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    Association between blood glucose levels and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial. Yuan Tao,He Hongyu,Liu Yuepeng,Wang Jianwei,Kang Xin,Fu Guanghui,Xie Fangfang,Li Aimin,Chen Jun,Wang Wenxue Trials BACKGROUND:Blood glucose levels that are too high or too low after traumatic brain injury (TBI) negatively affect patient prognosis. This study aimed to demonstrate the relationship between blood glucose levels and the Glasgow Outcome Score (GOS) in TBI patients. METHODS:This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. Information on the disease, laboratory examination, insulin therapy, and surgery for patients with TBI was collected as candidate variables according to clinical importance. Additionally, data on 5-year and 6-month GOS were collected as primary and secondary outcomes, respectively. For multivariate analysis, a generalized additive model (GAM) was used to investigate relationships between blood glucose levels and GOS. The results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). We further applied a two- piecewise linear regression model to examine the threshold effect of blood glucose level and GOS. RESULTS:A total of 182 patients were included in the final analysis. Multivariate GAM analysis revealed that a bell-shaped relationship existed between average blood glucose level and 5-year GOS score or 6-month GOS score. The inflection points of the average blood glucose level were 8.81 (95% CI: 7.43-9.48) mmol/L considering 5-year GOS as the outcome and were 8.88 (95% CI 7.43-9.74) mmol/L considering 6-month GOS score as the outcome. The same analysis revealed that there was also a bell relationship between average blood glucose levels and the favorable outcome group (GOS score ≥ 4) at 5 years or 6 months. CONCLUSION:In a population of patients with traumatic brain injury, blood glucose levels were associated with the GOS. There was also a threshold effect between blood glucose levels and the GOS. A blood glucose level that is either too high or too low conveys a poor prognosis. TRIAL REGISTRATION:ClinicalTrials.gov NCT02161055 . Registered on 11 June 2014. 10.1186/s13063-022-06005-5
    Association of serum vitamin C with liver fibrosis in adults with nonalcoholic fatty liver disease. Scandinavian journal of gastroenterology OBJECTIVE:This study aimed to investigate the association between serum vitamin C and liver fibrosis in patients with NAFLD in the US adults. METHODS:We conducted a cross-sectional analysis of data from the 2017 to 2018 cycle of National Health and Nutrition Examination Survey (NHANES). Serum vitamin C and transient elastography (TE)-accessed liver stiffness was taken as independent and dependent variables, respectively. Liver steatosis and fibrosis were detected by controlling attenuation parameter (CAP) and TE. NAFLD was defined by a CAP score of ≥248 dB/m without any indication of other causes of chronic liver disease. The median liver stiffness of ≥8.2 kPa was used to identify significant fibrosis (≥F2) among NAFLD patients. We calculated the adjusted odds ratio (OR) and 95% confidential intervals (CIs) for associations with significant NAFLD fibrosis using multivariable logistic regression models. RESULTS:Overall, 1926 individuals with NAFLD were included in the analysis and 267 subjects met the definition of significant fibrosis. Serum vitamin C was associated with lower odds of liver fibrosis in NAFLD after adjusting for potential confounders (OR = 0.60, 95% CI, 0.43-0.84), while in the subgroup analysis stratified by gender and body mass index (BMI), this association showed a difference after adjusting for confounders (males: OR = 0.43, 95% CI, 0.26-0.71; females: OR = 0.78, 95% CI, 0.49-1.24). There were no significant associations of serum vitamin C with liver fibrosis in NAFLD with underweight or normal (OR = 1.34, 95% CI, 0.19-9.34). CONCLUSIONS:This cross-sectional study indicated an association of serum vitamin C with significant fibrosis in men and overweight or obese patients with NAFLD. 10.1080/00365521.2022.2041085
    Positive Association between the Triglyceride-Glucose Index and Hyperuricemia in Chinese Adults with Hypertension: An Insight from the China H-Type Hypertension Registry Study. International journal of endocrinology BACKGROUND:Previous studies have revealed the triglyceride-glucose (TyG) index is closely related to hyperuricemia in the general population. However, this relationship in hypertensive patients has not been reported. The aims of this study are to investigate the relationship of the TyG index and hyperuricemia in adult Chinese hypertension. METHODS:The China H-type Hypertension Registration (an observational, noninterventional, and real-world study) was conducted from March 01, 2018, to August 31, 2018, in 16 communities in Wuyuan of China. The TyG index was calculated from fasting triglycerides (mg/dL) and fasting glucose (mg/dL)/2. Hyperuricemia was categorized by uric acid concentration ≥420 mol/L (7 mg/dL). RESULTS:Overall average TyG index of 13,060 adults with hypertension was 8.87; age was 63.81 years. The TyG index was positively correlated with serum uric acid by multiple linear regression analyses ( = 38.03; 95% CI: 34.55 to 41.51). Coincidentally, logistic analyses also demonstrated the TyG index had a positive correlation with hyperuricemia (OR = 2.04; 95% CI: 1.87 to 2.24). Strong linear associations of the TyG index with serum uric acid and hyperuricemia were confirmed by restricted cubic spline analysis. Compared with subjects in the lowest quartile (7.13 to 8.44) of the TyG index, subjects in the 2-4 quartiles had 1.25 (95% CI: 1.10 to 1.41), 1.63 (95% CI: 1.43 to 1.86), and 2.79 (95% CI: 2.41 to 3.24) times greater incident risk of developing hyperuricemia. The TyG index had significant correlations between male patients and hyperuricemia (OR = 2.01) by subgroup analysis. CONCLUSION:Positive associations were found between the TyG index and serum uric acid and between the TyG index and hyperuricemia in adults with hypertension. This trial was registered at clinicaltrials.gov as ChiCTR1800017274. 10.1155/2022/4272715
    Significance of hyperhomocysteinaemia as an effective marker for vasculogenic erectile dysfunction: a cross-sectional study. Translational andrology and urology Background:The primary objective of this cross-sectional study aimed at evaluating serum levels of homocysteinemia (Hcy) in a cohort of erectile dysfunction (ED) patients, and at assessing the correlation between Hcy and vasculogenic ED. Methods:A total of 119 Chinese patients presenting with ED [International Index of Erectile Function (IIEF)-5≤21] were enrolled in this study. The whole cohort was asked to complete the IIEF-5 questionnaire and blood analysis. A detailed medical history, physical examination, nocturnal penile tumescence (NPT) tests and penile color Doppler ultrasonography (pDUS) were performed by a urologist. Based on the pDUS result, they were further categorized into 2 main groups: non-vasculogenic ED (n=79) and vasculogenic ED (n=40). Results:Age and Hcy levels were significantly higher in the vasculogenic ED group compared to the non-vasculogenic ED group (38.45±8.51 32.29±7.57 and 22.91±5.85 16.31±5.23 µmol/L, respectively, P<0.01). Univariate and multivariable regression analyses showed that the incidence of vasculogenic ED raised significantly with the increase of Hcy level. After multivariable adjustment, ED patients with hyperhomocysteinaemia (HHcy) had 13.42 times the odds of vasculogenic ED compared with patients without HHcy (OR: 13.42, 95% CI: 3.78 to 47.64). Moreover, the risk of vasculogenic ED was 1.24 (95% CI: 1.04 to 1.48, P=0.01) per-unit increase in Hyc concentration for ED with HHcy. In addition, the smoothing curve revealed that Hcy levels were inversely correlated with peak-systolic velocity (PSV) (β: -0.48, 95% CI: -0.91 to -0.05, P=0.04) in vasculogenic ED patients by multivariate regression analysis. Furthermore, in the analysis of receiver operating characteristic curve, the area under curve for Hcy to predict vasculogenic ED was 0.81 (95% CI: 0.73 to 89) in patients with ED. Conclusions:These findings suggest a dose-dependent association between Hcy and vasculogenic ED. HHcy was a risk factor for vasculogenic erectile dysfunction. Therefore, HHcy is likely to be a potential indicator to predict and diagnose vasculogenic ED when using pDUS. 10.21037/tau-21-953
