Roles of serum uric acid on the association between arsenic exposure and incident metabolic syndrome in an older Chinese population.

Growing evidences showed that heavy metals exposure may be associated with metabolic diseases. Nevertheless, the mechanism underlying arsenic (As) exposure and metabolic syndrome (MetS) risk has not been fully elucidated. So we aimed to prospectively investigate the role of serum uric acid (SUA) on the association between blood As exposure and incident MetS. A sample of 1045 older participants in a community in China was analyzed. We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort. MetS events were defined according to the criteria of the International Diabetes Federation (IDF). Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS. To investigate the role of SUA in the association between As and MetS, a mediation analysis was conducted. In the fully adjusted log-binominal model, per interquartile range increment of As, the risk of MetS increased 1.25-fold. Compared with the lowest quartile of As, the adjusted relative risk (RR) of MetS in the highest quartile was 1.42 (95% confidence interval, CI: 1.03, 2.00). Additionally, blood As was positively associated with SUA, while SUA had significant association with MetS risk. Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA, with the proportion of 15.7%. Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population. Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS.

The Interplay between nighttime/midday sleep duration and the number of new-onset chronic diseases: A decade-long prospective study in China.

OBJECTIVE: To investigate the interplay between individual nighttime and midday sleep duration and the number of new-onset chronic diseases and determine the optimal sleep duration associated with lowest number of new-onset chronic diseases. METHODS: We used data from the China Health and Retirement Longitudinal Study (CHARLS) covering a decade and involving 10,828 participants. A random intercept cross-lagged model was used to explore the interplay between nighttime/midday sleep durations and new-onset chronic diseases at both the within-individual and between-individual levels, followed by a dose-response analysis at the between-individual level to determine the optimal sleep duration. New-onset chronic diseases include 14 types of self-reported diseases diagnosed by doctors. RESULTS: Within-individual analysis revealed that increased nighttime/midday sleep duration led to a higher number of new-onset chronic diseases, and an increased number of new-onset chronic diseases resulted in decreased nighttime sleep duration. Between nighttime and midday sleep, one type of sleep duration increase was likely to lead to an increase in another type. Between-individual analysis found a nonlinear relationship between the number of new-onset chronic diseases and nighttime sleep duration, identifying the optimal nighttime sleep duration as 7.46 h. CONCLUSIONS: These findings elucidate the interplay between sleep duration and number of new-onset chronic diseases and underscore the need for public awareness and comprehensive interventions. Future studies should focus on refining sleep monitoring and exploring the sleep-chronic diseases nexus in greater depth.

Long-term trends in the burden of nasopharyngeal carcinoma in China: A comprehensive analysis from 1990 to 2021 and projections to 2030 based on the global burden of disease study 2021.

BACKGROUND AND PURPOSE: Nasopharyngeal carcinoma (NPC) is a significant public health issue in China, with distinctive epidemiological characteristics and evolving trends. This study aims to analyze long-term trends in NPC burden from 1990 to 2021 and provide projections. MATERIALS AND METHODS: Data from the Global Burden of Disease (GBD) database (1990-2021) was utilized to evaluate NPC metrics, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Joinpoint regression identified significant changes over time. Age-period-cohort (APC) analyses assessed the effects of age, period, and cohort. A decomposition analysis identified factors influencing changes in NPC incidence, prevalence, and DALYs. Projections were made for future trends up to 2030. RESULTS: In 2021, NPC significantly impacted China, with males experiencing higher incidence (5.16 per 100,000) and mortality rates (2.32 per 100,000) than females. NPC prevalence was 342,477 cases, with males accounting for 260,164. DALYs totaled 982,657, predominantly affecting males. From 1990 to 2021, the age-standardized incidence rate (ASIR) in China decreased from 4.64 to 3.42 per 100,000, while globally it declined from 1.74 to 1.38 per 100,000. Between 1990 and 2021, trends showed an initial decline in ASIR and ASPR, followed by a steady increase from 2006 onwards, with males experiencing more significant rises. Mortality rates showed a general downward trend, yet males remained disproportionately affected. Comparative global data indicated that while NPC metrics are declining worldwide, the burden remains higher in China. Decomposition analysis highlighted aging and population growth as major contributors to the NPC burden. BAPC projections indicated a continuing rise in age-standardized incidence and prevalence rates for both males and females up to 2030. CONCLUSIONS: The burden of NPC in China remains significant, particularly among the male population. Despite declining mortality rates, the increasing prevalence suggests that more people are living with NPC. Targeted public health interventions are urgently needed to address these gender-specific trends and reduce the disease burden.

