Association of serum oleic acid level with depression in American adults: a cross-sectional study.

BACKGROUND: As the most abundant fatty acid in plasma, oleic acid has been found to be associated with multiple neurological diseases; however, results from studies of the relationship between oleic acid and depression are inconsistent. METHODS: This cross-sectional study analyzed 4,459 adults from the National Health and Nutrition Examination Survey 2011-2014. The following covariates were adjusted in multivariable logistic regression models: age, sex, race/ethnicity, education level, marital status, body mass index, physical activity, smoking status, alcohol status, metabolic syndrome, omega-3 polyunsaturated fatty acids, and total cholesterol. RESULTS: Serum oleic acid levels were positively associated with depression. After adjusting for all covariates, for every 1 mmol/L increase in oleic acid levels, the prevalence of depression increased by 40% (unadjusted OR: 1.35, 95%CI: 1.16-1.57; adjusted OR: 1.40, 95% CI: 1.03-1.90). CONCLUSIONS: Our study suggests that oleic acid may play a role in depression. Further research is needed to investigate the potential benefits of changing oleic acid levels for the treatment and prevention of depression.

Association between serum lactate dehydrogenase and 60-day mortality in Chinese Hakka patients with acute myeloid leukemia: A cohort study.

BACKGROUND: There is evidence that a high level of serum lactate dehydrogenase (LDH) is associated with poorer overall survival in acute myeloid leukemia (AML), but its link to 60-day mortality of AML remains unclear. METHODS: All patients newly diagnosed with AML were included in this cohort study. LDH was measured for the first time after admission. Multivariable logistic regression was used to explore the association between serum LDH and 60-day mortality. Interaction and stratified analyses were conducted including age, sex, albumin, glucose, myoglobin, and standard chemotherapy. RESULTS: Three hundred and seventy-one patients ≥15 years of age, who were newly diagnosed with AML, were consecutively selected. The total prevalence of 60-day mortality was 27.2% (101/371), while it was 32.1% (42/131) and higher than in the LDH ≥570U/L compared with the LDH<570U/L, with the prevalence of 24.6% (59/240); however, the difference was not statistically significant. In multivariate regression models, odd ratios and corresponding 95% confidence intervals (CIs) for Log2 and twice limit of normal (ULN) of LDH were 1.46 (1.0, 2.14) and 2.76 (1.24, 6.16), respectively. Interaction analysis revealed no interactive role in the association between LDH concentration and 60-day mortality. CONCLUSIONS: Serum LDH level was associated with 60-day mortality, especially for the patients with LDH ≥570U/L.

HOMA-IR is positively correlated with biological age and advanced aging in the US adult population.

BACKGROUND: Insulin resistance (IR) had been reported to be associated with age; however, few studies have explored the association between IR and biological age (BA). The HOMA-IR value is a useful indicator of the extent of IR. This cross-sectional study is to explore the relationship between HOMA-IR and BA/advanced aging in the US population. METHODS: This study is a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data. The survey comprised 12,266 people from the NHANES, and their full HOMA-IR data as well as BA data were extracted. Four multiple linear regressions were performed to analyze the association between HOMA-IR and BA, and four multiple logistic regression models were performed to analyze the association between HOMA-IR and advanced aging. In addition, trend tests and stratified analysis were performed and smoothed fitted curves were plotted to test the robustness of the results. RESULTS: HOMA-IR was positively correlated with BA [ß: 0.51 (0.39, 0.63)], and it was the same to advanced aging [OR: 1.05 (1.02, 1.07)], and both showed a monotonically increasing trend. The trend tests showed that the results were stable (all P for trend < 0.0001). The smoothed fitted curves showed that there were non-linear relationships between HOMA-IR and BA/advanced aging. And the stratified analysis indicated that the relationship between HOMA-IR and BA/advanced aging remained robust in all subgroups. CONCLUSION: The study suggested that HOMA-IR is positively correlated with BA and advanced aging in the US adult population, with a monotonic upward trend. This is a new finding to reveal the relationship between HOMA-IR and age from new standpoint of BA rather than chronological age (CA). And it may contribute to a better understanding of human health aging and may aid future research in this field.

