Evaluating complementaries among urban water, energy, infrastructure, and social Sustainable Development Goals in China.

Urban areas' performance in water, energy, infrastructure, and socio-economic sectors is intertwined and measurable through Sustainable Development Goals (SDGs) 6-13. Effective synergy among these is critical for sustainability. This study constructs an indicator framework that reflects progress towards these urban SDGs in China. Findings indicate underperformance in SDGs 8-11, suggesting the need for transformative actions. Through network analysis, the research reveals complementarities among these SDGs. Notably, the SDG space divides into socio-economic and ecological clusters, with SDG 6 (Clean Water and Sanitation) central to both. Additionally, SDG 8 (Decent Work and Economic Growth) and SDG 9 (Industry, Innovation, and Infrastructure) act as bridges, while greater synergies exist between SDG 12 (Responsible Consumption and Production) and SDG 13 (Climate Action). An in-depth view at the indicator-level shows a core-periphery structure, emphasizing indicators like SDG 6.2 (Wastewater Treatment Rate) and SDG 6.6 (Recycled Water Production Capacity per capita) as pivotal. This study confirms the urban SDG space's stability and predictiveness, underscoring its value in steering well-aligned policy decisions for sustainable growth.

Regional characteristics of groundwater sulfate source and evolution in the multi-layer aquifer system of the northern Shaanxi coal mine base, northwestern China: Evidence from geochemical and isotopic fingerprints.

Groundwater sulfate contamination in mining areas has attracted widespread attention. However, deciphering the source and evolution of sulfate in large-scale mining areas remains a challenge due to intense anthropogenic influences and complex hydrogeological conditions. In this study, 94 groundwater samples were analyzed by a combination of self-organizing maps, MixSiar model, multi-isotope analyses (δ34S, δ18OSO4, δD and δ18Owater) and hydrogeochemical methods to investigate the regional characteristics of groundwater sulfate source and evolution in China's largest coalfield (the Shenfuyu Coalfield). The results showed that the source and evolution of groundwater sulfate were controlled by human activities (mining and agricultural activities) and hydrogeological conditions. The groundwater sulfate primarily originated from pyrite oxidation, gypsum dissolution and human inputs. For the mining districts with shallow mining depths, pyrite oxidation and fertilizer contributed to groundwater sulfate. In addition, the ground cracks and abandoned mines controlled the BSR and pyrite oxidation processes. In contrast, the gypsum dissolution and cation exchange dominated the sulfate evolution in the mining districts with deep mining depths due to slow groundwater circulation. This study provided new insights into the source and evolution of groundwater sulfate in large coalfields, as well as references for regional water resource utilization and protection.

Scaling of development indicators in countries and its origin.

Population-normalized indicators (e.g., GDP per capita), under the assumption of the indicators scaling linearly with population, are ubiquitously used in national development performance comparison. This assumption, however, is not valid because it may ignore agglomeration effect resulting from nonlinear interactions in socioeconomic systems. Here, we present extensive empirical evidence showing the sub-linear scaling rather than the presumed linear scaling between population and multiple indicators of national development performance. We then develop a theoretical framework based on the scaling rule observed in cities to explore the origin of scaling in countries. Finally, we demonstrate that urbanization plays a pivotal role in transforming national development from limited sub-linear growth to unlimited super-linear growth. This underscores the significance of urbanization in achieving sustained growth and elevating human living standards at the national level. Our findings have the potential to inform policies aimed at promoting equitable inter-country comparison and achieving sustainable development in countries.

IL-33 released during challenge phase regulates allergic asthma in an age-dependent way.

