Association between dynapenic abdominal obesity and arthritis among the middle-aged and older Chinese: a longitudinal study.

BACKGROUND: This study aimed to assess the longitudinal association between dynapenic abdominal obesity and new-onset arthritis among the middle-aged and older Chinese population. METHODS: We included 6863 participants from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Dynapenia was defined as handgrip strength < 28 kg for males, and < 18 kg for females. Abdominal obesity was defined as a waist circumference ≥ 90 cm for males and ≥ 85 cm for females. Based on the definitions, all participants were divided into four groups: no dynapenia and no abdominal obesity (ND/NAO), abdominal obesity alone (ND/AO), dynapenia alone (D/NAO), and dynapenia and abdominal obesity (D/AO). The association between dynapenic abdominal obesity and new-onset arthritis was assessed by sex using the Poisson regression models. RESULTS: After a four-year follow-up, 1272 (18.53%) participants reported new-onset arthritis. Those in the D/AO group had a significantly increased risk of new-onset arthritis compared to those in the ND/NAO group (adjusted relative risk (RR): 1.34, 95% confidence interval (CI): 1.01-1.77). In females, the ND/AO (RR: 1.21, 95% CI: 1.03-1.43) and D/AO (RR: 1.39, 95% CI: 1.01-1.93) groups were associated with a higher risk of arthritis. This significant association was not observed in males. CONCLUSIONS: Our results indicated that the combined effect of dynapenia and abdominal obesity significantly increased the risk of new-onset arthritis in females, but this association was not observed in males.

Relationship between mixed exposure to phenyl hydroxides, polycyclic aromatic hydrocarbons, and phthalates and the risk of arthritis.

BACKGROUND: To determine the relationship between mixed exposure to three types of endocrine-disrupting chemicals (EDCs), namely phenyl hydroxides, polycyclic aromatic hydrocarbons (PAHs), and phthalates (PAEs), and risk of arthritis. METHODS: Participants were selected from National Health and Nutrition Examination Survey (NHANES). The relationships between the urinary concentrations of phenyl hydroxides, PAHs, and PAEs and the risk of arthritis were analyzed by generalized linear regression model. The mixed exposure to these EDCs and the risk of arthritis was analyzed by weighted quantile sums (WQSs) and Bayesian kernel machine regression (BKMR) model. RESULTS: Our analysis showed that participants with urinary benzophenone-3 and methylparaben concentrations in the highest quartile (Q4) had an increased risk of arthritis compared with those in Q1. For each one-unit increase in the natural logarithm-converted urinary concentrations of 1-hydroxynapthalene and 2-hydroxynapthalene, the risk of arthritis increased by 5% and 8%, respectively. Chemical mixing index coefficients were significantly associated with risk of arthritis in both WQS positive- and negative-constraint models. In the BKMR model, there was a significant positive correlation between mixed exposure and the risk of arthritis. CONCLUSION: Mixed exposure to phenyl hydroxides, PAHs, and PAEs increased the risk of arthritis, with exposure to PAHs being the key factor.

Acute Arthritis Presentations of Gonorrhea and Syphilis - A Concise Update.

According to the 2021 CDC sexually transmitted disease surveillance report, national cases of syphilis and gonorrhea continue to rise. Currently, South Dakota ranks #1 in syphilis and #2 in gonorrhea cases per 100,000 population. The higher incidence increases the likelihood South Dakota clinicians will encounter different presentations of syphilis and gonorrhea. Recently, we have seen patients presenting with acute STI related inflammatory arthritis. This review discusses the acute arthritic presentations associated with gonorrhea and syphilis and its treatment.

Relationship between sleep quality and duration and the incidence rate of arthritis: A prospective cohort study.

