Tertile Of Score Research Articles

Nutrients-Rich Food Index Scores and the Overall Survival of Ovarian Cancer Patients: Results from the Ovarian Cancer Follow-Up Study, a Prospective Cohort Study.

Background: The nutrients-rich food (NRF) index provides a score of diet quality. Although high diet quality is associated with survival of ovarian cancer (OC), the associations between NRF index scores and OC survival remain unevaluated. Methods: The prospective cohort study enrolled 703 women with newly diagnosed epithelial OC to assess the correlations between NRF index scores and overall survival (OS) in OC patients. Dietary consumption was evaluated through a food frequency questionnaire and diet quality was calculated based on NRF index scores, including three limited nutrients and six (NRF6.3), nine (NRF9.3), or eleven (NRF11.3) benefit nutrients. All-cause deaths were ascertained through medical records combined with active follow-up. Immunohistochemistry (IHC) analyses were conducted to evaluate the expression of IHC indicators (including Estrogen Receptor, Progesterone Receptor, p53, Vimentin, and Wilms' tumor 1), which were identified by two independent pathologists. The Cox proportional hazards regression models were applied for estimating the hazard ratios (HRs) and 95% confidence intervals (CIs). Moreover, we performed the penalized cubic splines model to assess the curvilinear associations of NRF index scores with OC survival. Results: During the median follow-up of 37.17 (interquartile: 24.73-50.17) months, 130 deaths were documented. Compared to the lowest tertiles, the highest tertile of index scores [NRF9.3 (HR = 0.63, 95% CI = 0.41-0.95), NRF6.3 (HR = 0.59, 95% CI = 0.39-0.89), and NRF11.3 (HR = 0.57, 95% CI = 0.38-0.87)] were correlated to better OS, showing an obvious linear trend (all p trend < 0.05). Interestingly, the curvilinear association between the NRF6.3 index score and OC survival was also observed (p non-linear < 0.05). Subgroup analyses, stratified by clinical, demographic, and IHC features, showed similar risk associations as the unstratified results. Furthermore, there were significant multiplicative interactions between NRF index scores and Progestogen Receptors as well as Wilms' tumor 1 expressions (all p interaction < 0.05). Conclusions: Higher NRF index scores were associated with an improved OS in OC patients.

Dietary patterns and risk for gastric cancer: A case-control study in residents of the Huaihe River Basin, China.

Evidence linking dietary patterns and the risk of gastric cancer was limited, especially in Chinese populations. This study aimed to explore the association between dietary patterns and the risk of gastric cancer in residents of the Huaihe River Basin, China. The association between dietary patterns and the risk of gastric cancer was investigated through a case-control study. Dietary patterns were identified with factor analysis based on responses to a food frequency questionnaire (FFQ). Gastric cancer was diagnosed according to the International Classification of Diseases, 10th Revision (ICD 10). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated across the tertiles of dietary pattern scores using unconditional logistic regression models. A total of 2,468 participants were included in this study. Six main dietary patterns were extracted, and those patterns explained 57.09% of the total variation in food intake. After adjusting for demographic characteristics, lifestyle factors, individual disease history, family history of cancer and Helicobacter. Pylori (H. pylori) infection, comparing the highest with the lowest tertiles of dietary pattern scores, the multivariable ORs (95% CIs) were 0.786 (0.488, 1.265; P trend < 0.001) for the flavors, garlic and protein pattern, 2.133 (1.299, 3.502; P trend < 0.001) for the fast food pattern, 1.050 (0.682, 1.617; P trend < 0.001) for the vegetable and fruit pattern, 0.919 (0.659, 1.282; P trend < 0.001) for the pickled food, processed meat products and soy products pattern, 1.149 (0.804, 1.642; P trend < 0.001) for the non-staple food pattern and 0.690 (0.481, 0.989; P trend < 0.001) for the coffee and dairy pattern. The specific dietary patterns were associated with the risk of gastric cancer. This study has implications for the prevention of gastric cancer.

The effect of foetal and early childhood growth on metabolic derangements of Sri Lankan children

BackgroundPrevious studies have shown that delayed prenatal growth followed by accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The present study aimed to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka.MethodsA school-based cross-sectional study was conducted among 5–15-year-old children selected using a two-stage probability-proportionate-to-size cluster sampling technique. Birth-weight (BW) was extracted from records (denotes prenatal growth) and body mass index(BMI)-Z score and fat mass(FM) measured to denote the current growth of children. Fasting and random blood glucose, lipid profile and blood pressure(BP) were measured. The sample was stratified by age (5—< 10 and 10—15 years); was further categorized into tertiles of BW and BMI-Z scores. Based on these two parameters, metabolic parameters were evaluated within each age category.ResultsThe sample comprised 833(494 boys) healthy school children. Metabolic parameters did not significantly differ by sex or across BW tertiles of each BMI-Z score tertile. However, significant changes in some metabolic parameters were noted across the BMI-Z score tertiles of each BW tertile. Children belonging to the lowest BW and highest BMI-Z score tertiles had worst metabolic profiles, while those in the lowest BW as well as BMI-Z score tertile were protected. Excessive fat deposition seemed to move children to higher BMI-Z score tertiles.ConclusionPoor prenatal growth is not the sole risk factor for abnormal metabolic profile found in childhood. Those who gain fat, denoted by weight, during early childhood are at a higher risk of developing metabolic abnormalities than those who do not. This favours the accelerated postnatal growth hypothesis.

