Hyperuricemia was defined as serum uric acid (UA) levels of ≥7 mg/dL for males and ≥ 6 mg/dL for females. Serum carotenoid levels were measured using high-performance liquid chromatography. Multivariate linear regression was used to analyze the correlation between serum carotenoids and UA levels. Multivariate logistic regression and restricted cubic spline (RCS) analyses were performed to explore the potential association between serum carotenoids and hyperuricemia. Additionally, subgroup and interaction analyses were conducted to determine variations across different population groups. This cross-sectional study included 13,561 participants. Multivariate linear regression analysis revealed that higher levels of serum carotenoids were correlated with lower UA levels. Specifically, the beta coefficients (β) and 95% confidence intervals (CIs) were as follows: α-carotene (-0.23 [-0.31, -0.15]), β-carotene (-0.30 [-0.38, -0.21]), β-cryptoxanthin (-0.17 [-0.25, -0.09]), lutein/zeaxanthin (-0.12 [-0.20, -0.04]), and total serum carotenoids (-0.25 [-0.33,-0.16]). However, lycopene showed no significant correlation with UA (-0.01 [-0.09, 0.08]). Multivariate logistic regression analysis indicates a significant inverse association between serum carotenoids and the risk of hyperuricemia. The odds ratios (ORs) and 95%CIs were as follows: α-carotene (0.61 [0.49, 0.77]), β-carotene (0.67 [0.51, 0.86]), β-cryptoxanthin (0.69 [0.51, 0.88]), lutein/zeaxanthin (0.72 [0.56, 0.97]), lycopene (0.82 [0.67, 1.00]) and total serum carotenoids (0.73 [0.57, 0.92]). RCS analysis indicated a potential nonlinear relationship between lycopene and hyperuricemia, with an inflection point at 33.45 μg/dL. Subgroup and interaction analyses demonstrated that the inverse association remained consistent across various demographic groups. This study found that higher serum carotenoid levels are associated with lower UA levels and reduced risk of hyperuricemia. Notably, while lycopene was associated with reduced hyperuricemia risk, its effect showed some heterogeneity.

The relationship between lipoproteins and the risk of esophageal cancer: a Mendelian randomization study.

Esophageal cancer (EC) causes approximately 508,000 deaths annually, making it a significant cause of cancer-related mortality. While previous studies have suggested an association between lipoprotein levels and EC risk, the causal relationship remains unexplored. This study aims to investigate the causal link between lipoproteins and EC using Mendelian randomization (MR). This study employed MR to determine the causal effect between lipoproteins and EC risk, with body mass index (BMI) used as a confounder in multivariable MR (MVMR) analysis. Sensitivity analyses were conducted to assess the reliability of the results. Univariable MR (UVMR) analysis indicated that low-density lipoprotein (LDL) had a significant inverse association with EC risk (p = 0.03; OR = 0.89; 95%CI, 0.73-0.98), while high-density lipoprotein (HDL) and triglycerides showed no significant association. In the synthesis of findings across diverse datasets, LDL maintained a notable inverse association with the likelihood of EC (p < 0.001; OR = 0.89; 95%CI, 0.84-0.94). Triglyceride levels indicated a potential trend toward an adverse correlation with EC susceptibility (p = 0.03; OR = -0.94; 95%CI, 0.89-0.99), whereas HDL levels did not establish a definitive causal link with the occurrence of EC. MVMR analysis, adjusting for BMI, confirmed these findings. LDL exhibits a clear inverse causal relationship with EC risk, regardless of BMI adjustment. No causal effects were observed for HDL in relation to EC risk. Meanwhile, there is a small but statistically significant causal relationship between triglycerides and EC risk.