Little is known about the relationship between sleep duration and quality and the risk of arthritis in the older adult population of China. The participants were a prospective cohort of adults aged 65 years and over who had not had arthritis at baseline and had participated in follow-up surveys from 2011 to 2018 in the Chinese Longitudinal Health and Longevity Survey (CLHLS). A Cox proportional-hazards regression model was established. The dose-response relationship between sleep duration and the incidence of arthritis was analyzed. The results of a Cox proportional-risk regression model revealed that sleep duration and quality were associated with the risk of arthritis in the participants. Specifically, compared with participants with good sleep quality, those with poor sleep quality had a 38% higher risk of developing arthritis (hazard ratio [HR] = 1.38, 95% confidence interval [CI] = 1.09-1.74), and compared with participants with a sleep duration of 5 to 10 hours, those with a sleep duration shorter than 5 hours had a higher risk of developing arthritis (HR = 1.56, 95% CI = 1.27-1.91). Moreover, the results of a restricted cubic spline Cox proportional-hazards regression model showed that there was an approximately non-linear dose-response relationship between sleep duration and the incidence rate of arthritis (P nonlinear < .0001). Participants with poor sleep quality and a sleep duration shorter than 5 hours had a higher risk of developing arthritis than those with better sleep quality and a longer sleep duration.

Distinct clinical outcomes linked to peripheral arthritis and dactylitis in axial spondyloarthritis: findings from a retrospective Irish cohort.

INTRODUCTION: Axial spondyloarthritis (AxSpA) is a chronic inflammatory condition primarily affecting the axial skeleton. Peripheral features such as peripheral arthritis (PA) and dactylitis are common in AxSpA disease. This study aimed to investigate the independent impact of these manifestations on patient presentation and disease outcomes within an Irish AxSpA cohort. METHODS: 912 Irish AxSpA patients were analyzed in this study. Disease outcomes in patients with and without peripheral arthritis or dactylitis were compared using univariate and multivariate methods. The prevalence of extra-spinal manifestations was further assessed in relation to AxSpA disease duration. RESULTS: 30.2% of patients reported PA, while 6.6% had dactylitis. PA and dactylitis were strongly linked, with 70% of patients presenting with dactylitis also showing features of PA. Psoriasis was more common in both patients with PA (OR 2.2, P < 0.001) and dactylitis (OR 3.38, P < 0.001). Dactylitis, but not PA was strongly linked to uveitis (OR 2.91, P < 0.001) and inflammatory bowel disease (OR 3.15, P < 0.001), while PA was associated with worse patient functioning and reduced quality of life. PA, but not dactylitis was linked with increased AxSpA disease duration. DISCUSSION: Despite high concurrence of PA and dactylitis in AxSpA patients, each manifestation is independently associated with worse outcomes. While some of these overlapped, several outcomes are specific to either PA or dactylitis. Due to its strong association with uveitis and inflammatory bowel disease, an early presentation of dactylitis may represent a unique subset of patients and serve as a valuable predictive marker for the later onset of these conditions.

The association between arthritis and cognitive function impairment in the older adults: Based on the NHANES 2011-2014.

OBJECTIVE: Arthritis has been postulated as a prevalent potential risk factor for the emergence of dementia and cognitive impairment. This conjecture prompted an examination of the correlation between arthritis and cognitive impairment using the National Health and Nutrition Examination Survey (NHANES) repository. The analysis was meticulously adjusted for potential confounders such as age and assorted systemic comorbidities, to ensure robustness in the results obtained. METHODS: Among 2,398 adults aged 60 years and above, logistic regression and cubic spline models were employed to elucidate the relationship between arthritis and cognitive performance. This was assessed utilizing tests such as Immediate Recall test (IRT), Delayed Recall test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). RESULTS: In our investigation, a total of 19931 individuals were analyzed, among which 2,398 patients (12.03%) were identified with arthritis. Subjects with arthritis inflammation had lower DSST and AFT scores compared to the healthy group, indicating cognitive decline. After adjusting for all covariates, arthritis was significantly associated with higher DSST and AFT scores by logistic regression modeling (OR: 0.796, 95% CI: 0.649-0.975; OR: 0.769, 95% CI: 0.611-0.968). CONCLUSION: Our analysis underscores the potential linkage between arthritis prevalence and cognitive impairment within a nationally representative of US older adults.

The Impact of Different MEFV Genotypes on Clinical Phenotype of Patients with Familial Mediterranean Fever: Special Emphasis on Joint Involvement.