Does the timing of intake matter? Association between caffeine intake and depression: Evidence from the National Health and Nutrition Examination Survey.

BACKGROUND: Recent research suggests that caffeine intake is associated with a reduced risk of depression. However, the relationship between caffeine intake during different periods of the day and depression is still unclear. METHODS: This cross-sectional study analyzed noninstitutionalized adults from the National Health and Nutrition Examination Survey, with a weighted representation of approximately 218 million US adults. Covariate-adjusted sample-weighted regressions were used to examine associations between caffeine intake and depression in different periods. RESULTS: Caffeine intake during non-early morning periods (outside of 5:00-8:00 AM) is associated with a high prevalence of depression (unadjusted OR: 1.08, 95%CI: 1.05-1.11; adjusted OR: 1.03, 95 % CI: 1.00-1.06). Participants who consumed caffeine in the early morning (5:00-8:00 AM) had a lower prevalence of depression compared to participants who did not consume caffeine in the early morning (unadjusted OR: 0.75, 95%CI: 0.67-0.85; adjusted OR: 0.86, 95 % CI: 0.75-0.99). LIMITATIONS: Cross-sectional study could not determine the temporal association; patients with depression in this study were not clinically diagnosed with Major Depressive Disorder. CONCLUSIONS: Among US adults, early morning caffeine consumers had a lower prevalence of depression than non-consumers; caffeine intake during non-early morning periods is associated with a high prevalence of depression. Our results may suggest the importance of caffeine intake time for depression.

Associations between sleep disturbance, inflammatory markers and depressive symptoms: Mediation analyses in a large NHANES community sample.

Both depression and sleep disturbance have been linked to inflammation. However, the role that inflammation plays in the relationship between sleep disturbance and depression remains unclear. We examined pairwise associations between inflammatory markers (neutrophil-to-lymphocyte ratio [NLR] and C-reactive protein level [CRP]), sleep disturbance, and depressive symptoms in a robust, ethnically diverse sample (n = 32,749) from the National Health and Nutrition Examination Survey (NHANES). We found higher levels of inflammatory markers in participants with depression and/or sleep disturbance compared to those without depression or sleep disturbance. Sleep disturbance was positively associated with inflammatory markers and depressive symptoms even after considering a wide range of potential confounders (e.g., age, sex, body mass index). Inflammatory marker levels were nonlinearly associated with depressive symptoms and were positively associated with depressive symptoms after reaching the inflection point (NLR, 1.67; CRP, 0.22 mg/dL). Inflammatory markers mediated a marginal portion (NLR, 0.0362%, p = 0.026; CRP, 0.0678%; p = 0.018) of the potential effects of sleep disturbance on depressive symptoms. Our research showed that inflammatory markers, sleep disturbance, and depression are pairwise correlated. Increased inflammatory markers levels slightly mediate the association between sleep disturbance and depression.

Dietary Magnesium Intake Affects the Vitamin D Effects on HOMA-ß and Risk of Pancreatic ß-Cell Dysfunction: A Cross-Sectional Study.