The association of adolescent to midlife weight change with age at natural menopause: a population study of 263,586 women in Norway.

Age at menopause varies considerably among women and is linked to health after menopause. Body mass index is associated with age at natural menopause, but the influence of weight change remains unclear. Thus, we studied associations of adolescent to midlife weight change with age at natural menopause. We performed a retrospective population-based cohort study of 263,586 women aged 50-69 years attending BreastScreen Norway (2006-2015). The associations were estimated as hazard ratios (HRs) for having reached menopause using Cox proportional hazard models. We included nine categories of weight change based on recalls of adolescent weight compared to peers and quartiles of midlife weight in kilograms. We adjusted for year and country of birth, education, number of childbirths, height, smoking, and exercise. Women with the largest estimated weight loss had highest hazard of reaching menopause (adjusted HR 1.11, 95% CI: 1.06-1.17) compared to women with estimated stable average weight. Conversely, women with the largest estimated weight gain had lower hazard (adjusted HR 0.96, 95% CI: 0.93-0.99). Women with estimated stable high weight had lowest hazard of reaching menopause (adjusted HR 0.93, 95% CI: 0.90-0.95). Our findings suggest that changes in body weight across the life course may influence the timing of menopause.

Concordant and discordant breast density patterns by different approaches for assessing breast density and breast cancer risk.

PURPOSE: To examine the discrepancy in breast density assessments by radiologists, LIBRA software, and AI algorithm and their association with breast cancer risk. METHODS: Among 74,610 Korean women aged ≥ 34 years, who underwent screening mammography, density estimates obtained from both LIBRA and the AI algorithm were compared to radiologists using BI-RADS density categories (A-D, designating C and D as dense breasts). The breast cancer risks were compared according to concordant or discordant dense breasts identified by radiologists, LIBRA, and AI. Cox-proportional hazards models were used to determine adjusted hazard ratios (aHRs) [95% confidence intervals (CIs)]. RESULTS: During a median follow-up of 9.9 years, 479 breast cancer cases developed. Compared to the reference non-dense breast group, the aHRs (95% CIs) for breast cancer were 2.37 (1.68-3.36) for radiologist-classified dense breasts, 1.30 (1.05-1.62) for LIBRA, and 2.55 (1.84-3.56) for AI. For different combinations of breast density assessment, aHRs (95% CI) for breast cancer were 2.40 (1.69-3.41) for radiologist-dense/LIBRA-non-dense, 11.99 (1.64-87.62) for radiologist-non-dense/LIBRA-dense, and 2.99 (1.99-4.50) for both dense breasts, compared to concordant non-dense breasts. Similar trends were observed with radiologists/AI classification: the aHRs (95% CI) were 1.79 (1.02-3.12) for radiologist-dense/AI-non-dense, 2.43 (1.24-4.78) for radiologist-non-dense/AI-dense, and 3.23 (2.15-4.86) for both dense breasts. CONCLUSION: The risk of breast cancer was highest in concordant dense breasts. Discordant dense breast cases also had a significantly higher risk of breast cancer, especially when identified as dense by either AI or LIBRA, but not radiologists, compared to concordant non-dense breast cases.

Sequences of sickness absence, disability pension and unemployment four years before and five years after musculoskeletal diagnosis among Swedish twins.

AIMS: To investigate sustainable working life via identification of time-related sequences of sickness absence (SA), disability pension (DP) and unemployment four years before and five years after the first musculoskeletal diagnosis in a Swedish twin cohort. Other aims were to account for familial confounding and to examine the associations between sequences and sociodemographic characteristics. METHODS: Among 28,474 Swedish twins, the patterns of interruptions of working life four years before the first M00-M99 diagnosis (MSD) and five years after MSD diagnosis were investigated with a sequence analysis in a seven-element state space consisting of sustainable working life, unemployment >90 days, moderate SA/DP (30-179 days), almost full year of SA/DP (180-365 days), full year of SA/DP (⩾ 365 days), death, and old-age pension. RESULTS: The six-cluster solution had the best fit to the data. Five clusters had varying patterns of interruptions of sustainable working life (Clusters 2-6, n = 537-1949 with SA/DP, unemployment, but also accounting death and old-age pension) compared with the largest cluster with primarily sustainable working life (n = 23,316). Age, sex and familial factors affected the likelihood of belonging to the clusters with SA/DP. CONCLUSIONS: Most Swedish twins with or without MSD diagnosis have a sustainable working life, although MSD was both prevalent and a strong risk factor for belonging to the clusters with SA/DP. Thus, early prevention of MSD and prevention of recurrent or long sickness absences due to any cause would be merited while paying special attention to women also.

