BACKGROUND Dietary supplement(DS)usage among United States adults has significantly increased.Patients with steatotic liver disease(SLD)may have unique moti-vations to take DS in light of their liver condition and co-...BACKGROUND Dietary supplement(DS)usage among United States adults has significantly increased.Patients with steatotic liver disease(SLD)may have unique moti-vations to take DS in light of their liver condition and co-morbidities.AIM To characterize DS use in SLD patients and explore motivations for their use.METHODS Adults≥18 years old with complete transient elastography and dietary data from the National Health and Nutrition Examination Survey between January 2017 and March 2020 were studied.SLD was defined using consensus criteria,combining clinical indicators with elastography thresholds.The DS Questionnaire(DSQ)was used to record participants’use of DSQ.Sample weights were applied to estimate national prevalence.RESULTS Of 2413 participants with SLD,1058 reported using DS,for an estimated prevalence of 44.8%[standard error(SE)2.4]with an average of 2.6(SE 0.2)DS per person.Among SLD participants taking DSQ,53.2%(SE 3.3)reported using non-vitamin/non-mineral ones,with an average of 1.8(SE 0.1)such supplements per person.DS users were more likely to be female,have higher levels of education,and have greater food security(P<0.02 for all).The most common motivations for using DS were to follow doctor’s advice(36.7%,SE 1.8),to improve overall health(22.1%,SE 2.0),and to maintain health(19.2%,SE 1.9).CONCLUSION Nearly half of individuals with SLD report taking DS.This study underscores the pressing need to deepen our understanding of DS use/motivations to develop tailored patient counseling strategies.展开更多
BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains ina...BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.展开更多
AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National ...AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.展开更多
BACKGROUND Cardiovascular health(CVH)plays a crucial role in overall health,but its association with metabolic-associated fatty liver disease(MAFLD)remains unclear.AIM To investigate the relationship between CVH,measu...BACKGROUND Cardiovascular health(CVH)plays a crucial role in overall health,but its association with metabolic-associated fatty liver disease(MAFLD)remains unclear.AIM To investigate the relationship between CVH,measured using Life’s Essential 8(LE8)and Life’s Simple 7(LS7),and the prevalence of MAFLD.METHODS This cross-sectional study had a sample of 2234 individuals,representing approximately 120 million individuals in the United States.Baseline parameters were compared between the LE8 and LS7 groups.Logistic regression models were used to evaluate the relationship between LE8,LS7,and MAFLD,while taking into account confounding factors.The investigation employed restricted cubic splines to investigate non-linear associations.Subgroup analyses and sensitivity studies were performed to evaluate the strength and reliability of the results.RESULTS Higher LE8 and LS7 scores were significantly associated with a decreased risk of MAFLD,even after controlling for demographic,socioeconomic,and clinical variables.This association demonstrated a non-linear pattern,with the most dramatic risk reduction observed at higher CVH levels.Individual CVH components,notably healthy behaviors and factors,exhibited strong relationships with MAFLD.Subgroup analyses indicated consistent relationships across several demographics.Sensitivity tests utilizing other MAFLD definitions validated the robustness of the findings.CONCLUSION Higher adherence to CVH criteria,as indicated by LE8 and LS7 scores,is associated with a significantly lower risk of MAFLD.These results emphasize the need to advance CVH to control and avoid MAFLD.展开更多
BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study invest...BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI） 〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.展开更多
AIM:To assess nutrition,physical activity and health-ful knowledge in obese children with biopsy-proven nonalcoholic steatohepatitis(NASH or NA)compared to children without liver disease.METHODS:Children with biopsy-p...AIM:To assess nutrition,physical activity and health-ful knowledge in obese children with biopsy-proven nonalcoholic steatohepatitis(NASH or NA)compared to children without liver disease.METHODS:Children with biopsy-proven NASH comprised the NASH group.Age,sex and ethnicity matched control groups consisted of obese(OB)and lean(CO) children with no liver disease.Subjects were adminis-tered the School Physical Activity and Nutrition Survey and one blood draw was obtained.RESULTS:Fifty-seven patients were enrolled with a mean age of 12.1±2.1 years,and all were Hispanic.Even though the OB and NA had a similar increased body mass index(%),35%of the NA group always read nutrition labels compared to none in the OB(P<0.05),and more NA children felt their diet is"less healthy".NA consumed the least amount of fruits with only 25%having≥1 fruit/d vs 45%in OB and 64.7% in CO(P<0.05 NA vs CO).Only 15%of NA subjects performed light exercise vs 35%and 59%of OB and CO groups,respectively(P=0.02).The mean physical activity score was lowest in the NA group(P<0.05).Amongst the subjects with NASH,we found that 100% of patients with grade 2 or 3 fibrosis had a sedentary score>2 compared to only 63.6%of those with grade 1 or no fibrosis(P<0.05).CONCLUSION:Children with NASH had increased sedentary behavior,decreased activity,and fruit intake.Larger studies may determine the benefit of changing these behaviors as treatment for NASH.展开更多
