Exposure to air pollution, genetic susceptibility, and prevalence of sarcopenia in the UK.

BACKGROUND: The role of environmental factors, particularly air pollutants, in the prevalence of sarcopenia remains unclear. OBJECTIVES: This study explored the relationship between the prevalence of sarcopenia and prolonged exposure to air pollutants, and investigated potential interactions with genetic susceptibility and inflammation. METHODS: Data from 408,117 people at baseline and 35,060 participants in the longitudinal analysis in the UK Biobank were used in this prospective cohort study. Utilizing land use regression models, air pollutants (nitrogen dioxide (NO2), nitric oxides (NOx), and particulate matter with aerodynamic diameters of ≤2.5 µm (PM2.5) and ≤10 µm (PM10) were estimated and classified into quartiles. Alterations in body composition were among the secondary results. RESULTS: Lastly, 3353 people (0.8 %) developed sarcopenia. Higher levels of air pollutants were linked to an increased prevalence of sarcopenia after controlling for confounding variables (highest vs lowest quartile: NOx, OR, 1.21 [95 % CI, 1.16-1.26]; NO2, OR, 1.22 [95 % CI, 1.16-1.27]; PM2.5, OR, 1.17 [95 % CI, 1.12-1.22]; PM10, OR, 1.15 [95 % CI, 1.10-1.20]; all P<.001). Longitudinal analysis revealed that air pollutants had adverse changes in body composition, including increased muscle fat infiltration and decreased muscle mass. At baseline, the probability of sarcopenia was strongly correlated with NOx, NO2, PM2.5, and PM10, and increased with elevated PRSBMI or CRP levels in subgroup analyses. CONCLUSION: Air pollutants may contribute to accelerated muscle aging and highlight the importance of environmental factors in sarcopenia development.

Radiometric calibration of a multiphoton microscope capable of measuring absolute photon flux of single photon sources.

Precise photon flux measurement of single photon sources (SPSs) is essential to the successful application of SPSs. In this work, a novel method, to our knowledge, was proposed for direct measurement of the absolute photon flux of single photon sources with a femtosecond laser multiphoton microscope. A secondary 2-mm-diameter aperture was installed under the microscope objective to define the numerical aperture (NA) of the microscope. The defined NA was precisely measured to be 0.447. An LED-based miniaturized integrating sphere light source (LED-ISLS) was used as a standard radiance source to calibrate the photon flux responsivity of the multiphoton microscope, with the defined NA. The combined standard uncertainty of the measured photon flux responsivity was 1.97%. Absolute photon flux from a quantum-dot based emitter was measured by the multiphoton microscope. The uncertainty of the photon flux was evaluated to be 2.1%. This work offers a new, to our knowledge, radiometric method for fast calibration of photon flux responsivity of microscopes, and absolute photon flux calibration of single photon sources.

Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer.

The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.

The Diagnostic Value of the Systemic Immune-Inflammation Index for Venous Thromboembolism in Lung Cancer Patients: A Retrospective Study.

Background: Venous thromboembolism (VTE) is considered a common complication in lung cancer patients. Despite its widespread use, the Khorana score performed moderately in predicting VTE risk. This study aimed to determine the diagnostic utility of the Systemic Immunoinflammatory Index (SII) and to create a novel nomogram for predicting VTE in patients with pulmonary carcinoma. Materials and Methods: The data, like clinical features and laboratory indicators, of inpatients diagnosed with lung cancer from March 2019 to March 2020 were collected and analyzed. Univariate and multivariate logistic analyses were performed to confirm the risk factors and then construct a nomogram model. The calibration curve and clinical decision curve analysis (DCA) were used to assess the model's fitting performance. The receiver-operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the diagnostic value of SII and the nomogram. Results: This study enrolled 369 lung patients with a VTE morbidity rate of 23.33%. The patients with VTE had higher SII levels than the non-VTE group (1441.47 ± 146.28 vs. 626.76 ± 26.04, P < 0.001). SII is the stronger correlator for VTE among inflammatory markers, of which the optimal cut-off value was 851.51. Univariate and multivariate analysis revealed that the age, metastasis, antitumor treatment, hemoglobin<100 g/L, SII>851.51 × 109/L, and D-dimer>2 folds were independent risk factors for lung cancer-related VTE, and a new prediction nomogram model was constructed based on them. ROC curve analysis showed the AUC of the new model and Khorana score were 0.708 (0.643-0.772) and 0.600 (0.531-0.699). Conclusion: The SII was a simple and valuable biomarker for VTE, and the new nomogram model based on it can accurately forecast the occurrence of VTE. They can be utilized in clinical practice to identify those at high risk of VTE in lung cancer patients.