Genome-Wide Association Study of Temporomandibular Disorder-Related Pain in Finnish Populations.

BACKGROUND: Temporomandibular disorders (TMD) are multifactorial musculoskeletal pain and dysfunctions in temporomandibular joints (TMJs) and masticatory muscles. Genetic factors play a role in TMD-related pain, but only a few genome-wide association studies (GWAS) have been conducted. OBJECTIVE: The aim of this GWAS was to explore genetic factors associated with painful TMD in Finnish populations. METHODS: Data from two epidemiological surveys, the Northern Finland Birth Cohort 1966 (NFBC1966) and the Health 2000 Survey in Finland, including altogether 468 cases and 6833 controls, were used. Case definition was based on pain on palpation of masticatory muscles and/or TMJs. GWASs of the whole data and stratified by sex were conducted from both cohorts using additive models, followed by meta-analysis of the two cohorts. Replications of the previously reported TMD risk loci (rs73460075, DMD; rs4794106, SGCA; rs73271865, SP4; rs60249166, RXP2; rs1531554, BAHCCI; rs5862730, OTUD4/SMAD1; rs10092633, SFRP1; rs34612513, SOX14/CLDN18; rs878962, TSPAN9) were also investigated. RESULTS: Four genome-wide significant loci were found in sex-stratified analysis of NFBC1966, including associations at three loci in males (rs1023114, PRIM2, p = 5 × 10-9; rs4244867, ALG10, p = 3 × 10-8; rs79841648, ADCYAP1, p = 4 × 10-9) and one locus in females (rs148476652, DNER, p = 4 × 10-9). However, the results could not be replicated in the Health 2000 Survey or in the meta-analysis of these two cohorts. The previous TMD GWAS associations did not replicate in our data either. CONCLUSION: Several TMD pain-associated variants were found in sex-stratified analysis of NFBC1966, suggesting the role of neuroendocrine stress responses and central nervous system. These findings need to be confirmed in future studies.

Breast cancer in women with previous gestational diabetes: a nationwide register-based cohort study.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common pregnancy complication characterized by insulin resistance. A link has been suggested between insulin resistance and breast cancer, which is the most common cancer in women. Hence, women with previous GDM may be at increased risk of developing breast cancer, yet, the existing evidence is conflicting. This study explored the association between GDM and incident breast cancer, including age at cancer diagnosis. Additionally, we investigated the potential impact of severity of insulin resistance during pregnancy and of subsequent diabetes development on the breast cancer risk. METHODS: We conducted a nationwide, register-based cohort study including all women giving birth in Denmark from 1997 to 2018. We defined GDM and breast cancer based on ICD-10 codes. Premenopausal and postmenopausal breast cancer was pragmatically defined as age at outcome < 50 years and ≥ 50 years, respectively. A proxy for severity of insulin resistance during pregnancy was based on insulin treatment; subsequent diabetes was defined as presence of ICD-10 codes and/or antidiabetic medication after pregnancy. The statistical analyses included Cox regression, logistic regression and t-test. RESULTS: Of 708,121 women, 3.4% had GDM. The median follow-up period was 11.9 years (range 0-21.9). The overall breast cancer risk was comparable in women with and without previous GDM (adjusted hazard ratio 0.96 [95% CI 0.83-1.12]). Premenopausal and postmenopausal breast cancer risk also did not differ; however, women with previous GDM had a breast cancer diagnosis at younger age (42.6 vs. 43.5 years, p-value 0.01). All-cause mortality was similar regardless of GDM history. Severity of insulin resistance during pregnancy and subsequent diabetes did not affect breast cancer risk. CONCLUSIONS: This large, population-based cohort study showed no higher risk of incident breast cancer in women with previous GDM compared to women without previous GDM after a median of almost 12 years of follow-up. This was evident irrespective of menopausal state. The breast cancer risk was not influenced by the severity of insulin resistance during pregnancy and by subsequent diabetes development. Regardless of GDM history, attention towards prevention, early detection and treatment of breast cancer should be prioritized.