Familial Mediterranean Fever (FMF) is the most common monogenic autoinflammatory disease worldwide. In this retrospective cohort study, we aimed to assess the effects of various MEFV genotypes on the clinical characteristics of the patients, with a special focus on the joint involvement. In total, 782 patients with FMF were categorized into 3 groups according to the MEFV mutation; Group 1: Patients homozygous for M694V; Group 2: Patients carrying other pathogenic MEFV variants in exon 10 in homozygous or compound heterozygous states; and Group 3: FMF patients with other variants or without mutations. Clinical and demographic findings were compared between groups. Among the 782 FMF patients, total frequency of arthritis was 237 (30.3%): 207 (26.4%) were acute monoarthritis and 67 (8.5%) were chronic arthritis. Both the frequency of arthritis (acute and/or chronic) (40.4% vs. 24.8% vs. 26.7%; p:0.001) and acute monoarthritis (35.4% vs. 20% vs. 23.7%; p:0.001) were significantly higher in Group 1 than in the other groups. FMF patients with chronic arthritis showed a distinct juvenile idiopathic arthritis (JIA) distribution pattern with a more frequent enthesitis-related arthritis (ERA) subtype (43.2%). HLA-B27 was positive in 24% of the ERA patients.Conclusion: Homozygous M694V mutation is associated with a more frequent and longer acute monoarthritis comparing to other MEFV genotypes. In addition, the risk of chronic arthritis seems not related to the MEFV mutations. However, FMF patients with chronic arthritis show a distinct ILAR JIA distribution pattern with a more frequent ERA and undifferentiated arthritis subtype. What is known: • Homozygous M694V mutation is associated with a more frequent and longer acute monoarthritis What is new: • FMF patients with chronic arthritis show a distinct ILAR JIA distribution pattern with a more frequent ERA subtype • ERA patients with negative HLA-B27 antigen should also be assessed for polyserositis episodes of FMF, especially in countries with high FMF carrier frequency.

Association between endometriosis and arthritis: results from NHANES 1999-2006, genetic correlation analysis, and Mendelian randomization study.

Background: Previous studies reported that endometriosis may have a higher risk of arthritis. However, it remains unclear whether the association between endometriosis and arthritis has genetic correlations, or the relationship is causal. Linkage Disequilibrium Score (LDSC) and Mendelian Randomization (MR) analyses use genetic variation as a natural experiment to explore genetic correlations and causal inferences from observational data, reducing unmeasured confounding factors. Method: Participants (aged 20-54 years, n = 2,915) for the cross-sectional study were obtained from the National Health and Nutrition Examination Survey (NHANES). Endometriosis and arthritis were diagnosed based on self-reported by reproductive health and medical condition questionnaire. Weighted multivariable logistic regression was used to explore the relationship between endometriosis and arthritis. LDSC and MR analysis were performed using the genome-wide association study (GWAS) summary statistics to identify the causal association. Result: A significant positive association between endometriosis and arthritis was found after multivariable adjustment (OR = 1.89; 95% CI: 1.33, 2.67). When exploring different types of arthritis, a positive association was revealed with rheumatoid arthritis (RA), other types of arthritis, and cases that the arthritis type were unknown, with an OR of 2.07 (95% CI: 1.03, 4.17), 2.78 (95% CI: 1.30, 5.95), and 2.06 (95% CI: 1.36, 3.11), respectively. However, genetic correlation analysis between endometriosis and RA did not reveal any significant findings (all P values > 0.05). Moreover, MR analysis also failed to identify a causal relationship between endometriosis and RA (all P values > 0.05). Conclusion: Cross-sectional study identified a significant positive association between endometriosis and arthritis among US women, especially among RA, while findings based on LDSC and MR analysis did not support a genetic correlation or causal role. These findings suggest that clinicians should pay more attention to the coexistence of RA in endometriosis patients and explore the shared pathophysiological mechanisms of these two disorders, with a particular focus on extrinsic factors rather than intrinsic genetic inheritance.

Exploring the causal association between frailty index with the common types of arthritis: a Mendelian randomization analysis.