Epithelial-derived cytokines, especially type 2 alarmins (TSLP, IL-25, and IL-33), have emerged as critical mediators of type 2 inflammation. IL-33 attracts more interest for its strong association with allergic asthma, especially in childhood asthma. However, the age-dependent role of IL-33 to the development of allergic asthma remains elusive. Here, using OVA-induced allergic asthma model in neonatal and adult mice, we report that IL-33 is the most important alarmin in neonatal lung both at steady state or inflammation. The deficiency of IL-33/ST2 abrogated the development of allergic asthma only in neonates, whereas in adults the effect was limited. Interestingly, the deficiency of IL-33/ST2 equally dampened the ILC2 responses in both neonatal and adult models. However, the effect of IL-33/ST2 deficiency on Th2 responses is age-dependent, which is only blocked in neonates. Furthermore, IL-33/ST2 signaling is dispensable for OVA sensitization. Following OVA challenge in adults, the deficiency of IL-33/ST2 results in compensational more TSLP, which in turn recruits and activates lung DCs and boosts Th2 responses. The enriched γδ T17 cells in IL-33/ST2 deficient neonatal lung suppress the expression of type 2 alarmins, CCL20 and GM-CSF via IL-17A, thus might confer the inhibition of allergic asthma. Finally, on the basis of IL-33 deficiency, the additive protective effects of TSLP blocking is much more pronounced than IL-25 blocking in adults. Our studies demonstrate that the role of IL-33 for ILC2 and Th2 responses varies among ages in OVA models and indicate that the factor of age should be considered for intervention of asthma.

Evaluating carbon emissions reduction compliance based on 'dual control' policies of energy consumption and carbon emissions in China.

Dual control policies aim to effectively reduce energy consumption and carbon emission by setting targets for total volume and intensity control. With global climate change becoming increasingly serious. China, as a large energy-consuming and carbon-emitting country, faces a huge challenge to reduce carbon emissions. The transition from the "dual control of energy consumption" to the "dual control of carbon emissions" in China is necessary to optimize energy structures, promote energy conservation, reduce carbon emissions, and reach carbon neutrality. This study utilizes multi-regional input-output models to evaluate the results toward both goals from production-based, consumption-based, and income-based perspectives. The findings indicate that "dual control of carbon emissions" is a more precise approach than "dual control of energy consumption". Some provinces have met the latter goal while still falling short of the former. Provinces having met their production-based energy intensity and carbon emission intensity targets, but having failed their consumption-based and income-based targets, are identified to develop a comprehensive and accurate assessment of these targets. A net outflow of embodied energy and carbon emissions is observed among provinces in less-developed central and southern regions to more-developed eastern and northern regions. Suggestions and policy implications based on these findings include establishing a comprehensive evaluation of energy and carbon intensity, considering both consumption-based and income-based perspectives, as well as facilitating enhanced cooperation among developed and developing provinces.

Impact of omega-3 fatty acids on hypertriglyceridemia, lipidomics, and gut microbiome in patients with type 2 diabetes.

BACKGROUND: Fish oil (FO), a mixture of omega-3 fatty acids mainly comprising docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), has been recommended for patients with type 2 diabetes (T2D) and hypertriglyceridemia. However, its effects on lipidomic profiles and gut microbiota and the factors influencing triglyceride (TG) reduction remain unclear. METHODS: We conducted a 12-week, randomized, double-blind, placebo-controlled trial in 309 Chinese patients with T2D with hypertriglyceridemia (ClinicalTrials.gov: NCT03120299). Participants were randomly assigned (1:1) to receive either 4 g FO or corn oil for 12 weeks. The primary outcome was changes in serum TGs and the lipidomic profile, and the secondary outcome included changes in the gut microbiome and other metabolic variables. FINDINGS: The FO group had significantly better TG reduction (mean [95% confidence interval (CI)]: -1.51 [-2.01, -1.01] mmol/L) compared to the corn oil group (-0.66 [-1.15, -0.16] mmol/L, p = 0.02). FO significantly altered the serum lipid profile by reducing low-unsaturated TG species and increasing those containing DHA or EPA. FO had minor effects on gut microbiota, while baseline microbial features predicted the TG response to FO better than phenotypic or lipidomic features, potentially mediated by specific lipid metabolites. A total of 9 lipid metabolites significantly mediated the link between 4 baseline microbial variables and the TG response to FO supplementation. CONCLUSIONS: Our findings demonstrate differential impacts of omega-3 fatty acids on lipidomic and microbial profiles in T2D and highlight the importance of baseline gut microbiota characteristics in predicting the TG-lowering efficacy of FO. FUNDING: This study was funded by the National Nature Science Foundation.

Modeling the dynamic impacts of maritime network blockage on global supply chains.