The social nutrition status was investigated among 246 subjects aged 60-90 living at three urban communities in Chengdu of Sichuan Province. The questionnaire was designed to evaluate socirydeweraphic background, the ...The social nutrition status was investigated among 246 subjects aged 60-90 living at three urban communities in Chengdu of Sichuan Province. The questionnaire was designed to evaluate socirydeweraphic background, the subjects' nutrition knowledge, and the support systerns for geriatric nutrition. Fasting venous blcod was colected for the analysis of biochemical parameters. Blood pressure, bene mineral contents (BMC), body weight (BW) and they height (BH) were measured at the same time. Only 49. 7% of the subjects correctly an swered four basic questions on nutrition. Food patterns for the elder1y were simple and modest. Several nutrition-related disorders for the elderly were including high systolic bbo pressure (44. 6 % ), hyPertriglyceridemia (25. 9 % ), high diasto1ic blood pressure (25. 1% ),obesity (24. 5% ), high PBG (20. 6% ), emaciation (19. 9%), high FBG (17.9%) and osteoporosis (16. 8%). These data indicate that the support systems for the geriatric nutrition will have to be improved.展开更多
Background:To examine the association between alcohol drinking and short sleep duration among Chinese adults.Methods:Based on inclusion and exclusion criteria,28,167 records of 15,074 adults longitudinal data were obt...Background:To examine the association between alcohol drinking and short sleep duration among Chinese adults.Methods:Based on inclusion and exclusion criteria,28,167 records of 15,074 adults longitudinal data were obtained from the China Health and Nutrition Survey for the period from 2004 to 2011.A multilevel logistic regression model was employed to explore the association between alcohol drinking and sleep duration.Results:Compared with nondrinking participants,a high drinking frequency was positively correlated with a short sleep duration in both the males(odds ratio(OR)=1.33,95%confidence interval(CI)=1.20–1.48,P<0.001)and females(OR=1.60,95%CI=1.18–2.18,P=0.003)before the covariates were adjusted.After adjusting for age,residence area,education level,marital status,smoking,coffee consumption,tea consumption,and activity level,this association remained significant in the males(OR=1.31,95%CI=1.17–1.46,P<0.001)but not in the females(OR=1.16,95%CI=0.85–1.59,P=0.340).Conclusion:The present results suggest that a high drinking frequency was positively correlated with a short sleep duration in male population.Comprehensive measures therefore need to be implemented to improve sleep duration,especially to increase awareness of the dangers of drinking alcohol.展开更多
The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data fro...The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.展开更多
Objective Ferritin,initially acting as an iron-storage protein,was found to be associated with metabolic diseases.Our study was designed to investigate the association between serum ferritin and metabolic-associated f...Objective Ferritin,initially acting as an iron-storage protein,was found to be associated with metabolic diseases.Our study was designed to investigate the association between serum ferritin and metabolic-associated fatty liver disease(MAFLD)using data from the National Health and Nutrition Examination Survey(NHANES)of the United State of America.Methods A cross-sectional study was conducted,enrolling a total of 2145 participants from the NHANES in the 2017–2018 cycles.Hepatic steatosis and liver fibrosis were assessed by ultrasound images and several non-invasive indexes.Multiple regression analysis was conducted to determine the associations between serum ferritin concentration and MAFLD and liver fibrosis.Results The analysis revealed that participants with higher serum ferritin levels(Q3 and Q4 groups)had a higher prevalence of MAFLD than those with the lowest serum ferritin levels[Q3 vs.Q1:OR=2.17(1.33,3.53),P<0.05 in fatty liver index(FLI);Q4 vs.Q1:OR=3.13(1.91,5.13),P<0.05 in FLI].Additionally,participants with the highest serum ferritin levels(Q4 group)displayed a higher prevalence of liver fibrosis[Q4 vs.Q1:OR=2.59(1.19,5.62),P<0.05 in liver stiffness measurement;OR=5.06(1.12,22.94),P<0.05 in fibrosis-4 index],with significantly increased risk observed in participants with concomitant diabetes[OR=7.45(1.55,35.72),P=0.012].Conclusion Our study revealed that elevated serum ferritin levels are associated with a higher prevalence of MAFLD and advanced liver fibrosis in patients.Elevated serum ferritin levels combined with diabetes are important risk factors for liver fibrosis.展开更多
BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and const...BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.展开更多
BACKGROUND Dietary fiber is essential for human health and can help reduce the symptoms of constipation.However,the relationship between dietary fiber and diarrhea is,poorly understood.AIM To evaluate the relationship...BACKGROUND Dietary fiber is essential for human health and can help reduce the symptoms of constipation.However,the relationship between dietary fiber and diarrhea is,poorly understood.AIM To evaluate the relationship between dietary fiber and chronic diarrhea.METHODS This retrospective study was conducted using data from the United States National Health and Nutrition Examination Survey,conducted between 2005 and 2010.Participants over the age of 20 were included.To measure dietary fiber consumption,two 24-hour meal recall interviews were conducted.The independent relationship between the total amount of dietary fiber and chronic diarrhea was evaluated with multiple logistic regression and interaction analysis.RESULTS Data from 12829 participants were analyzed.Participants without chronic diarrhea consumed more dietary fiber than participants with chronic diarrhea(29.7 vs 28.5,P=0.004).Additionally,in participants with chronic diarrhea,a correlation between sex and dietary fiber intake was present:Women who consume more than 25 g of dietary fiber daily can reduce the occurrence of chronic diarrhea.CONCLUSION Dietary fiber can reduce the occurrence of chronic diarrhea.展开更多