The correlation between skeletal muscle index of the L3 vertebral body and malnutrition in patients with advanced lung cancer.

BACKGROUND: Studies have shown that the skeletal muscle index at the third lumbar vertebra (L3 SMI) had reasonable specificity and sensitivity in nutritional assessment and prognostic prediction in digestive system cancers, but its performance in lung cancer needs further investigation. METHODS: A retrospective study was performed on 110 patients with advanced lung cancer. The L3 SMI, the Patient-Generated Subjective Global Assessment score (PG-SGA score), body mass index (BMI), and serological indicators were analyzed. According to PG-SGA scores, patients were divided into severe malnutrition (≥9 points), mild to moderate malnutrition (≥3 points and ≤ 8 points), and no malnutrition (≤2 points) groups. Pearson correlation and logistic regression analysis were adopted to find factors related to malnutrition, and a forest plot was drawn. The receiver operating characteristic (ROC) curve was performed to compare the diagnostic values of malnutrition among factors, which were expressed by the area under curve (AUC). RESULTS: 1. The age of patients in the severe malnutrition group, the mild to moderate malnutrition group, and the no malnutrition group significantly differed, with mean ages of 63.46 ± 10.01 years, 60.42 ± 8.76 years, and 55.03 ± 10.40 years, respectively (OR = 1.062, 95%CI: 1.008 ~ 1.118, P = 0.024; OR = 1.100, 95%CI: 1.034 ~ 1.170, P = 0.002). Furthermore, the neutrophil to lymphocyte ratio (NLR) of the severe malnutrition group was significantly higher than that of the no malnutrition group, with statistical significance. The difference between the mild to moderate malnutrition group and the no malnutrition group were not statistically significant, with NLR of 4.07 ± 3.34 and 2.47 ± 0.92, respectively (OR = 1.657,95%CI: 1.036 ~ 2.649, P = 0.035). The L3 SMI of patients in the severe malnutrition and mild to moderate malnutrition groups were significantly lower than that of the patients in the no malnutrition group, with statistical significance. The L3 SMI of patients in the severe malnutrition group, mild to moderate malnutrition group, and no malnutrition group were 27.40 ± 4.25 cm2/m2, 38.19 ± 6.17 cm2/m2, and 47.96 ± 5.02 cm2/m2, respectively (OR = 0.600, 95%CI: 0.462 ~ 0.777, P < 0.001; OR = 0.431, 95%CI: 0.320 ~ 0.581, P < 0.001). 2. The Pearson correlation analysis showed that the PG-SGA score positively correlated with age (r = 0.296, P < 0.05) but negatively correlated with L3 SMI (r = - 0.857, P < 0.05). The L3 SMI was also negatively correlated with age (r = - 0.240, P < 0.05). 3. The multivariate analysis showed that the L3 SMI was an independent risk factor for malnutrition (OR = 0.446, 95%CI: 0.258 ~ 0.773, P = 0.004; OR = 0.289, 95%CI: 0.159 ~ 0.524, P < 0.001). CONCLUSION: 1. The differences in the L3 SMI was statistically significant among advanced lung cancer patients with different nutritional statuses. 2. In the nutritional assessment of patients with lung cancer, the L3 SMI was consistent with the PG-SGA. 3. The L3 SMI is an independent predictor of malnutrition in patients with advanced lung cancer.