    The Association between Seropositivity and Bone Mineral Density in Adults. Mediators of inflammation Objectives:Current evidence on the associations between () infection and bone mineral density (BMD) is conflicting. Therefore, a nationally representative sample of adults was analyzed to investigate the associations of seropositivity and BMD in this study. Methods:A retrospective cross-sectional study was conducted with 2555 subjects aged 40-85 years in the US National Health and Nutrition Examination Survey (NHANES) 1999-2001. Multivariable logistic regression models were performed to evaluate the associations between seropositivity and BMD. Subgroup analyses stratified by sex, age, race, and body mass index (BMI) were performed. Results:No association was found between seropositivity and BMD ( = 0.006, 95% CI: -0.003 to 0.015, = 0.177). In the subgroup analyses stratified by age, a positive association was observed between the seropositivity and total BMD among subjects aged 40-55 years ( = 0.018, 95% CI: 0.004 to 0.033, = 0.012); in the subgroup analyses stratified by sex, a positive association was observed between the seropositive and total BMD in male ( = 0.019, 95% CI: 0.007 to 0.032, = 0.003); in the subgroup analyses stratified by age and sex, the total BMD was higher in men aged 40-55 years with seropositive than those with seronegative ( = 0.034, 95% CI: 0.013 to 0.056, = 0.002). Conclusions:In conclusion, no association between seropositive and total BMD was demonstrated among most middle-aged and elderly adults. infection may not be one key factor in the loss of BMD. 10.1155/2022/2364666
    Birth weight influences differently on systolic and diastolic blood pressure in children and adolescents aged 8-15. BMC pediatrics AIM:Globally, hypertension is one of the main threats to public health and a significant risk factor predisposing individuals to various cardiovascular conditions. Hypertension in the young is particularly complex and challenging. Accumulating evidence has implicated that low birth weight is vital for elevated blood pressure, and birth weight was negatively correlated with blood pressure. However, fewer studies with conflicting results have addressed the associations between birth weight and blood pressure in children and adolescents, and there is no relevant research conducted in the NHANES population. The principal objective of this project was to investigate the relationship between birth weight and blood pressure in children and adolescents in NHANES. METHODS:A total of 7600 subjects aged 8 to15 were enrolled in the present study from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Outcome variables were systolic blood pressure(SBP) and diastolic blood pressure(DBP). Birth weight was regarded as an independent variable. EmpowerStats software and R (version 3.4.3) were performed to examine the association between birth weight and SBP or DBP. RESULTS:Birth weight was negatively correlated with SBP in the fully-adjusted model(β = -0.02, 95%CI: -0.04 to -0.04, p = 0.0013), especially in non-Hispanic White (β = -0.03, 95%CI: -0.06 to -0.00,p = 0.0446), aged between 13 to 15(β = -0.03, 95%CI: -0.04 to -0.01, p = 0.0027), and male individuals(β = -0.03, 95%CI: -0.05 to -0.01, p = 0.0027). However, there was no unidirectional association between birth weight and DBP in the fully adjusted model(β = -0.01, 95%CI: -0.03 to 0.02, p = 0.5668) and in sub-analysis. An inverted U-shaped and J-shaped relationship was uncovered between birth weight and DBP in those aged 13 or above and Mexican Americans, respectively. The inflection point calculated by a recursive algorithm of birth weight in these groups was all 105 oz. CONCLUSIONS:The current study identified that birth weight was negatively related to SBP but not significantly related to DBP in children and adolescents aged 8 to 15, highlighting different potential mechanisms behind high SBP and high DBP in the young. However, an inverted U-shaped and J-shaped relationship between birth weight and DBP was observed, suggesting that targeted intervention measures should be taken for different groups of people rather than generalizations. 10.1186/s12887-022-03346-7
    Association between sleep duration on workdays and blood pressure in non-overweight/obese population in NHANES: a public database research. Su Yingjie,Li Changluo,Long Yong,He Liudang,Ding Ning Scientific reports This study aimed to explore the association between sleep duration on workdays and blood pressure (BP) including systolic blood pressure (SBP) and diastolic blood pressure (DBP) in non-overweight/obese population. A cross-sectional study composed of 2887 individuals from NHANES was conducted. Subjective sleep duration on workdays were evaluated by the questionnaire. Multiple linear regression analyses were done to explore the relationship between sleep duration and BP. Compared with sleep duration of 6-8 h, both sleep duration < 6 h and ≥ 8 h on workdays were significantly associated with increased SBP (β, 3.58 [95% CI 1.60, 5.56] and 1.70 [95% CI 0.76, 2.64], respectively). However, the significant association was not founded in DBP. The stratified analyses showed that in females, sleep duration (< 6 h or ≥ 8 h) on workdays were associated with SBP (β = 5.99 and 2.41, respectively, both P < 0.0005). In addition, the SBP levels were much higher among participants aged (≥ 60) with sleep duration < 6 h. The effect size was 7.23 (P = 0.0217). In the subgroup classified by race, a significantly positive association between sleep duration (< 6 h, ≥ 8 h) and SBP can be seen in the White population (β = 6.64 (P = 0.0007) and 1.91 (P = 0.0215), respectively). In non-overweight/obese population, both short sleep duration (< 6 h) and long sleep duration (≥ 8 h) on workdays were correlated with higher level of SBP. 10.1038/s41598-022-05124-y
    Adiponectin is negatively associated with disease activity and Sharp score in treatment-naïve Han Chinese rheumatoid arthritis patients. Chen Xixi,Wang Kaiwen,Lu Tao,Wang Jiajia,Zhou Ting,Tian Juan,Zhou Bin,Long Li,Zhou Qiao Scientific reports The association and potential role of the protein hormone adiponectin in autoimmune diseases causing musculoskeletal disorders, including rheumatoid arthritis (RA), are controversial. Conflicting results may arise from the influences of confounding factors linked to genetic backgrounds, disease stage, disease-modifying anti-rheumatic drugs and patients' metabolic characteristics. Here, we examined serum level of adiponectin and its relationship with disease activity score 28 with erythrocytes sedimentation rate (DAS28[ESR]) and Sharp score in a treatment-naïve Han Chinese RA population. This cross-sectional study enrolled 125 RA patients. Serum level of total adiponectin was assessed by enzyme-linked immunosorbent assay (ELISA). Other important clinical and laboratory parameters were collected from the hospital database. DAS28(ESR) was calculated according to the equation previously published. Sharp score was evaluated based on hands radiographs by an independent radiologist. The correlation between serum adiponectin level and DAS28(ESR) or the Sharp score was investigated by univariate and multivariable linear regression analyses, respectively. Multiple imputation by chained equations was used to account for missing data. Univariate analyses showed a significant positive correlation between DAS28(ESR) and age or C-reactive protein (CRP) (both p = 0.003), while serum adiponectin level was negatively correlated with DAS28(ESR) (p = 0.015). The negative correlation between adiponectin level and DAS28(ESR) remained true in multivariable analyses adjusted for confounders. In addition, the univariate analyses revealed positive correlations of Sharp score to disease duration (p < 0.001), CRP (p = 0.023) and ESR (p < 0.001). In the multivariable model adjusted for confounders, adiponectin was negatively correlated with Sharp score (p = 0.013). In this single-institution cross-sectional study, serum adiponectin level in treatment-naive RA patients is negatively correlated with DAS28(ESR) and the Sharp score after adjustment for prominent identified confounders. Serum adiponectin may be potentially useful for assessing disease activity and radiographic progression of RA. 10.1038/s41598-022-06115-9
