Adherence to dietary guide for elderly adults and health risks of older adults in ethnic minority areas in China: a cross-sectional study.

BACKGROUND: The impact of dietary guidelines on health in ethnic minority regions needs to be further explored because of multiple sociocultural factors. Therefore, this study was conducted to analyze the association between adherence to dietary guidelines and health risks in an elderly population in an ethnic minority region. METHODS: A cross-sectional survey was conducted among 836 older adults in ethnic minority areas. They were asked to describe their daily dietary intake levels through a semi-quantitative food frequency questionnaire. The closeness coefficient for each study subject was calculated by using the technique for order preference by similarity to an ideal solution (TOPSIS), which measures the adherence to Dietary Guide for Elderly Adults (DGEA). Regression models were used to analyze the association between adherence and health risks. RESULTS: The daily food of the elderly in this area comprised cereals and vegetables. They had low intake of milk, dairy products, and water and high intake of salt. The closeness coefficient for the total population was 0.51, and the adherence of this population to dietary guidelines for the elderly was low. In both the crude model and the models adjusted for covariates, the closeness coefficient was not significantly associated with clinical indicators and health outcomes (p > 0.05). CONCLUSIONS: No association was found between adherence to large sample-based dietary guidelines and clinical indicators or health outcomes in ethnic minority populations. The applicability of dietary guidelines to ethnic minority areas and whether they yield the expected health benefits require further study.

Spectrochemical determination of effects on rat liver of binary exposure to benzo[a]pyrene and 2,2',4,4'-tetrabromodiphenyl ether.

Benzo[a]pyrene (B[a]P) and polybrominated diphenyl ethers (PBDEs) are persistent environmental contaminants. The effects in organisms of exposures to binary mixtures of such contaminants remain obscure. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy is a label-free, non-destructive analytical technique allowing spectrochemical analysis of macromolecular components, and alterations thereof, within tissue samples. Herein, we employed ATR-FTIR spectroscopy to identify biomolecular changes in rat liver post-exposure to B[a]P and BDE-47 (2,2',4,4'-tetrabromodiphenyl ether) congener mixtures. Our results demonstrate that significant separation occurs between spectra of tissue samples derived from control versus exposure categories (accuracy = 87%; sensitivity = 95%; specificity = 79%). Additionally, there is significant spectral separation between exposed categories (accuracy = 91%; sensitivity = 98%; specificity = 90%). Segregation between control and all exposure categories were primarily associated with wavenumbers ranging from 1600 to 1700 cm-1 . B[a]P and BDE-47 alone, or in combination, induces liver damage in female rats. However, it is suggested that binary exposure apparently attenuates the toxic effects in rat liver of the individual contaminants. This is supported by morphological observations of liver tissue architecture on hematoxylin and eosin (H&E)-stained liver sections. Such observations highlight the difficulties in predicting the endpoint effects in target tissues of exposures to mixtures of environmental contaminants.

Correlation between urinary contents of some metals and fasting plasma glucose levels: A cross-sectional study in China.

Many metals are involved in the pathogenesis of diabetes, but most of existing studies focused on single metals. The study of mixtures represents real-life exposure scenarios and deserves attention. This study aimed to explore the potential relationship of urinary copper (Cu), zinc (Zn), arsenic (As), selenium (Se), and strontium (Sr) contents with fasting plasma glucose (FPG) levels in 2766 participants. The levels of metals in urine were determined by inductively coupled plasma-mass spectrometry. We used linear regression models and the Bayesian kernel machine regression (BKMR) to evaluate the association between metals and FPG levels. In the multiple metals linear regression, Zn (ß = 0.434), Se (ß = 0.172), and Sr (ß = -0.143) showed significant association with FPG levels (all P < 0.05). The BKMR model analysis showed that the results of single metal association were consistent with the multiple metals linear regression. The mixture of five metals had a positive over-all effect on FPG levels, and Zn (PIP = 1.000) contributed the most to the FPG levels. Cu and As were negatively correlated with FPG levels in women. The potential interaction effect between Cu and Sr was observed in participants aged ≥ 60 years old (Pinteraction = 0.035). In summary, our results suggested that multiple metals in urine are associated with FPG levels. Further studies are needed to confirm these findings and clarify the underlying mechanisms.