Miniaturized integrating sphere light sources based on LEDs for radiance responsivity calibration of optical imaging microscopes.

LED-based integrating sphere light sources (LED-ISLSs) in the size of typical microscope slides were developed to calibrate the radiance responsivity of optical imaging microscopes. Each LED-ISLS consists of a miniaturized integrating sphere with a diameter of 4 mm, an LED chip integrated on a printed circuit board, and a thin circular aperture with a diameter of 1 mm as the exit port. The non-uniformity of the radiant exitance of the LED-ISLSs was evaluated to be 0.8%. The normal radiance of the LED-ISLSs in the range of (5∼69) W m-2 sr-1 was measured with a standard uncertainty of 1.3% using two precision apertures and a standard silicon photodetector whose spectral responsivity is traceable to an absolute cryogenic radiometer. The LED-ISLSs were applied to calibrate the radiance responsivity of a home-built optical imaging microscope with a standard uncertainty of 2.6∼2.9%. The LED-ISLSs offer a practical way to calibrate the radiance responsivity of various optical imaging microscopes for results comparison and information exchange.

Measurement of the distance between two parallel precision apertures using time-of-flight method for cryogenic radiometry.

Time-of-flight method was adopted to measure the distance between two parallel precision apertures utilized in a vacuum chamber for cryogenic radiometry. The diameters of the apertures are 9 mm and 8 mm, respectively. A 1550-nm femtosecond pulse laser, a 70-GHz photodetector, and a 30-GHz oscilloscope were used to measure the round-trip flight time difference between the flat front surfaces of the two precision apertures. The distance between the apertures was analyzed to be 0.36423 m with a relative standard uncertainty of 0.004%. The non-contact distance measurement method is useful for applications such as low background infrared radiance measurement system based on an absolute cryogenic radiometer.

Reversible Solubilization of Pyrene by a Gas Switchable Surfactant Investigated by Molecular Dynamics Simulation.

The reversible solubilization behavior of pyrene by a CO2/N2 switchable surfactant (named N'-dodecyl- N, N-dimethylacetamidinium bicarbonate (DDAB)) was investigated with molecular dynamics (MD) simulations. We first individually simulated the aggregation of the inactive surfactant N'-dodecyl- N, N-dimethylacetamidines (DDA) and effective surfactant DDAB in water. Detailed structural properties analysis showed that DDAB molecules aggregated into a micelle, while the aggregation of DDA molecules was considered to be an oil droplet that was separated from the water phase. MD simulations revealed that pyrene molecule was solubilized in the interior hydrophobic region of the micelle as expected. Pyrene was adsorbed on the surface of the oil droplet which is due to the dense packing of DDA molecules inside the oil droplet. The simulated release process showed that the solubilized pyrene in the interior was squeezed out when the micelle was changed to an oil droplet. Reduced density gradient (RDG) function was used to study the weak interactions and explore the molecular driving force behind the reversible solubilization. The results demonstrated that repulsion effects of water molecules on the DDA headgroups play an important role on the pyrene release. Because of the persistent molecular motion of DDA molecules into the droplet center, pyrene was finally repelled out of the oil droplet. Our study provided a molecular mechanism into the reversible solubilization of a gas-controlled switchable surfactant. This is expected to be useful for surfactant-enhanced remediation (SER) experiments.

A New Method of Directing Endoscope Pathway in Single-Nostril Transpheoidal Approach for Safety by Using Volume Rendering With Thin-Section Computed Tomographic Image.