Association between sarcopenia and cognitive function in older Chinese adults: Evidence from the China health and retirement longitudinal study.

Sarcopenia and cognitive impairment are the most common causes of disability in the aging population. The potential role of sarcopenia in the development of cognitive impairment remains poorly understood. A cross-sectional analysis was performed using nationally representative data to evaluate associations between sarcopenia and cognition in China. We included 2,391 participants (35.63% female) who were at least 60 years of age in 2015 from the China Health and Retirement Longitudinal Study (CHARLS). Muscle strength, appendicular skeletal mass (ASM), and physical performance measurements, were measured to diagnose sarcopenia according to the Asian Working Group for Sarcopenia 2019 (AWGS2019). Cognitive function was assessed by 10 items in the Telephone Interview for Cognitive Status (TICS-10), delayed word recall, and graph drawing. Based on cognitive score tertiles, data were divided into three groups. Multiple linear and logistic regression models were used to assess the relationship between sarcopenia and cognition. The prevalence of possible sarcopenia was 27.16% for men and 27.46% for women. Cognitive decline was significantly associated with sarcopenia status (β = -0.88, p < 0.001) and negatively associated with components of sarcopenia in male group. The results remained consistent in male after further adjusting for creatinine, uric acid, blood sugar, etc. Low cognitive function in female was only associated with low muscle strength (β = -0.85, p = 0.02). In addition, participants with possible sarcopenia had greater risk of cognitive decline than those without sarcopenia (OR = 1.41; 95% CI: 1.06-1.87). However, the same association was not significant in female group. We suggest that sarcopenia might be associated with cognition function, with possible sarcopenia being significantly associated with higher cognition risk in China population, which providing a further rationale for timely recognition and management of sarcopenia.

The reverse association of dietary antioxidant index with osteoporosis in postmenopausal iranian women: A case-control study.

Osteoporosis, a prevalent bone malady, is prevalent in Iran. Several studies have represented the role of dietary antioxidants on osteoporosis. The dietary antioxidant index (DAI) is a valid and reliable index, which indicates a comprehensive view of dietary antioxidant capacity. This study aimed to survey the relationship of the DAI with the risk of osteoporosis in postmenopausal women in Iran. This research aimed to examine the association between the DAI and the risk of osteoporosis among postmenopausal women in Iran. In this case-control study, 440 postmenopausal women (220 cases and 220 controls) were enrolled. The dietary intake of contributors was evaluated using a 147-item food frequency questionnaire. To estimate the DAI, the amount of six antioxidant micronutrients such as Vitamins A, C, and E, selenium, manganese, and zinc was standardized. Then, the DAI was estimated by collecting the standardized consumption of these antioxidant micronutrients. Our findings represented the participants in the first (crude odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.13-2.85, P = 0.013) and second (crude OR = 1.60, 95% CI: 1.01-2.55, P = 0.043) tertiles of the DAI scores had significantly higher odds of osteoporosis compared to those in the third one; while after modifying for confounding factors, this significant reverse relationship was observed just between women in the first and third tertiles of the DAI scores (adjusted OR = 1.90, 95% CI: 1.34-3.18, P = 0.015). The consequence of this study suggested that adherence to a diet rich in antioxidant compounds may have protective effects against osteoporosis.

Abstract C097: Association between a healthy lifestyle index and breast cancer risk among post-menopausal women in the Multiethnic Cohort (MEC) Study