Background: Some studies have shown that, the circulating vitamin D (Vit D) concentration in the body exerts a crucial role in regulating the pancreatic ß-cell function. Meanwhile, the role of magnesium is important in the synthesis of Vit D, since it is an essential element for activating Vit D. Nevertheless, there remains insufficient studies concerning whether dietary Magnesium intake influences the association between Vit D and risk of pancreatic ß-cell dysfunction. Hence, this cross-sectional study aimed to assess the effect of Magnesium intake alterations on the association between serum Vit D levels and the risk of pancreatic ß-cell dysfunction. Methods: This large-scale cross-sectional study involves four cycles of National Health and Nutrition Examination Survey (NHANES) (2007-2014), with totally 4,878 participants. Groups were divided depending on the median daily intake of Magnesium, namely, the low intake group (Magnesium intake <267 Magnesium/d) and the high intake group (Magnesium intake ≥ 267 Magnesium/d). By constructing multiple multivariate linear and logistics regression models, the associations between serum Vit D levels and HOMA-ß, as well as between serum Vit D levels and the risk of pancreatic ß-cell dysfunction were explored at different Magnesium intakes. Results: In this cross-sectional study, the serum Vit D level is independently correlated with the HOMA-ß index [ß: 0.65 (0.40-0.90)] and the risk of pancreatic ß-cell dysfunction [OR: 0.95 (0.92-0.98)]. Moreover, such correlations are affected by different dietary Magnesium intakes (P for interaction < 0.001). Conclusion: According to the results of this study, the dietary Magnesium intake influences the associations of serum Vit D levels with HOMA-ß index and pancreatic ß-cell dysfunction. Besides, the finding requires validation through more RCT or cohort studies.

Using optimal subset regression to identify factors associated with insulin resistance and construct predictive models in the US adult population.

Background: In recent decades, with the development of the global economy and the improvement of living standards, insulin resistance (IR) has become a common phenomenon. Current studies have shown that IR varies between races. Therefore, it is necessary to develop individual prediction models for each country. The purpose of this study was to develop a predictive model of IR applicable to the US population. Method: In total, 11 cycles of data from the NHANES database were selected for this study. Of these, participants from 1999 to 2010 (n = 14931) were used to establish the model, and participants from 2011 to 2020 (n = 13,646) were used to validate the model. Univariate and multivariable logistic regression was used to analyze the factors associated with IR. Optimal subset regression was used to filter the best modeling variables. ROC curves, calibration curves, and decision curve analysis were used to determine the strengths and weaknesses of the model. Results: After screening the variables by optimal subset regression, variables with covariance were excluded, and a total of seven factors (including HDL, LDL, ALB, GLB, GLU, BMI, and waist) were finally included to establish the prediction model. The AUCs were 0.851 and 0.857 in the training and validation sets, respectively, and the Brier value of the calibration curve was 0.153. Conclusion: The optimal subset predictive model proposed in this study has a great performance in predicting IR, and the decision curve analysis shows that it has a high net clinical benefit, which can help clinicians and epidemiologists easily detect IR and take appropriate interventions as early as possible.

Serum 25(OH)D Levels Modify the Association between Triglyceride and IR: A Cross-Sectional Study.

Background: Triglycerides and 25(OH)D had been reported as correlates of IR, but the results suggest substantial heterogeneity across races. In addition, little research reported on whether different 25(OH)D levels affect triglycerides and IR. Therefore, a similar study on the US population would be a great addition to the current one. This study investigated the association between triglycerides and IR at different 25(OH)D levels. Methods: A total of 19,926 participants were included, each containing specific indicators for the study project. IR was estimated as a HOMA-IR index ≥2.73. Four multivariate logistic regression models were developed to analyze the association between TG and IR and whether different 25(OH)D levels influenced this association. Smoothed fitting curves were plotted. Results: Triglyceride was significantly associated with IR (OR: 1.3, 95 CI %), while this association received different 25(OH)D levels (P for interaction <0.001). The effect value OR was 1.33 with the high levels, and its effect value OR was 1.28 with the low levels. Conclusion: This study demonstrates that triglyceride levels are significantly associated with insulin in the US adult population and can be used as a predictor of IR. This correlation was compromised at different 25 (OH)D levels, so future studies need to be explored in more ethnically diverse contexts.

Association Between Visceral Adiposity Index and Insulin Resistance: A Cross-Sectional Study Based on US Adults.