BACKGROUND: Previous observational studies indicated a complex association between frailty and arthritis. AIMS: To investigate the genetic causal relationship between the frailty index and the risk of common arthritis. METHODS: We performed a large-scale Mendelian randomization (MR) analysis to assess frailty index associations with the risk of common arthritis in the UK Biobank (UKB), and the FinnGen Biobank. Summary genome-wide association statistics for frailty, as defined by the frailty index, and common arthritis including rheumatoid arthritis (RA), osteoarthritis (OA), psoriatic arthritis (PSA), and ankylosing spondylitis (AS). The inverse-variance weight (IVW) method served as the primary MR analysis. Heterogeneity testing and sensitivity analysis were also conducted. RESULTS: Our results denoted a genetic association between the frailty index with an increased risk of OA, the odds ratio (OR)IVW in the UKB was 1.03 (95% confidence interval [CI]: 1.01-1.05; P = 0.007), and ORIVW was 1.55 (95% CI: 1.16-2.07; P = 0.003) in the FinnGen. For RA, the ORIVW from UKB and FinnGen were 1.03 (1.01-1.05, P = 0.006) and 4.57 (1.35-96.49; P = 0.025) respectively. For PSA, the frailty index was associated with PSA (ORIVW = 4.22 (1.21-14.67), P = 0.023) in FinnGen, not in UKB (P > 0.05). However, no association was found between frailty index and AS (P > 0.05). These results remained consistent across sensitivity assessments. CONCLUSION: This study demonstrated a potential causal relationship that genetic predisposition to frailty index was associated with the risk of arthritis, especially RA, OA, and PSA, not but AS. Our findings enrich the existing body of knowledge on the subject matter.

Association between different triglyceride-glucose index combinations with obesity indicators and arthritis: results from two nationally representative population-based study.

BACKGROUND: Insulin resistance (IR) and arthritis are strongly associated, and the triglyceride-glucose (TyG) index combinations with obesity indicators [including TyG-BMI (glucose triglyceride-body mass index), TyG-WC (glucose triglyceride-waist circumference), and TyG-WHtR (glucose triglyceride-waist height ratio)] has recently been recognized as a more effective indicator for assessing IR. However, there is a lack of research on its association with arthritis, and it is also important to assess in different populations. METHODS: The analysis utilized data from the China Health and Retirement Longitudinal Study (CHARLS) and the National Health and Nutrition Examination Survey (NHANES). Arthritis diagnosis relied on self-reporting confirmed by physicians. The association of TyG-BMI, TyG-WC, and TyG-WHtR with arthritis was analyzed through weighted logistic regression models, and exploring nonlinear effects with restricted cubic spline (RCS) models. Secondary and sensitivity analyses included receiver operating characteristic curve (ROC) analysis, comparisons of z score-related odds ratios, subgroup analyses, and multiple imputation. RESULTS: The study involved 6141 CHARLS participants and 17,091 NHANES participants. Adjusting for confounding variables, TyG-BMI and TyG-WHtR demonstrate a positive correlation with arthritis prevalence in both CHARLS (TyG-BMI: OR = 1.02, 95% CI 1.00-1.04; TyG-WHtR: OR = 1.13, 95% CI 1.03-1.24) and NHANES (TyG-BMI: OR = 1.07, 95% CI 1.06-1.08; TyG-WHtR: OR = 1.50, 95% CI 1.40-1.60). RCS regression analysis demonstrated a significant nonlinear association. ROC analysis indicated that TyG-BMI and TyG-WHtR were superior to TyG for the diagnosis of arthritis in both CHARLS and NHANES. CONCLUSIONS: TyG-BMI and TyG-WHtR demonstrate a positive correlation with arthritis prevalence in both Chinese and the U.S. populations, displaying superior diagnostic relevance compared to TyG.

Lifetime Trauma Exposure and Arthritis in Older Adults.