    Effect of serum vitamin D on metabolic associated fatty liver disease: a large population-based study. Scandinavian journal of gastroenterology BACKGROUND:Several studies have revealed that serum vitamin D is an important factor for metabolic associated fatty liver disease (MAFLD), but there had been no consistent conclusion. METHODS:Of 427,507 subjects who underwent health examination, 83,625 who met the inclusion criteria were included in a cross-sectional analysis. Clinical and laboratory data were collected for analysis. MAFLD was diagnosed by abdominal imaging. RESULTS:Multivariate linear regression models discovered a negative association between serum vitamin D and MAFLD (OR: 0.92, 95% CI: 0.90 to 0.94,  = .001), after adjusting for other well-identified risk factors. The same result was found when serum vitamin D was handled as a categorical variable (quartile, Q1-Q4) (Q4 vs. Q1, OR: 0.82, 95% CI: 0.77 to 0.87,  < .001), and a significant linear trend was observed ( for trend <.001). After analysis, a nonlinear relationship was detected between serum vitamin D and MAFLD, with an inflection point of 2.23 (44.6 nmol/L or 17.84 ng/mL). The effect sizes and the confidence intervals on the left and right sides of the inflection point were 1.16 (1.06 to 1.28) and 0.89 (0.86 to 0.91), respectively. All interactions with MAFLD were not significant for age, sex, diabetes, hypertension, smoking and body mass index ( for interaction = .110, .558, .335, .195, .616 and .401, respectively). CONCLUSIONS:There was a nonlinear relationship between serum vitamin D and MAFLD. When the serum vitamin D level was ≥44.6 nmol/L (17.84 ng/mL), a negative correlation between serum vitamin D and MAFLD was detected. Below this level, serum vitamin D might promote the progression of MAFLD. 10.1080/00365521.2022.2039284
    The association between skinfold thicknesses and estimated glomerular filtration rate in adolescents: a cross-sectional study. BMC nephrology BACKGROUND:Obesity is one of the causes of glomerular hyperfiltration. Studies on the relationship between body fat content and glomerular hyperfiltration have been limited to special children. Therefore, we aimed to evaluate the correlation between skinfold thickness, which represents body fat content, and estimated glomerular filtration rate (eGFR). METHODS:The cross-sectional study included 6655 participants (3532 boys and 3123 girls; age: 12 - 17.99 years); data was obtained from the National Health and Nutrition Examination Survey (NHANES; 2001-2010). The independent variables were subscapular skinfold thickness and triceps skinfold thickness. The dependent variable was eGFR. We used multivariate linear regression models to evaluate their associations and also performed subgroup analyses. RESULTS:After adjusting for age, standing height, race, family income, blood urea nitrogen and uric acid variables, multivariate regression analysis identified that triceps skinfold thickness and subscapular skinfold thickness were positively correlated with eGFR and glomerular hyperfiltration in boys. In subgroup analyses stratified by age and body mass index, triceps skinfold thickness was also associated with glomerular hyperfiltration in boys. There was a linear relationship between triceps skinfold thickness and eGFR in boys (β = 0.389, P < 0.001) and girls (β = 0.159, P = 0.0003). CONCLUSIONS:Triceps skinfold thickness and subscapular skinfold thickness are positively correlated with eGFR and glomerular hyperfiltration in US male adolescents. In all adolescents, there is a linear relationship between triceps skinfold thickness and eGFR. 10.1186/s12882-022-02709-7
    Association between parity and bone mineral density in postmenopausal women. BMC women's health BACKGROUND:Pregnancy has been considered a risk factor for the development of osteoporosis. Despite much research in this field, the relationship between parity and bone mineral density (BMD) is still controversial. Therefore, we conducted this study to investigate whether there was an association between parity and BMD of the femoral neck and lumbar spine in postmenopausal women. METHODS:Cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES). Three linear regression models, Model 1 (unadjusted), Model 2 (adjusted for age and body mass index (BMI)), and Model 3 (adjusted for all covariates), were established to evaluate the relationship between parity and BMD. In addition, the p value trend of BMD in the different parity groups was mutually verified with the results of multiple regression. Multiple logistic regression models were used to assess the relationship between parity and osteoporosis. RESULTS:In total, 924 postmenopausal women aged 45-65 years were eligible for this study. After adjustment for potential confounders, women with ≥ 6 parities had significantly lower lumbar spine BMD than women with 1-2 parities (β = - 0.072, 95% CI: - 0.125, - 0.018, P = 0.009). However, there was no correlation between parity and femoral neck BMD in any of the three regression models. Furthermore, ≥ 6 parities were associated with a significantly higher prevalence of lumbar spine osteoporosis compared with 1-2 parities (OR = 3.876, 95% CI: 1.637, 9.175, P = 0.002). CONCLUSIONS:After adjustment for BMD-related risk factors, ≥ 6 parities were associated with decreased lumbar spine BMD but not femoral neck BMD in postmenopausal women. This suggests that postmenopausal women with high parity are at increased risk of lumbar osteoporotic fractures and should pay more attention to their bone health. 10.1186/s12905-022-01662-9
    Predictors of hyperkalemia after total parathyroidectomy in patients with drug-refractory secondary hyperparathyroidism. Gland surgery Background:The purpose of this retrospective study was to explore the primary possible risk factors for the development of postoperative hyperkalemia after total parathyroidectomy with autotransplantation (TPTX + AT) in patients with drug-refractory secondary hyperparathyroidism (SHPT). Methods:The clinical data of 149 patients receiving maintenance dialysis for drug-refractory SHPT, who underwent TPTX + AT, were reviewed and analyzed. Demographic data, dialysis status, and laboratory test indices were collected from enrolled patients. According to the postoperative serum potassium level >5.3 mmol/L or not, they were divided into hyperkalemia group and non-hyperkalemia group. The differences in general clinical data and laboratory indicators between the two groups were compared; logistic regression analysis was performed to analyze the risk factors affecting the development of postoperative hyperkalemia in patients; receiver operating characteristic (ROC) subject workup curves were analyzed for the threshold values of postoperative hyperkalemia. Results:Of the 149 participants, 25 (16.78%) developed postoperative hyperkalemia after TPTX + AT. Univariate analysis suggested that dialysis duration, SHPT duration, dialysis modality, and preoperative alkaline phosphatase, blood potassium, and blood calcium levels were independently associated with the development of hyperkalemia after TPTX + AT. Univariate logistic analysis suggested that dialysis duration [odds ratio (OR) 1.18, 95% confidence interval (CI): 1.03, 1.35, P=0.014], preoperative blood potassium (OR 4.95, 95% CI: 2.05, 11.96, P<0.001), and preoperative blood calcium (OR 16.17, 95% CI: 1.36, 191.58, P=0.027) were 3 factors that predicted hyperkalemia after TPTX + AT. According to ROC curve analysis, the optimal cutoff point for dialysis duration was 8.5 years, the optimal cutoff level for preoperative blood potassium was 4.57 mmol/L, and the optimal cutoff level for preoperative blood calcium was 2.31 mmol/L. Of these 3 factors, preoperative blood potassium had a more balanced sensitivity, specificity, and optimal diagnostic efficacy. Conclusions:Patients with drug-refractory SHPT are prone to hyperkalemia after TPTX + AT. Duration of dialysis and preoperative blood potassium and blood calcium levels can help predict the development of postoperative hyperkalemia. 10.21037/gs-22-27