Association between oil tea intake and the risk of type 2 diabetes in adults: A cross-sectional study in Gongcheng, Guangxi, China.

BACKGROUND AND OBJECTIVES: The associations between oil tea and type 2 diabetes (T2D) have been little studied in the population. This study aimed to evaluate whether oil tea intake is related to the reduced risk of T2D in adults. METHODS AND STUDY DESIGN: A rural-based cross-sectional study was conducted in Gongcheng Yao Autonomous County, Guangxi, southern China (2018-2019), with a total of 3178 population included in the final analysis. A multivariable logistic regression model was used to analyze the associations between the intake frequency, daily intake of oil tea and the risk of T2D. We further compared the association differences between the daily intake of oil tea and the risk of diabetes under different dietary patterns, which were generated from food frequency intake data using principal factor analysis. RESULTS: The differences in the frequency and daily intake of oil tea in both groups (diabetes group and the non-diabetes group) were statistically significant (p<0.05). After adjusting for age, sex, smoking status, physical activity, body mass index (BMI), compared with non-oil tea drinkers, intake ≥3 times /d had an inverse association with T2D (OR=0.417; 95% CI: 0.205-0.848, p<0.05); while daily intake of more than 600 mL/d but less than 900 mL/d was significantly associated with reduced T2D risk (OR=0.492; 95% CI: 0.284-0.852, p=0.011). In the Chinese traditional dietary and the plant-based dietary model, compared with the non-oil tea drinkers, the fourth intake group had a lower risk of diabetes, with an OR (95%CI) value of 0.500 (0.291-0.854) and 0.505 (0.298-0.855), respectively, but no statistical significance (All p>0.05). CONCLUSIONS: Our study suggests that oil tea was associated with a reduced risk of T2D aged 30 years or older.

An analysis of spatiotemporal pattern for COIVD-19 in China based on space-time cube.

This study seeks to examine and analyze the spatial and temporal patterns of 2019 novel coronavirus disease (COVID-19) outbreaks and identify the spatiotemporal distribution characteristics and changing trends of cases. Hence, local outlier analysis and emerging spatiotemporal hot spot analysis were performed to analyze the spatiotemporal clustering pattern and cold/hot spot trends of COVID-19 cases based on space-time cube during the period from 23 January 2020 to 24 February 2020. The main findings are as follows: (1) The outbreak had spread rapidly throughout the country within a short time and the current totality incidence rate has decreased. (2) The spatiotemporal distribution of cases was uneven. In terms of the spatiotemporal clustering pattern, Wuhan and Shiyan city were the center as both cities had high-high clustering pattern with a surrounding unstable multiple-type pattern in partial areas of Henan, Anhui, Jiangxi, and Hunan provinces, and Chongqing city. Those regions are continuously in the hot spot on the spatiotemporal tendency. (3) The spatiotemporal analysis technology based on the space-time cube can analyze comprehensively the spatiotemporal pattern of epidemiological data and produce a visual output of the consequences, which can reflect intuitively the distribution and trend of data in space-time. Therefore, the Chinese government should strengthen the prevention and control efforts in a targeted manner to cope with a highly changeable situation.

Effects of Benzo (a) Pyrene and 2,2',4,4'-Tetrabromodiphenyl Ether Exposure on the Thyroid Gland in Rats by Attenuated Total Reflection Fourier-Transform Infrared Spectroscopy.

Benzo[a]pyrene (B[a]P) and 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) are widespread environmental pollutants and can destroy thyroid function. We assessed the biochemical changes in the thyroid tissue of rats exposed to B[a]P and BDE-47 using attenuated total reflection Fourier-transform infrared spectroscopy combined with support vector machine(SVM). After B[a]P and BDE-47 treatment in rats, the structure of thyroid follicles was destroyed and epithelial cells were necrotic, indicating that B[a]P and BDE-47 may lead to changes of the thyroid morphology of the rats. These damages are mainly related to C=O stretch vibrations of lipids (1743 cm-1), as well as the secondary structure of proteins [amide I (1645 cm-1) and amide II (1550 cm-1)], and carbohydrates [C-OH (1138 cm-1), C-O (1106 cm-1, 1049 cm-1, 991 cm-1), C-C (1106 cm-1) stretching] and collagen (phosphodiester stretching at 922 cm-1) vibration modes. When SVM was used for classification, there was a substantial separation between the control and the exposure groups (accuracy = 96%; sensitivity = 98%; specificity = 87%), and there was also a major separation between the exposed groups (accuracy = 93%; sensitivity = 94%; and specificity = 92%).