OBJECTIVE: Experiencing potentially traumatic events across one's lifecourse increases risk for poor physical health outcomes. Existing models emphasize the effects of any lifetime trauma exposure, risk accumulation (multiple traumas over time), and sensitive periods of exposure (specific exposure timepoints leading to lasting consequences). We examined how different indices of trauma exposure across the lifecourse were associated with later life arthritis, a common and debilitating health condition. METHODS: Data include 5717 Health and Retirement Study participants (age mean [standard deviation] = 65.4 [12.9] years) who reported on lifetime adversity and trauma in 2006-2008. Lifetime trauma exposure was modeled as any trauma, accumulation of traumas, and lifecourse profiles (no exposure, childhood only, adulthood only, childhood and adulthood exposure). Outcomes included prevalent arthritis at baseline and incident arthritis across 12 years of follow-up. Covariate-adjusted generalized linear models for prevalence ratios and Cox proportional hazards models for hazard ratios were conducted. RESULTS: Any lifetime trauma was associated with both prevalent arthritis at baseline (prevalence ratio = 1.13, 95% confidence interval = 1.05-1.22) and incident arthritis over 12 years (hazard ratio = 1.25, 95% confidence interval = 1.17-1.47). Greater trauma accumulation was significantly associated with both prevalent and incident arthritis. Childhood exposure was particularly strongly associated with prevalent and incident cases, with adulthood exposure being unassociated with incident arthritis. Across models, trauma exposure was associated with prevalent cases of both immune-related and osteoarthritis types. CONCLUSIONS: Higher lifetime trauma burden, especially during childhood, may predispose individuals to arthritis later in life. Early intervention or prevention efforts should identify trauma as an important risk factor for musculoskeletal health across the lifecourse.

Development of Autoimmune Diseases Among Children With Pediatric Acute-Onset Neuropsychiatric Syndrome.

Importance: Epidemiologic studies indicate a high rate of autoimmune conditions among patients with obsessive-complusive disorder and other psychiatric conditions. Furthering the understanding of the inflammatory diatheses of psychiatric conditions may open doors to new treatment paradigms for psychiatric disorders. Objectives: To evaluate whether pediatric acute-onset neuropsychiatric syndrome (PANS) is associated with an inflammatory diathesis by assessing signs of immune activation and vasculopathy during a psychiatric symptom exacerbation (flare), estimating the risk of developing arthritis and other autoimmune diseases, and characterizing subtypes of arthritis. Design, Setting, and Participants: This retrospective cohort study used longitudinal clinical data on 193 consecutive patients with PANS followed up within the Stanford Immune Behavioral Health Clinic from September 1, 2012, to December 31, 2021. Main Outcomes and Measures: Medical records were reviewed, and a predefined set of immune markers that were measured during a flare and the features and imaging findings of arthritis and other autoimmune diseases were collected. Immune activation markers included (1) autoimmunity signs (antinuclear antibody, antihistone antibody, antithyroglobulin antibody, C1q binding assay, and complement levels [C3 and C4]); (2) immune dysregulation or inflammation signs (leukopenia, thrombocytosis, C-reactive protein, and erythrocyte sedimentation rate); and (3) vasculopathy signs (livedo reticularis, periungual redness and swelling, abnormally prominent onychodermal band, palatal petechiae, high von Willebrand factor antigen, and high d-dimer). Last, the cumulative risk of developing arthritis and autoimmune diseases was estimated using product limit (Kaplan-Meier) survival probability. Results: The study included data from 193 children (112 boys [58.0%]) who had PANS at a mean (SD) age of 7.5 (3.5) years. They were followed up for a mean (SD) of 4.0 (2.1) years. Among those tested for immune activation markers, 54.2% (97 of 179) had nonspecific markers of autoimmunity, 12.0% (22 of 184) had nonspecific signs of immune dysregulation or inflammation, and 35.8% (69 of 193) had signs of vasculopathy. By 14 years of age, the estimated cumulative incidence of arthritis was 28.3% (95% CI, 20.8%-36.3%), and the estimated cumulative incidence of another autoimmune disease was 7.5% (95% CI, 4.0%-12.4%). Novel findings in the subgroup with arthritis include joint capsule thickening (55.0% [22 of 40]), distal interphalangeal joint tenderness (81.8% [45 of 55]), and spinous process tenderness (80.0% [44 of 55]). Among the 55 patients with arthritis, the most common subtypes of arthritis included enthesitis-related arthritis (37 [67.3%]), spondyloarthritis (27 [49.1%]), and psoriatic arthritis (10 [18.2%]). Conclusions and Relevance: This study found that patients with PANS show signs of immune activation and vasculopathy during psychiatric symptom flares and have an increased risk of developing arthritis and other autoimmune diseases compared with the general pediatric population. The most common arthritis subtype was enthesitis-related arthritis. These findings suggest that PANS may be part of a multisystem inflammatory condition rather than an isolated psychiatric or neuroinflammatory disorder.