The association between C-reactive protein to albumin ratio and adverse outcomes in acute ischemic stroke patients: A study in the Korean population.

Introduction: Our study aimed to explore the relationship between the C-reactive protein to albumin ratio (CAR) and adverse outcomes at 3 months in Korean patients with acute ischemic cerebral infarction. Methods: This study focused on a sample of 1654 individuals with acute ischemic stroke (AIS), who received medical treatment at a reputable hospital in South Korea between January 2010 and December 2016. We used multivariate logistic regression models to show the effect of CAR admission on 3-month adverse outcomes in patients with AIS, as well as generalized additive modeling (GAM) and two-stage linear regression modeling to explore whether there was a linear relationship. Results: A total of 1654 patients with acute ischemic cerebral infarction were enrolled in the study, and the CAR was determined to be associated with poor results for patients with AIS after 3 months. with correction for potential confounders (odds ratio [OR], 1.23; 95 % confidence interval [CI], 1.08-1; p < 0.001). A nonlinear relationship was found between the CAR and adverse outcomes at 3 months for patients with AIS, with a threshold of approximately 0.6. The effect sizes, CIs, and p-values above and below the threshold were 1.39 (1.25-1.55, p < 0.001) and 1.08 (0.81-1.43, p = 0.60). Conclusions: The adverse outcomes of patients with AIS at three months were independently correlated with the CAR. In addition, there was a nonlinear relationship between adverse outcomes and the CAR, with the CAR increasing the risk of adverse outcomes at 3 months for patients with AIS when the CAR was less than 0.6.

Intergenerational transmission of fertility in Great Britain: A parity-specific investigation using the 1970 British Cohort Study.

Studies in low-fertility settings have consistently found positive relationships between parents' and children's fertility timing and family sizes, and these persist after accounting for socio-demographic factors. We explore intergenerational transmission of fertility in Great Britain, where socio-economic inequalities are larger and could play a greater role in explaining intergenerational continuities than in other settings. Using the 1970 British Cohort Study, a long-running longitudinal data set, we estimate parity-specific discrete-time event-history models to investigate the role of mother's family size and age at first birth in birth transitions. We find stronger evidence for transmission of birth timing and family size in transitions to first and third births than second births. Family size transmission affects daughters more than sons. Accounting for socio-economic and demographic characteristics does not explain these associations. Except for first births, transmission of fertility is equally likely across the socio-economic hierarchy, highlighting the importance of socialization and cultural preferences for fertility transmission, even in the relatively unequal British context.

Total testosterone, sex hormone-binding globulin, and free testosterone concentrations and risk of primary liver cancer: A prospective analysis of 200,000 men and 180,000 postmenopausal women.

In most countries, males have ~2-3 times higher incidence of primary liver cancer than females. Sex hormones have been hypothesized to contribute to these differences, but the evidence remains unclear. Using data from the UK Biobank, which included ~200,000 males and ~180,000 postmenopausal females who provided blood samples at recruitment, we estimated hazard ratios (HR2) and 95% confidence intervals (CI) for a doubling in hormone concentration from multivariable adjusted Cox regression for circulating total testosterone, sex-hormone binding globulin (SHBG), and free testosterone concentrations and risk of primary liver cancer. After a median of 11.8 years of follow-up, 531 cases of primary liver cancer were observed, of which 366 occurred in males and 165 occurred in females. Total testosterone and SHBG were shown to be positively associated with liver cancer risk in both males and females (Total testosterone HR2: 3.42, 95% CI:2.42-4.84 and 1.29, 0.97-1.72, respectively; SHBG HR2: 5.44, 4.42-6.68 and 1.52, 1.09-2.12, respectively). However, free testosterone was inversely associated with primary liver cancer in males (HR2: 0.42, 0.32-0.55) and no association was observed in females. When analyses compared two main liver cancer subtypes, hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), there was evidence of heterogeneity; associations for total testosterone and SHBG concentrations were only positively associated with HCC in both males (HR2: 3.56, 2.65-4.79 and 7.72, 6.12-9.73, respectively) and females (HR2: 1.65, 1.20-2.27 and 6.74, 3.93-11.5, respectively) but not with ICC. Further research understanding the mechanisms of how sex-steroids may influence liver cancer risk is needed.

Wasserstein regression with empirical measures and density estimation for sparse data.