Abstract Consistent evidence supports maintaining a healthy weight, engaging in physical activity, and limiting alcohol consumption as potential strategies for reducing breast cancer risk. Sleep duration and sedentary behavior are also emerging breast cancer risk factors. While these cardiometabolic factors have been associated with an increased risk of breast cancer, prior studies have primarily investigated these factors separately. The association between a healthy lifestyle index (HLI) and breast cancer risk, particularly across racially and ethnically diverse postmenopausal women, has not been well studied. Within the Multiethnic Cohort study, ongoing analyses are examining associations between an HLI and risk of invasive breast cancer among 65,813 eligible postmenopausal women (African American [18.7 %], Native Hawaiian [6.7 %], Japanese American [28.2%], Latina [21.1%], and White [25.3%]). During a median follow-up of 23 years, 4,571 incident invasive breast cancer cases were diagnosed between baseline (1993-1996) and the end of follow-up (2017). Self-reported baseline information on seven lifestyle factors was used to create an HLI based on the sum of scores (max HLI score=23): Healthy Eating Index 2010 (HEI 2010) score divided into quartiles (scored 1-4), metabolic equivalents (METs) of moderate and vigorous physical activity (1-3), time spent sedentary (1-3), smoking status and duration (1-5), alcohol consumption (1-3), body mass index (BMI) (1-3) and sleep duration (1-2). Preliminary analyses included descriptive statistics as well as age- and race and ethnicity-adjusted Cox proportional hazards models of invasive breast cancer to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for the association with HLI score (tertiles, (T)) using age as the timescale. The mean HLI score in the overall population was 15.3 [Standard Deviation (SD): 2.1] with 51.4% of the analytic population in an HLI score tertile of ≥18 to 23 (T3; most healthy) and 13.2% in the lowest HLI score tertile ≥7 to &amp;lt;15 (T1; least healthy). The mean HLI scores by race/ethnicity were the following: African American 16.5 [SD: 2.5], Native Hawaiian 16.7 [SD: 2.6], Japanese American 18.2 [SD: 2.2], Latina 17.3 [SD: 2.2] and White 17.2 [SD: 2.6] women. Preliminary findings suggest that overall, women in HLI score T3 had on average, a BMI of 23.6 [3.7] (mean [SD] kg/m2), dietary intake HEI 2010 scores between 60-78.9, exerted &amp;gt; 6 METs of moderate and strenuous activity, spent &amp;lt; 6 hours a day sedentary, consumed less than 4.9 grams of ethanol per day, slept between 7 to 8 hours and were never smokers. In initial age- and race and ethnicity-adjusted analyses, postmenopausal women with an HLI score in T2 (HR: 0.90 [95% CI:0.82-0.98]) and in T3 (HR: 0.81 [95% CI: 0.74–0.89]) (p-trend &amp;lt;0.001) were at reduced risk of breast cancer compared to women in T1. Ongoing analyses include race and ethnicity stratified and fully adjusted multivariable Cox proportional hazards regression. Citation Format: Bethany T. Ogbenna, Iona Cheng, James Butler III, Typhanye Dyer, Xin He, Loic Le Marchand, Lynne Wilkens, Cher Dallal. Association between a healthy lifestyle index and breast cancer risk among post-menopausal women in the Multiethnic Cohort (MEC) Study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C097.

Pretreatment endocrine symptoms and recurrence-free survival among young premenopausal patients with breast cancer: a prospective cohort study.

Pretreatment endocrine symptoms in premenopausal patients might be considered as a potential marker of poor prognosis. We conducted a cohort study to evaluate the association between endocrine symptoms prior to treatment and recurrence-free survival (RFS) among premenopausal patients with breast cancer aged ⩽40 years. Data were obtained from a prospective cohort study (NCT03131089) conducted at the Samsung Medical Center from 2013 to 2021. We included patients aged ⩽40 years who had been diagnosed with breast cancer. The primary outcome measure was RFS. Endocrine symptoms were measured using the Functional Assessment of Cancer Therapy - Endocrine Symptoms (FACT-ES). We also calculated the hazard ratio (HR) for recurrence or all-cause mortality by comparing the tertiles of the FACT-ES score at diagnosis. Among the 977 participants, the mean (standard deviation) age was 35.3 (3.9) years. At diagnosis, 17.2% of the patients had at least one severe endocrine symptom. During 3512 person-years of follow-up, the high symptom group had a worse RFS than the low-symptom group [HR = 2.05; 95% confidence interval (CI) = 1.19-3.54]. In particular, hot flashes (HR = 5.59; 95% CI = 1.96-15.93) and breast sensitivity (HR = 1.82; 95% CI = 1.00-3.32) were associated with reduced RFS. Close monitoring of pretreatment endocrine symptoms may be important in patients diagnosed with breast cancer at a young age.

The association of the Korean Healthy Eating Index with chronic conditions in middle-aged single-person households.

This study investigated the association between dietary quality based on the Korean Healthy Eating Index (KHEI), and the prevalence of chronic conditions among middle-aged individuals (40-60 ys of age) living alone. The participants were selected (1,517 men and 2,596 women) from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 and classified into single-person households (SPH) and multi-person households (MPH). Nutrient intake, KHEI, and the prevalence of chronic conditions were compared according to household size. The odds ratios (ORs) of chronic conditions were analyzed according to the tertile levels of KHEI by gender within each household size category. Men in SPH had a significantly lower total KHEI score (P < 0.0001) and a lower prevalence of obesity (OR, 0.576) than those in MPH. For men, the adjusted ORs for obesity, hypertension, and hypertriglyceridemia in the first tertile (T1) of KHEI scores within SPH compared with the third tertile (T3) were 4.625, 3.790, and 4.333, respectively. Moreover, the adjusted OR for hypertriglyceridemia in the T1 group compared to the T3 group within the MPH was 1.556. For women, the adjusted ORs for obesity and hypertriglyceridemia in T1 compared to T3 within the SPH were 3.223 and 7.134, respectively, and 1.573 and 1.373 for obesity and hypertension, respectively, within MPH. A healthy eating index was associated with a reduced risk of chronic conditions in middle-aged adults. Greater adherence to a healthy eating index could lower the risk of chronic conditions in middle-aged adults living alone.