BACKGROUND Dyslipidemia is frequently present in patients with diabetes.The associations of remnant cholesterol and mortality remains unclear in patients with diabetes.AIM To explore the associations of remnant choles...BACKGROUND Dyslipidemia is frequently present in patients with diabetes.The associations of remnant cholesterol and mortality remains unclear in patients with diabetes.AIM To explore the associations of remnant cholesterol with all-cause and cardiovas-cular mortality in patients with diabetes.METHODS This prospective cohort study included 4740 patients with diabetes who par-ticipated in the National Health and Nutrition Examination Survey from 1999 through 2018.Remnant cholesterol was used as the exposure variable,and all-cause and cardiovascular mortality were considered outcome events.Outcome data were obtained from the National Death Index,and all participants were followed from the interview date until death or December 31,2019.Multivariate proportional Cox regression models were used to explore the associations between exposure and outcomes,in which remnant cholesterol was modeled as both a categorical and a continuous variable.Restricted cubic splines(RCSs)were calculated to assess the nonlinearity of associations.Subgroup(stratified by sex,age,body mass index,and duration of diabetes)and a series of sensitivity analyses were performed to evaluate the robustness of the associations.RESULTS During a median follow-up duration of 83 months,1370 all-cause deaths and 389 cardiovascular deaths were documented.Patients with remnant cholesterol levels in the third quartile had a reduced risk of all-cause mortality[hazard ratio(HR)95%confidence interval(CI):0.66(0.52-0.85)];however,when remnant cholesterol was modeled as a continuous variable,it was associated with increased risks of all-cause[HR(95%CI):1.12(1.02-1.21)per SD]and cardiovascular[HR(95%CI):1.16(1.01-1.32),per SD]mortality.The RCS demonstrated nonlinear associations of remnant cholesterol with all-cause and cardiovascular mortality.Subgroup and sensitivity analyses did not reveal significant differences from the above results.CONCLUSION In patients with diabetes,higher remnant cholesterol was associated with increased risks of all-cause and cardiovascular mortality,and diabetes patients with slightly higher remnant cholesterol(0.68-1.04 mmol/L)had a lower risk of all-cause mortality.展开更多
BACKGROUND Individuals with diabetes mellitus are more likely to experience depression,although most patients remain undiagnosed.The relation between total bilirubin and depression has been increasingly discussed,but ...BACKGROUND Individuals with diabetes mellitus are more likely to experience depression,although most patients remain undiagnosed.The relation between total bilirubin and depression has been increasingly discussed,but limited studies have examined the association of total bilirubin with depression risk in adults with diabetes,which warrants attention.AIM To investigate the association between total bilirubin levels and the risk of depression in adults with diabetes.METHODS The study included adults with diabetes from the National Health and Nutrition Examination Survey 2007-2018.Depression was determined using the Patient Health Questionnaire-9.Multivariable logistic regression,propensity scorematched analysis and restricted cubic spline models were utilized to investigate the association between total bilirubin levels and depression risk in adults with diabetes.RESULTS The study included 4758 adults with diabetes,of whom 602(12.7%)were diagnosed with depression.After adjusting for covariates,we found that diabetic adults with lower total bilirubin levels had a higher risk of depression(OR=1.230,95%CI:1.006-1.503,P=0.043).This association was further confirmed after propensity score matching(OR=1.303,95%CI:1.034-1.641,P=0.025).Subgroup analyses showed no significant dependence of age,body mass index,sex,race or hypertension on this association.Restricted cubic spline models displayed an inverted U-shaped association of total bilirubin levels with depression risk within the lower range of total bilirubin levels.The depression risk heightened with the increasing levels of total bilirubin,reaching the highest risk at 6.81μmol/L and decreasing thereafter.CONCLUSION In adults with diabetes,those with lower levels of total bilirubin were more likely to have depressive symptoms.Serum total bilirubin levels may be used as an additional indicator to assess depression risk in adults with diabetes.展开更多
BACKGROUND There is a lack of literature discussing the utilization of the stacking ensemble algorithm for predicting depression in patients with heart failure(HF).AIM To create a stacking model for predicting depress...BACKGROUND There is a lack of literature discussing the utilization of the stacking ensemble algorithm for predicting depression in patients with heart failure(HF).AIM To create a stacking model for predicting depression in patients with HF.METHODS This study analyzed data on 1084 HF patients from the National Health and Nutrition Examination Survey database spanning from 2005 to 2018.Through univariate analysis and the use of an artificial neural network algorithm,predictors significantly linked to depression were identified.These predictors were utilized to create a stacking model employing tree-based learners.The performances of both the individual models and the stacking model were assessed by using the test dataset.Furthermore,the SHapley additive exPlanations(SHAP)model was applied to interpret the stacking model.RESULTS The models included five predictors.Among these models,the stacking model demonstrated the highest performance,achieving an area under the curve of 0.77(95%CI:0.71-0.84),a sensitivity of 0.71,and a specificity of 0.68.The calibration curve supported the reliability of the models,and decision curve analysis confirmed their clinical value.The SHAP plot demonstrated that age had the most significant impact on the stacking model's output.CONCLUSION The stacking model demonstrated strong predictive performance.Clinicians can utilize this model to identify highrisk depression patients with HF,thus enabling early provision of psychological interventions.展开更多