Background: Visceral obesity index (VAI) is an empirical mathematical model used to evaluate the distribution and function of fat. Some studies have shown that VAI may be associated with the development of insulin resistance. In view of the differences in insulin resistance among different ethnic groups, this study attempts to analyze the special relationship between VAI and insulin resistance in American adults. Methods: We conducted a cross-sectional study through NHANES database. A total of 27309 patients over the age of 18 from the United States took part in the survey. It was divided into two groups: the IR-positive group and the IR-negative group. The association of VAI with IR was evaluated by logistic regression analyses mainly, including univariate analysis, multivariate regression analysis, curve fitting analysis and subgroup analysis. Results: The results showed that in the full-adjusted model, there is a strong positive association between VAI level and insulin resistance (OR: 1.28 (1.2~1.37), P<0.001) and there is a threshold effect. Conclusions: This study suggests that higher VAI levels are associated with insulin resistance. VAI index may be used as a predictor of insulin resistance.

The association between serum cadmium and diabetes in the general population: A cross-sectional study from NHANES (1999-2020).

Background: Associations between serum cadmium and diabetes had been reported in previous studies, however there was still considerable controversy regarding associations. Studies in general population that investigated the effects of serum cadmium on diabetes were currently lacking. We designed this cross-sectional study among U.S. adults under high and low cadmium exposure to assess associations between serum cadmium and diabetes. Methods: This cross-sectional study analyzed 52,593 adults who aged more than 20 years and participated in the National Health and Nutrition Examination Survey (NHANES), 1999-2020. The missing values and extreme values in the covariables were filled by multiple interpolation. Univariate logistics regression, multivariate logistics regression and smooth fitting curves were used to analyze the association between serum cadmium and diabetes. Simultaneously, sensitivity analysis was carried out by converting the serum cadmium from continuous variable to categorical variable. The stratification logistics regression model was used to analyze whether there were special groups in each subgroup to test the stability of the results. Results: In this cross-sectional study, serum cadmium levels were negatively correlated with the occurrence of diabetes in the low serum cadmium exposure group (OR = 0.811, 95% CI 0.698, 0.943; P = 0.007). There was no association between serum cadmium level and the occurrence of diabetes in the high serum cadmium exposure group (OR = 1.01, 95% CI 0.982, 1.037; P = 0.511). These results were consistent across all the subgroups (P for interaction >0.05). Conclusion: Serum cadmium was negatively associated diabetes among the representative samples of the whole population in the United States under the normal level of serum cadmium exposure. However, there was no association between serum cadmium level and the occurrence of diabetes in the high serum cadmium exposure group. This study promoted an update of new preventative strategy targeting environment for the prevention and control of diabetes in the future.

Dietary Magnesium Intake Level Modifies the Association Between Vitamin D and Insulin Resistance: A Large Cross-Sectional Analysis of American Adults.

Background: Previous clinical studies and randomized controlled trials have revealed that low serum vitamin D levels are associated with the risk of developing insulin resistance. Magnesium has been reported to be a protective factor for insulin resistance, and magnesium has been considered an important co-factor for vitamin D activation. However, the effect of dietary magnesium intake on the relationship between vitamin D and the risk of developing insulin resistance has not been comprehensively investigated. Therefore, we designed this cross-sectional analysis to assess whether dietary magnesium intake modifies the association of vitamin D and insulin resistance. Methods: A total of 4,878 participants (male: 48.2%) from 4 consecutive cycles of the National Health and Nutrition Examination Survey (2007-2014) were included in this study after a rigorous screening process. Participants were stratified by their dietary magnesium intake into low-intake (<267 mg/day) and high-intake (≥267 mg/day) groups. We assessed differences between serum vitamin D levels and the risk of developing insulin resistance (interaction test), using a weighted multivariate logistic regression to analyze differences between participants with low and high magnesium intake levels. Results: There was a negative association between vitamin D and insulin resistance in the US adult population [OR: 0.93 (0.88-0.98)], P < 0.001. Dietary magnesium intake strengthened the association (P for interaction < 0.001). In the low dietary magnesium intake group, vitamin D was negatively associated with the insulin resistance [OR: 0.94 (0.90-0.98)]; in the high dietary magnesium intake group, vitamin D was negatively associated with insulin resistance [OR: 0.92 (0.88-0.96)]. Conclusion: Among adults in the United States, we found an independent association between vitamin D level and insulin resistance, and this association was modified according to different levels of magnesium intake.