Associations of the inflammatory diet index and smoking status with the risk of chronic obstructive pulmonary disease and lung cancer.

It remains unknown whether a low-inflammatory diet could modify the chronic obstructive pulmonary disease (COPD) and lung cancer risk related to smoking. To investigate the association between a low-inflammatory diet, smoking status, and the risk of COPD and lung cancer. A total of 171 050 COPD-free and lung cancer-free (mean age: 55.80) individuals were included in this study. COPD and lung cancer were defined as hospital admission. An inflammatory diet index (IDI) was developed based on C-reactive protein levels and was a weighted sum of 34 food groups. Participants were grouped into tertiles corresponding to IDI scores (lowest, middle, and highest). Over 2 091 071 person-years of follow-up, a total of 4007 individuals developed COPD (person-years: 2 075 579), and 1049 developed lung cancer. In comparison with the highest tertile of the IDI score, hazard ratios (HRs) and 95% confidence intervals (CIs) of COPD and lung cancer related to a low-inflammatory diet were 0.66 (0.61, 0.72) and 0.76 (0.65, 0.89), respectively. A low-inflammatory diet may prolong COPD onset by 1.88 (1.50, 2.27) years and lung cancer onset by 1.05 (0.45, 1.65) years. In joint effect analyses, participants with the lowest/middle IDI score and smoking had a significant 37% decrease in COPD risk and a 35% decrease in lung cancer risk compared to the participants with the highest IDI score and smoking. Replacing each standard deviation unit (≈1080.426 g day-1) of pro-inflammatory foods with anti-inflammatory foods was associated with a 30% lower COPD risk. Our findings suggest that a low-inflammatory diet may significantly mitigate the risk of smoking on COPD development, and delay the COPD onset by about 2 years. However, a low-inflammatory diet is associated with a reduced risk of lung cancer among only smokers. Substituting equal intake of pro-inflammatory foods with anti-inflammatory foods is related to a decreased risk of COPD, but not lung cancer.

Diet quality and survival after ovarian cancer: results from an ovarian cancer follow-up study (OOPS).

Background and aims: Owing to the limited studies and controversial evidence, the connection between diet quality and survival of patients with ovarian cancer (OC) has been indistinct. Our study intends to first investigate this topic based on Chinese diet quality scores. Methods: Our data come from an ovarian cancer follow-up study, which includes 796 patients with OC between 2015 and 2020. Three diet quality scores, including the Chinese Healthy Eating Index (CHEI), Dietary Balance Index (DBI), and Chinese Food Pagoda Score (CFPS), were calculated using a validated 111-item food frequency questionnaire. We used the Cox proportional hazards regression model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Potential multiplicative and additive interactions were also assessed. Results: With a median follow-up time of 37.17 months (interquartile: 24.73-50.17 months), we recorded 130 deaths. According to comparisons of the highest to lowest tertile of scores, the pre-diagnosis CHEI was linked to better overall survival (OS) in patients (HR = 0.56, 95% CI: 0.36, 0.88). A dose-response relationship between CHEI and OS was also observed (HR = 0.85, 95% CI: 0.71, 1.00, per 1 standard deviation increment). However, no evidence of significant associations between DBI and CFPS with OS was observed. Additionally, significant multiplicative and additive interactions were seen in the diet quality scores (CHEI and DBI) with the body mass index and the menopausal status. Conclusions: A high CHEI was associated with an improved OS for patients with OC, while DBI and CFPS were unrelated to OC survival.