BACKGROUND Recent research has underscored the potentially protective role of dietary antioxidants against chronic conditions,such as cardiovascular diseases and stroke.The composite dietary antioxidant index(CDAI),wh...BACKGROUND Recent research has underscored the potentially protective role of dietary antioxidants against chronic conditions,such as cardiovascular diseases and stroke.The composite dietary antioxidant index(CDAI),which reflects the overall intake of key dietary antioxidants,has been identified as a crucial metric for exploring this relationship.Although previous research has shown a negative correlation between CDAI levels and stroke risk in prediabetic individuals,there remains a substantial gap in understanding this association among individuals with diabetes,who are at an inherently greater risk for cerebrovascular events.AIM To investigate the association between CDAI and stroke risk in individuals with diabetes.METHODS Using a cross-sectional study design,this investigation analyzed data from the National Health and Nutrition Examination Survey spanning from 2003 to 2018 that included 6735 participants aged over 20 years with diabetes.The CDAI was calculated from 24-h dietary recalls to assess intake of key antioxidants:Vitamins A,C,and E;carotenoids;selenium;and zinc.Multivariate logistic regression and restricted cubic spline analysis were used to rigorously examine the relationship between CDAI and stroke risk.RESULTS The participant cohort,with an average age of 59.5 years and a slight male majority,reflected the broader demographic characteristics of individuals with diabetes.The analysis revealed a strong inverse relationship between CDAI levels and stroke risk.Remarkably,those in the highest quintile of CDAI demonstrated a 43%lower prevalence of stroke compared to those in the lowest quintile,even after adjustments for various confounders.This finding not only highlights the negative association between CDAI and stroke risk but also underscores the significant potential of antioxidant-rich diets in reducing stroke prevalence among patients with diabetes.CONCLUSION Our findings suggested that CDAI was inversely associated with stroke prevalence among patients with diabetes.These results suggest incorporating antioxidant-rich foods into dietary regimens as a potential strategy for stroke prevention.展开更多
BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association betwe...BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.展开更多
BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions.AIM To evaluate the association between serum estradiol level ...BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions.AIM To evaluate the association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women using population-based data.METHODS This study included 673 postmenopausal women,aged 40-59 years,from the National Health and Nutrition Examination Survey between 2013 and 2016.Weighted multivariable linear regression models were used to evaluate the association between serum E2 Level and appendicular lean mass index(ALMI).When non-linear associations were found by using weighted generalized additive model and smooth curve fitting,two-piecewise linear regression models were further applied to examine the threshold effects.RESULTS There was a positive association between serum E2 level and ALMI.Compared to individuals in quartile 1 group,those in other quartiles had higher ALMI levels.An inverted U-shaped curve relationship between serum E2 Level and ALMI was found on performing weighted generalized additive model and smooth curve fitting,and the inflection point was identified as a serum E2 level of 85 pg/mL.CONCLUSION Our results demonstrated an inverted U-shaped curve relationship between serum E2 levels and ALMI in middle-aged postmenopausal women,suggesting that low serum E2 levels play an important in the loss of muscle mass in middleaged postmenopausal women.展开更多
BACKGROUND Depression presents significant challenges to mental health care.Although phy-sical activity is highly beneficial to mental and physical health,relatively few stu-dies have conducted on the relationship bet...BACKGROUND Depression presents significant challenges to mental health care.Although phy-sical activity is highly beneficial to mental and physical health,relatively few stu-dies have conducted on the relationship between them.AIM To investigate the association between muscle quality index(MQI)and incidence of depression.METHODS The data used in this cross-sectional study were obtained from the 2011-2014 National Health and Nutritional Examination Survey,which included informa-tion on MQI,depression,and confounding factors.Multivariable logistic regre-ssion models were employed,while taking into account the complex multi-stage sampling design.A restricted cubic spline model was utilized to investigate the non-linear relationship between the MQI and depression.Additionally,subgroup analyses were performed to identify influential factors.RESULTS The prevalence of depression in this population was 8.44%.With the adjusted model,the MQI was associated with depression in females(odds ratio=0.68,95%confidence interval:0.49-0.95)but not in males(odds ratio=1.08,95%confidence interval:0.77-1.52).Restricted cubic spline adjustment of all covariates showed a significant negative non-linear relationship between depression and the MQI in females.The observed trend indicated an 80%decrease in the risk of depression for each unit increase in MQI,until a value of 2.2.Subsequently,when the MQI exceeded 2.2,the prevalence of depression increased by 20%for every unit increase in the MQI.Subgroup analyses further confirmed that the MQI was negatively associated with de-pression.CONCLUSION The MQI was inversely correlated with depression in females but not males,suggesting that females with a higher MQI might decrease the risk of depression.展开更多
Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical I...Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical Information Mart for Intensive Care(MIMIC);however,these data are often characterized by a high degree of dimensional heterogeneity,timeliness,scarcity,irregularity,and other characteristics,resulting in the value of these data not being fully utilized.Data-mining technology has been a frontier field in medical research,as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models.Therefore,data mining has unique advantages in clinical big-data research,especially in large-scale medical public databases.This article introduced the main medical public database and described the steps,tasks,and models of data mining in simple language.Additionally,we described data-mining methods along with their practical applications.The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.展开更多
基金Supported by The National Institutes of Health,No.K24AG080021,No.R01AG059183,and No.P30DK026743.