Association of Dietary and Plasma Magnesium with Glycaemic Markers in a Chinese Population.

Certain metals play a role in the pathogenesis of diabetes. This study aimed to investigate the potential association of plasma magnesium (Mg) and dietary intake of Mg with glycaemic markers. A cross-sectional study was conducted on 2373 subjects in Guangxi, China. Dietary Mg was obtained through a food frequency questionnaire containing 109 common foods. Plasma Mg concentration was determined by inductively coupled plasma mass spectrometry. Multiple linear regression combined with multivariable restricted cubic spline (RCS) functions was applied to evaluate the association of plasma Mg and dietary Mg with haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG). In linear regression, dietary Mg was significantly associated with FPG in the overall population (ß = - 0.087, P < 0.05) and in women (ß = - 0.098, P < 0.05). Plasma Mg was significantly associated with FPG in the overall population (ß = - 0.096, P < 0.05) and in men (ß = - 0.110, P < 0.05) and women (ß = - 0.088, P < 0.05). In the RCS model, no non-linear association was found between dietary and plasma Mg and HbA1c levels. Dietary and plasma Mg are significantly negatively associated with fasting glucose.

Sex-Specific Associations of Urinary Metals with Renal Function: a Cross-sectional Study in China.

BACKGROUND: Extensive studies have revealed the link between heavy metals and CKD. Compared to single meta-elements, mixture of metals reflect real-life metals exposure scenarios and are of interest. However, the mechanism of action of metal mixture on renal function is unclear. METHODS: This study aimed to explore the potential relationship between urinary arsenic (As), cadmium (Cd), lead (Pb), manganese (Mn), and chromium (Cr) contents with estimated glomerular filtration rate (eGFR) levels in 2775 participants. The levels of metals in urine were determined by inductively coupled plasma-mass spectrometry. We used linear regression models and the Bayesian kernel machine regression (BKMR) to evaluate the association between metals and eGFR levels. RESULTS: In linear regression analysis, urinary As (ß = 2.723, 95%CI: 0.29, 5.157) and Pb (ß = 3.081, 95%CI: 1.725, 4.438) were positively associated with eGFR in the total population. In the BKMR model, a mixture of the five metals had a positive joint effect on eGFR levels, while Pb (PIP = 0.996) contributed the most to eGFR levels. Pb was positively associated with eGFR levels in the total participants and women. As was positively correlated with eGFR levels in women. Pb and eGFR levels were positively correlated when the other metals were set at 25th, 50th, and 75th percentiles. CONCLUSIONS: To the best of our knowledge, all five metals mixed exposure was positively associated with eGFR. Pb showed more important effects than the other four metals in the mixture, especially in women.

ApoE gene polymorphisms and metals and their interactions with cognitive function.