Simultaneous Hybrid Coronary Revascularization vs Conventional Strategies for Multivessel Coronary Artery Disease: A 10-Year Follow-Up

BackgroundAlthough evidence is sufficient to confirm that hybrid coronary revascularization (HCR) is safe and effective in the short term, its value in the long run is debatable. ObjectivesThis study sought to compare the long-term outcomes of HCR with coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for multivessel disease. MethodsThree groups of patients, 540 each, receiving HCR, CABG, or PCI between June 2007 to September 2018, were matched using propensity score matching. Patients were stratified by EuroSCORE (European System for Cardiac Operative Risk Evaluation) II (low ≤0.9; 0.9 < medium <1.5; high ≥1.5) and SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score (low ≤22; 22 < medium <33; high ≥33). Major adverse cardiac and cerebrovascular events (MACCE) and Seattle Angina Questionnaire (SAQ) scores were compared among the 3 groups. ResultsIn terms of MACCE and SAQ, HCR performed similarly to off-pump CABG but significantly outperformed PCI (P < 0.001). In the low-to-medium EuroSCORE II and medium-to-high SYNTAX score tertiles, MACCE rates in the HCR group were significantly lower than those in the PCI (EuroSCORE II: low, 30.7% vs 41.2%; P = 0.006; medium, 31.3% vs 41.7%; P = 0.013; SYNTAX score: medium, 27.6% vs 41.2%; P = 0.018; high, 32.4% vs 52.7%; P = 0.011) but were similar to those in the CABG group. In the high EuroSCORE II stratum, HCR had a lower MACCE rate than CABG (31.9% vs 47.0%; P = 0.041) and PCI (31.9% vs 53.7%; P = 0.015). ConclusionsCompared with conventional strategies, HCR provided satisfactory long-term outcomes in MACCE and functional status for multivessel disease.

Predictive value of SYNTAX-Ⅱ score on prognosis of patients with chronic total occlusion undergoing percutaneous coronary intervention

Objective: To investigate the predictive value of SYNTAX-Ⅱ score on long term prognosis of patients diagnosed with chronic total occlusion (CTO) and received percutaneous coronary intervention (PCI). Methods: Patients undergoing CTO-PCI in Fuwai hospital from January 2010 to December 2013 were enrolled in this retrospective analysis. The SYNTAX-Ⅱ score of the patients was calculated. According to SYNTAX-Ⅱ score tertiles, patients were stratified as follows: SYNTAX-Ⅱ≤20, 20<SYNTAX-Ⅱ≤27, SYNTAX-Ⅱ>27. Primary endpoint was major adverse cardiac events (MACCE), including all-cause death, myocardial infarction, stroke and any revascularization. Secondary endpoints included stent thrombosis, heart failure and target lesion failure (TLF). Patients were followed up by outpatient visit or telephone call at 1 month, 6 months and 1 year after PCI, and annually up to 5 years. Multivariate Cox regression model was used to analyze the independent risk factors of all-cause death in patients undergoing CTO-PCI. The predictive value of SYNTAX score with SYNTAX-Ⅱ score for all-cause death was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Results: A total of 2 391 patients with CTO and received PCI were enrolled in this study. The mean age was (57.0±10.5) years, 1 994 (83.40%) patients were male. There were 802 patients in lower tertile group (SYNTAX-Ⅱ≤20), 798 patients in intermediate group (20<SYNTAX-Ⅱ≤27) and 791 patients in upper tertile group (SYNTAX-Ⅱ>27). At the end of 5-year follow-up, the loss to follow-up rate of the three groups was 9.10%(73/802), 10.78%(86/798)and 8.85%(70/791), respectively. The rate of all-cause mortality (1.78% (13/729) vs. 3.65% (26/712) vs. 9.02% (65/721), P<0.001), cardiac death (1.37% (10/729) vs. 2.11% (15/712) vs. 4.85% (35/721), P<0.001), target vessel myocardial infarctions (4.25% (31/729) vs. 4.49% (32/712) vs. 7.07% (51/721), P=0.03), probable stent thrombosis (1.51% (11/729) vs. 2.81% (20/712) vs. 3.61% (26/721), P=0.04) and heart failure (1.78% (13/729) vs. 1.97% (14/712) vs. 5.41% (39/721), P<0.001) increased in proportion to increasing SYNTAX-Ⅱ score (all P<0.05). Multivariable Cox regression analysis indicated that female (HR=2.05, 95%CI 1.12-3.73, P=0.01), left ventricular ejection fraction (HR=0.97, 95%CI 0.95-1.00, P=0.05) and SYNTAX-Ⅱ score (HR=1.07, 95%CI 1.02-1.11,P=0.01) were independent predictors for all-cause mortality in patients undergoing CTO-PCI. The predicted value of the SYNTAX-Ⅱ score for all-cause death was significantly higher than the SYNTAX score (AUC 0.71 vs. 0.60, P=0.003). Conclusion: For CTO patients who underwent percutaneous coronary intervention, SYNTAX-Ⅱ score is an independent predictor for 5-year all-cause death, and SYNTAX-Ⅱ serves as an important predictor for all-cause death in these patients.

Diet and Risk of Non-Alcoholic Fatty Liver Disease, Cirrhosis, and Liver Cancer: A Large Prospective Cohort Study in UK Biobank.