    Association between obesity and bone mineral density in middle-aged adults. Journal of orthopaedic surgery and research BACKGROUND:The relationship between obesity and bone mineral density (BMD) varies in different studies. Our aim in this study was to explore the association between obesity (body mass index ≥ 30) and BMD among adults 40-59 years of age. METHODS:This study was conducted on a sample of 2218 participants (986 men and 1232 women) aged 40 to 59 years from the National Health and Nutrition Examination Survey 2011-2018. The independent variable was body mass index (BMI). The outcome variable was lumbar BMD. The associations of BMI with lumbar BMD were examined using multivariable linear regression models. RESULTS:BMI was positively associated with lumbar BMD after adjusting for other covariates [β 0.006; 95% confidence interval (CI) 0.003-0.008]. An inverted U-shaped association between BMI and lumbar BMD was further identified, with the point of infection at approximately 50 kg/m. In the subgroup analyses, the relationship between BMI and lumbar BMD in women and blacks was an inverted U-shape. CONCLUSION:Based on the results, it may be beneficial to appropriately increase BMI to promote BMD. However, considering the inverted U-shaped association, excessive BMI may be harmful to bone health in women and blacks. 10.1186/s13018-022-03161-x
    Correlation between perioperative parecoxib use and postoperative acute kidney injury in patients undergoing radical mastectomy: a retrospective cohort analysis. BMC anesthesiology BACKGROUND:Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely prescribed drugs worldwide. However, the effect of NSAIDS on postoperative renal function is still unclear. Few studies have assessed the effects of parecoxib on renal function. Our aim is to investigate a correlation between parecoxib and the presence or absence of AKI postoperatively after a breast cancer surgery operation. METHODS:This was a retrospective cohort study that we performed on our hospitalized database. From January 2012 to August 2021, 3542 female patients undergoing radical mastectomy were enrolled, all data including the patients' information and laboratory results were obtained from electronic medical system. The main outcome was the incidence of AKI postoperatively. AKI was defined in accordance with the KDIGO criteria. Study groups were treated with or without parecoxib. Univariable and multivariable logistic regression analyses were performed. RESULTS:In our study, about 5.76% experienced AKI. The incidence rate of postoperative AKI (3.49%) within 7 days in the parecoxib group was lower than that in the control group (6.00%, P = 0.05). Compared to the control group, the AKI's incidence was reduced by 49% (OR = 0.46; 95%CI 0.27-0.97) in parecoxib group in multivariable logistic regression analysis. There was a reduction in the incidence of postoperative AKI in other three subgroups: preoperative eGFR < 90 mL/min·1.73/m2 (OR = 0.52; 95%CI 0.27-0.97), blood loss < 1000 ml (OR = 0.48; 95%CI 0.24-0.96) and non-diabetes (OR = 0.51; 95%CI 0.26-0.98). CONCLUSIONS:Parecoxib was associated with incidence of postoperative acute kidney injury. 10.1186/s12871-022-01688-4
    Association between the cardiometabolic index and non-alcoholic fatty liver disease: insights from a general population. Zou Jiawang,Xiong Hailan,Zhang Huimin,Hu Chong,Lu Song,Zou Yang BMC gastroenterology BACKGROUND:Emerging evidence suggests that cardiometabolic index (CMI) is closely related to diabetes, hypertension, stroke, cardiovascular disease, and kidney disease, which implies that CMI has the value as an indicator of metabolic diseases. However, data on the relationships between CMI and non-alcoholic fatty liver disease (NAFLD) risks have not been reported. This study is designed to examine the association between CMI and NAFLD in the general population. METHODS:The current study included 14,251 subjects whose CMI was the product of triglyceride/high-density lipoprotein cholesterol ratio and waist-to-height ratio. Linear regression was used to analyze the correlation between baseline information and CMI, logistic regression was used to study the relationship between CMI and NAFLD, and subgroup analysis was used to explore potential high-risk groups. RESULTS:After adjusted for potential confounding factors, higher CMI was independently associated with NAFLD, in which every additional standard deviation (SD) of CMI increased the risk of NAFLD by 28% (OR 1.28 per SD increase, 95% CI 1.19-1.37, P for trend < 0.0001). There were also significant differences in CMI-related NAFLD risk among different ages and genders, in which the CMI-related NAFLD risk in young people was significantly higher than that in other age groups (OR = 2.63 per SD increase for young people, OR = 1.38 per SD increase for young and middle-aged people, OR = 1.18 per SD increase for middle-aged and elderly people; OR = 1.14 per SD increase for elderly people, P for interaction = 0.0010), and the CMI-related NAFLD risk in women was significantly higher than that in men (OR = 1.58 per SD increase for women, OR = 1.26 per SD increase for men, P for interaction = 0.0045). CONCLUSIONS:Current studies have found that after excluding potential confounding factors, higher CMI in the general population is independently associated with NAFLD risk. 10.1186/s12876-022-02099-y
    Dietary cholesterol and egg intake are associated with the risk of gestational diabetes: a prospective study from Southwest China. BMC pregnancy and childbirth BACKGROUND:An increasing body of evidence suggests that cholesterol intake increases during pregnancy and may influence the risk of gestational diabetes mellitus (GDM). However, existing evidence remains controversial and limited. The present study aimed to determine the relation among dietary cholesterol, specifically egg consumption, in pregnant Chinese women and their risk of GDM. METHODS:A population-based study that included 1617 pregnant women was conducted in 2017. At baseline, dietary information was collected by 24-hour dietary recalls over three days. GDM was diagnosed by a 75 g 2-hr oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. Logistic regression models were used to examine the associations of dietary cholesterol and egg intake with GDM. In addition, path analysis including cholesterol intake, plasma lipid profiles and GDM risk was conducted. RESULTS:The average total cholesterol intake was 340.8 mg/d, and cholesterol from eggs accounted for 59.2%. The odds ratio (OR) of GDM risk was 1.48 for the highest quartile of total cholesterol intake compared to the lowest quartile (95% CI 1.10-2.00; P = 0.015) after adjustment for potential risk factors for GDM. Moreover, cholesterol from eggs rather than from other foods was positively associated with incident GDM (OR=1.09, 95% CI 1.03-1.17). Each additional egg consumed per day was positively correlated with a higher risk of GDM (OR=1.32, 95% CI 1.11-1.58). Path analysis indicated that cholesterol intake not only increased the risk of GDM by elevating plasma total cholesterol (TC), but also increased the risk of GDM through other non hyperlipidemia pathways. CONCLUSIONS:Maternal dietary cholesterol intake was significantly associated with incident GDM, and egg consumption was a major driver of the association in this population. More studies are needed to substantiate these findings and to explore the underlying mechanisms. 10.1186/s12884-022-04382-y