OBJECTIVE: To analyze the relationship between plasma metal elements, ApoE gene polymorphisms and the interaction between the two and impaired cognitive function in elderly population. METHOD: A stratified sample was drawn according to the age of the study population, and 911 subjects were included. Baseline information and health indicators were obtained, and cognitive function status was assessed by health examination, a general questionnaire and Mini-Mental Status Examination. Plasma metal elements were measured, and SNP typing was performed. Binary logistic regression was used to analyze the factors influencing cognitive function status and the association between the SNP genetic pattern of the ApoE gene and cognitive function. RESULTS: The differences in gene frequencies and genotype frequencies of the ApoE rs7412 and rs7259620 genotype frequencies were statistically different between the cognitive impairment group and the control group (P < 0.05). statistically differences were found for the codominant model in rs7412-TT compared with the CC genotype (OR = 3.112 (1.159-8.359), P = 0.024) and rs7259620-AA compared with the GG genotype (OR = 1.588 (1.007-2.504), P = 0.047). Statistically differences were found in the recessive models rs7412-TT compared with (CC + CT) (OR = 2.979 (1.112-7.978), P = 0.030), rs7259620-AA compared with (GG + GA), and rs405509-GG compared with (TT + TG) (OR = 1.548(1.022-2.344), P = 0.039) all of which increased the risk of developing cognitive impairment. The differences in plasma Fe, Cu, and Rb concentrations between the case and control groups were significant (P < 0.05). The regression results showed that the plasma Cd concentrations in the Q1 range was a protective factor for cognitive function compared with Q4 (0.510 (0.291-0.892), P = 0.018). Furthermore, there was a multiplicative interaction between the codominant and recessive models for the Q2 concentrations of Cd and the rs7259620 loci, and the difference was significant, indicating increased risk of developing cognitive impairment (codominant model OR = 3.577 (1.496-8.555), P = 0.004, recessive model OR = 3.505 (1.479-8.307), P = 0.004). There was also a multiplicative interaction between Cd and the recessive model at the rs405509 loci, and the difference was significant, indicating increased risk of developing cognitive impairment (OR = 3.169 (1.400-7.175), P = 0.006). CONCLUSION: The ApoE rs7412, rs7259620 and rs405509 loci were associated with cognitive impairment in the elderly population, and there was an interaction between plasma metalloid Cd and the rs7259620 and rs405509 loci that increased the risk of cognitive impairment in the elderly population.

Association of CYP19A1 Gene, Plasma Zinc, and Urinary Zinc with the Risk of Type 2 Diabetes Mellitus in a Chinese Population.

To explore the effects of CYP19A1 gene polymorphisms, plasma zinc, and urinary zinc levels and their interactions on type 2 diabetes mellitus (T2DM) in residents of Gongcheng County, Guangxi, China. The case-control study was used for the investing. The MassARRAY System was applied to genotype the CYP19A1 genes rs752760, rs10046, rs10459592, and rs700518 in 540 study subjects. Plasma and urinary zinc concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS). Conditional logistic regression showed that rs752760 and plasma zinc were associated with T2DM risks with ORs of 0.593 (95% CI: 0.371-0.948) and 0.563 (95% CI: 0.356-0.889), respectively. Unconditional logistic regression analysis showed an association between urinary zinc levels and the risk of T2DM as well, with an OR of 0.352 (95% CI: 0.212-0.585). The results of the multiplicative interaction model showed that the rs752760 T allele was associated with a significantly reduced risk of T2DM with moderate/low plasma zinc levels, with ORs of 0.340 (95% CI: 0.161-0.715) and 0.583 (95% CI: 0.346-0.981), respectively, and the rs752760 T allele was also associated with a significantly decreased risk of T2DM with moderate/low urinary zinc levels, with ORs of 0.358 (95% CI: 0.201-0.635) and 0.321 (95% CI: 0.183-0.562), respectively. CYP19A1 rs752760 T allele and moderate/low plasma/urinary zinc levels reduce the risk of T2DM.

Associations Between Plasma Metals and Cognitive Function in People Aged 60 and Above.

The objective of the study was to explore the relationship between the plasma levels of 22 metals and cognition status in older adults aged 60 years and above. A cross-sectional survey was conducted between 2018 and 2019. Inductively coupled plasma mass spectrometry (ICP-MS) was used to detect the concentrations of metals, and a mini-mental state examination (MMSE) questionnaire was used to estimate the cognition status of the elderly. Based on the years of education and MMSE scores, the participants were separated into the normal and impaired cognition groups. Lasso regression, logistic regression, and restricted cubic spline models were used to explore the relationship between the metals and cognitive status. A total of 1667 subjects were included in the study, and 333 (19.97%) of the participants had impaired cognition. Then, 12 metals, including Al, Fe, Ni, Cu, As, Se, Rb, Sr, Mo, Cd, Sn, and Sb were selected by lasso regression. Before the multivariate adjustment, Al and Cu were associated with the risk of increasing cognitive impairment (OR = 1.756, 95% CI: 1.166-2.646, P = 0.007; OR = 1.519, 95% CI: 1.050-2.197, P = 0.026, respectively). By contrast, Rb was associated with a decrease in the risk of cognitive impairment (OR = 0.626, 95% CI: 0.427-0.918, P = 0.017), but Cd was significantly associated with an increase in this risk (OR = 1.456, 95% CI: 1.003-2.114, P = 0.048). After multivariate adjustment, only Al (OR = 1.533, 95% CI: 1.000-2.350, P = 0.050) maintained a borderline difference with the risk of cognitive impairment. A significant positive correlation was found between the risk of cognitive impairment and Al, Cu, and Cd, contrary to the negative correlation found with Rb.