Background and Aims: Epidemiological evidence has shown the association between nutritional habits and liver disease. However, results remain conflicting. This study investigated the influence of dietary factors on the risk of incident non-alcoholic fatty liver disease (NAFLD), cirrhosis, and liver cancer. Methods: Data from the UK Biobank database were analyzed (n = 372,492). According to baseline data from the food frequency questionnaire, two main dietary patterns (Western and prudent) were identified using principal component analysis. We used cox proportional hazards models to explore the associations of individual food groups and dietary patterns with NAFLD, cirrhosis, and liver cancer. Results: During a median follow-up of 12 years, 3527 hospitalized NAFLD, 1643 cirrhosis, and 669 liver cancer cases were recorded among 372,492 participants without prior history of cancer or chronic liver diseases at baseline. In multivariable adjusted analysis, participants in the high tertile of Western dietary pattern score had an 18% (95%CI = 1.09−1.29), 21% (95%CI = 1.07−1.37), and 24% (95%CI = 1.02−1.50) higher risk of incident NAFLD, liver cirrhosis, and liver cancer, respectively, compared with the low tertile. Participants in the high tertile of prudent scores had a 15% (95%CI = 0.75−0.96) lower risk of cirrhosis, as compared with those in the low tertile. In addition, the higher consumption of red meat and the lower consumption of fruit, cereal, tea, and dietary fiber were significantly associated with a higher risk of NAFLD, cirrhosis, and liver cancer (ptrend < 0.05). Conclusions: This large prospective cohort study showed that an increased intake of food from the Western dietary pattern could be correlated with an increased risk of chronic liver diseases, while the prudent pattern was only correlated with a reduced liver cirrhosis risk. These data may provide new insights into lifestyle interventions for the prevention of chronical liver diseases.

The association between healthy eating index score with semen parameters in infertile men: A cross-sectional study.

Infertility has been a major problem for young couples in recent years. One way to assay the diet quality is the healthy eating index (HEI), related to infertility. This study aims to assess the association between the HEI score with semen parameters in Iranian infertile men. Two hundred and sixty eligible men (18-55 yr), were referred to the major infertility clinic in the summer of 2018 and entered this cross-sectional study. Based on the 5 edition of the world health organization laboratory manual, semen parameters including sperm concentration, volume, motility, and morphology were analyzed, and to specify the dietary intake of individuals a 168-item questionnaire was used. Also, to calculate the total HEI score, all 13 components based on HEI-2015 components and scoring standards were summed up. Participants in the highest tertile, had no difference in mean sperm parameters with those in the lowest tertile in the crude model. No significant association was found between sperm parameters and HEI score tertiles in the crude model, even after adjustment for potential confounders, except for concentration (OR: 0.39 and CI: 0.15, 0.99, p = 0.04). Participants in the highest tertile had a lower risk of abnormal concentration and motility in the crude model. The risk of abnormal concentration decreased, and motility increased in the adjusted model. In this cross-sectional study, there was no significant relationship between HEI and sperm indexes, except for sperm concentration. Therefore, more studies need to be done in the future.

Persons with rheumatoid arthritis have higher barriers to physical activity than controls: a cross-sectional study using the Facilitators and Barriers to Physical Activity Questionnaire (FasBarPAQ)

Facilitators and barriers to performing physical activity (PA) may vary among persons with rheumatoid arthritis (RA) as well as between RA patients and healthy individuals. Primary objective: To investigate associations of presence of RA and levels of stress and depression with scores for facilitators and barriers to PA, using a new questionnaire (FasBarPAQ). Secondary objectives: investigate inter-individual score differences in persons with RA, and associations with RA disease-specific variables. Persons with RA from two outpatient clinics (n = 203) and blood donor controls (n = 293) filled in the new 14-item FasBarPAQ questionnaire, the Hospital Anxiety and Depression Scale depression scale (HADS-D), Cohen’s perceived stress scale, and questions regarding PA. Clinical data, and self-reported disease activity and physical function were collected for the persons with RA. Data were analyzed using linear and logistic regression. RA was associated with lower Facilitators scores (coefficient = − 1.30, p = 0.015), higher Barriers scores (coefficient = 2.36, p < 0.001) and lower Total Facilitators-Barriers scores (coefficient = − 3.67, p < 0.001). HADS-D ≥ 8 was associated with lower Total scores (coefficient = − 3.32, p = 0.022), and the two higher stress score tertiles were associated with higher Barriers and lower Total scores (p = 0.023 to p < 0.001). Persons with RA reported greatly varying facilitators and barriers profiles. Seropositivity and higher patient global assessment were associated with higher Barriers scores (coefficients = 1.79, p = 0.011; 0.60, p < 0.001) and lower Total scores (coefficients = − 3.60, p = 0.003; − 0.98, p < 0.001). Persons with RA had higher barriers and lower facilitators for PA, with varying individual profiles. The new FasBarPAQ questionnaire may be a useful screening tool for healthcare providers treating persons with RA.

