Association between Serum 25-Hydroxyvitamin D Concentrations and Respiratory Infection among United States Adults.

BACKGROUND: Vitamin D plays an essential role in immune responses to infections. However, the association between serum 25(OH)D concentrations and respiratory infection remains unclear. OBJECTIVES: The current study aimed to examine the association between serum 25(OH)D concentrations and respiratory infection among the United States adults. METHODS: This cross-sectional study used data from the NHANES 2001-2014. Serum 25(OH)D concentrations were measured by radioimmunoassay or liquid chromatography-tandem mass spectrometry and were classified as ≥75.0 nmol/L (sufficiency), 50.0-74.9 nmol/L (insufficiency), 30.0-49.9 nmol/L (moderate deficiency), and <30 nmol/L (severe deficiency). The respiratory infections included self-reported head or chest cold as well as influenza, pneumonia, or ear infection within the last 30 d. The associations between serum 25(OH)D concentrations and respiratory infections were examined using weighted logistic regression models. Data are presented as ORs and 95% CIs. RESULTS: This study included 31,466 United States adults ≥20 y of age (47.1 y, 55.5% women) with a mean serum 25(OH)D concentration of 66.2 nmol/L. After adjusting for sociodemographic characteristics, season of examination, lifestyle and dietary factors, and body mass index, compared with participants with a serum 25(OH)D concentration ≥75.0 nmol/L, those with a serum 25(OH)D concentration <30 nmol/L had higher risk of head or chest cold (OR: 1.17; 95% CI: 1.01, 1.36) and other respiratory diseases, including influenza, pneumonia, and ear infections (OR: 1.84; 95% CI: 1.35, 2.51). In the stratification analyses, lower serum 25(OH)D concentrations were associated with a higher risk of head or chest cold in obese adults but not in nonobese adults. CONCLUSIONS: Serum 25(OH)D concentrations are inversely associated with respiratory infection occurrence among United States adults. This finding may shed light on the protective effect of vitamin D on the respiratory health.

Dietary inflammatory index and cardiovascular disease risk in Hispanic women from the Women's Health Initiative.

BACKGROUND: To evaluate the association between the dietary inflammatory index (DII®) and incident cardiovascular disease (CVD) in Hispanic women from the Women's Health Initiative (WHI), and to determine if body mass index (BMI) interacted with the DII scores. METHODS: Secondary analysis of baseline dietary data and long-term CVD outcomes among 3,469 postmenopausal women who self-identified as Hispanic enrolled in WHI. DII scores were calculated from self-administered food frequency questionnaires. The CVD outcomes included coronary heart disease (CHD) and stroke. Stratified Cox regression models were used to assess the relationship between DII scores and CVD in women with and without obesity. Models were adjusted for age, lifestyle risk factors, known risk factors, and neighborhood socioeconomic status. RESULTS: The incidence of CHD was 3.4 and 2.8% for stroke after a median follow-up of 12.9 years. None of the DIIs were associated with CVD risk in this sample of Hispanic women. BMI interacted with the DII (p < 0.20) and stratified models showed that the associations between the DII and CVD were only significant in women with overweight (p < 0.05). In this group, higher DII scores were associated with a higher risk of CHD (HR 1.27; 95% CI: 1.08, 1.51) and a higher risk of stroke (HR 1.32; 95% CI: 1.07, 1.64). CONCLUSION: Among postmenopausal Hispanic women with overweight, greater adherence to pro-inflammatory diets was associated with higher risk of CVD. Additional research is needed to understand how to promote long-term heart-healthy dietary habits to reduce inflammation and prevent CVD in at-risk Hispanic women.

Frequency of adding salt at the table and risk of incident cardiovascular disease and all-cause mortality: a prospective cohort study.