    Pregnancy Status Is Associated with Lower Hemoglobin A1c among Nondiabetes Women in the United States from NHANES 2005-2016. International journal of endocrinology BACKGROUND:It has been verified that the incidence rate of diabetes mellitus (DM) is sharply increased in pregnant female adults. However, the relationship between pregnant status and hemoglobin A1c (HbA1c) in nondiabetes women remains unclear. METHODS:We conducted a cross-sectional study of 7762 participants in the National Health and Nutrition Examination Survey (NHANES) 2005-2016. Multivariable linear regression models were performed to evaluate the associations between pregnant status with HbA1c and serum glucose in nondiabetes women. RESULTS:HbA1c was significantly lower in the pregnant group than in the nonpregnant group. There was a negative association between urine pregnancy test and HbA1c in all three models (model 1:  = -0.23, 95% CI: (-0.18 to -0.27); model 2:  = -0.20, 95% CI: (-0.15 to -0.24); model 3:  = -0.24, 95% CI: (-0.20 to -0.29)). In the subgroup analysis stratified by age, this negative association existed in all age subgroups (age <20:  = -0.20, 95% CI: (-0.04 to -0.27); age ≥20, <35:  = -0.24, 95% CI: (-0.20 to -0.29); age ≥35:  = -0.28, 95% CI: (-0.17, -0.39)). In the subgroup analysis stratified by race, the negative associations steadily existed in different subgroups (Mexican American: = -0.20, 95% CI:(-0.11 to -0.29); Other Hispanic: = -0.31, 95% CI: (-0.16 to -0.46); Non-Hispanic White:  = -0.24, 95% CI: (-0.17 to -0.31); Non-Hispanic Black:  = -0.21, 95% CI: (-0.12 to -0.31); Other races: = -0.22, 95% CI: (-0.08 to -0.35)). On the other hand, a negative association between self-reported pregnant status and HbA1c was also found (model 1:  = -0.22, 95% CI: (-0.18 to -0.27); model 2:  = -0.19, 95% CI: (-0.15 to -0.2); model 3:  = -0.23, 95% CI: (-0.19 to -0.28)). In the subgroup analysis stratified by age, this negative association also existed in all age subgroups. CONCLUSIONS:The study indicated that nondiabetes women with pregnant status had significantly lower HbA1c compared with those nonpregnant. Moreover, the negative associations between pregnant status and HbA1c steadily existed in subgroups stratified by age and gender. 10.1155/2022/4742266
    Association of neutrophil to lymphocyte ratio with preterm necrotizing enterocolitis: a retrospective case-control study. BMC gastroenterology BACKGROUND:There have been few studies on the relationship between the neutrophil to lymphocyte ratio (NLR) and necrotizing enterocolitis (NEC). We conducted a retrospective case-control study to investigate this relationship in preterm neonates. METHODS:A total of 199 preterm neonates diagnosed with NEC between January 2018 and January 2020 were included in this study. For each preterm infant with NEC that was admitted to the neonatal intensive care unit (NICU), controls were preterm neonates (matched for gestation and year of birth) who were not diagnosed with NEC. Exclusion criteria were post-maturity, small or large for gestational age (week of pregnancy), congenital major anomalies, and cyanotic congenital heart disease. Univariate and multivariate logistic regression analyses were used to identify the association between NLR and preterm NEC. RESULTS:This study included 93 preterm neonates with NEC and 106 matched controls. There were no significant differences in gestational age (GA), birth weight (BW), age, sex, vaginal delivery (VD), chorioamnionitis (CA), and gestational diabetes mellitus (GDM) between the groups. Compared with the control group, the lower and higher NLR levels in the NEC group were statistically different. Following univariate analysis, NLR was a risk factor for NEC (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.00-1.90; P = 0.042), and according to multivariate analysis, risk factors for NEC were NLR ≥ 3.20 and NLR < 1.60, within 1 week before NEC diagnosis. Thus, NLR values of ≥ 1.60 and < 3.20 were determined as the predictive cut-off values for protecting preterm infants from NEC (Model I: OR, 0.20; 95% CI, 0.10-0.40; P < 0.001) and (Model II: OR, 0.10; 95% CI, 0.00-0.40; P < 0.001]. CONCLUSIONS:NLR ≥ 1.60 and NLR < 3.20 were associated with a decreased risk of NEC in preterm infants. 10.1186/s12876-022-02329-3
    Association between sleep duration and albumin in US adults: a cross-sectional study of NHANES 2015-2018. BMC public health BACKGROUND:Albumin has multiple functions and is used in the clinical assessment of liver function, kidney function and nutritional status. However, few epidemiological studies have evaluated the association between sleep duration and albumin. Therefore, we carried out a cross-sectional study to address this issue. The aim of the study was to investigate the association between sleep duration and albumin in American adults based on the NHANES (National Health and Nutrition Examination Survey). METHODS:A total of 9,973 participants aged [Formula: see text] 20 years were included in this study from NHANES 2015-2018. Weighted data were calculated according to analytical guidelines. Linear regression models and smooth curve fitting were used to assess and describe the relationship between sleep duration and albumin. The inflection point was determined by a two-step recursive method. Moreover, univariate and stratified analyses were performed. RESULTS:There was an inverted U-shaped association between sleep duration and albumin levels. Albumin levels were highest when the sleep duration was 7.5 h. Compared to 7-8 h of sleep, short sleep duration was linked to lower albumin levels [sleep duration [Formula: see text] 5 h: β [Formula: see text]-1.00, 95% CI (-1.26, -0.74), P < 0.0001]. Compared to 7-8 h of sleep, long sleep duration was related to lower albumin levels [sleep duration [Formula: see text] 9 h: β [Formula: see text] -0.48, 95% CI (-0.68, -0.27), P < 0.0001]. CONCLUSIONS:Sleep duration had an inverted U-shaped relationship with albumin, with short or long sleep duration associated with significantly lower albumin levels. 10.1186/s12889-022-13524-y
    Early Neutrophil-to-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke After Successful Revascularization. Zou Feihui,Wang Jian,Han Bin,Bao Jiannan,Fu Yin,Liu Kefeng World neurosurgery OBJECTIVE:To explore the association between early neutrophil-to-lymphocyte ratio (ENLR) and prognosis of anterior circulation large-vessel occlusion stroke (LVOS) after patients undergo endovascular treatment (EVT) with successful revascularization. METHODS:Patients who experienced acute anterior circulation LVOS and underwent EVT at Changzhou Second People's Hospital Affiliated to Nanjing Medical University between May 2017 and May 2020 were included in this retrospective study. We collected information about patients' baseline characteristics, medical history, laboratory test results, imaging data, and endovascular treatment outcomes, as well as data from follow-up at 3 months. Univariate and multivariate logistic regression models were used to evaluate the association between ENLR and functional disease prognosis. A piecewise linear regression model was also applied to compute the threshold effect of ENLR on poor prognosis (defined as modified Rankin Scale score 3-6) at 3 months using a smoothing plot. RESULTS:Of 224 patients who received EVT during the study period, 160 patients were included in the analysis. After adjustments were made for potential confounders, multivariate analysis demonstrated a significant association between ENLR and poor prognosis at 3 months (odds radio 1.19; 95% confidence interval 1.07-1.32; P = 0.0016). An ENLR ≥9.75 was found to be significantly associated with poor prognosis at 3 months (odds ratio 1.54; 95% confidence interval 1.19-2.00; P = 0.0119). CONCLUSIONS:Increased ENLR after successful revascularization is independently associated with poor prognosis. These findings suggest that ENLR could be used to inform treatment strategies for patients who experience anterior circulation LVOS. 10.1016/j.wneu.2021.10.097