Prevalence and predictors of arthritis among adults in a rural set-up in Kenya: a cross-sectional study.

Introduction: arthritis is a significant public health problem affecting many people globally. Exposure to various risk factors puts individuals at risk of developing arthritis. Therefore, this study aimed to assess the prevalence and predictors of arthritis among residents of a rural set-up in Nyamira County, Kenya. Methods: a community-based cross-sectional study design was employed. Simple random sampling was utilized to select households from a household list. All the residents of the sampled household above 40 years were included. Descriptive analysis was done to describe the study population. Bivariate and multivariate analysis was also done to identify statistically significant arthritis-related variables. Results: the prevalence of arthritis was 44.6%. Previous joint injury/infection [AOR=2.74; 95%CI=1.59-4.77; p<0.001], being unemployed [AOR=2.77; 95%CI=1.50-5.21; p=0.001], age above 51 years, and hypertension [AOR=1.90; 95%CI=1.03-3.53, p=0.040] were associated with an increased risk of arthritis. Conversely, being male [AOR=0.42; 95% CI=0.22-0.75; p=0.005], standing for > 2 hours [AOR=0.48; 95%CI=0.29-0.81; p=0.006], and constant shifting from sit to stand positions [AOR=0.45; 95% CI=0.26-0.76; p=0.003] were associated with a lower risk of arthritis. Most participants (75%) had an arthritis knowledge score of more than 66%. Conclusion: the study found a high prevalence of arthritis in the community. Arthritis was strongly associated with various risk factors under study. Therefore, there is a need to take preventive measures for modifiable factors to enhance a reduced prevalence of arthritis.

Arthritis increases the risk of erectile dysfunction: Results from the NHANES 2001-2004.

Objective: This study assessed the association between erectile dysfunction (ED) and arthritis. Methods: Weighted logistic regression and subgroup analyses were used to investigate the association between arthritis incidence and ED among participants in the 2001-2004 National Health and Nutrition Examination Survey database. Results: Among the participants, 27.8% and 18.5% had a self-reported history of ED and arthritis, respectively. ED was associated with arthritis (odds ratio [OR]=4.00; 95% confidence interval [CI]: 3.20-4.99; p<0.001], which remained significant after adjustment (OR=1.42, 95% CI: 1.00-1.96; p<0.001). Stratified by type of arthritis, after full adjustment, osteoarthritis remained significant (OR=1.11; 95% CI: 1.03-1.20; p=0.017), and rheumatoid arthritis (OR=1.03, 95% CI: 0.93-1.13; p= 0.5) and other arthritis (OR=1.04, 95% CI: 0.98-1.11; p=0.2) were not significantly correlated with ED. Multiple inference analyses confirmed the robustness of the results. Conclusion: Our study showed that arthritis was strongly associated with ED. There is an urgent need to raise awareness and conduct additional research on the reasons behind this association in order to implement more scientific and rational treatment programs for patients with ED and arthritis.

Association of Sleep Quality and General, Mental, and Oral Health with Lifestyle Traits (Dietary Intake, Smoking Status) in Arthritis: A Cross-Sectional Study from the Canadian Community Health Survey (CCHS).

Arthritis is associated with health challenges. Lifestyle traits are believed to influence arthritis development and progression; however, data to support personalized treatment regimens based on holistic lifestyle factors are missing. This study aims to provide a comprehensive list of associations between lifestyle traits and the health status of individuals with arthritis in the Canadian population, using binary logistic regression analysis on data from the Canadian Community Health Survey, which includes 104,359 respondents. Firstly, we explored the association between arthritis and various aspects of health status including self-reported lifestyle factors. Secondly, we examined the associations between self-reported dietary intake and smoking status with general, mental, and oral health, and sleep disturbance among individuals both with and without arthritis. Our analysis revealed that individuals with arthritis reported considerably poorer general, mental, and oral health, and poorer sleep quality compared to those without arthritis. Associations were also found between self-reported dietary intake and various measures of health status in individuals with arthritis. Smoking and exposure to passive smoking were associated not only with arthritis but also with compromised sleep quality and poorer general, mental, and oral health in people with and without arthritis. This study highlights the need for personalized and holistic approaches that may include a combination of dietary interventions, oral health improvements, sleep therapies, and smoking cessation for improved arthritis prevention and care.