Vitamin D levels and tumor necrosis factor-α activity in newly diagnosed patients with type 2 diabetes mellitus: An exploratory study in North-East India

Background: Diabetes poses a global threat, leading to hospitalizations and premature death if not managed properly. It involves tumor necrosis factor-α (TNF-α), an inflammatory cytokine, which binds to TNF-α receptor-1, triggering sphingomyelinase, and ceramide production. Vitamin D acts as an anti-inflammatory agent, reducing inflammatory cytokines and proinflammatory cell growth, and benefiting diabetes mellitus (DM). Aims and Objectives: The primary objective was to compare serum Vitamin D and TNF-α levels in diabetics and non-diabetics. The secondary objective was to explore Vitamin D and TNF-α correlation in newly diagnosed type 2 diabetes. Materials and Methods: A case–control study involved 92 subjects in each group. Data included demographics, clinical assessments, glycemic parameters, Vitamin D, and TNF-α. Statistical analysis used student’s t-test and Pearson correlation (P&lt;0.05). Results: The cohort comprised 34 females (36.96%) and 58 males (63.04%). Cases had significantly higher glycemic levels: FBG (247.2±53.92 mg/dL vs. 91.45±16.64 mg/dL), postprandial plasma glucose (319.7±72.08 mg/dL vs. 111.3±21.76 mg/dL), and glycated hemoglobin (HbA1c) (10.39±2.41% vs. 5.43±0.48%). Mean serum Vitamin D in cases (22.63 ng/mL) was significantly lower than controls (58.15 ng/mL), and mean TNF-α in cases (5.01 pg/mL) was higher than controls (4.63 pg/mL, P&lt;0.0001). HbA1c negatively correlated with serum Vitamin D (r=−0.7461) and positively with TNF-α (r=0.7831). Vitamin D correlated negatively with TNF-α (r=−0.6481). Conclusion: The study revealed lower serum Vitamin D and higher TNF-α levels in cases, with a significant inverse association. It also found an inverse link between Vitamin D and HbA1c and a strong positive correlation between HbA1c and TNF-α. Recognizing Vitamin D and TNF-α’s diagnostic significance promises innovative strategies for managing type 2 DM.

Association between dietary folate intake and HPV infection: NHANES 2005-2016.

Recent studies have established a correlation between folate levels and the incidence of cervical cancer. Given that Human Papillomavirus (HPV) infection is a primary etiological factor in the development of cervical cancer, the nature of the relationship between dietary folate intake and HPV infection remains an area of ongoing investigation. To investigate the association between dietary folate intake and HPV infection, this study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2016. Multivariate logistic regression analysis was employed to examine the potential associations. Furthermore, the use of restricted cubic splines (RCS) facilitated the exploration of any non-linear correlations. Additionally, subgroup analyses were used to explore this correlation in different populations. The study encompassed a total of 6747 women aged between 18 and 59 years. For every one mcg increase in folate intake, the incidence of HPV infection is reduced by 1% (OR = 0.99, p<0.05). Besides, folate intake was categorized into quartiles as follows: Q1 (<211 mcg/day), Q2 (211-311 mcg/day), Q3 (311-448 mcg/day), and Q4 (>448 mcg/day). The adjusted odds ratios (OR) for the different folate levels were as follows: Q2: 0.94 (95% CI: 0.76-1.16), Q3: 0.84 (95% CI: 0.67-1.04), and Q4: 0.63 (95% CI: 0.49-0.81). The RCS analysis confirmed a nonlinear relationship between dietary folate intake and HPV infection risk. Notably, a significant inverse association was observed when dietary folate intake exceeded 193.847 mcg/day. In conclusion, the findings of this study indicate a negative association between dietary folate intake and the risk of HPV infection. This association demonstrates a nonlinear pattern, particularly evident at higher levels of folate consumption.

The Association between Vitamin D and Lipid Profile among Healthy Malay Adults in K ota Bharu, Malaysia

