Relationship between residual cholesterol and cognitive performance: a study based on NHANES.

Background and aims: Age-related cognitive impairment impacts a significant portion of the elderly population. Remnant cholesterol (RC) has attracted increased attention in relation to cardiovascular disease, diabetes, hypertension, and fatty liver disease. Nevertheless, its role in cognitive function is still enigmatic, prompting our exploration into the potential associations between them. Methods: A total of 1,331 participants from the NHANES (2011-2014) database, all aged over 60, were included in this investigation. Cognitive function was assessed using four widely applied tests, including the Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL), CERAD Delayed Recall (CERAD-DR), Animal Fluency Test (AFT), as well as Digit Symbol Substitution test (DSST). Z-score is calculated by scores from the above four tests. The association between RC, total cholesterol (TC) to RC and cognitive performance was assessed by logistic regression analyses. In addition, restricted cubic spline (RCS) regression was performed to assess non-linearity between RC and cognitive function. Subgroup analysis was performed to evaluate the robustness of the results in populations with relevant covariate variables. Results: Those with Z-scores below the 25% quartile are defined as having cognitive impairment, totaling 498 individuals. Observationally, higher RC levels and a lower TC/RC were associated with an increased risk of cognitive impairment. After adjusting for confounding factors, the impact of RC levels on cognitive performance quartiles was consistent across various subgroups, except in individuals with trouble sleeping, no/unknown alcohol use, and no hypertension. Americans with high RC levels and trouble sleeping are more likely to develop cognitive impairment, with an odds ratio of 2.33 (95% CI: 1.18-4.59). Conclusion: This study suggests that higher RC levels and lower levels of TC/RC are associated with an increased likelihood of cognitive impairment, suggesting that RC can serve as a novel and convenient indicator for predicting the risk of cognitive impairment in the US population.

Association between sarcopenia and sleep disorders: a cross-sectional population based study.

Objective: Sleep disorders is a worldwide public health problem. We sought to examine the association between sarcopenia, a decline in skeletal muscle mass and function, and sleep disorders within the adult demographic of the United States during the period spanning 2011 to 2018. Methods: Diagnosis of sarcopenia and sleep disorders was ascertained through appropriate calculations and a structured questionnaire. The primary correlation analysis was conducted using a weighted multivariate logistic regression model. Furthermore, to confirm the presence of a potential non-linear association between sarcopenia and sleep disorders, additional analyses were performed using multivariate logistic regression and restricted cubic spline (RCS) regression with dose-response curve analysis. Subgroup analyses were also conducted to explore the influence of relevant socio-demographic factors and other covariates. Results: The final analysis encompassed 5,616 participants. Model 4, inclusive of all pertinent covariates, revealed a positive correlation between sarcopenia and sleep disorders, yielding an odds ratio (OR) of 1.732 (95% CI: 1.182-2.547; P = 0.002). Further analysis, utilizing the restricted cubic spline model, indicated a decreasing trend in sleep disorders as sarcopenia indices rose. Stratified analyses across diverse variables underscored the significant impact of sarcopenia on sleep disorders prevalence in several subgroups. Specifically, males, individuals aged 40 and above, non-Hispanic whites, those with high school education or equivalent, unmarried individuals, obese individuals (BMI ≥ 30), alcohol drinkers, former smokers, diabetics, and those engaging in less rigorous recreational activities exhibited a more pronounced association between sarcopenia and sleep disorders. The incidence of sleep disorders exhibited an upward trend as the incidence of sarcopenia declined among study participants. Conclusions: In summary, our study provides evidence of an association between sarcopenia and the prevalence of sleep disorders, with a negative correlation observed between the sarcopenia index and the odds ratio of sleep disorders. These findings suggest that maintaining optimal muscle mass may have a beneficial impact on sleep-related issues. In terms of exploring the mechanisms underlying the relationship between sarcopenia and sleep disorders, more in-depth research is warranted to ascertain the definitive causal relationship.

Adjuvant Chemoradiation Therapy Versus Chemotherapy Alone for Resected Oligodendroglioma: A Surveillance, Epidemiology and End Results (SEER) Analysis.

OBJECTIVE: The benefit of postoperative adjuvant therapy for survival of oligodendrocyte glioma remains unclear. In this study, we compared the effect of chemoradiation therapy (CRT) and chemotherapy (CT) alone in patients who underwent resection. We aim to identify which adjuvant therapy provides more survival benefits. METHODS: We identified patients who underwent oligodendroglioma resection in the Surveillance, Epidemiology and End Results (SEER) database. A multivariate Cox regression analysis was used to evaluate the factors affecting survival rates. We used a propensity matching analysis to minimize selection bias in each group. We performed subgroup analyses based on patients' clinical characteristics. RESULTS: This study identified 1826 patients who received adjuvant CT (n = 503) or adjuvant CRT (n = 1323). On multivariate analysis, elderly, white and other race, and temporal lobe and parietal lobe tumor site were independent risk factors for improved overall survival (OS). After 1:1 propensity match, we included 501 patients who received CT and 501 with CRT. Patients in the CT group showed improved overall survival rate compared with those who received CRT (median OS: 146 months vs. 111 months). Subgroup analysis showed that improved overall survival in CT group was more significant in patients who were younger or older, male or female, white race, frontal lobe and parietal lobe tumor site, smaller tumor size (≤4 cm), and with gross total resection (GTR) (P < 0.05). CONCLUSIONS: In patients with resected oligodendroglioma, adjuvant CT is associated with better survival compared to adjuvant CRT. The benefit was more significant in patients who were younger and older, male and female, white race, frontal lobe and parietal lobe tumor site, smaller tumor size (≤4 cm), and with GTR.

Autologous platelet-rich plasma intrauterine perfusion to improve pregnancy outcomes after implantation failure: A systematic review and meta-analysis.

AIMS: Previous studies have reported inconsistent findings on the efficacy of platelet-rich plasma (PRP) therapy in women with implantation failure. The objective of this review was to evaluate whether PRP administration could improve pregnancy outcomes in women with implantation failure undergoing in vitro fertilization. METHODS: Electronic databases were searched for studies that explored the effects of PRP for patients with implantation failure. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Based on the available data, we performed subgroup analyses and sensitivity analyses. RESULTS: Eight studies were included. PRP treatment improved pregnancy outcomes for all women compared with no treatment or placebo (clinical pregnancy rate: OR 2.24, 95% CI 1.41-3.54; live birth rate: OR 5.76, 95% CI 1.55-21.44; miscarriage rate: OR 0.18, 95% CI 0.05-0.63), especially in randomized controlled trials. No significant differences were detected in multiple pregnancy rates (OR 2.54, 95% CI 0.67-9.67). Furthermore, subgroup analysis based on the number of previous implantation failures showed that PRP treatment improved pregnancy outcomes in women with recurrent implantation failure (clinical pregnancy rate: OR 2.55, 95% CI 1.49-4.38; live birth rate: OR 5.07, 95% CI 1.15-22.34; miscarriage rate: OR 0.20, 95% CI 0.05-0.78). CONCLUSION: PRP administration could improve pregnancy outcomes in women with recurrent implantation failure. Due to the limited evidence available, the efficacy of PRP in women with recurrent implantation failure needs to be further verified in high-quality studies with larger sample sizes.