BACKGROUND: Adding salt at the table is a prevalent eating habit, but its long-term relationship with cardiovascular disease (CVD) and all-cause mortality remains unclear. We evaluated the associations of adding salt at the table with the risk of incident CVD and all-cause mortality. METHODS: Among 413,109 middle- and old-aged adults without cancer or CVD, all participants reported the frequency of adding salt at the table at baseline. The associations between adding salt at the table and incident CVD (the composite endpoint of coronary heart disease, stroke, heart failure, and CVD deaths) and all-cause mortality were investigated using Cox proportional hazards models. RESULTS: Of the study population, the mean age was 55.8 years and 45.5% were men; 44.4% reported adding salt at the table; 4.8% reported always adding salt at the table. During a median follow-up of 12 years, there were 37,091 incident CVD cases and 21,293 all-cause deaths. After adjustment for demographic, lifestyle, and cardiometabolic risk factors, the multivariable-adjusted hazard ratios (HRs) for participants who always added salt at the table versus never/rarely added salt at the table were 1.21 (95% confidence interval [CI]: 1.16-1.26) for CVD, 1.19 (95%CI: 1.05-1.35) for CVD mortality, and 1.22 (95%CI: 1.16-1.29) for all-cause mortality, respectively. CONCLUSIONS: In this prospective cohort study, a higher frequency of adding salt at the table was associated with a greater risk of incident CVD and mortality. Our findings support the benefits of restricting the habit of adding salt at the table in promoting cardiovascular health.

Associations of depression status with plasma levels of candidate lipid and amino acid metabolites: a meta-analysis of individual data from three independent samples of US postmenopausal women.

Recent animal and small clinical studies have suggested depression is related to altered lipid and amino acid profiles. However, this has not been examined in a population-based sample, particularly in women. We identified multiple metabolites associated with depression as potential candidates from prior studies. Cross-sectional data from three independent samples of postmenopausal women were analyzed, including women from the Women's Health Initiative-Observational Study (WHI-OS, n = 926), the WHI-Hormone Trials (WHI-HT; n = 1,325), and the Nurses' Health Study II Mind-Body Study (NHSII-MBS; n = 218). Positive depression status was defined as having any of the following: elevated depressive symptoms, antidepressant use, or depression history. Plasma metabolites were measured using liquid chromatography-tandem mass spectrometry (21 phosphatidylcholines (PCs), 7 lysophosphatidylethanolamines, 5 ceramides, 3 branched chain amino acids, and 9 neurotransmitters). Associations between depression status and metabolites were evaluated using multivariable linear regression; results were pooled by random-effects meta-analysis with multiple testing adjustment using the false discovery rate (FDR). Prevalence rates of positive depression status were 24.4% (WHI-OS), 25.7% (WHI-HT), and 44.7% (NHSII-MBS). After multivariable adjustment, positive depression status was associated with higher levels of glutamate and PC 36 : 1/38 : 3, and lower levels of tryptophan and GABA-to-glutamate and GABA-to-glutamine ratio (FDR-p < 0.05). Positive associations with LPE 18 : 0/18 : 1 and inverse associations with valine and serotonin were also observed, although these associations did not survive FDR adjustment. Associations of positive depression status with several candidate metabolites including PC 36 : 1/38 : 3 and amino acids involved in neurotransmission suggest potential depression-related metabolic alterations in postmenopausal women, with possible implications for later chronic disease.

Association between serum selenium concentrations and learning disability in a nationally representative sample of U.S. children.