OBJECTIVE: This study aims to locate important structures surrounding the sella node and measure the distances and angles between signalized points by using both three-dimensional reconstruction technique and volume-rendering. These distances and angles can provide more accurate reference for surgeries in pituitary adenomas. METHODS: Ninty volunteers' skulls were scanned and thin-section computed tomographic images were displayed. The highest point of saddle node on double sides were marked as point A (right) and A1 (left), the highest point of posterior Clinton process on double side as B (right) and B1 (left). And the point of alas minor ossis sphenoridalis with sohenoidal creast was marked as point O. For the latter can not been distinguished in images, point O was used to replace the anterior nasal spine, which can accurately locate the median sagittal plane. The result of three-dimensional reconstruction is used to measure the distance between O and A, A1, B, B1 and angles between OA, OA1, OB, OB1 and their projection line on the standard horizontal plane (α, α1, ß, ß1). Analyzing the difference by examining the significance difference between both sides can also help the authors to determine whether there is a symmetric difference. RESULTS: The distance of OA was measured as 23.2 (6.5) mm [range, 11.2-45.2 mm; 95% confidence interval (CI), 21.9-24.4 mm]. The distance of OA1 was measured as 23.4 (5.7) mm (range, 9.9-47.2 mm; 95% CI, 22.2-24.6 mm). The distance of OB was measured as 31.1 (5.5) mm (range, 17.8-45.2 mm; 95% CI, 30.0-32.2 mm). The distance of OB1 was measured as 31.2 (6.0) mm (range, 10.1-47.8 mm; 95% CI, 30.0-32.5 mm). The angle of α was measured as 81.1 (10.0)° (range, 60-137.5°, 95% CI, 79.0-83.2°). The angle of α1 was measured as 81.3 (8.5)° (range, 60-97.4°, 95% CI, 79.5-83.1°). The angle of ß was measured as 91.5 (5.2)° (range, 74.9-102.2°, 95% CI, 90.5-92.6°). The angle of ß1 was measured as 91.0 (6.6)° (range, 74.7-104.7°, 95% CI, 89.2-92.0°). CONCLUSIONS: The above results can facilitate the location of these structures and minimize surgical trauma to optic chiasm and carotid artery surrounding. The method is especially effective in promising more secure and accurate direction to guide surgeons during surgeries in pituitary adenomas.

Three-dimensional anatomic analysis of retrosigmoid approach with thin-section computed tomographic image.

OBJECTIVE: This study aimed to locate and measure the distances between important structures of the retrosigmoid approach using both three-dimensional reconstruction technique and volume-rendering technique. METHODS: We scanned skulls of 120 volunteers to get the final result with thin-section computed tomographic image. RESULTS: The distance of AC was measured as 39.46 (4.22) mm (range, 15.80-50.80 mm; 95% confidence interval (CI), 38.69-40.22 mm). The diameter of internal auditory pore was measured as 5.39 (0.77) mm (range, 3.40-8.20 mm; 95% CI, 5.25-5.53 mm). The distance of AB was measured as 41.10 (4.22) mm (range, 34.90-51.30 mm; 95% CI, 39.43-42.77 mm). The distance of BC was measured as 5.93 (1.31) mm (range, 4.10-7.50 mm; 95% CI, 5.70-6.17 mm). The vertical distance was measured as 2.33 (0.26) mm (range, 1.87-2.80 mm; 95% CI, 2.23-2.42 mm). CONCLUSIONS: These abovementioned results can help to locate these structures to help in minimizing surgical trauma to the nerve and blood vessels.

Morphologic measure of retrosigmoid approach using volume rendering with thin-section computed tomography.