Burden of non-communicable diseases among women of reproductive age in Kenya: a cross-sectional study.

OBJECTIVE: To examine the burden of non-communicable diseases (NCDs) among women of reproductive age in Kenya, highlighting the prevalence and risk factors. DESIGN: Cross-sectional design based on the 2022 Kenya Demographic and Health Survey. SETTING: Kenya. PRIMARY OUTCOMES: Predict the burden of hypertension, diabetes, heart disease, lung disease, arthritis, depression, anxiety, breast and cervical cancer. RESULTS: Overall, 15.9% of Kenyan women aged 15-49 years were living with at least one NCD. The most prevalent NCD among this cohort was hypertension (8.7%) followed by arthritis (2.9%) and depression (2.8%). Our findings revealed that increasing age, increasing wealth, being married or formerly married, being overweight or obese, consuming alcohol and some occupations were risk factors of NCDs among women of reproductive age in Kenya. CONCLUSION: We conclude that hypertension is the most prevalent NCD among women of reproductive age in Kenya. The findings underscore the multifaceted nature of NCD risk factors in Kenya, emphasising the importance of targeted interventions that consider age, economic status, education, marital status, occupation and lifestyle factors.

Differential interplay between multimorbidity patterns and frailty and their mutual mediation effect on mortality in old age.

BACKGROUND: Multimorbidity and frailty often concurrently occur among older adults. OBJECTIVES: To assess the reciprocal association between multimorbidity (condition count and patterns) and frailty and examine the mutual mediation effect of multimorbidity and frailty in their associations with mortality among Chinese older adults. METHODS: This nationwide population-based longitudinal study included 16,563 participants aged ≥65 years in the Chinese Longitudinal Healthy Longevity Survey who were surveyed in 2008 and followed up in 2011, 2014, and 2018. Frailty phenotype was assessed by the modified Fried criteria and vital status was ascertained from family members. Cross-lagged panel model (CLPM) was used to test bidirectional associations between multimorbidity and frailty. The direct and indirect effects of multimorbidity and frailty on mortality were evaluated using the combined CLPM with survival analysis. RESULTS: Three multimorbidity patterns were identified: cardiometabolic diseases, cognitive-sensory disorder, and arthritis-digestive-respiratory diseases. The number of chronic conditions and cognitive-sensory disease pattern showed bidirectional associations with frailty across waves (range for ß: 0.046-0.109; all P < 0.001), while cardiometabolic and arthritis-digestive-respiratory patterns unidirectionally predicted frailty change. Furthermore, frailty mediated 23%-27% of the association between multimorbidity and mortality. Only the number of conditions and cognitive-sensory disease pattern were significant mediators in the association between frailty and mortality, with the proportion of mediation ranging 4%-12%. CONCLUSIONS: Multimorbidity measures including condition count and cognitive-sensory disease pattern are bi-directionally associated with frailty in older adults. These multimorbidity measures and frailty partially mediated each other's association with mortality, with frailty acting as a more prominent pathway in the association between multimorbidity and mortality.

Depressive symptoms and associated factors among older patients with arthritis: evidence from a community-based study in eastern China.