Background:The effect of vitamin D in regulating lipid profiles is one of the proposed mechanisms for the association between vitamin D deficiency and cardiovascular heart disease (CHD). However, the relationship between vitamin D status and lipid profiles remained unclear.&#x0D; Objective: The objective of this study is to evaluate the association of vitamin D status on serum lipids among healthy adults.&#x0D; Material and Methods: This is cross-sectional study, involving 120 healthy adults with age of 18-50 years from the Malay adult in Kota Bharu, Malaysia which were selected via random sampling. To decrease the seasonal variability, the study was conducted within 2 months, between July and August 2015. Serum 25(OH)D, serum parathyroid hormone (PTH), serum triglycerides (TG), serum total cholesterol (TC), serum low density lipoprotein cholesterol (LDL-C) and serum high density lipoprotein cholesterol (HDL-C), fasting blood sugar (FBS) and serum insulin were measured.&#x0D; Results: The mean serum 25(OH) D was 23.50 ± 8.74 nmol/L. Based on the definition of vitamin D deficiency as serum 25(OH)D less than 30mmol/L, the proportion of vitamin D deficiency among our study subjects was 76.7%. Our data revealed that serum 25(OH) D had significant inverse association with HDL-C and significant positive association with TC, TG and LDL-C.&#x0D; Conclusions: Our study shows highly prevalence of vitamin D deficient among healthy Malay adult population in Kota Bharu, Malaysia. Serum 25(OH) D was positively associated with TC, TG and LDL-C and negatively associated with HDL-C. Perhaps optimizing the level of vitamin D might improve the lipid profiles among healthy Malay adults.&#x0D; Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 214-220

Prognostic Impact of the Tricuspid Annular Plane Systolic Excursion/Pulmonary Arterial Systolic Pressure Ratio in Acute Pulmonary Embolism.

Currently available risk stratification models for acute pulmonary embolism (PE) include hemodynamic status, cardiac biomarkers, right ventricle (RV) dysfunction on imaging, and clinical scores. Focusing on the length-tension relationship of the ventricle might have a superior predictive capability over RV dysfunction in terms of mortality and classification of patients with acute PE. In this study, our hypothesis suggests that the tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio has superior predictive capability for in-hospital mortality in patients with acute PE compared to TAPSE or sPAP as distinct measures. This single-center study comprised retrospectively evaluated 703 patients referred to our tertiary cardiovascular center with acute PE. We divided patients into quartiles based on the TAPSE/sPAP ratio. Different models were developed to quantify the predictive relationship between in-hospital death and echocardiographic measurements. A base model was created with variables including risk status and RV/LV ratio >1. Then, to evaluate the predictive contribution of each measurement; TAPSE/sPAP, TAPSE, and sPAP were sequentially added to the base model. After that, the performance of each model was evaluated. Predictive and discriminative power was the highest in model containing TAPSE/sPAP. There was still a significant inverse association between TAPSE/sPAP and the risk of in-hospital death even after adjusting for risk status and RV/LV ratio >1. Receiver operating characteristic curve analysis for TAPSE/sPAP revealed the best cut-off value as 0.34. The outcomes of our study reveal that the ratio of TAPSE/sPAP serves as a more potent predictor of mortality than either of the 2 measurements taken separately. The interpretation and utilization of the TAPSE/sPAP cut-off value in acute PE can assist in identifying patients at risk of deterioration and guide the consideration of more intensive treatment options across all risk groups.

Waist circumference, among metabolic syndrome components, predicts degraded trabecular bone score: a retrospective study of a female population from the 2005-2008 NHANES cohorts.

Osteoporosis and metabolic syndrome (MetS) are conditions associated with ageing and chronic inflammation; among MetS' components, visceral obesity has been correlated to low bone mineral density in postmenopausal women. However, data on an increased fracture risk in MetS are still contrasting. The trabecular bone score (TBS) is an indicator of bone quality and a potential predictive factor for fractures. We aim to explore the relationship between MetS components and TBS. we analyzed data from 3962 women in the 2005-2006 and 2007-2008 NHANES cohorts, for whom a valid TBS value was available. All analyses were adjusted for the principal risk factors of altered bone metabolism. An inverse significant association was observed between TBS and most of the MetS variables investigated, with the strongest correlation found with waist circumference (WC) (P <0.001). WC represented the major predictor of degraded TBS (P <0.001), in adjusted models considering age, 25(OH)Vitamin D, smoke and insulin resistance. Increased WC was significantly associated with the presence of bone fractures at the logistic regression analysis (P = 0.001) in all study participants and in the subgroup of women ≤50 years old after adjustment for potential confounders (P = 0.006). This study, using a large sample of women, found a negative association of MetS on bone health, mainly driven by visceral obesity.