Association of Residual Ischemic Disease With Clinical Outcomes After Percutaneous Coronary Intervention

BackgroundAnatomical scoring systems have been used to assess completeness of revascularization but are challenging to apply to large real-world datasets. ObjectivesThe aim of this study was to assess the prevalence of complete revascularization and its association with longitudinal clinical outcomes in the U.S. Department of Veterans Affairs (VA) health care system using an automatically computed anatomic complexity score. MethodsPatients undergoing percutaneous coronary intervention (PCI) between October 1, 2007, and September 30, 2020, were identified, and the burden of prerevascularization and postrevascularization ischemic disease was quantified using the VA SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) score. The association between residual VA SYNTAX score and long-term major adverse cardiovascular events (MACE; death, myocardial infarction, repeat revascularization, and stroke) was assessed. ResultsA total of 57,476 veterans underwent PCI during the study period. After adjustment, the highest tertile of residual VA SYNTAX score was associated with increased hazard of MACE (HR: 2.06; 95% CI: 1.98-2.15) and death (HR: 1.50; 95% CI: 1.41-1.59) at 3 years compared to complete revascularization (residual VA SYNTAX score = 0). Hazard of 1- and 3-year MACE increased as a function of residual disease, regardless of baseline disease severity or initial presentation with acute or chronic coronary syndrome. ConclusionsResidual ischemic disease was strongly associated with long-term clinical outcomes in a contemporary national cohort of PCI patients. Automatically computed anatomic complexity scores can be used to assess the longitudinal risk for residual ischemic disease after PCI and may be implemented to improve interventional quality.

Dietary protein score and carbohydrate quality index with the risk of chronic kidney disease: Findings from a prospective cohort study.

This study aimed to examine the associations between dietary protein score and carbohydrate quality index (CQI) and the risk of chronic kidney disease (CKD) in Iranian adults. This population-based cohort study was performed within the Tehran Lipid and Glucose Study framework on 6,044 subjects aged ≥18 years old, who were followed up for a mean of 7.7 years. Dietary protein score and CQI were determined using a food frequency questionnaire. CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2. A multivariate Cox proportional hazard regression model was used to estimate the risk of CKD across tertiles of protein score and CQI. The mean (standard deviation) of age and body mass index of participants were 37.9 (12.8) years and 26.8 (4.7) kg/m2, respectively. During the 7.7 ± 2.7 years of follow-up, 1,216 cases (20.1%) of CKD were ascertained. In the final adjusted model, individuals in the highest tertile of protein score had decreased risk of CKD (HR: 0.85, 95% CI: 0.74-0.98, P trend = 0.033). Also, there is a significant association between total carbohydrate score (HR: 0.85, 95% CI: 0.73-0.99, P trend = 0.016), the ratio of whole grain/total grains (HR: 0.81, 95% CI: 0.70-0.94, P trend = 0.004), and glycemic index (HR: 1.30, 95% CI: 1.12-1.51, P trend < 0.001) and risk of CKD. However, no significant association was found between total protein intakes, plant-to-animal ratio, and solid carbohydrate/total carbohydrate with the risk of CKD. Our results revealed a diet with a high protein score and high quality of carbohydrates, characterized by higher intakes of plant proteins, low glycaemic index (GI) carbohydrates, whole grain, fibers, and lower intakes of animal proteins, can be related to reduced CKD risk.

Abstract 13104: Prognostic Value of a Progressive Decrease in Apoj-Glyc Levels in Patients Attending A&amp;E Departments With Suspected Acute Coronary Syndrome or Angina-Like Pain

Introduction: Reduced serum levels of glycosylated apolipoprotein J (ApoJ-Glyc) have been proposed as a marker for the early detection of myocardial ischemia with a potential prognostic value. Objective: The EDICA clinical trial assessed the performance of ApoJ-Glyc as a biomarker for the early detection of myocardial ischemia in patients attending the A&amp;E department with chest pain suggestive of acute coronary syndrome (ACS) and investigated -as a secondary pilot objective- its prognostic value. Methods: EDICA -a multi-centre, international, diagnostic study (NCT04119882) assessed 404 patients. Based on clinical variables and diagnostic tests, 291 patients were considered to have had a “non-ischemic” event and 113 an “ischemic” event. Blood samples were obtained for the assessment of high-sensitivity troponin and ApoJ-Glyc at admission and at 1h and 3h thereafter. GRACE Risk Score was calculated in all ischemic patients. Patients were followed up for 6 months after presentation and the occurrence of MACE (cardiac death, recovered cardiac arrest, re-infarction, cardiac failure, new admission for ACS after discharge, or unplanned revascularization for cardiac ischemia after discharge) was recorded. ApoJ-Glyc serum levels were analyzed with a novel ELISA targeting a specific glycosylated variant of ApoJ (ApoJ-GlycA2). Results: Among the patients in the ischemic group, 8.8% had MACE at 6-months and these showed a 26% mean reduction in ApoJ-GlycA2 levels 3h post-admission compared with levels at presentation. This reduction was not observed in patients without MACE. Patients in the highest GRACE Risk Score tertile (&gt;118 points) showed a progressive decrease in ApoJ-GlycA2 levels after presentation compared with patients in the lower risk tertiles (mean decrease: 41% at 1h, P=0.01 and 35% at 3h, P=0.02 when compared with admission levels). Conclusions: A progressive decrease in ApoJ-Glyc levels after A&amp;E admission appears to not only identify patients with ischemic events but also those at higher risk of suffering serious recurrent cardiovascular events at 6-months’ follow-up. Further studies in larger cohorts of patients are warranted to validate the potential role of ApoJ-Glyc in risk stratification in the context of cardiac ischemic events.