Prevalence of burnout in medical students in China: A meta-analysis of observational studies.

ABSTRACT: This meta-analysis aimed to estimate the prevalence of burnout among medical students in China.A systematic search from the following electronic databases: China National Knowledge Infrastructure, Wangfang database, VIP database, Chinese biomedical literature database, PubMed, Embase, Web of Science, and Google Scholar was independently conducted by 2 reviewers from inception to September 2019. The data were analyzed using stata software Version 11. Heterogeneity was assessed using I2 tests, and publication bias was evaluated using funnel plots and Egger's test. The source of heterogeneity among subgroups was determined by subgroup analysis of different parameters.A total of 48 articles with a sample size of 29,020 met the inclusion criteria. The aggregate prevalence of learning burnout was 45.9% (95% confidence interval [CI] = 38.1%-53.8%). The prevalence rate of high emotional exhaustion was 37.5% (95% CI: 21.4%-53.7%). The percentage was 44.0% (95% CI: 29.2%-58.8%) for low personal accomplishment. The prevalence rate was 36.0% (95% CI: 23.0%-48.9%) in depersonalization dimension. In the subgroup analysis by specialty, the prevalence of burnout was 30.3% (95% CI: 28.6%-32.0%) for clinical medicine and 43.8% (95% CI: 41.8%-45.8%) for other medical specialties. The total prevalence of burnout between men and women was 46.4% (95% CI: 44.8%-47.9%) and 46.6% (95% CI: 45.5%-47.6%), respectively. The prevalence of burnout with Rong Lian's scale was 43.7% (42.1%-45.2%), and that with the other scales was 51.4% (50.4%-52.4%). The prevalence rates were 62.9% (61.3%-64.6%), 58.7% (56.3%-61.1%), 46.5% (42.9%-50.2%), and 56.0% (51.6%-60.4%) from Grades 1 to 4, respectively. There was a statistically significant difference among the different grades (P = .000).Our findings suggest a high prevalence of burnout among medical students. Society, universities, and families should take appropriate measures and allot more care to prevent burnout among medical students.

Association between TFEB gene polymorphism, gene-environment interaction, and fatty liver disease: A case-control study in China.

BACKGROUND: Fatty liver disease (FLD) is a serious public health problem that is rapidly increasing. Evidence indicates that the transcription factor EB (TFEB) gene may be involved in the pathophysiology of FLD; however, whether TEFB polymorphism has an association with FLD remains unclear. OBJECTIVES: To explore the association among TFEB polymorphism, gene-environment interaction, and FLD and provide epidemiological evidence for clarifying the genetic factors of FLD. METHODS: This study is a case-control study. Sequenom MassARRAY was applied in genotyping. Logical regression was used to analyze the association between TFEB polymorphism and FLD, and the gene-environment interaction in FLD was evaluated by multiplication and additive interaction models. RESULTS: (1) The alleles and genotypes of each single nucleotide polymorphism and haplotypes of TFEB in the case and control groups were evenly distributed; no statistically substantial difference was observed. (2) Logistic regression analysis indicated that TFEB polymorphism is not remarkably associated with FLD. (3) In the multiplicative interaction model, rs1015149, rs1062966, rs11754668 and rs2273068 had remarkable interaction with the amount of cigarette smoking. Rs1062966 and rs11754668 also had a considerable interaction body mass index and alcohol intake, respectively. However, no remarkable additive interaction was observed. CONCLUSION: TFEB polymorphism is not directly associated with FLD susceptibility, but the risk can be changed through gene-environment interaction.

Effects of Oil Tea on Obesity and Dyslipidemia: A Cross-Sectional Study in China.