OBJECTIVE: The objective of this study was to research the jugular foramen, internal auditory pore, and the turning point between its components using imageological methods and provide theoretical basis for retrosigmoid approach. METHODS: A total of 100 cases of adult hip computed tomographic scans were reconstructed. α, ß, AC, AB, BC, and the shortest distance were measured. RESULTS: The angle α was measured as 39.50 (4.74) degrees (range, 29.3-48.5 degrees; 95% confidence interval [CI], 38.64-40.35 degrees). The angle ß was measured as 46.35 (5.51) degrees (range, 31.09-64.74 degrees; 95% CI, 45.35-47.35 degrees). The distance of AC was measured as 44.94 (3.84) mm (range, 34.9-54.9 mm; 95% CI, 44.25-45.64 mm). The distance of AB was measured as 43.68 (4.56) mm (range, 33.8-54.7 mm; 95% CI, 42.86-44.51 mm). The distance of BC was measured as 6.15 (2.04) mm (range, 2.7-14.7 mm; 95% CI, 5.78-6.52 mm). The safe distance was measured as 5.21 (0.23) mm (range, 0.84-12.92 mm; 95% CI, 5.17-5.25 mm). CONCLUSIONS: These previously mentioned results can help to locate these structures in the measurement plane and provide reference for surgery.

Effect of teacher-student relationship on academic engagement: the mediating roles of perceived social support and academic pressure.

Although previous research has established that a strong teacher-student relationship can enhance students' academic engagement, the mechanisms underlying this effect remain less explored. Therefore, this study examined the mediating roles of perceived social support and academic pressure in the association between teacher-student relationship and academic engagement. A survey involving 1,058 Chinese university students was conducted, with teacher-student relationship, perceived social support, academic pressure, and academic engagement being the evaluated factors. The results of structural equation modeling revealed that (a) teacher-student relationship directly and positively associated academic engagement, (b) teacher-student relationship indirectly and positively associated academic engagement through perceived social support, and (c) teacher-student relationship indirectly and positively associated academic engagement through both perceived social support and academic pressure. These results indicate that perceived social support and academic pressure are the primary factors mediating the effect of teacher-student relationship on academic engagement among university students.

Association Between Cardiovascular Health and Retinopathy in US Adults: From NHANES 2005-2008.

PURPOSE: Investigating the relationship between cardiovascular health (CVH) and retinopathy in the adult population of the United States. DESIGN: The cross-sectional study. METHODS: The study utilized samples, including the diabetes population, from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2008 (N= 4249), to assess cardiovascular health (CVH) using the Life's Essential 8 (LE8) assessment. Retinopathy is determined through imaging assessment by professionals independently grading fundus photographs. Univariable and multivariable weighted logistic regression models, restricted cubic splines (RCS), subgroup analysis and weighted quantile sum (WQS) regression approaches were employed to assess the association between LE8 score-based CVH status and retinopathy. The mediation analysis was conducted to investigate whether serum albumin levels mediated the relationship between LE8 score and retinopathy. RESULTS: In a fully adjusted logistic regression model, participants in the moderate and high CVH groups had a 39% (odds ratio (OR) 0.61, 95% confidence interval (CI) 0.43-0.87, P-value = 0.01) and 56% (OR 0.44, 95% CI 0.25-0.77, P-value < 0.001) lower odds of developing retinopathy compared to the low CVH group. The RCS model indicates a significant non-linear relationship between CVH and retinopathy. The WQS regression analysis suggests that blood glucose (47.65%) and blood pressure (19.41%) have the highest weights in relation to retinopathy. Mediation analysis suggests that serum albumin partially mediates the relationship between LE8 scores and retinopathy. CONCLUSION: This study demonstrates a significant negative correlation between overall cardiovascular health measured by LE8 scores and retinopathy. Public health strategies that promote achieving optimal cardiovascular health indicators may help reduce the burden of retinal microvascular diseases.

Association of Life's Essential 8 with metabolic dysfunction-associated steatotic liver disease (MASLD), a cross-sectional study from the NHANES 2003-2018.