Pre-existing mental health disorders and fear of COVID-19 pandemic: Data from a phone survey in community-dwelling older adults recruited in the NutBrain study.

COVID-19 has caused a parallel epidemic of fear, anxiety, depression, stress, and frustration, particularly among the most fragile and vulnerable individuals, such as older people and those with previous mental health disorders. The present study aims to investigate the association between pre-existing mental health disorders, particularly depressive symptoms and Mild Cognitive Impairment (MCI), and the fear of COVID-19 and to explore which cognitive domains were involved in coping with fear in older people. In April 2020, we conducted a phone-interview questionnaire on community-dwelling older adults living in Lombardy Region (Italy) who participated in the NutBrain study. At baseline, socio-demographic characteristics along with lifestyles, and medical history were recorded. Participants underwent a neuropsychological battery exploring the global cognitive function and specific cognitive domains, to detect cases of MCI. The Center for Epidemiologic Studies Depression scale (CES-D) was used for screening depressive symptoms. During the phone survey, respondents were assessed using a structured questionnaire querying about fear of the COVID-19 pandemic. We performed multivariate logistic regression models to study the association between MCI and depressive symptomatology and fear. We also explored which cognitive domains were associated with fear. Odds Ratios (OR) with Confidence Intervals (95%CI) were estimated adjusting for potential confounders. Out of the 351 respondents (mean age 73.5 ± 6.1 years, 59.8% women, 49.1% high education), at baseline, 22.9% had MCI and 18.8% had depressive symptoms. In the multivariate analyses gender, age, and body mass index were significantly associated with the fear score. Considering different domains of fear, MCI was associated with fear of being infected themselves (OR 2.55, 95%CI 1.39-4.70) while depressive symptoms were associated with fear of contagion for family members (OR 2.38, 95%CI 1.25-4.52). Impaired executive cognitive function was positively associated with the highest tertile of the fear score (OR 3.28, 95%CI 1.37-7.74) and with fear of contagion for themselves (OR 3.39, 95%CI 1.61-7.17). Older adults experienced different fear reactions, particularly when suffering from neurocognitive disorders and depressive symptoms; executive dysfunction was associated with increased fear. These results highlighted the need to pay attention to the psychological effects of the outbreak of COVID-19 to target intervention, especially among vulnerable subgroups of individuals. [ClinicalTrials.gov], identifier [NCT04461951].

Healthy eating index in Iranian infertile men: A cross-sectional study

Background: Infertility had an increasing trend between couples in Iran. Some epidemiological studies have reported a relationship between infertility and lifestyle patterns including dietary habits. Our objective was to identify the relation between Healthy eating index and sperm parameters in Iranian infertile men. Materials and Methods: This cross-sectional was performed on 400 newly diagnosed infertile men in Yazd Reproductive Sciences Institute from July to December 2019. Men were recruited when their infertility was confirmed by the expert andrologist based on WHO criteria. They delivered a semen sample and answered a 168 items semiquantitative food frequency questionnaire (FFQ).All data were analyzed using SPSS V. 22 software. P-value less than 0.5 considered as significant. Results: There was significant association between sperm density and HEI score tertile in crude model but after adjustment for potential confounders there was not any association. Participants in highest tertile had a higher risk of density and lower risk of motility in crude model (OR =1.69; 95 Percentage CI: 1.00, 2.88; P=0.05 and OR=1.31; 95 Percentage CI: 0.78, 2.21; P=0.29) and risk of density (OR=1.15; 95 Percentage CI: 0.65, 2.03; P=0.63 and OR=1.31; 95 Percentage CI: 0.71, 2.40; P=0.38) and motility decrease in adjusted models (OR=0.86; 95 Percentage CI: 0.49, 1.52; P=0.59 and OR=0.92; 95 Percentage CI: 0.50, 1.67; P=0.74). Conclusions: We concluded that adherence to HEI principles can have a positive effect on men's fertility. However, more research is needed to confirm these relations and provide the evidence needed to exert these findings into clinical practice.