Recent phenomena such as pandemics, geopolitical tensions, and climate change-induced extreme weather events have caused transportation network interruptions, revealing vulnerabilities in the global supply chain. A salient example is the March 2021 Suez Canal blockage, which delayed 432 vessels carrying cargo valued at $92.7 billion, triggering widespread supply chain disruptions. Our ability to model the spatiotemporal ramifications of such incidents remains limited. To fill this gap, we develop an agent-based complex network model integrated with frequently updated maritime data. The Suez Canal blockage is taken as a case study. The results indicate that the effects of such blockages go beyond the directly affected countries and sectors. The Suez Canal blockage led to global losses of about $136.9 ($127.5-$147.3) billion, with India suffering 75% of these losses. Global losses show a nonlinear relationship with the duration of blockage and exhibit intricate trends post blockage. Our proposed model can be applied to diverse blockage scenarios, potentially acting as an early-alert system for the ensuing supply chain impacts. Furthermore, high-resolution daily data post blockage offer valuable insights that can help nations and industries enhance their resilience against similar future events.

AGR2: The Covert Driver and New Dawn of Hepatobiliary and Pancreatic Cancer Treatment.

The anterior gradient protein 2 (AGR2) plays a crucial role in facilitating the formation of protein disulfide bonds within the endoplasmic reticulum (ER). Research suggests that AGR2 can function as an oncogene, with its heightened expression linked to the advancement of hepatobiliary and pancreatic cancers through invasion and metastasis. Notably, AGR2 not only serves as a pro-oncogenic agent but also as a downstream targeting protein, indirectly fostering cancer progression. This comprehensive review delves into the established functions and expression patterns of AGR2, emphasizing its pivotal role in cancer progression, particularly in hepatobiliary and pancreatic malignancies. Furthermore, AGR2 emerges as a potential cancer prognostic marker and a promising target for immunotherapy, offering novel avenues for the treatment of hepatobiliary and pancreatic cancers and enhancing patient outcomes.

Identifying the spatio-seasonal pattern of hydrochemical evolution and surface water-groundwater interaction in a large urban river basin, Northwest China.

There is insufficient understanding of the spatio-temporal evolution of surface water-groundwater quality and hydraulic connection under both natural and human influences in urban river basins. To this end, this paper investigated the spatio-seasonal pattern of hydrochemical evolution and surface water-groundwater interaction in a typical urban river basin (Dahei River basin) based on isotopic and hydrochemical data of 132 water samples collected during three seasons (normal, wet and dry seasons). From the normal season to the wet season, surface water in the Dahei River basin was dominated by the impacts of evaporation and groundwater discharge processes. During this period, the precipitation and agricultural activities (canal irrigation) were frequent. Thus, groundwater was affected by irrigation infiltration of surface water and precipitation from high-altitude areas. From the wet season to the dry season, precipitation decreased and irrigation methods changed (canal irrigation → well irrigation). In this case, groundwater discharge had a stronger impact on surface water, and shallow groundwater was recharged by deep groundwater through the well irrigation. Under this hydrological pattern, the hydrochemical characteristics of surface water were mainly influenced by evaporation, human activities (agricultural irrigation and sewage treatment) and groundwater discharge. In contrast, the hydrochemical characteristics of groundwater were main influenced by water-rock interactions (dissolution of evaporites and silicates, and cation exchange) and human activities. This study contributed to a better understanding of the hydrochemical and hydrological processes in urban river basins and provided a theoretical basis for the sustainable management of water resources.

Catechol compounds as dual-targeting agents for fish protection against Ichthyophthirius multifiliis infections.

Aquaculture is one of the fastest growing sectors in global food production, recognized as a significant contributor to poverty alleviation, food security, and income generation. However, the frequent occurrence of diseases caused by pathogen infections result in reduced yields and economic losses, posing a substantial constraint to the sustainable development of aquaculture. Here, our study identified that four catechol compounds, quercetin, luteolin, caffeic acid, and chlorogenic acid, exhibited potent antiparasitic effects against Ichthyophthirius multifiliis in both, in vitro and in vivo. The parasite is recognized as one of the most pathogenic to fish worldwide. Using a combination of in silico methods, the dipeptidyl peptidase (DPP) was identified as a critical target for catechol compounds. The two hydroxyl radicals of the catechol group were essential for its binding to and interacting with the DPP protein. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses indicated that catechol compounds disrupt pathways associated with the metabolism and growth of I. multifiliis, thereby exerting antiparasitic effects. Furthermore, these compounds attenuated the expression of proinflammatory cytokines in vivo in fish and promoted macrophage polarization toward M2 phenotype by inhibiting the STAT1 signaling pathway. The dual activity of catechol compounds, acting as both direct antiparasitic and anti-inflammatory agents in fish, offers a promising therapeutic approach for combating I. multifiliis infections in aquaculture.