There is limited research on the relationship between Life's Essential 8 (LE8) score and metabolic dysfunction-associated steatotic liver disease (MASLD). Our aim is to investigate the relationship between overall lifestyle assessed by LE-8 score and MASLD in a nationally representative sample. We employed the LE8 score to comprehensively evaluate cardiovascular health, the assessment of MASLD primarily utilized the Fatty Liver Index. The weighted logistic regression models, restrictive cubic splines (RCS), subgroup analyses and the weighted quantile sum (WQS) regression were used to evaluate the relationship between the cardiovascular health and MASLD. Logistic regression models revealed that higher LE8 scores were associated with lower odds of having MASLD. The RCS revealed a significant nonlinear dose-response relationship between LE8 scores and MASLD. The WQS regression model indicated that blood glucose contributed the most to the risk of MASLD. The subgroup analysis indicates that there are significant differences in this association across age, educational level, and poverty income ratio. Our study suggests that an inverse correlation between LE8 and the risk of MASLD. Our findings underscore the utility of the LE8 algorithm in MASLD risk assessment and provide support for MASLD prevention through the promotion of healthy lifestyles.

CT-based muscle and adipose measurements predict prognosis in patients with digestive system malignancy.

The role of skeletal muscle and adipose tissue in the progression of cancer has been gradually discussed, but it needs further exploration. The objective of this study was to provide an in-depth analysis of skeletal muscle and fat in digestive malignancies and to construct novel predictors for clinical management. This is a retrospective study that includes data from Cancer Center, the First Hospital of Jilin University. Basic characteristic information was analyzed by T tests. Correlation matrices were drawn to explore the relationship between CT-related indicators and other indicators. Cox risk regression analyses were performed to analyze the association between the overall survivals (OS) and various types of indicators. A new indicator body composition score (BCS) was then created and a time-dependent receiver operating characteristic curve was plotted to analyze the efficacy of the BCS. Finally, a nomogram was produced to develop a scored-CT system based on BCS and other indicators. C-index and calibration curve analyses were performed to validate the predictive accuracy of the scored-CT system. A total of 575 participants were enrolled in the study. Cox risk regression model revealed that VFD, L3 SMI and VFA/SFA were associated with prognosis of cancer patients. After adjustment, BCS index based on CT was significantly associated with prognosis, both in all study population and in subgroup analysis according to tumor types (all study population: HR 2.036, P < 0.001; colorectal cancer: HR 2.693, P < 0.001; hepatocellular carcinoma: HR 4.863, P < 0.001; esophageal cancer: HR 4.431, P = 0.008; pancreatic cancer: HR 1.905, P = 0.016; biliary system malignancies: HR 23.829, P = 0.035). The scored-CT system was constructed according to tumor type, stage, KPS, PG-SGA and BCS index, and it was of great predictive validity. This study identified VFD, L3 SMI and VFA/SFA associated with digestive malignancies outcomes. BCS was created and the scored-CT system was established to predict the OS of cancer patients.

Inflammation mediates the relationship between diet quality assessed by healthy eating index-2015 and metabolic syndrome.

Background: Metabolic syndrome is a cluster of metabolic disorders, including obesity, hypertension, hyperglycemia, and abnormal lipid levels. However, researches on the association between overall dietary quality measured by the Healthy Eating Index-2015 (HEI-2015) and the risk of metabolic syndrome is still lacking. Methods: This study utilized data from four cycles (2011-2018) of the National Health and Nutrition Examination Survey (NHANES) database, including 17,582 participants. Logistic regression analysis was employed to explore the correlation between HEI and the risk of metabolic syndrome. Additionally, mediation analysis was conducted to examine the effects of Systemic Immune-Inflammation Index (SII) and serum uric acid as potential mediators between HEI and metabolic syndrome risk. Weighted quantile sum (WQS) regression evaluated the composite exposure impact of the 13 components of the HEI on metabolic syndrome, as well as the proportion of their weights. Results: Higher dietary quality measured by HEI-2015 (at the 75th percentile) was negatively correlated with the risk of metabolic syndrome (OR=0.80, 95%CI=0.72-0.89, P=0.003). Higher SII and serum uric acid levels were identified as risk factors for metabolic syndrome (P for trend<0.001). Approximately 37.5% of the effect of HEI on metabolic syndrome occurrence was mediated by SII (Indirect effect=-0.002, 95%CI (-0.003,-0.001), Direct effect=-0.022, 95%CI (-0.0273,-0.015)). Additionally, 25% of the effect of HEI on metabolic syndrome occurrence was mediated by serum uric acid levels (Indirect effect=-0.006, 95%CI (-0.010,-0.012), Direct effect=-0.024, 95%CI (-0.041,-0.009)). WQS regression analysis revealed the highest weighted proportions for seafood and plant proteins (25.20%) and sodium (17.79%), while the weight for whole fruit was the lowest (0.25%). Conclusion: Better dietary quality measured by HEI-2015 was associated with a lower likelihood of metabolic syndrome. Higher SII and serum uric acid levels were identified as risk factors for metabolic syndrome and potential mediators.