BACKGROUND: Oxidative stress has been implicated in the pathogenesis of neurodevelopmental disorders. As an anti-oxidative agent, selenium plays an important role in human health. However, the relationship between selenium status and learning disability (LD), a common neurodevelopmental disorder, is unknown. OBJECTIVE: To examine the association between serum selenium concentrations and learning disability. DESIGN: Nationwide, population-based, cross-sectional study. PARTICIPANTS/SETTING: Children aged 4-11 years who have available data on serum selenium concentrations and LD (N = 1,076) from the U.S. National Health and Nutrition Examination Survey 1999-2000. EXPOSURE: Serum selenium levels were measured using atomic absorption spectrometry. MAIN OUTCOME MEASURES: Diagnosis of LD was reported by the children's parents. STATISTICAL ANALYSES PERFORMED: Logistic regression models with survey weights were conducted adjusting for age, race/ethnicity, family income, total energy intake, body mass index, and serum cotinine levels. RESULTS: In this study, 8.2% (95% confidence interval [CI] 5.2%-11.2%) of children had a diagnosis of LD. Serum selenium concentration was lower among children with LD than those without LD (geometric mean ± standard error, 107.7 ± 2.7 ng/mL vs. 112.8 ± 1.0 ng/mL, P for difference = 0.08). The adjusted odds ratio (OR) of LD comparing the highest with lowest tertile of serum selenium concentrations was 0.39 (95% CI 0.19-0.82). Each 10 ng/mL increment in serum selenium concentrations was associated with 31% (OR 0.69, 95% CI 0.51-0.93) lower odds of LD. CONCLUSIONS: Higher serum selenium concentration was associated with a lower risk of LD in U.S. children. The causal relationship between selenium and LD and the underlying mechanisms warrant further investigation.

Association of Anemia with Neurodevelopmental Disorders in a Nationally Representative Sample of US Children.

OBJECTIVE: To examine the associations of anemia with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and learning disability in US children. STUDY DESIGN: We included children and adolescents aged 3-17 years from the National Health Interview Survey (NHIS), 1997-2018. Information about physician-diagnosed history of anemia, ASD, ADHD, and learning disability was reported by a parent or guardian. Multiple logistic regression with sample weights was used to estimate the ORs and 95% CIs of neurodevelopmental disorders according to the presence of anemia. RESULTS: Of the total population of 213 893 children aged 3-17 years (mean age [SE], 10.01 [0.01] years), 2379 were reported to have a diagnosis of anemia, for a weighted prevalence of 1.06% (95% CI, 1.01-1.12). The prevalence of ASD was 1.94% (95% CI, 1.20-2.68) among children with anemia and 1.07% (95% CI, 1.01-1.14) among those without anemia. The corresponding prevalences were 12.24% (95% CI, 10.47-14.00) and 7.73% (95% CI, 7.58-7.88) for ADHD and 15.03% (95% CI, 13.08-16.99) and 7.75% (95% CI, 7.39-7.70) for learning disability, respectively. Compared with those without anemia, children with anemia were more likely to have neurodevelopmental disorders, with an aOR of 2.07 (95% CI, 1.39-3.08) for ASD, 1.84 (95% CI, 1.55-2.19) for ADHD, and 2.22 (95% CI, 1.90-2.60) for learning disability. CONCLUSIONS: In a nationally representative sample of US children, we found significant associations between anemia and neurodevelopmental disorders including ASD, ADHD, and learning disability. Further investigation is warranted to assess the causality and elucidate the underlying mechanisms.

Prevalence and Distribution of Electronic Cigarette Use Before and During Pregnancy Among Women in 38 States of the United States.