文摘BACKGROUND Dietary supplement(DS)usage among United States adults has significantly increased.Patients with steatotic liver disease(SLD)may have unique moti-vations to take DS in light of their liver condition and co-morbidities.AIM To characterize DS use in SLD patients and explore motivations for their use.METHODS Adults≥18 years old with complete transient elastography and dietary data from the National Health and Nutrition Examination Survey between January 2017 and March 2020 were studied.SLD was defined using consensus criteria,combining clinical indicators with elastography thresholds.The DS Questionnaire(DSQ)was used to record participants’use of DSQ.Sample weights were applied to estimate national prevalence.RESULTS Of 2413 participants with SLD,1058 reported using DS,for an estimated prevalence of 44.8%[standard error(SE)2.4]with an average of 2.6(SE 0.2)DS per person.Among SLD participants taking DSQ,53.2%(SE 3.3)reported using non-vitamin/non-mineral ones,with an average of 1.8(SE 0.1)such supplements per person.DS users were more likely to be female,have higher levels of education,and have greater food security(P<0.02 for all).The most common motivations for using DS were to follow doctor’s advice(36.7%,SE 1.8),to improve overall health(22.1%,SE 2.0),and to maintain health(19.2%,SE 1.9).CONCLUSION Nearly half of individuals with SLD report taking DS.This study underscores the pressing need to deepen our understanding of DS use/motivations to develop tailored patient counseling strategies.
文摘BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.
基金Supported by the National Natural Science Foundation of China(No.82074500)CACMS Innovation Fund(No.CI2021A02605)+1 种基金Administration of Traditional Chinese Medicine of Zhejiang Province(No.2024ZR029)Science and Technology Program of Wenzhou City(No.Y2023210).
文摘AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.
基金Supported by The Science Foundation of 925th Hospital,No.2023[3]and No.2022[3/4]The Guizhou Provincial Health Commission Science and Technology Fund,No.gzwkj2023-135。
文摘BACKGROUND Cardiovascular health(CVH)plays a crucial role in overall health,but its association with metabolic-associated fatty liver disease(MAFLD)remains unclear.AIM To investigate the relationship between CVH,measured using Life’s Essential 8(LE8)and Life’s Simple 7(LS7),and the prevalence of MAFLD.METHODS This cross-sectional study had a sample of 2234 individuals,representing approximately 120 million individuals in the United States.Baseline parameters were compared between the LE8 and LS7 groups.Logistic regression models were used to evaluate the relationship between LE8,LS7,and MAFLD,while taking into account confounding factors.The investigation employed restricted cubic splines to investigate non-linear associations.Subgroup analyses and sensitivity studies were performed to evaluate the strength and reliability of the results.RESULTS Higher LE8 and LS7 scores were significantly associated with a decreased risk of MAFLD,even after controlling for demographic,socioeconomic,and clinical variables.This association demonstrated a non-linear pattern,with the most dramatic risk reduction observed at higher CVH levels.Individual CVH components,notably healthy behaviors and factors,exhibited strong relationships with MAFLD.Subgroup analyses indicated consistent relationships across several demographics.Sensitivity tests utilizing other MAFLD definitions validated the robustness of the findings.CONCLUSION Higher adherence to CVH criteria,as indicated by LE8 and LS7 scores,is associated with a significantly lower risk of MAFLD.These results emphasize the need to advance CVH to control and avoid MAFLD.
文摘BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI） 〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.
基金Supported by National Institute of Health[NIH K12 RR 17665(Morey Haymond,MD(PI)C Wayne Smith,MD(Mentor)]
文摘AIM:To assess nutrition,physical activity and health-ful knowledge in obese children with biopsy-proven nonalcoholic steatohepatitis(NASH or NA)compared to children without liver disease.METHODS:Children with biopsy-proven NASH comprised the NASH group.Age,sex and ethnicity matched control groups consisted of obese(OB)and lean(CO) children with no liver disease.Subjects were adminis-tered the School Physical Activity and Nutrition Survey and one blood draw was obtained.RESULTS:Fifty-seven patients were enrolled with a mean age of 12.1±2.1 years,and all were Hispanic.Even though the OB and NA had a similar increased body mass index(%),35%of the NA group always read nutrition labels compared to none in the OB(P<0.05),and more NA children felt their diet is"less healthy".NA consumed the least amount of fruits with only 25%having≥1 fruit/d vs 45%in OB and 64.7% in CO(P<0.05 NA vs CO).Only 15%of NA subjects performed light exercise vs 35%and 59%of OB and CO groups,respectively(P=0.02).The mean physical activity score was lowest in the NA group(P<0.05).Amongst the subjects with NASH,we found that 100% of patients with grade 2 or 3 fibrosis had a sedentary score>2 compared to only 63.6%of those with grade 1 or no fibrosis(P<0.05).CONCLUSION:Children with NASH had increased sedentary behavior,decreased activity,and fruit intake.Larger studies may determine the benefit of changing these behaviors as treatment for NASH.