Associations of micronutrient dietary patterns with sarcopenia among US adults: a population-based study.

Background: Current epidemiological evidence points to an association between micronutrient (MN) intake and sarcopenia, but studies have focused on single MN, and no combined effects on MNs have been reported. The aim of this study was to investigate the relationship between different MN intake patterns and sarcopenia and skeletal muscle mass. Methods: We performed a population-based cross-sectional study, with a total of 5,256 U.S. adults aged 20-59 years, and we collected total daily MN intake and appendicular skeletal muscle mass measured by Dual-Energy X-ray Absorptiometry (DXA). Principal component analysis (PCA) was used to obtain nutrient patterns and principal component scores based on the intake of 14 MNs, and logistic regression analysis was used to assess the effects of single MN and MN intake patterns on sarcopenia and muscle mass. Results: We defined three MN intake patterns by PCA: (1) adherence to VitB-mineral, high intake of vitamin B and minerals; (2) adherence to VitAD-Ca-VB12, high intake of vitamin A, vitamin D, calcium and vitamin B12; and (3) adherence to Antioxidant Vit, high intake of antioxidant vitamins A, C, E, and K. These three nutrient patterns explained 73.26% of the variance of the population. A negative association was observed between most single MN intakes and sarcopenia, and after adjusting for confounders, adherence to the highest tertile of the three nutrient patterns was associated with a lower risk of sarcopenia and relatively higher skeletal muscle mass compared to the lowest adherence. In subgroup analysis, MN intake patterns were significantly correlated with sarcopenia in middle-aged females. Conclusion: Nutritional patterns based on MN intake were significantly related to sarcopenia, indicating that MNs interact with each other while exerting their individual functions, and that MN dietary patterns may provide promising strategies for preventing the loss of muscle mass, with further prospective studies warranted in the future.

Vitamin B6 Turnover Predicts Long-term Mortality Risk in Patients with Type 2 Diabetes.

Background: Inflammation can increase vitamin B6 uptake and catabolism. Higher vitamin B6 turnover [4-pyridoxic acid (4-PA)/pyridoxal 5'-phosphate (PLP) ratio], was associated with mortality risk in the general population. Objectives: We aimed to investigate the association between 4-PA/PLP and long-term mortality in patients with type 2 diabetes mellitus (T2DM), an inflammatory disease. Methods: In this prospective cohort study from the National Health and Nutrition Examination Survey (NHANES) cycles 2005-2010, the concentrations of 4-PA and PLP in plasma were measured using high-performance liquid chromatography, with mortality data updated to 31 December 2019. We included 2074 patients with T2DM aged between 20 and 85 y at baseline. Results: There were 739 deaths among 2279 patients with T2DM with a median follow-up of 11.83 y. In the age- and sex-adjusted COX model (model 1), 4-PA/PLP was positively associated with mortality in patients with T2DM [hazard ratio (HR) and 95% confidence interval (CI) highest compared with lowest quartiles: 35.55 (18.29, 69.09); P < 0.001], and in model 3, which was adjusted for demographics as well as inflammation, nutrition, and renal function, high 4-PA/PLP concentrations remained an independent risk factor for mortality in patients with T2DM [HR (95% CI) highest compared with lowest quartiles: 5.03 (2.46, 10.30); P < 0.001]. In restricted cubic spline (RCS), the link between 4-PA/PLP and all-cause mortality displays a positive correlation. Patients with died within the previous 2 y were excluded, the sensitivity analysis had no effect on the association between 4-PA/PLP and mortality in patients with T2DM. Finally, comparable results were found in subgroup analyses of specific-cause mortality. Conclusion: Higher vitamin B6 turnover is associated with long-term mortality risk in patients with T2DM. 4-PA/PLP may serve as a convenient prognostic marker in T2DM management.