Multi-isotopes (δD, δ18Owater, 87Sr/86Sr, δ34S and δ18Osulfate) as indicators for groundwater salinization genesis and evolution of a large agricultural drainage lake basin in Inner Mongolia, Northwest China.

Groundwater salinization, a major eco-environmental problem in arid and semi-arid areas, can accelerate soil salinization, reducing crop productivity and imbalances in ecosystem diversity. This study classified water samples collected from the Ulansuhai Lake basin into five clusters using self-organizing maps (SOM). On this basis, multiple isotopes (δ18Owater, δD, 87Sr/86Sr, δ18Osulfate and δ34S) and isotopic models (Rayleigh fractionation and Bayesian isotope mixing models) were used to identify and quantify the genesis and evolution of groundwater salinization. The results showed that the samples were brackish or saline water, and the hydrochemical types were dominated by Na + K-Cl (SO4). It has been proved that the processes associated with groundwater salinization in the Ulansuhai Lake basin were dominated by water-rock interaction and human inputs. Among them, evaporite dissolution contributed substantially to groundwater salinity. Furthermore, salt inputs from human activities cannot be negligible. Based on the model calculations, evaporite dissolution accounted for the most significant proportion of all sources, with a mean value of 53 %. In addition, human inputs from regular agricultural activities (28 % from sewage and manure and 8 % from fertilizers) constituted another vital source of groundwater salinization associated with extensive agricultural activities in the study area. This study's results can deepen our understanding of the genesis of groundwater salinization and the evolution of the agricultural drainage lake basin. This knowledge will assist the Environmental Protection Department in developing effective policies for groundwater management in the Yellow River Basin.

Incidence and prognosis of olfactory and gustatory dysfunctions related to SARS-CoV-2 Omicron strain infection in China: A national multicenter survey of 35,566 individuals.

Objective: This cross-sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID-19 in China. Methods: This study was conducted by 45 tertiary Grade-A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID-19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders. Results: Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self-reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms. Conclusions: The incidence of dysosmia and dysgeusia following infection with the SARS-CoV-2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS-CoV-2 vaccination, history of head-facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms.

Posterior capsular radial sign: a novel method to confirm anterior vitreous cortex resection in phacovitrectomy.

BACKGROUND: The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body. METHODS: A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery. RESULTS: Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ2 = 7.81, P > 0.05). CONCLUSION: In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.

Anthropogenic processes drive spatiotemporal variability of sulfate in groundwater from a multi-aquifer system: Dilution caused by mine drainage.

The water quality evolution of surface and groundwater caused by mining activities and mine drainage is a grave public concern worldwide. To explore the effect of mine drainage on sulfate evolution, a multi-aquifer system in a typical coal mine in Northwest China was investigated using multi-isotopes (δ34SSO4, δ18OSO4, δD, and δ18Owater) and Positive Matrix Factorization (PMF) model. Before mining, the Jurassic aquifer was dominated by gypsum dissolution, accompanied by cation exchange and bacterial sulfate reduction, and the phreatic aquifers and surface water were dominated by carbonate dissolution. Significant increase in sulfate in phreatic aquifers due to mine drainage during the early stages of coal mining. However, in contrast to common mining activities that result in sulfate contamination from pyrite oxidation, mine drainage in this mining area resulted in accelerated groundwater flow and enhanced hydraulic connections between the phreatic and confined aquifers. Dilution caused by the altered groundwater flow system controlled the evolution of sulphate, leading to different degrees of sulfate decrease in all aquifers and surface water. As the hydrogeochemical characteristic of Jurassic aquifer evolved toward phreatic aquifer, this factor should be considered to avoid misjudgment in determining the source of mine water intrusion. The study reveals the hydrogeochemical evolution induced by mine drainage, which could benefit to the management of groundwater resources in mining areas.