    Associations between pyrethroid exposure and serum sex steroid hormones in adults: Findings from a nationally representative sample. Chemosphere BACKGROUND:Pyrethroids have been considered as potential endocrine-disrupting chemicals and have been shown to be associated with endocrine-related health outcomes. However, limited studies directly explored the link between pyrethroid exposure and sex hormones in the general population. OBJECTIVES:To explore the associations between exposure to pyrethroids and serum sex steroid hormones in adults. METHODS:We evaluated the cross-sectional associations in 1235 adults aged ≥20 years who had been assigned to the National Health and Nutrition Examination Survey (NHANES) 2013-2014. The urinary concentration of 3-phenoxybenzoic acid (3-PBA) was applied as a biomarker of human pyrethroid exposure levels. Information on sex steroid hormones, including total testosterone (TT), estradiol (E2), and sex hormone-binding globulin (SHBG) in serum were measured. Free androgen index (FAI) and the ratio of TT to E2 (TT/E2) were also calculated. The percent changes with 95% confidence intervals (CIs) for a doubling of 3-PBA concentrations in the serum sex hormone levels were estimated using generalized linear regression models. RESULTS:The overall median concentrations of creatinine-adjusted 3-PBA were 0.58 μg/g creatinine, and 90.0% of adults had a detectable level of 3-PBA. In females, every two-fold increase in 3-PBA was associated with 4.34% (95% CI: 1.58%, 7.18%) higher levels of TT and 4.05% (95% CI: 7.03%, 1.16%) higher levels of SHBG, respectively. In males, a doubling in 3-PBA was associated with 3.02% (95% CI: 1.21%, 4.86%) increase in SHBG but 1.85% (-3.59%, -0.07%) decrease in FAI, respectively. In addition, significant non-linear associations of 3-PBA with SHBG in both males and females and TT in females were observed. CONCLUSIONS:Environmental pyrethroid exposure was associated with altered sex hormones in adults. This study provides important epidemiological evidence for the association of pyrethroids with endocrine disruption. 10.1016/j.chemosphere.2022.134591
    Investigation of the association between lens autofluorescence ratio and diabetes: a cross-sectional study. Photodiagnosis and photodynamic therapy AIMS/HYPOTHESIS:Lens autofluorescence ratio (LFR) is a novel approach to detect advanced glycation end products in a time-saving and non-invasive manner. However, its associations with glycemia and diabetes remain unclear. We conducted this study to address this issue in Chinese adults. METHODS:We enrolled a total of 4,705 participants aged 20-70 years in China between May 2020 and January 2021 in a cross-sectional study. LFR was determined by biomicroscopy (ClearPath DS-120). Diabetes was ascertained by oral glucose tolerance test, self-reported history, and/or antidiabetic medication use. Correlation and logistic regression analyses were performed. RESULTS:LFR was higher in participants with diabetes than those without (23.27 ± 6.51 vs. 19.45 ± 5.08, p < 0.001). LFR correlated with fasting plasma glucose and hemoglobin A1c in the overall and diabetes-stratified populations. The odds of diabetes was increased by 6% per one percent higher of LFR after multivariable-adjustment (odds ratio (OR) 1.06, 95% CI 1.04-1.08, p < 0.001). Participants in the highest quartile of LFR had higher odds of diabetes compared with those in the lowest quartile (OR 1.83, 95% CI 1.33-2.52, p < 0.001). Mediation analysis showed that, insulin resistance, as assessed by triglyceride-glucose index, may underline the relationship between high LFR and increased odds of diabetes. CONCLUSIONS:LFR, a non-invasive indirect measure of advanced glycation end products, appears to be associated with glycemia and the risk of developing diabetes in Chinese adults. 10.1016/j.pdpdt.2022.102888
    Association Between Blood Flow Pattern and Rupture Risk of Abdominal Aortic Aneurysm Based on Computational Fluid Dynamics. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery OBJECTIVES:This study aimed to derive a novel classification of blood flow pattern in abdominal aortic aneurysms (AAA) based on computational fluid dynamics (CFDs), and to determine the predictive value of flow patterns in AAA rupture. METHODS:This was an age and sex matched case control study. Cases were identified as patients who underwent emergency endovascular or open repair due to ruptured or AAA at risk of impending rupture. Controls were age and sex matched with patients with an AAA who were asymptomatic and had a confirmed unruptured AAA from computed tomography angiography images from the same period. Classification of blood flow pattern (type I: non-helical main flow channel with multiple vortices; type II: non-helical main flow channel with single vortices; and type III, helical main flow channel with helical vortices) and haemodynamic parameters (areas of low wall shear stress [A], aneurysm pressure drop [Δ pressure], etc) were derived from CFD analyses. Multivariable regression was used to determine independent AAA rupture risk factors. The incremental discriminant and reclassification abilities for AAA rupture were compared among different models. RESULTS:Fifty-three ruptured and 53 intact AAA patients were included. Ruptured AAA showed a higher prevalence of type III flow pattern than intact AAA (60.4% vs. 15.1%; p < .001). Type III flow pattern was associated with a significantly increased risk of aneurysm rupture (odds ratio 10.22, 95% confidence interval 3.43 - 30.49). Among all predicting models, the combination of AAA diameter, haemodynamic parameters (A or Δ pressure), and flow pattern showed highest discriminant abilities in both the overall population (c-index = 0.862) and subgroup patients with AAAs < 55 mm (c-index = 0.972). Compared with AAA diameter, adding the flow pattern could significantly improve the reclassification abilities in both the overall population (net reclassification index [NRI] = 0.321; p < .001) and the subgroup of AAAs < 55 mm (NRI = 0.732; p < .001). CONCLUSION:Type III flow pattern was associated with a significantly increased risk of AAA rupture. The integration of blood flow pattern may improve the identification of high risk aneurysms in both overall population and in those with AAAs < 55 mm. 10.1016/j.ejvs.2022.05.027
    Impaired fasting blood glucose is associated with incident albuminuria: Data from a Chinese community-based cohort. Jiang Yimeng,Jia Jia,Li Jianping,Huo Yong,Fan Fangfang,Zhang Yan Journal of diabetes and its complications OBJECTIVE:Growing evidence links hyperglycemia in the diabetic range to albuminuria, while the association between impaired fasting glucose (IFG) and albuminuria is not well established. The study intends to explore whether IFG is longitudinally associated with incident albuminuria in a non-diabetic Chinese community-based cohort. METHODS:Participants with urine albumin creatinine ratio (UACR) both in 2014 and 2018 from the atherosclerotic cohort were included. A total of 1649 non-diabetic subjects were ultimately included in the analysis after ruling out participants with UACR≥30 mg/g and self-reported history of renal diseases at baseline. Fasting blood glucose (FBG) was assessed by Roche C8000 Automatic Analyzer and UACR was measured with Unicel DxC 800 Synchron biochemistry analyzer using spot morning urine sample. Incident albuminuria was defined as an advance from normal to microalbuminuria or macroalbuminuria. Multivariable logistic regression model was used to investigate the relationship between FBG and incident albuminuria. RESULTS:During a mean follow-up of 4.38 years, 82 (4.97%) participants developed incident albuminuria. Logistic regression analysis showed that after adjustment, the risk of incident albuminuria increased by 71% (OR = 1.71, 95%CI: 1.11-2.62, P = 0.014) for every 18 mg/dl (1 mmol/l) increase of FBG level. Besides, FBG level was independently and gradably associated with incident albuminuria. Compared with the FBG < 100 mg/dl (5.6 mmol/l) group, the risk increased 1.63-fold for incident albuminuria (OR = 2.63, 95%CI:1.42-4.87, P = 0.002) in the FBG 110-126 mg/dl (6.1-7.0 mmol/l) group while the association between FBG 100-110 mg/dl (5.6-6.1 mmol/l) group and the outcome was not significant. Subgroup and interaction analyses were performed and no significant modification effect was found. CONCLUSION:IFG was independently associated with incident albuminuria in Chinese community-based population. The higher the FBG level, the higher the risk of incident albuminuria, which may suggest that screening for albuminuria should be emphasized in population with IFG so as to prevent and treat it in an early stage. 10.1016/j.jdiacomp.2022.108125