Serum klotho as a novel biomarker for metabolic syndrome: findings from a large national cohort.

Background: Metabolic syndrome is a cluster of metabolic abnormalities that significantly increase the risk of cardiovascular disease and mortality. The identification of novel biomarkers associated with mortality in patients with metabolic syndrome could facilitate early risk stratification and targeted interventions. Methods: We conducted a large prospective cohort study using data from five cycles (2009-2016) of the National Health and Nutrition Examination Survey (NHANES) database, including a total of 40,439 participants. Logistic regression analysis was used to assess the association between serum klotho protein levels and metabolic syndrome, while Cox regression analysis was employed to examine the correlation between serum klotho levels and all-cause mortality. Mortality data were updated until December 31, 2019. Results: After adjusting for demographic and socioeconomic confounders, the logistic regression model demonstrated that higher serum klotho levels were significantly associated with a decreased prevalence of metabolic syndrome (OR [95% CI] Highest vs. lowest quartile: 0.84 [0.70-0.99], P=0.038). In the Cox regression model, elevated klotho levels were found to significantly reduce the risk of all-cause mortality among individuals with metabolic syndrome (HR [95% CI] Highest vs. lowest quartile: 0.68 [0.51-0.90], P=0.006). Conclusion: Serum klotho levels were found to be inversely associated with the prevalence of metabolic syndrome, independent of potential confounding factors such as demographics, socioeconomic status, and lifestyle factors. Furthermore, higher klotho levels strongly indicated a lower risk of all-cause mortality in individuals with metabolic syndrome.

Revisiting the mechanisms linking blood glucose to cognitive impairment: new evidence for the potential important role of klotho.

Background: The association between blood glucose and cognition is controversial. Klotho is an anti-aging protein with neural protective effects. This study aimed to use a population-based study to disentangle the relationship between blood glucose levels and cognitive function in older adults, and to explore the role of klotho in it. Methods: A total of 1445 eligible participants from National Health and Nutrition Examination Survey (NHANES) 2011-2014 were included in our study. Cognitive function was assessed by Digit Symbol Substitution Test (DSST) and categorized into four quartiles (Q1-Q4). General characteristics and laboratory test results including serum klotho concentration and blood glucose levels were collected. Associations of cognitive function and klotho levels with blood glucose concentrations were explored through multivariate linear regression models. Mediation models were constructed to figure out the mediating role of klotho. Results: All three multivariate linear regression models showed a negative correlation between blood glucose and cognitive function. (Model 1, ß=-0.149, 95%CI: -0.202,-0.096, p=0.001; Model 2, ß=-0.116, 95%CI: -0.167,-0.065, p=0.001; Model 3, ß=-0.007, 95%CI: -0.118,-0.023, p=0.003). Mediation analysis showed that klotho mediated the statistical association between blood glucose level and cognitive function with proportions (%) of 12.5. Conclusion: Higher blood glucose levels are associated with poorer cognitive performance in non-diabetic older adults, partially mediated through lower klotho levels.