INTRODUCTION: To examine the prevalence and the changing pattern of e-cigarette use from preconception to pregnancy. AIMS AND METHODS: This is a cross-sectional study using data from the multi-site Pregnancy Risk Assessment Monitoring System in the United States, 2016-2017. All participating mothers with information on e-cigarette use before and during pregnancy were included. Self-reported information about e-cigarette use were assessed using questionnaires. Weighted prevalences of e-cigarette use before and during pregnancy were calculated. Multivariable logistic regressions were used to examine the association between various demographic characteristics and e-cigarette use before or during pregnancy. RESULTS: This study included 69 508 pregnant women from 38 states in the United States. The weighted prevalence of e-cigarette use before pregnancy and during the last 3 months of pregnancy was 3.6% (95% confidence interval [CI] 3.4%-3.9%) and 1.1% (0.9%-1.2%), respectively. The prevalence varied across states, ranging from 1.3% to 8.3% for e-cigarette use before pregnancy and from 0.1% to 3.4% for e-cigarette use during the last 3 months of pregnancy. Among women who used e-cigarettes before pregnancy, 24.4% (21.7%-27.1%) continued to use e-cigarettes during pregnancy. Among women who used e-cigarettes during pregnancy, 62.3% (56.5%-68.0%) were dual users. In multivariable analyses, cigarette smoking was most strongly associated with e-cigarette use. The adjusted odds ratio comparing smokers with nonsmokers before pregnancy was 11.10 (95% CI 9.34-13.20) for e-cigarette use before pregnancy and 6.72 (95% CI 4.38-10.31) for e-cigarette use during pregnancy. CONCLUSIONS: Using data from 38 states in the United States, we showed geographical variations in the prevalence of e-cigarette use before and during pregnancy. Among women who used e-cigarettes before pregnancy, a quarter of them continued to use e-cigarettes during pregnancy. Conventional cigarette use is a strong risk factor for e-cigarette use before and during pregnancy. The prevalence of e-cigarette use needs to be monitored continuously. IMPLICATIONS: This study provides important information to understand the status and changing patterns of e-cigarette use in pregnant women in the United States. Among pregnant women in 38 states in the United States, 3.6% of them used e-cigarettes during the 3 months before pregnancy and 1.1% used them during the last 3 months of pregnancy. The prevalence varied across states. A quarter of women who used e-cigarettes before pregnancy continued to use e-cigarettes during pregnancy. Cigarette smoking is the strongest predictor of e-cigarette use. Future research about health effects of e-cigarette use during pregnancy is in urgent need.

Maternal cigarette smoking before and during pregnancy and the risk of preterm birth: A dose-response analysis of 25 million mother-infant pairs.

BACKGROUND: Most of the women who smoke before pregnancy continue smoking during pregnancy, and some start to quit smoking after being pregnant, although existing guidelines for pregnancy recommend that women who smoke should quit smoking before pregnancy. Findings about the timing and intensity of maternal smoking, especially low-intensity smoking (1-9 cigarettes per day), and preterm birth are still inconsistent and ambiguous. This study aimed to examine the association of the timing of smoking and doses of smoking before pregnancy and during the first or second trimester of pregnancy with preterm birth in a large-scale population-based retrospective cohort study. METHODS AND FINDINGS: We used nationwide birth certificate data from singleton mother-infant pairs in the United States National Vital Statistics System, 2011-2018. All adult women with live singleton births, without preexisting hypertension or diabetes, and with complete data on smoking and gestational age at delivery were included. Participants reported their smoking status (yes or no) and daily number of cigarettes consumed before and during each trimester of pregnancy. The outcome of interest was preterm birth, defined as a birth before 37 weeks of gestation. Logistic regression models were used to estimate the odds ratio (OR) with 95% confidence intervals (CIs) of preterm birth associated with smoking status and the number of cigarettes consumed, adjusting for maternal age, race/ethnicity, parity, education levels, prepregnancy BMI, previous history of preterm birth, marital status, infant sex, and initiation of prenatal care. This study included 25,623,479 women, with a mean age of 29 years (range 20-50 years); 13,742,486 (53.6%) participants were of non-Hispanic white ancestry, 5,971,598 (23.3%) of Hispanic ancestry, and 3,417,456 (13.34%) of non-Hispanic black ancestry. The prevalence of preterm birth was 9.3% (n = 2,378,398). We found that maternal smoking during pregnancy, even at a very low level of intensity, was associated with an increased risk of preterm delivery. The adjusted ORs (95% CI) of preterm birth for mothers who smoked 1-2, 3-5, 6-9, 10-19, and ≥20 cigarettes per day during the first trimester compared with mothers who did not smoke were 1.31 (1.29-1.33), 1.31 (1.30-1.32), 1.33 (1.31-1.35), 1.44 (1.43-1.45), and 1.53 (1.52-1.55), respectively (all P values < 0.001), whereas for those who smoked during the second trimester, the corresponding ORs were 1.37 (1.35-1.39), 1.36 (1.35-1.38), 1.36 (1.34-1.38), 1.48 (1.47-1.49), and 1.59 (1.58-1.61), respectively (all P values < 0.001). Furthermore, smokers who quit before pregnancy, regardless of smoking intensity, had a comparable risk of preterm birth with nonsmokers, although this was not the case when cessation occurred in the first or second trimester of pregnancy. The major limitation of this study is the self-reported information about smoking, which may be subject to information bias. In addition, we cannot rule out the possibility of residual confounding caused by unmeasured factors in an observational research design. CONCLUSIONS: In this study, we observed that low-intensity cigarette consumption during either the first or second trimester of pregnancy, even as low as 1-2 cigarettes per day, was associated with an increased risk of preterm birth. These findings suggest that there is no safe level or safe trimester for maternal smoking during pregnancy. Women of reproductive age who smoke should be strongly encouraged and supported to quit smoking before pregnancy.