文摘The social nutrition status was investigated among 246 subjects aged 60-90 living at three urban communities in Chengdu of Sichuan Province. The questionnaire was designed to evaluate socirydeweraphic background, the subjects' nutrition knowledge, and the support systerns for geriatric nutrition. Fasting venous blcod was colected for the analysis of biochemical parameters. Blood pressure, bene mineral contents (BMC), body weight (BW) and they height (BH) were measured at the same time. Only 49. 7% of the subjects correctly an swered four basic questions on nutrition. Food patterns for the elder1y were simple and modest. Several nutrition-related disorders for the elderly were including high systolic bbo pressure (44. 6 % ), hyPertriglyceridemia (25. 9 % ), high diasto1ic blood pressure (25. 1% ),obesity (24. 5% ), high PBG (20. 6% ), emaciation (19. 9%), high FBG (17.9%) and osteoporosis (16. 8%). These data indicate that the support systems for the geriatric nutrition will have to be improved.
基金This study was supported by the National Social Science Foundation of China(No.16BGL183)This research uses data from China Health and Nutrition Survey+1 种基金The authors would like to thank the National Institute of Nutrition and Food Safety,China Center for Disease Control and Prevention,Carolina Population Center,the University of North Carolina at Chapel Hill,the National Institute for Health(R01-HD30880,DK056350,and R01-HD38700)the Fogarty International Center,NIH for financial support for the China Health and Nutrition Survey data collection and analysis files from 1989 to 2006 and both parties plus the China-Japan Friendship Hospital,Ministry of Health for support for China Health and Nutrition Survey 2009 and future surveys.
文摘Background:To examine the association between alcohol drinking and short sleep duration among Chinese adults.Methods:Based on inclusion and exclusion criteria,28,167 records of 15,074 adults longitudinal data were obtained from the China Health and Nutrition Survey for the period from 2004 to 2011.A multilevel logistic regression model was employed to explore the association between alcohol drinking and sleep duration.Results:Compared with nondrinking participants,a high drinking frequency was positively correlated with a short sleep duration in both the males(odds ratio(OR)=1.33,95%confidence interval(CI)=1.20–1.48,P<0.001)and females(OR=1.60,95%CI=1.18–2.18,P=0.003)before the covariates were adjusted.After adjusting for age,residence area,education level,marital status,smoking,coffee consumption,tea consumption,and activity level,this association remained significant in the males(OR=1.31,95%CI=1.17–1.46,P<0.001)but not in the females(OR=1.16,95%CI=0.85–1.59,P=0.340).Conclusion:The present results suggest that a high drinking frequency was positively correlated with a short sleep duration in male population.Comprehensive measures therefore need to be implemented to improve sleep duration,especially to increase awareness of the dangers of drinking alcohol.
基金This study was supported by the Jungwon University Research Grant(2021-044).
文摘The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.
基金supported by grants from the National Natural Science Foundation of China(No.82172983).
文摘Objective Ferritin,initially acting as an iron-storage protein,was found to be associated with metabolic diseases.Our study was designed to investigate the association between serum ferritin and metabolic-associated fatty liver disease(MAFLD)using data from the National Health and Nutrition Examination Survey(NHANES)of the United State of America.Methods A cross-sectional study was conducted,enrolling a total of 2145 participants from the NHANES in the 2017–2018 cycles.Hepatic steatosis and liver fibrosis were assessed by ultrasound images and several non-invasive indexes.Multiple regression analysis was conducted to determine the associations between serum ferritin concentration and MAFLD and liver fibrosis.Results The analysis revealed that participants with higher serum ferritin levels(Q3 and Q4 groups)had a higher prevalence of MAFLD than those with the lowest serum ferritin levels[Q3 vs.Q1:OR=2.17(1.33,3.53),P<0.05 in fatty liver index(FLI);Q4 vs.Q1:OR=3.13(1.91,5.13),P<0.05 in FLI].Additionally,participants with the highest serum ferritin levels(Q4 group)displayed a higher prevalence of liver fibrosis[Q4 vs.Q1:OR=2.59(1.19,5.62),P<0.05 in liver stiffness measurement;OR=5.06(1.12,22.94),P<0.05 in fibrosis-4 index],with significantly increased risk observed in participants with concomitant diabetes[OR=7.45(1.55,35.72),P=0.012].Conclusion Our study revealed that elevated serum ferritin levels are associated with a higher prevalence of MAFLD and advanced liver fibrosis in patients.Elevated serum ferritin levels combined with diabetes are important risk factors for liver fibrosis.
文摘BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.
文摘BACKGROUND Dietary fiber is essential for human health and can help reduce the symptoms of constipation.However,the relationship between dietary fiber and diarrhea is,poorly understood.AIM To evaluate the relationship between dietary fiber and chronic diarrhea.METHODS This retrospective study was conducted using data from the United States National Health and Nutrition Examination Survey,conducted between 2005 and 2010.Participants over the age of 20 were included.To measure dietary fiber consumption,two 24-hour meal recall interviews were conducted.The independent relationship between the total amount of dietary fiber and chronic diarrhea was evaluated with multiple logistic regression and interaction analysis.RESULTS Data from 12829 participants were analyzed.Participants without chronic diarrhea consumed more dietary fiber than participants with chronic diarrhea(29.7 vs 28.5,P=0.004).Additionally,in participants with chronic diarrhea,a correlation between sex and dietary fiber intake was present:Women who consume more than 25 g of dietary fiber daily can reduce the occurrence of chronic diarrhea.CONCLUSION Dietary fiber can reduce the occurrence of chronic diarrhea.