The problem of modeling the relationship between univariate distributions and one or more explanatory variables lately has found increasing interest. Existing approaches proceed by substituting proxy estimated distributions for the typically unknown response distributions. These estimates are obtained from available data but are problematic when for some of the distributions only few data are available. Such situations are common in practice and cannot be addressed with currently available approaches, especially when one aims at density estimates. We show how this and other problems associated with density estimation such as tuning parameter selection and bias issues can be side-stepped when covariates are available. We also introduce a novel version of distribution-response regression that is based on empirical measures. By avoiding the preprocessing step of recovering complete individual response distributions, the proposed approach is applicable when the sample size available for each distribution varies and especially when it is small for some of the distributions but large for others. In this case, one can still obtain consistent distribution estimates even for distributions with only few data by gaining strength across the entire sample of distributions, while traditional approaches where distributions or densities are estimated individually fail, since sparsely sampled densities cannot be consistently estimated. The proposed model is demonstrated to outperform existing approaches through simulations and Environmental Influences on Child Health Outcomes data.

Fall risk screening in older adults using the "CARE" frailty scale: The NuAge cohort results.

BACKGROUND: "CARE" is an electronic health (e-health) application (app) which assesses frailty with its frailty module and risk of falls with its mobility module. This study examines and compares the risk of incident falls (i.e., ≥1, ≥2 and severe falls) among older people in Quebec classified as "frail" and those classified as being at a high risk of falls by the CARE app. METHODS: A subset of men and women (n = 1151; 74.2 ± 4.2 years; 52.8 % female) who participated in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) were selected for this study. Pre-frail and frail states using the CARE frailty scale as well as high risk of falls estimated by CARE mobility module were determined at baseline. Pre-frail and frail states were merged in a single "frail state" group. Incident falls (i.e., ≥1, ≥2 and severe falls) were annually recorded over a 3-year follow-up. RESULTS: Both CARE frail state (Odd ratio (OR) ≥1.89 with P ≥ 0.040) and high risk of falls estimated by the CARE mobility module (OR) ≥3.32 with P ≥ 0.023) were significantly associated with incident falls (i.e., at least one fall) and recurrent falls (i.e., at least two falls). A greater association with these fall outcomes was observed with the high risk of falls than with the frail state. No significant association between the high risk of falls and severe falls was found (OR = 1.71 with P = 0.227), whereas that was the case with frail state (OR = 3.08 with P = 0.003). CONCLUSIONS: Frail state determined by the CARE frailty module and high risk of falls determined by the CARE mobility module were both significantly associated with fall outcomes, a greater association being shown with the CARE high risk of falls and with CARE frail state for severe falls. These results suggest that the CARE app may be useful for screening older people for the risk of falls.

A blood-based biomarker panel for non-invasive diagnosis of metabolic dysfunction-associated steatohepatitis.

The current diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) and its severe form, metabolic dysfunction-associated steatohepatitis (MASH), is suboptimal. Here, we recruited 700 individuals, including 184 from Hong Kong as a discovery cohort and 516 from San Diego, Wenzhou, and Hong Kong as three validation cohorts. A panel of 3 parameters (C-X-C motif chemokine ligand 10 [CXCL10], cytokeratin 18 fragments M30 [CK-18], and adjusted body mass index [BMI]) was formulated (termed N3-MASH), which discriminated patients with MASLD from healthy controls with an area under the receiver operating characteristic (AUROC) of 0.954. Among patients with MASLD, N3-MASH could identify patients with MASH with an AUROC of 0.823, achieving 90.0% specificity, 62.9% sensitivity, and 88.6% positive predictive value. The diagnostic performance of N3-MASH was confirmed in three validation cohorts with AUROC of 0.802, 0.805, and 0.823, respectively. Additionally, N3-MASH identifies patients with MASH improvement with an AUROC of 0.857. In summary, we developed a robust blood-based panel for the non-invasive diagnosis of MASH, which might help clinicians reduce unnecessary liver biopsies.

Prenatal iodine intake and infant temperament in a multiethnic US cohort.