Association between vitamin D3 levels and insulin resistance: a large sample cross-sectional study.

Previous studies have shown that vitamin D3 may be a potential factor in insulin resistance, but the relationship between vitamin D3 and insulin resistance still remains controversial. At present, more research is needed to explore the relationship between vitamin D3 and insulin resistance. The samples from 2009 to 2018 in NHANES database were analyzed to Investigate the relationship and the potential mechanism. We performed a cross-sectional study of five periods in the NHANES database. Finally, 9298 participants were selected through strict inclusion and exclusion criteria, Multivariate logistic regression analysis and curve fitting were conducted to explore the relationship between vitamin D3 level and insulin resistance. Moreover, subgroup analysis was used to further prove the association. The results revealed that there was a strong association between vitamin D3 and insulin resistance (OR 0.82, 95% CI 0.72-0.93). However, subgroup analyses indicated that this correlation varied between individuals and races. There was a negative correlation between vitamin D3 level and insulin resistance, which provides a new proof for exploring the influencing factors of insulin resistance. More well-designed studies are still needed to further elaborate on these associations.

The association between vitamin D3 and diabetes in both hyperuricemia and non-hyperuricemia populations.

BACKGROUND: Previous studies have shown that hyperuricemia is involved in diabetes, obesity, hypertension, chronic kidney disease, and other diseases. At the same time, studies have shown that vitamin D3 levels in the body are linked to the onset of diabetes. However, there is currently no sufficient evidence to prove whether this connection is affected by the uric acid level. Therefore, we attempted to investigate the association between vitamin D3 content and the occurrence of diabetes in populations with different uric acid levels though the data of NHANES database from 2009 to 2018. METHOD: Using the NHANES database, we performed a cross-sectional analysis. The participants were chosen based on stringent inclusion and exclusion requirements. This study finally included a total number of 16,735 individuals. Multivariate logistic regression analysis was used to investigate the association between vitamin D3 and diabetes mellitus in hyperuricemia and non-hyperuricemia patients after complete adjustment, and multivariate linear regression analysis was used to illustrate the association between vitamin D3 and uric acid. RESULT: The results showed that the association between vitamin D3 and diabetes was weakened in hyperuricemia patients (OR 0.95 (0.92,0.98)). An independent association was discovered between vitamin D3 and uric acid (ß -0.12 (-0.16, -0.07)) in all groups of population. CONCLUSIONS: This study shows that vitamin D3 content is associated with the incidence of diabetes in people with high level of uric acid. This study offers a fresh perspective on the elements that influence the etiology of diabetes in hyperuricemia patients.

Associations between TG/HDL ratio and insulin resistance in the US population: a cross-sectional study.

BACKGROUND: Clinical data on the relationship between triglycerides (TG)/HDL ratio and insulin resistance (IR) suggest that TG/HDL ratio may be a risk factor for IR. However, there is evidence that different races have different risk of developing IR. The relationship on TG/HDL ratio and IR in various populations needs to be improved. Therefore, we investigated whether TG/HDL ratio was linked to IR in different groups in the United States after controlling for other covariates. METHODS: The current research was conducted in a cross-sectional manner. From 2009 to 2018, the National Health and Nutrition Examination Survey (NHANES) had a total of 49,696 participants, all of whom were Americans. The target-independent variable was TG/HDL ratio measured at baseline, and the dependent variable was IR. Additionally, the BMI, waist circumference, education, race, smoking, alcohol use, alanine transaminase, aspartate transaminase, and other covariates were also included in this analysis. RESULTS: The average age of the 10,132 participants was 48.6 ± 18.4 years, and approximately 4936 (48.7%) were males. After correcting for confounders, fully adjusted logistic regression revealed that TG/HDL ratio was correlated with IR (odds ratio = 1.51, 95% CI 1.42-1.59). A nonlinear interaction between TG/HDL ratio and IR was discovered, with a point of 1.06. The impact sizes and CIs on the left and right sides of the inflection point were 6.28 (4.66-8.45) and 1.69 (1.45-1.97), respectively. According to subgroup analysis, the correlation was strong in females, alcohol users, and diabetes patients. Meanwhile, the inverse pattern was observed in the aged, obese, high-income, and smoking populations. CONCLUSION: In the American population, the TG/HDL ratio is positively associated with IR in a nonlinear interaction pattern.