基金Supported by Project of National Natural Science Foundation of China,No.82274345 and No.82104907Fundamental Research Funds for the Central public welfare research institutes Grant,No.ZZ13-YQ-016 and No.ZZ13-YQ-016-C1.
文摘BACKGROUND Dyslipidemia is frequently present in patients with diabetes.The associations of remnant cholesterol and mortality remains unclear in patients with diabetes.AIM To explore the associations of remnant cholesterol with all-cause and cardiovas-cular mortality in patients with diabetes.METHODS This prospective cohort study included 4740 patients with diabetes who par-ticipated in the National Health and Nutrition Examination Survey from 1999 through 2018.Remnant cholesterol was used as the exposure variable,and all-cause and cardiovascular mortality were considered outcome events.Outcome data were obtained from the National Death Index,and all participants were followed from the interview date until death or December 31,2019.Multivariate proportional Cox regression models were used to explore the associations between exposure and outcomes,in which remnant cholesterol was modeled as both a categorical and a continuous variable.Restricted cubic splines(RCSs)were calculated to assess the nonlinearity of associations.Subgroup(stratified by sex,age,body mass index,and duration of diabetes)and a series of sensitivity analyses were performed to evaluate the robustness of the associations.RESULTS During a median follow-up duration of 83 months,1370 all-cause deaths and 389 cardiovascular deaths were documented.Patients with remnant cholesterol levels in the third quartile had a reduced risk of all-cause mortality[hazard ratio(HR)95%confidence interval(CI):0.66(0.52-0.85)];however,when remnant cholesterol was modeled as a continuous variable,it was associated with increased risks of all-cause[HR(95%CI):1.12(1.02-1.21)per SD]and cardiovascular[HR(95%CI):1.16(1.01-1.32),per SD]mortality.The RCS demonstrated nonlinear associations of remnant cholesterol with all-cause and cardiovascular mortality.Subgroup and sensitivity analyses did not reveal significant differences from the above results.CONCLUSION In patients with diabetes,higher remnant cholesterol was associated with increased risks of all-cause and cardiovascular mortality,and diabetes patients with slightly higher remnant cholesterol(0.68-1.04 mmol/L)had a lower risk of all-cause mortality.
文摘BACKGROUND Individuals with diabetes mellitus are more likely to experience depression,although most patients remain undiagnosed.The relation between total bilirubin and depression has been increasingly discussed,but limited studies have examined the association of total bilirubin with depression risk in adults with diabetes,which warrants attention.AIM To investigate the association between total bilirubin levels and the risk of depression in adults with diabetes.METHODS The study included adults with diabetes from the National Health and Nutrition Examination Survey 2007-2018.Depression was determined using the Patient Health Questionnaire-9.Multivariable logistic regression,propensity scorematched analysis and restricted cubic spline models were utilized to investigate the association between total bilirubin levels and depression risk in adults with diabetes.RESULTS The study included 4758 adults with diabetes,of whom 602(12.7%)were diagnosed with depression.After adjusting for covariates,we found that diabetic adults with lower total bilirubin levels had a higher risk of depression(OR=1.230,95%CI:1.006-1.503,P=0.043).This association was further confirmed after propensity score matching(OR=1.303,95%CI:1.034-1.641,P=0.025).Subgroup analyses showed no significant dependence of age,body mass index,sex,race or hypertension on this association.Restricted cubic spline models displayed an inverted U-shaped association of total bilirubin levels with depression risk within the lower range of total bilirubin levels.The depression risk heightened with the increasing levels of total bilirubin,reaching the highest risk at 6.81μmol/L and decreasing thereafter.CONCLUSION In adults with diabetes,those with lower levels of total bilirubin were more likely to have depressive symptoms.Serum total bilirubin levels may be used as an additional indicator to assess depression risk in adults with diabetes.
文摘BACKGROUND There is a lack of literature discussing the utilization of the stacking ensemble algorithm for predicting depression in patients with heart failure(HF).AIM To create a stacking model for predicting depression in patients with HF.METHODS This study analyzed data on 1084 HF patients from the National Health and Nutrition Examination Survey database spanning from 2005 to 2018.Through univariate analysis and the use of an artificial neural network algorithm,predictors significantly linked to depression were identified.These predictors were utilized to create a stacking model employing tree-based learners.The performances of both the individual models and the stacking model were assessed by using the test dataset.Furthermore,the SHapley additive exPlanations(SHAP)model was applied to interpret the stacking model.RESULTS The models included five predictors.Among these models,the stacking model demonstrated the highest performance,achieving an area under the curve of 0.77(95%CI:0.71-0.84),a sensitivity of 0.71,and a specificity of 0.68.The calibration curve supported the reliability of the models,and decision curve analysis confirmed their clinical value.The SHAP plot demonstrated that age had the most significant impact on the stacking model's output.CONCLUSION The stacking model demonstrated strong predictive performance.Clinicians can utilize this model to identify highrisk depression patients with HF,thus enabling early provision of psychological interventions.