    Development and Validation of Machine Learning Models to Predict Epidermal Growth Factor Receptor Mutation in Non-Small Cell Lung Cancer: A Multi-Center Retrospective Radiomics Study. Cancer control : journal of the Moffitt Cancer Center OBJECTIVE:To develop and validate a generalized prediction model that can classify epidermal growth factor receptor mutation status in non-small cell lung cancer patients. METHODS:A total of 346 patients (296 in the training cohort and 50 in the validation cohort) from four centers were included in this retrospective study. First, 1085 features were extracted using IBEX from the computed tomography images. The features were screened using the intraclass correlation coefficient, hypothesis tests and least absolute shrinkage and selection operator. Logistic regression (LR), decision tree (DT), random forest (RF), and support vector machine (SVM) were used to build a radiomics model for classification. The models were evaluated using the following metrics: area under the curve (AUC), calibration curve (CAL), decision curve analysis (DCA), concordance index (C-index), and Brier score. RESULTS:Sixteen features were selected, and models were built using LR, DT, RF, and SVM. In the training cohort, the AUCs was .723, .842, .995, and .883; In the validation cohort, the AUCs were .658, 0567, .88, and .765. RF model with the best AUC, its CAL, C-index (training cohort=.998; validation cohort=.883), and Brier score (training cohort=.007; validation cohort=0.137) showed a satisfactory predictive accuracy; DCA indicated that the RF model has better clinical application value. CONCLUSION:Machine learning models based on computed tomography images can be used to evaluate status in patients with non-small cell lung cancer, and the RF model outperformed LR, DT, and SVM. 10.1177/10732748221092926
    J-shaped relationship between serum zinc levels and the severity of hepatic necro-inflammation in patients with MAFLD. Nutrition, metabolism, and cardiovascular diseases : NMCD BACKGROUND AND AIMS:Zinc is an essential trace element that plays an important role in maintaining health, and affecting gene expression, signal transduction and regulation of apoptosis. It is uncertain whether serum zinc levels are altered in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). We aimed to investigate the association between serum zinc levels and the severity of hepatic necro-inflammation (HN) in patients with MAFLD. METHODS AND RESULTS:Liver disease severity was graded histologically using the NAFLD activity score. HN was defined as the sum of ballooning and lobular inflammation. We used a smooth function regression model to analyze the relationship between serum zinc levels and HN. A total of 561 (76.5% men) patients with biopsy-confirmed MAFLD were enrolled. They had a mean age of 41.3 years, and a mean serum zinc level of 17.0 ± 4.1 μmol/L. Compared to those with mild hepatic necro-inflammation (MHN, grades 0-2; n = 286), patients with severe hepatic necro-inflammation (SHN, grades 3-5; n = 275) had lower serum zinc concentrations (16.3 ± 4.2 vs. 17.6 ± 4.0 μmol/L; p < 0.001). However, a threshold saturation effect analysis showed that there was an inflection in serum zinc levels at 24 μmol/L. After adjustment for potential confounders, serum zinc levels <24 μmol/L were inversely associated with SHN (adjusted-odds ratio 0.88, 95%CI 0.83-0.93; p < 0.001), whereas serum zinc levels >24 μmol/L were positively associated with SHN (adjusted-odds ratio 1.42, 95%CI: 1.03-1.97; p = 0.035). CONCLUSIONS:There is a J-shaped relationship between serum zinc levels and the severity of hepatic necro-inflammation in patients with biopsy-proven MAFLD. 10.1016/j.numecd.2022.01.035
    Outcomes of inferior vena cava reconstruction using artificial or autologous materials in ex vivo liver resection and autotransplantation. Qiu Yiwen,Yang Xianwei,Huang Bin,Wei Gengfu,Chen Yin,Yang Kangmin,Wang Wentao Asian journal of surgery BACKGROUND:The use of artificial or autologous materials for inferior vena cava (IVC) reconstruction is controversial. This study retrospectively explored the effects of different materials on perioperative outcomes. METHODS:This study included 91 patients who underwent IVC reconstruction during liver autotransplantation between 2014 and 2020. A univariate analysis was performed to select variables affecting postoperative morbidity. The effect of IVC reconstruction materials on perioperative outcomes was tested with a multivariable generalized linear model. The effects on postoperative morbidity and operation time were further tested with the multivariate regression analysis based on the generalized estimating equation. Adjusted models were used in all analyses. RESULTS:A median operation time of 710 (633-790) min, a median blood loss of 2200 (1550-3000) mL, an incidence of 33% (30/91) for major morbidities and a median comprehensive complication index (CCI) of 0.0 (0.0-26.2) were observed, with no IVC reconstruction-related complications postoperatively or in the long term. The IVC reconstruction material had no significant effect on postoperative outcomes, while artificial materials significantly increased inpatient cost (191 ± 35 vs. 164 ± 36 k Yuan, p < 0.001). The multivariate regression revealed a significant shift in outcomes of operation time (p = 0.0368). DISCUSSION:Artificial grafts are recommended for IVC reconstruction if cost is not a factor. 10.1016/j.asjsur.2022.03.045
    Association of serum vitamin C with all-cause and cause-specific death: Data from National Health and Nutrition Examination Survey (NHANES 2003-2006). Nutrition (Burbank, Los Angeles County, Calif.) OBJECTIVES:The association between levels of circulating vitamin C and mortality remains controversial. The aim of this study was to explore the non-linear association between serum vitamin C levels and all-cause or cause-specific mortality. METHODS:We included 9902 US adults with their serum vitamin C levels from the National Health and Nutrition Examination Survey (NHANES 2003-2006). Their survival information was retrieved from baseline until 2015 using the national death index. Multivariable Cox proportional hazards models were used to show the risk for all-cause or cause-specific death according to baseline serum vitamin C levels. Smooth curve fitting and threshold effect analyses were used to clarify potential nonlinearity. RESULTS:During a median follow-up of 10.6 y, there were 1558 all-cause deaths, including 320 from cancer, 374 from cardiovascular disease (CVD), and 120 from respiratory diseases. Serum vitamin C levels had a U-shaped relationship with all-cause or CVD-associated mortality. Interestingly, serum vitamin C levels lower than the threshold value (1.06 mg/dL) were negatively associated with all-cause (fully adjusted hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.59-0.86) and CVD (fully adjusted HR, 0.70; 95% CI, 0.47-1.03) mortality. In contrast, serum vitamin C levels higher than the threshold value (1.06 mg/dL) were positively associated with all-cause (fully adjusted HR, 1.33; 95% CI, 1.15-1.54) and CVD (fully adjusted HR, 1.60, 95% CI, 1.23-2.10) mortality, respectively. CONCLUSION:Serum vitamin C levels showed a U-shaped relationship with all-cause and CVD-associated deaths among US adults using the NHANES data. 10.1016/j.nut.2022.111696