Impact of long-term mining activity on groundwater dynamics in a mining district in Xinjiang coal Mine Base, Northwest China: insight from geochemical fingerprint and machine learning.

Long-term coal mining could lead to a serious of geo-environmental problems. However, less comprehensive identification of factors controlling the groundwater dynamics were involved in previous studies. This study focused on 68 groundwater samples collected before and after mining activities, Self-Organizing Maps (SOM) combining with Principal Component Analysis (PCA) derived that the groundwater samples were classified into five clusters. Clusters 1-5 (C1-C5) represented the groundwater quality affected by different hydrochemical processes, mainly including mineral (carbonate and evaporite) dissolution and cation exchange, which were controlled by the hydrochemical environment at different stages of mining activities. Combining with the time-series data, the Extreme Gradient Boosting Decision Trees (XGBoost) derived that the mine water inflow (feature relative importance of 40.0%) and unit goaf area (feature relative importance of 29.2%) were dominant factors affecting the confined groundwater level, but had less or lagged impact on phreatic groundwater level. This was closely related to the height of the water flow fractured zone and hydraulic connection between aquifers. The results of this study on the coupled evolution of groundwater dynamics could enhance our understanding of the effects of mining on aquifer systems and contribute to the prevention of water hazards in the coalfields.

Bariatric Surgery and Its Metabolic Echo Effect on Serum Uric Acid Levels.

Bariatric surgery (BS) has been a significant means of reducing weight in obese individuals. The metabolic changes after bariatric surgery are crucial as they extend its advantages beyond weight loss. As its name implies, "metabolic surgery" also addresses obesity-related metabolic concerns. Bariatric surgery has always been associated with lessened serum uric acid (SUA) levels. In this review, we examined current studies to understand how surgical therapies impact serum uric acid levels. Strongly minded on the extent and timing of changes in the level of serum uric acid after bariatric surgeries. We conducted a comprehensive search for relevant current studies in PubMed, Google Scholar, JAMA, and the Cochrane Library until February 1, 2024. We aimed to analyze the metabolic advantages of bariatric surgery, focusing on its function in treating hyperuricemia and lowering the risk of associated disorders. Our review elaborates on factors contributing to decreased serum uric acid levels after bariatric surgery, such as alterations in renal function, insulin sensitivity, and inflammatory markers.

The association between gout flares and monosodium urate burden assessed using musculoskeletal ultrasound in patients with gout.

Background: Ultrasound (US) has a high sensitivity in detecting monosodium urate (MSU) deposition in gout patients. However, the value of US in predicting gout flares has been reported only in a few monocentric studies. Objective: To investigate the association between gout flares in the previous year and US-detected MSU burden using two different US scores. Design: A retrospective study. Methods: Patients with gout were consecutively recruited to undergo musculoskeletal US examinations of their knees, ankles, and feet. The score derived from Outcome Measure in Rheumatology (hereinafter referred to as MSU score) and musculoskeletal US features-based (hereinafter referred to as MSKF score) were used to quantify the MSU burden of gout. Odds ratios for frequent gout flares were calculated. Results: We enrolled 1894 patients with gout (mean age: 45 years; gout duration: 5 years; males: 96.1%), experiencing a median of three flares over the past year. Of these, 428 (22.6%) patients reported frequent (⩾7) gout flares. The MSU and MSKF median scores were 6 and 9, respectively. For each five-point increase in MSU and MSKF score, the odds ratio of frequent gout flares increased 1.13-fold and 1.24-fold, respectively. The area under the curve (AUC) for the MSU and MSKF score was 0.635 [95% confidence interval (CI): 0.604-0.665] and 0.688 (95% CI: 0.659-0.718), respectively, (AUC difference 0.054, p value for AUC difference < 0.001). Conclusion: The MSU and MSKF scores were significantly associated with the number of gout flares in the previous year. The MSKF score outperformed the MSU score in terms of frequent gout flare discrimination.

Data Science Applications in Circular Economy: Trends, Status, and Future.