Simple Universal Strategy for Quantification of Carboxyl Groups on Carbon Nanomaterials: Carbon Dioxide Vapor Generation Coupled to Microplasma for Optical Emission Spectrometric Detection.

The physicochemical properties and applications of carbon nanomaterials are remarkably dependent on the amount of carboxyl group on their surfaces. Unfortunately, it is challenging to determine the carboxyl group on carbon nanomaterials at an ultralow density not only due to the low sensitivities of conventional techniques, but also because there are no matrix-matched certified reference materials available. In this work, a novel strategy comprising coupling carbon dioxide vapor generation to a microplasma optical emission spectrometer was developed for the sensitive and accurate quantification of surface carboxyl groups on carbon nanomaterials. The carboxyl group on multiwall carbon nanotubes (MWCNTs), graphene (G), or its oxide (GO) was converted to carboxylic acid using concentrated hydrochloric acid prior to quantification. The generated carboxylic acid was purified and then reacted with sodium bicarbonate to generate CO2, which was swept into a miniaturized point discharge optical emission spectrometer (µPD-OES) for the detection of carbon atomic emission lines. Potassium hydrogen phthalate (KHP) served as a calibration standard for quantification of the carboxyl group on G/GO/MWCNTs, thus, overcoming the lack of CRMs. Owing to the high sensitivity of µPD-OES for the detection of CO2, a limit of detection of 0.1 µmol g-1 (1 nmol) was obtained for the carboxyl group based on a sample mass of 10 mg G/GO/MWCNTs, superior to that obtained using conventional methods. Moreover, the proposed method not only retains several unique advantages of good accuracy and elimination of the use of complicated, expensive, and high power-consumption instruments, but was also applicable to the quantification of the carboxyl group on other nanomaterials such as carboxylated magnetic microspheres.

The Relation of Optimism to Relative Telomere Length in Older Men and Women.

OBJECTIVE: Mounting evidence suggests that higher optimism is associated with reduced risk of age-related morbidities and premature mortality. However, possible biological mechanisms underlying these associations remain understudied. One hypothesized mechanism is a slower rate of cellular aging, which in turn delays age-related declines in health. METHODS: We used data from two large cohort studies to test the hypothesis that higher optimism is associated with longer leukocyte telomere length. With cross-sectional data from the Health and Retirement Study (HRS; n = 6417; mean age = 70 years) and the Women's Health Initiative (WHI; N = 3582; mean age = 63 years), we used linear regression models to examine the association of optimism with relative telomere length (assessed in leukocytes from saliva [HRS] or plasma [WHI]). Models adjusted for sociodemographics, depression, health status, and health behaviors. RESULTS: Considering both optimism and telomere length as continuous variables, we found consistently null associations in both cohorts, regardless of which covariates were included in the models. In models adjusting for demographics, depression, comorbidities, and health behaviors, optimism was not associated with mean relative telomere length (HRS: ß = -0.002, 95% confidence interval = -0.014 to 0.011; WHI: ß = -0.004, 95% confidence interval = -0.017 to 0.009). CONCLUSIONS: Findings do not support mean telomere length as a mechanism that explains observed relations of optimism with reduced risk of chronic disease in older adults. Future research is needed to evaluate other potential biological markers and pathways.

Trajectories and the influencing factors of behavior problems in preschool children: a longitudinal study in Guangzhou, China.