    Associations between education levels and prevalence of depressive symptoms: NHANES (2005-2018). Li Lingli,Sun Wang,Luo Jinglan,Huang Hao Journal of affective disorders PURPOSE:Our study investigated the relationships between the prevalence of depressive symptoms and education levels in those aged ≥20 years. METHODS:A total of 34,102 participants from the National Health and Nutrition Examination Surveys 2005-2018 were involved in our cross-sectional study. The relations of depressive symptoms (as outcome variable) and education levels (as an independent variable) were analyzed using multivariable logistic regression models in the main analyzes. Sensitivity analyzes, including a multiple sensitivity analysis, were also performed. RESULT:The education levels were negatively associated with depressive symptoms after adjusting related covariates. Compared with the reference group of individuals with less than 9th grade, people with college graduate or above had an adjusted odds ratio (OR) of 0.464 (95% CI 0.361, 0.595, P < 0.0001). On the other hand, the statistically significant negative association disappeared among Mexican Americans, other races, separated, and high family poverty income ratio group. These results remained stable under a wide range of sensitivity analyzes. CONCLUSION:Our study indicated the elevated education levels correlated with the decreased prevalence of depressive symptoms, and race, marital status, and family economic factors played a critical role in the relationship. This report reminds us to pay close attention to the further study of factors that affected the association between depressive symptoms and education levels. LIMITATIONS:The cross-sectional study leaves problems about the direction of causality unclear. 10.1016/j.jad.2022.01.010
    The development and application of a prediction model for postpartum depression: optimizing risk assessment and prevention in the clinic. Yang Shu-Ting,Yang Si-Qi,Duan Kai-Ming,Tang Yong-Zhong,Ping An-Qi,Bai Zhi-Hong,Gao Kai,Shen Yang,Chen Ming-Hua,Yu Ri-Li,Wang Sai-Ying Journal of affective disorders BACKGROUND:Preventive intervention can significantly reduce the human and economic costs of postpartum depression (PPD) compared with treatment post-diagnosis. However, identifying women with a high PPD risk and making a judgement as to the benefits of preventive intervention is a major challenge. METHODS:This is a retrospective study of parturients that underwent a cesarean delivery. Control group was used as development cohort and validation cohort to construct the risk prediction model of PPD and determine a risk threshold. Ketamine group and development cohort were used to verify the risk classification of parturients by evaluating whether the incidence of PPD decreased significantly after ketamine treatment in high-risk for PPD population. RESULTS:The AUC for the development cohort and validation cohort of the PPD prediction model were 0.751 (95%CI:0.700-0.802) and 0.748 (95%CI:0.680-0.816), respectively. A threshold of 19% PPD risk probability was determined, with a specificity and sensitivity in the validation cohort are 0.766 and 0.604, respectively. After matching the high-risk group and the low-risk group by propensity score, the results demonstrated that PPD incidence significantly reduced in the high-risk group following ketamine, versus non-ketamine, intervention (p < 0.01). In contrast, intervention in the low-risk group showed no significant difference in PPD outcomes (p > 0.01). LIMITATION:Randomized trials are needed to further verify the feasibility of the model and the thresholds proposed. CONCLUSION:This prediction model developed in this study shows utility in predicting PPD risk. Ketamine intervention significantly lowers PPD incidence in parturients with a risk classification threshold greater than 19%. 10.1016/j.jad.2021.09.099
    Prenatal environmental antibiotics and fetal and postnatal growth: A biomonitoring-based prospective study in Eastern China. Zhang Wei-Xi,Zeng Xin-Xin,Chen Qian,Yu Kan,Zheng Hang,Yu Xiao-Gang,Zhang Yong-Jun,Zhang Jun,Huang He-Yu,Huang Li-Su Chemosphere Thus far, the effect of environmental antibiotics exposure to offspring's growth remains unclear. Here we aimed to evaluate whether and to what extent environmental antibiotics exposure is associated with fetal and postnatal growth. A total of 735 pregnant women and their full-term offspring from the Shanghai Obesity Birth Cohort were involved in the study. Maternal urine specimen was collected during the third trimester, and urinary concentration of fifteen environmental antibiotics was measured by liquid chromatography-tandem mass spectrometry and enzymatic method. Children were followed at birth, 12, 24 and 60 months, and growth parameters of the weight and height of children were recorded. Linear regression model was applied, and it was found that maternal veterinary antibiotic (VA) concentration was negatively associated with birth weight and ponderal index [per natural-logarithm (ln)-unit: adjusted β (95% confidence interval, CI) = - 42.1 (- 74.0, - 10.3) for birth weight, -0.11 (- 0.19, - 0.02) for birth weight z-score, and - 0.03 (- 0.05, - 0.002) for ponderal index]. Regarding specific VA, each ln-unit increment of florfenicol concentrations was likely to be associate with 39.7 g (95%CI: - 69.3, - 10.1) reduced birth weight, 0.10 (95%CI: - 0.18, - 0.02) reduced birth weight z-score, and 0.02 g/cm (95%CI: - 0.04, - 0.00) reduced ponderal index. Ciprofloxacin, a preferred-as-veterinary antibiotic, showed a similar dose-response relationship with neonatal anthropometric parameters to florfenicol. However, these adverse effects diminished as children grew up to 12-, 24- and 60-month-old. Larger prospective cohort studies and animal experiments are warranted to verify the hypothesis that environmental antibiotics exposure in early life, even at low doses, may cause fetal growth restriction. 10.1016/j.chemosphere.2021.132657
    Relationship between blood cadmium and abdominal aortic calcification: NHANES 2013-2014. Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) BACKGROUND:Cadmium is a common toxic heavy metal in the environment and can cause irreversible damage to the human body. It is well established that cadmium has direct cardiovascular toxicity, but the relationship between cadmium exposure and abdominal aortic calcification (AAC) is not clear. METHODS:This was a cross-sectional study that aimed to assess the relationship between blood cadmium (B-Cd) and AAC in U.S. adults ≥ 40 years old. We obtained data from the 2013-2014 National Health and Nutrition Examination Survey. The AAC score was quantified by the Kauppila score system, whereas severe AAC was defined as an AAC score ≥ 6. We performed multivariate regressions, correlated subgroup analyses, and interaction terms to evaluate the relationship between B-Cd and AAC score and severe AAC. RESULTS:For 1530 enrolled participants, the mean AAC score was 1.52 ± 3.32, and the prevalence of severe AAC was 8.95%. Participants with higher B-Cd levels showed higher AAC scores (β = 0.36, 95% CI: 0.03, 0.70, P = 0.0323) and an increased risk of severe AAC (OR=1.61, 95% CI: 1.01, 2.56, P = 0.0432). However, these associations were weakened after adjusting for serum cotinine to define smoking exposure. Subgroup analyses and correlated interaction terms indicated that the relationship between B-Cd and AAC was generally similar in different population settings, except for males, nonsmokers, and participants with a normal body mass index (BMI). The interaction terms indicated that smoking exposure status defined by serum cotinine interacted with the relationship between B-Cd and AAC condition (P for interaction=0.0413). CONCLUSIONS:There might be positive associations between B-Cd levels and AAC scores and the risk of severe AAC, while these associations were partially explained by smoking exposure. However, more well-designed studies are still needed to validate this relationship. 10.1016/j.jtemb.2022.126975