基金Supported by Strategic Priority Research Program of Chinese Academy of Sciences,No.XDB38010100Construction and Validation of an Early Identification System for Cardiovascular Disease Associated with Glucose Metabolism Disorders,No.202204295107020026Science and Technology Projects in Guangzhou,No.2023A04J1087.
文摘BACKGROUND Recent research has underscored the potentially protective role of dietary antioxidants against chronic conditions,such as cardiovascular diseases and stroke.The composite dietary antioxidant index(CDAI),which reflects the overall intake of key dietary antioxidants,has been identified as a crucial metric for exploring this relationship.Although previous research has shown a negative correlation between CDAI levels and stroke risk in prediabetic individuals,there remains a substantial gap in understanding this association among individuals with diabetes,who are at an inherently greater risk for cerebrovascular events.AIM To investigate the association between CDAI and stroke risk in individuals with diabetes.METHODS Using a cross-sectional study design,this investigation analyzed data from the National Health and Nutrition Examination Survey spanning from 2003 to 2018 that included 6735 participants aged over 20 years with diabetes.The CDAI was calculated from 24-h dietary recalls to assess intake of key antioxidants:Vitamins A,C,and E;carotenoids;selenium;and zinc.Multivariate logistic regression and restricted cubic spline analysis were used to rigorously examine the relationship between CDAI and stroke risk.RESULTS The participant cohort,with an average age of 59.5 years and a slight male majority,reflected the broader demographic characteristics of individuals with diabetes.The analysis revealed a strong inverse relationship between CDAI levels and stroke risk.Remarkably,those in the highest quintile of CDAI demonstrated a 43%lower prevalence of stroke compared to those in the lowest quintile,even after adjustments for various confounders.This finding not only highlights the negative association between CDAI and stroke risk but also underscores the significant potential of antioxidant-rich diets in reducing stroke prevalence among patients with diabetes.CONCLUSION Our findings suggested that CDAI was inversely associated with stroke prevalence among patients with diabetes.These results suggest incorporating antioxidant-rich foods into dietary regimens as a potential strategy for stroke prevention.
文摘BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.
基金The Institutional Review Board of the National Center for Health Statistics(NCHS)approved the survey protocols(Protocol#2011-17).
文摘BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions.AIM To evaluate the association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women using population-based data.METHODS This study included 673 postmenopausal women,aged 40-59 years,from the National Health and Nutrition Examination Survey between 2013 and 2016.Weighted multivariable linear regression models were used to evaluate the association between serum E2 Level and appendicular lean mass index(ALMI).When non-linear associations were found by using weighted generalized additive model and smooth curve fitting,two-piecewise linear regression models were further applied to examine the threshold effects.RESULTS There was a positive association between serum E2 level and ALMI.Compared to individuals in quartile 1 group,those in other quartiles had higher ALMI levels.An inverted U-shaped curve relationship between serum E2 Level and ALMI was found on performing weighted generalized additive model and smooth curve fitting,and the inflection point was identified as a serum E2 level of 85 pg/mL.CONCLUSION Our results demonstrated an inverted U-shaped curve relationship between serum E2 levels and ALMI in middle-aged postmenopausal women,suggesting that low serum E2 levels play an important in the loss of muscle mass in middleaged postmenopausal women.
文摘BACKGROUND Depression presents significant challenges to mental health care.Although phy-sical activity is highly beneficial to mental and physical health,relatively few stu-dies have conducted on the relationship between them.AIM To investigate the association between muscle quality index(MQI)and incidence of depression.METHODS The data used in this cross-sectional study were obtained from the 2011-2014 National Health and Nutritional Examination Survey,which included informa-tion on MQI,depression,and confounding factors.Multivariable logistic regre-ssion models were employed,while taking into account the complex multi-stage sampling design.A restricted cubic spline model was utilized to investigate the non-linear relationship between the MQI and depression.Additionally,subgroup analyses were performed to identify influential factors.RESULTS The prevalence of depression in this population was 8.44%.With the adjusted model,the MQI was associated with depression in females(odds ratio=0.68,95%confidence interval:0.49-0.95)but not in males(odds ratio=1.08,95%confidence interval:0.77-1.52).Restricted cubic spline adjustment of all covariates showed a significant negative non-linear relationship between depression and the MQI in females.The observed trend indicated an 80%decrease in the risk of depression for each unit increase in MQI,until a value of 2.2.Subsequently,when the MQI exceeded 2.2,the prevalence of depression increased by 20%for every unit increase in the MQI.Subgroup analyses further confirmed that the MQI was negatively associated with de-pression.CONCLUSION The MQI was inversely correlated with depression in females but not males,suggesting that females with a higher MQI might decrease the risk of depression.
基金the National Social Science Foundation of China(No.16BGL183).
文摘Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical Information Mart for Intensive Care(MIMIC);however,these data are often characterized by a high degree of dimensional heterogeneity,timeliness,scarcity,irregularity,and other characteristics,resulting in the value of these data not being fully utilized.Data-mining technology has been a frontier field in medical research,as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models.Therefore,data mining has unique advantages in clinical big-data research,especially in large-scale medical public databases.This article introduced the main medical public database and described the steps,tasks,and models of data mining in simple language.Additionally,we described data-mining methods along with their practical applications.The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.