Introduction: Depressive symptoms are often experienced by patients with arthritis and are correlated with poor health outcomes. However, the association between depressive symptoms and multidimensional factors (sociodemographic characteristics, health conditions, health behaviors, and social support) among older patients with arthritis in China remains poorly understood. This study aimed to explore the prevalence of depressive symptoms in older patients with arthritis in eastern China and identify the associated factors. Methods: We analyzed data of 1,081 older patients with arthritis using secondary data from 2014 to 2020 from a community-based ongoing study initiated in 2014 in eastern China. The prevalence of depressive symptoms was calculated, and univariate and multilevel logistic regression analyses were used to identify the associated factors. Results: The mean age of older patients with arthritis was 69.16 ± 7.13 years; 42.92% were men and 57.08% were women. The prevalence of depressive symptoms in older patients with arthritis was 14.99% (95% confidence interval: 12.91-17.26%), about 1.8 times higher than that in older adults without arthritis (8.49%, p < 0.001). Multilevel logistic regression identified perception of poor economic status (odds ratio [OR] = 5.52, p < 0.001), multimorbidity (OR = 1.96, p = 0.001), limitations in activities of daily living (OR = 2.36, p = 0.004), and living alone (OR = 3.13, p = 0.026) as factors positively associated with depressive symptoms. Patients diagnosed with arthritis at an older age had lower odds of experiencing depressive symptoms (OR = 0.67, p = 0.046). Conclusion: Screening for depressive symptoms is essential among older patients with arthritis, especially those who perceive themselves as having a poor economic status, are diagnosed at an earlier age, have multimorbidity, have limitations in activities of daily living, and live alone. The associations of age at arthritis diagnosis and dietary behaviors with depressive symptoms require further research.

Depression and risk of arthritis: A Mendelian randomization study.

INTRODUCTION: Observational studies have found that most patients with arthritis have depression. We aimed to determine the causal relationship between various types of arthritis and depression. METHODS: We conducted a two-sample bidirectional Mendelian randomized (MR) analysis to determine whether there was a significant causal relationship between depression and multiple types of arthritis. The data of our study were derived from the publicly released genome-wide association studies (GWASs) and the largest GWAS meta-analysis. MR analysis mainly used inverse-variance weighted method; supplementary methods included weighted median, weighted mode, and MR-Egger using MR pleiotropy residual sum and outlier to detect and correct for the presence of pleiotropy. RESULTS: After adjusting for heterogeneity and horizontal pleiotropy, we found that depression was associated with an increased risk of osteoarthritis (OA) (OR = 1.02, 95%CI: 1.01-1.02, p = 2.96 × E - 5). In the reverse analysis, OA was also found to increase the risk of depression (OR = 1.10, 95%CI: 1.04-1.15, p = .0002). Depression only increased the risk of knee OA (KOA) (OR = 1.25, 95%CI: 1.10-1.42, p = 6.46 × E - 4). Depression could potentially increase the risk of spondyloarthritis (OR = 1.52, 95%CI: 1.19-1.94, p ≤ 8.94 × E - 4). CONCLUSION: There is a bidirectional causal relationship of depression with OA. However, depression only augments the risk of developing KOA. Depression may increase the risk of spondyloarthritis and gout.

Inflammatory Bowel Disease-Associated Arthritis Is Associated with Concomitant Autoimmune and Inflammatory Disorders.

BACKGROUND: Extraintestinal Manifestations (EIMs) are a common and potentially debilitating complication of Inflammatory Bowel Diseases (IBD), sometimes requiring additional treatment beyond those used to control intestinal disease. IBD-associated arthritis (IAA), a form of spondyloarthritis, is associated with several factors including disease location, sex, and IBD type. However, much remains unknown about other clinical factors predicting development of EIMs. Our goal was to identify additional factors associated with IAA. METHODS: Participants in the LOCATION-IBD cohort were included in this analysis. We performed univariate and multivariate analysis of demographics, clinical data, and patient-reported outcomes data. RESULTS: The LOCATION-IBD cohort included 182 participants with (n = 53) and without (n = 110) joint EIMs and with joint pain of unclear etiology (n = 19). In a multivariate analysis comparing those with and without joint EIMs, female sex (OR = 2.5, p = 0.014), the presence of concomitant autoimmune and inflammatory disorders (OR = 2.5, p = 0.038), and Crohn's disease (OR = 2.9, p = 0.026) were associated with the presence of joint EIMs. CONCLUSION: This analysis reveals patients with IAA are more likely to have concomitant autoimmune disorders. Further studies are needed to confirm this association, understand the mechanisms underlying the common pathogenesis of these concurrent disorders, and evaluate their impact on the treatment of IAA.