The circular economy (CE) aims to decouple the growth of the economy from the consumption of finite resources through strategies, such as eliminating waste, circulating materials in use, and regenerating natural systems. Due to the rapid development of data science (DS), promising progress has been made in the transition toward CE in the past decade. DS offers various methods to achieve accurate predictions, accelerate product sustainable design, prolong asset life, optimize the infrastructure needed to circulate materials, and provide evidence-based insights. Despite the exciting scientific advances in this field, there still lacks a comprehensive review on this topic to summarize past achievements, synthesize knowledge gained, and navigate future research directions. In this paper, we try to summarize how DS accelerated the transition to CE. We conducted a critical review of where and how DS has helped the CE transition with a focus on four areas including (1) characterizing socioeconomic metabolism, (2) reducing unnecessary waste generation by enhancing material efficiency and optimizing product design, (3) extending product lifetime through repair, and (4) facilitating waste reuse and recycling. We also introduced the limitations and challenges in the current applications and discussed opportunities to provide a clear roadmap for future research in this field.

Efficacy and safety of orlistat in male patients with overweight/obesity and hyperuricemia: results of a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Obesity is associated with elevated serum uric acid (SUA) levels and frequent gout flares. Losing weight can reduce the SUA level and gout flares. The effect of orlistat on SUA levels and gout flares in patients with overweight/obesity and hyperuricemia (HUA) has not been extensively studied. This study investigated the effects of orlistat on SUA levels and gout flares compared to placebo in overweight and obese patients with HUA. METHODS: A total of 72 Chinese patients with overweight/obesity and HUA were randomly divided into a placebo group (35, 48.6%) and an orlistat group (37, 51.4%); the trial lasted 12 weeks. The primary endpoints were the relative changes in body weight, the SUA level, and gout flares in the per-protocol population. RESULTS: Orlistat reduced the proportion of patients with gout flares (log-rank P = 0.023, hazard ratio = 0.31, 95% confidence interval 0.11-0.85). There was no significant difference in SUA level between the two groups. The average weight loss of the orlistat group was 2.85 kg, and the average weight loss of the placebo group was 0.76 kg. The weight loss in the orlistat group was significantly greater than that in the control group (P < 0.05). CONCLUSIONS: This study is the first to demonstrate that orlistat has no significant effect on SUA levels in patients with overweight/obesity and HUA. The utility of orlistat as an adjunct therapy to prevent gout flares during weight loss in patients with HUA was emphasized. TRIAL REGISTRATION: Clinicaltrials.gov NCT05496075.

Correlation Between Impaired Sensitivity to Thyroid Hormones and Serum Uric Acid in Female Patients With Obesity and After Laparoscopic Sleeve Gastrectomy.

OBJECTIVE: An alterable risk factor for hyperuricemia is obesity. Additionally, obese people may have a moderate form of acquired resistance to thyroid hormones. Thyrotropin, thyroid hormones, and obesity all interact subtly. However, the connection between thyroid hormone sensitivity and hyperuricemia in obese patients both before and after laparoscopic sleeve gastrectomy (LSG) has not yet been clarified. The objective of our study was to investigate the connection between impaired thyroid hormone sensitivity and elevated uric acid (UA) levels before and after LSG. METHODS: In total, 1054 euthyroid patients with obesity (481 males, 573 females), 248 (143 female patients) of whom underwent subsequent LSG, were enrolled in this retrospective study. Anthropometric measurements and thyroid hormone and UA levels were taken before and 3 months after LSG. RESULTS: Female patients with obesity with impaired sensitivity to thyroid hormones had higher UA levels (P for trend <.01). The odds ratio of the fourth vs first quartile of thyroid feedback quantile index, thyrotropin index, and thyrotropin-thyroxine resistance index were 4.285 (confidence interval: 1.360-13.507), 3.700 (confidence interval: 1.276-10.729), and 2.839 (confidence interval: 1.014-7.948), respectively, with robust relationships with female hyperuricemia (all P < .05). However, there was only a positive correlation between the decline in UA levels and thyroid feedback quantile index, thyrotropin, and thyrotropin-thyroxine resistance index in female patients following LSG. CONCLUSION: Female hyperuricemia is correlated with higher thyroid hormone resistance index scores. Resistance to thyroid hormones was greatly improved by LSG. The decrease in UA levels after surgery is correlated with the improvement of thyroid hormone resistance after LSG.