OBJECTIVE: Maternal iodine plays a central role in fetal neurodevelopment. It is recommended that pregnant women consume sufficient levels of iodine to accommodate increased need for mother and fetus. We examined associations among prenatal dietary and supplemental iodine intake and infant temperament. DESIGN: The PRogramming of Intergenerational Stress Mechanisms (PRISM) study is an ongoing longitudinal pregnancy cohort. Data from 2011 to 2020 were used for this study. Women completed the Block98 FFQ ascertaining prenatal dietary and supplemental iodine intake and the Infant Behavior Questionnaire-Revised at infant age 6 months to ascertain infant temperament (Surgency/Extraversion, Negative Affectivity and Orienting/Regulation). SETTING: USA. PARTICIPANTS: Mother-child dyads (n 892). RESULTS: Women were primarily Black/Hispanic Black (44 %) and non-Black Hispanic (35 %) with 46 % reporting household income < $25 000/year. Nearly half had an estimated average requirement (EAR) < 160 µg/d (49 % based on dietary intake; 43 % based on diet and supplements). Girls born to women with an EAR ≥ 160 µg/d compared to girls born to women below this level had higher unadjusted extraversion scores for dietary plus supplemental intake (ß = 0·23 (0·13, 0·33)); decreased to ß = 0·05 (-0·08, 0·19) after adjusting for covariates. Boys born to women with an EAR ≥ 160 µg/d (based on diet and supplements) as compared to boys born to women below this level had statistically non-significant higher unadjusted negative affective score (ß = 0·06 (-0·08, 0·20)) that became significantly lower upon covariate adjustment (ß = -1·66 (-1·97, -1·35)). CONCLUSIONS: A significant proportion of these women reported suboptimal prenatal iodine intake. Suboptimal prenatal iodine intake may have implications for child neurodevelopment evident as early as infancy.

Food consumption markers and sociodemographic factors associated with obesity among adult women registered in the Food and Nutrition Monitoring System (SISVAN) in Brazil: a cohort study, 2015-2019.

Introduction: Carrying out studies using data from Food and Nutritional Monitoring is crucial given the current epidemiological scenario. This scenario reveals a coexistence of malnutrition and nutritional deficiencies alongside overweight and obesity, particularly among adult women in Brazil. Analyzing the microdata generated by the system is essential for accurately representing food and nutrition indicators in the country. Objective: To analyze the association of food consumption markers and sociodemographic factors with changes in the Body Mass Index (BMI) among adult women. Methodology: A cohort study with a final sample of 30,354 women evaluated through individual records between the years 2015 and 2019. Nutritional status was assessed using body mass index (BMI). Food consumption markers used were the ones available in the system, which referred to foods consumed the previous day. Linear regression was used to evaluate factors associated with BMI and multiple Poisson regression was used to estimate the relative risk of obesity incidence. Results: There was an increase in BMI between 2015 and 2019. The average increase in BMI was lower in women who consumed, in the previous day, beans (ß = -0,25; CI95%: -0.36; -0.13) and vegetables and/or legumes (ß = -0.12; CI95%: -0.21; -0.04) and the increase was greater when they consumed hamburgers and/or sausages (ß = 0.1; CI95%: 0.02; 0.19) adjusted by age, region and skin color. There was a 14% lower incidence of obesity in the group that consumed beans (RR = 0.86; 95% CI: 0.79; 0.93), and a 9% lower incidence when they consumed filled cookies, candies or treats (RR = 0.91; 95% CI 0.86; 0.96). The incidence of obesity was 11% higher in the group that consumed sweetened drinks (RR = 1.11; 95% CI: 1.05; 1.18) and 9% higher in the group that consumed instant noodles, packaged snacks or savory biscuits on the day before the 2015 registration (RR = 1.09; 95% CI: 1.03; 1.15). Conclusion: There was an increase in BMI in the population of adult women, rising nationally between 2015 and 2019, with the notable influence of diet on this change.

Global, regional, and national burden of age-related macular degeneration, 1990-2019: an age-period-cohort analysis based on the Global Burden of Disease 2019 Study.