Associations of Triglycerides/High-Density Lipoprotein Cholesterol Ratio With Insulin Resistance, Impaired Glucose Tolerance, and Diabetes in American Adults at Different Vitamin D3 Levels.

Background: Previous studies have shown that vitamin D3 (VD3) may be a protective factor for diabetes mellitus (DM), while triglycerides/high-density lipoprotein (TG/HDL) may be a risk factor for diabetes. However, no existing study has elucidated the interaction between TG/HDL and VD3. Therefore, this work aimed to investigate the relationships of TG/HDL with insulin resistance (IR), impaired glucose tolerance (IGT), and DM at different VD3 levels. Methods: With the use of the data from five National Health and Nutrition Examination Survey (NHANES) cycles, a total of 2,929 males and 3,031 females were divided into 4 groups according to their VD3 levels. Logistic regression was performed to observe the associations of TG/HDL ratio with IR, IGT, and DM in different groups. Results: The relationships of TG/HDL with IR, IGT, and DM showed a threshold effect, with the cutoff values of 1.094, 1.51, and 1.11, respectively. On both sides of the cutoff values, the correlation was first weakened and then enhanced with the increase in VD3 levels. Conclusion: TG/HDL is a risk factor for IR, IGT, and DM. Both too low and too high levels of VD3 can strengthen this association, whereas keeping VD3 at a reasonable level helps to reduce the associations of TG/HDL with IR, IGT, and DM.

Associations of TG/HDL Ratio with the Risk of Prediabetes and Diabetes in Chinese Adults: A Chinese Population Cohort Study Based on Open Data.

BACKGROUND: In the global chronic diseases, type 2 diabetes shows a significant upward trend, and there are more people before prediabetes (impaired glucose tolerance). Many patients with impaired glucose tolerance and undiagnosed diabetes do not know that their glucose metabolism system has been in a state of disorder. Every year, about 5% to 10% of prediabetics develop diabetes. One of the important achieving factors may be the increase in blood lipids. However, it is not clear whether the triglyceride/high-density lipoprotein ratio is associated with impaired glucose tolerance and diabetes in the Chinese population. Therefore, we investigated the relationship between triglyceride/high-density lipoprotein and impaired glucose tolerance and diabetes in the Chinese population. METHODS: We conducted a retrospective cohort study using data from the health screening program. The study included 116,855 participants from 32 locations in China, all of whom were adults over 20. Participants measured fasting blood glucose levels at each visit and collected information about their diabetes history. Impaired glucose tolerance was diagnosed as fasting blood glucose ≥6.00 mmol and self-reported diabetes mellitus. The patient was measured on the date of diagnosis or on his last visit (whichever comes first). RESULTS: The results showed that, after adjusting the potential confounding factors, the ratio of TG/HDL was positively correlated with the occurrence of prediabetes and diabetes, and there was a saturation effect. The inflection points were 1.04 and 1.33, respectively. The effect value and 95% confidence interval before and after the inflection point of impaired glucose tolerance patients were 1.57 and (1.42, 1.73) and 1.03 and (1.01, 1.05), respectively. The effect value and 95% confidence interval before and after the inflection point in patients with diabetes were 2.07 and (1.80, 2.39) and 1.08 and (1.04, 1.12).