BACKGROUND: Animal experiments have found that oil tea reduces body weight and improves blood lipid levels. However, the effect of oil tea on human health has not been confirmed yet. This study aims to explore the relationship between oil tea consumption and obesity and dyslipidemia. METHODS: In a cross-sectional population study in Guangxi, China, a semi-quantitative questionnaire was used to investigate the oil tea consumed and food consumption frequency in adults aged 30 years and over. Anthropometric variables and serum biochemical indicators were measured. A total of 2001 adults were divided into five groups based on their non-consumption status and quartile of consumption (groups non-drink oil tea, Q1-Q4). RESULTS: The risk of abdominal obesity tended to decrease significantly with increasing consumption of oil tea (P for trend< 0.05) in the overall participants (Q3 group, OR = 0.545, 95% CI = 0.336-0.884; Q4 group, OR = 0.520, 95% CI = 0.311-0.871) and in women (Q2 group, OR = 0.502, 95% CI = 0.274-0.920; Q3 group, OR = 0.397, 95% CI = 0.213-0.740; Q4 group, OR = 0.421, 95% CI = 0.228-0.780). Oil tea consumption Q1, Q2, Q3 and Q4 group significantly reduced the risk of abnormal HDL-cholesterol (P < 0.05). Oil tea consumption Q2 group significantly increased the risk of abnormal LDL-cholesterol (OR = 2.600, 95% CI = 1.033-6.546) in women. Oil tea consumption Q1 (OR = 0.081, 95% CI =0.008-0.864) and Q3 (OR = 0.057, 95% CI = 0.004-0.913) groups significantly reduced the risk of abnormal HDL-cholesterol in women. CONCLUSION: Oil tea consumption may be associated with a low risk of abdominal obesity. High-dose oil tea consumption may be associated with a low risk of abnormal HDL-cholesterol. Prospective studies with large sample sizes would be required to further investigate this association.

Associations of TFEB Gene Polymorphisms With Cognitive Function in Rural Chinese Population.

Background: The study aimed to investigate the relationship between transcription factor EB (TFEB) gene polymorphisms, including their haplotypes, and the cognitive functions of a selected population in Gongcheng County, Guangxi. Methods: A case-control study approach was used. The case group comprised 339 individuals with cognitive impairment, as assessed by their Mini-Mental State Examination scores; the control population also comprised 339 individuals who were matched by sex and age (± 5 years) in a 1:1 ratio. TFEB gene polymorphisms were genotyped in 678 participants (190 men and 488 women, aged 30-91 years) by using the Sequenom MassARRAY platform. Results: Multifactorial logistic regression analysis showed that in the dominant model, the risk of developing cognitive impairment was 1.547 times higher in cases with the TFEB rs14063A allele (AG + AA) than in those with the GG genotype (adjusted odds ratio [OR] = 1.547, Bonferroni correction confidence interval = 1.021-2.345). Meanwhile, the presence of the TFEB rs1062966T allele (CT + TT) was associated with a lower risk of cognitive impairment in comparison with the presence of the CC genotype (adjusted OR = 0.636, Bonferroni correction confidence interval = 0.405-0.998). In the co-dominant model, the risk of developing cognitive impairment was 1.553 times higher in carriers of the TFEB rs14063AG genotype than in carriers of the GG genotype (adjusted OR = 1.553, Bonferroni correction confidence interval = 1.007-2.397). After the Bonferroni correction and adjustment for confounding factors, the association of TFEB rs1062966 with cognitive function persisted in the analyses stratified by education level. Ethnically stratified analysis showed a significant association between TFEB rs1062966 and cognitive function in the Yao population. The multilocus linkage disequilibrium analysis indicated that the identified single nucleotide polymorphisms were not inherited independently. The haplotype analysis suggested that the rs14063A-rs1062966C-rs2278068C-rs1015149T haplotype of the TFEB gene increased the risk of cognitive impairment (P < 0.05) and that the rs14063G-rs1062966T-rs2278068C-rs1015149C haplotype was associated with a reduced risk of cognitive impairment (P < 0.05). Conclusion: TFEB rs1062966 polymorphisms and their rs14063A-rs1062966C-rs2278068C-rs1015149T and rs14063G-rs1062966T-rs2278068C-rs1015149C haplotypes are genetic factors that may affect cognitive function among the rural Chinese population.