Objectives: This study aimed to explore the burden of disease and disparities in age-related macular degeneration (AMD) at the global, regional, and national levels from 1990 to 2019 using data from the Global Burden of Disease (GBD) 2019 study, with a particular focus on associations with age, period, and cohort. Methods: We derived disability-adjusted life years (DALYs) and age-standardized rates of AMD from the GBD 2019. We used an age-period-cohort (APC) model to estimate the overall annual percentage changes in DALYs (net drifts), the annual percentage changes in different age groups (local drifts), the longitudinal age profiles (longitudinal age-specific rates), and the relative risks of period and cohort (period and cohort effects) between 1990 and 2019. Further analysis was conducted by country, region, gender and sociodemographic index (SDI). Results: Globally, the number of DALYs increased from 296771.9321 (95% uncertainty interval [UI], 205462.8041-418699.8184) in 1990 to 564055.0967 (95% UI, 392930.6967-789194.6407) in 2019 (59.7% were female), while the age-standardized DALYs rates decreased from 8.29 per 100,000 (95% UI, 5.8-11.58/100,000) to 7.05 per 100,000 (95% UI, 4.92-9.84/100,000). With increasing age, the burden of AMD increased, and the DALYs rates in female was greater than that in male in all age groups. The burden of disease varied across SDI regions and countries. The top three countries in terms of the number of DALYs were China, India and Italy, accounting for 45% of the global total. Conclusion: The burden of AMD varied according to SDI, country, and sex from 1990 to 2019. Due to global population growth and aging, AMD will continue to be a major public health problem in the future, and relevant health policies need to be continuously improved and optimized.

Cross-Sectional and Longitudinal Associations of Serum LRG1 with Severity and Prognosis Among Adult Community-Acquired Pneumonia Patients.

Background: Leucine-rich α-2 glycoprotein 1 (LRG1) is associated with various inflammatory lung diseases. Nevertheless, the connection between LRG1 and adult community-acquired pneumonia (CAP) individuals was still not well understood. Through a prospective cohort study, the correlations of serum LRG1 with severity and prognosis were evaluated in CAP patients. Methods: The study encompassed 327 patients who received the diagnosis of CAP. We collected fasting venous blood and clinical features. Serum LRG1 was detected by ELISA. CAP severity was assessed using various scoring systems. The prognostic outcomes were observed through follow-up visits. Results: The level of serum LRG1 at admission was gradually increased with CAP severity scores. Serum LRG1 level shown positive associations with inflammatory indices, including C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). Linear and logistic regression analyses suggested that serum LRG1 at admission was positively associated with severity scores and the risk of death in CAP patients. Serum LRG1 in combination with CAP severity scores significantly increased the predictive powers for severity and death compared with single serum LRG1 or severity scores. Conclusion: The study revealed positive connections of serum LRG1 levels with severity and poor prognosis in CAP patients, suggesting LRG1 partakes into the physiological processes of CAP. Serum LRG1 may be regarded as a potential biomarker in predicting the severity and death among CAP patients.

Exploring the relationship between polycystic ovarian syndrome, testosterone, and multiple sclerosis in women: A nationwide cohort study and genome-wide cross-trait analysis.

BACKGROUND: Women have a higher risk of developing multiple sclerosis (MS), potentially due to hormonal factors. Elevated testosterone levels, common in polycystic ovary syndrome (PCOS), might influence MS risk. OBJECTIVE: To investigate the relationship between PCOS, as a proxy for elevated testosterone levels, and MS risk through phenotypic and genomic analysis. METHODS: Cox regression models analysed the association between PCOS and MS risk. The genome-wide cross-trait analysis examined the genetic architecture. RESULTS: In a Swedish cohort of 1,374,529 women, 77 (0.3%) with PCOS and 3,654 (0.3%) without PCOS were diagnosed with MS. After adjusting for birth year and obesity, no association was found between PCOS and MS (HR = 0.91, 95% CI = 0.72-1.15), which was confirmed by Mendelian randomization analysis, where genetically predicted PCOS propensity, sex hormone-binding globulin (SHBG), or testosterone levels did not causally affect MS risk (all p-values > 0.05). By exploring horizontal pleiotropy, we identified shared genetic regions and 19 independent pleiotropic SNPs for SHBG with MS and 11 for testosterone with MS. CONCLUSION: We did not find evidence for a causal role of PCOS, as a proxy of elevated testosterone, in reducing the risk of MS in women. The shared genetic loci between testosterone, SHBG, and MS provide biological insights.

Correctly classifying cohort studies versus case series in systematic reviews and implications for evidence-based decision making.

The strength of a systematic review hinges in large part on the quality of evidence it appraises. Observational studies, including cohort studies and case series, are positioned lower on the hierarchy of evidence, with cohort studies typically higher than case series. The often subtle differences between these study designs may lead to misclassification and can impact the strength of recommendations derived from such data. This manuscript offers an approach to delineate the differences between cohort studies and case series and provides clinical examples of these subtleties. By providing a simple approach for distinguishing cohort studies from case series, this manuscript seeks to assist researchers performing systematic reviews.