BACKGROUND: Since child mental health problem was a global health issue, many researchers in western countries has focused on the trajectory of it to provide evidence for prevention programs. We designed this study to determine the trajectories of children's behavior problems, and to explore the effect of parent predictors on children's behavior problems in Guangzhou, China. METHODS: Children (N = 1480) for this longitudinal, population-based survey, were recruited from eight regular kindergartens (October, 2010) across four districts in Guangzhou. Repeated measurement design analysis was used to compare the variation in behavioral problems by gender, only child status, and temperament. Logistic regression was applied to analyze the effect of parents' risks (maternal depression, parenting style) on the change in child problem behaviors. RESULTS: The scores of behavior problems (externalizing, emotional, social communication problems) were stable during the entire preschool period by gender and child number. Children with difficult temperament exhibited more problem behaviors than children with easy temperament in the early years, and the misbehaviors declined significantly over time. Moreover, maternal depression and the increase in excessive interference/over protective or punishing parenting strategies resulted in an increase in child behavior problems. CONCLUSION: There was no difference between the only-child status and child with siblings in the trajectory of problem behaviors. Parent factors were significant predictions of trajectory of child behavior problem during preschool age.

Altruistic sharing behavior in children: Role of theory of mind and inhibitory control.

This study aimed to assess altruistic sharing behavior in children aged 3 to 5, 6 to 8, and 9 to 11 years and to explore the involvement of potential cognitive mechanisms, namely theory of mind (ToM) and inhibitory control. A total of 158 children completed a dictator game with stickers as incentives. ToM was evaluated using a false belief task in preschoolers and the Strange Story Test in school-age children. Inhibitory control was assessed in preschoolers with the Day-Night task and in older children with the Stroop Color-Word Test. The result was that 48.10% of children aged 3 to 5 years decided to share, and the percentage rose significantly with increasing age. The difference in altruism level in children who decided to share among the three age groups was nonsignificant. These results suggest that mechanisms underlying the decision to share or not and altruistic behavior may be different. No significant linear relations were found between cognitive processes (i.e., ToM and inhibitory control) and sharing behavior. Surprisingly, 9- to 11-year-olds who shared 3 of 10 stickers performed worse in inhibitory control than did those who shared any other number of stickers. In conclusion, the proportion of children who decided to share, but not the level of altruism, increased with age. ToM was not involved in altruistic sharing, whereas inhibitory control may play a role when deciding how much to share.

[Secular trends of overweight and obesity prevalence between 2007 and 2011 in children and adolescents in Guangzhou].

OBJECTIVE: This study aimed to explore the secular trends of overweight and obesity prevalence between 2007 and 2011 in children and adolescents in Guangzhou. METHODS: The data of physical examination was collected from the routine measurements carried out by the Health Care Facilities of Primary and Secondary schools between 2007 and 2011. Random stratified cluster sampling was conducted, all the students aged 5-18 years old form 19 primary and secondary schools from 4 districts (Tianhe district, Yuexiu district, Baiyun district and Haizhu district) were included in this survey, including 27 944 students in 2007 and 38 284 students in 2011. Body mass index reference norm established by Working Group on Obesity in China (WGOC) and the WHO cut-off criteria were employed for overweight and obesity screening, and the trend was analyzed. RESULTS: Prevalence of obesity in children and adolescents (7-18 years old) significantly increased from 5.96% (1 553/26 055) in 2007 to 6.56% (2 339/35 664) in 2011, and the difference showed statistical significance (χ(2) = 9.195, P < 0.05). Overweight and obesity was more common in boys (overweight: 13.25% (1 766/13 329) in 2007 and 13.87% (2 559/18 451) in 2011; obesity: 7.82% (1 042/13 329) in 2007 and 8.63% (1 592/18 451) in 2011) than in girls (overweight: 7.43% (946/12 726) in 2007 and 8.17% (1 406/17 213) in 2011; obesity: 4.11% (523/12 726) in 2007 and 4.48% (771/17 213) in 2011), and the difference showed statistical significance (overweight:χ(2) = 236.123 in 2007 and χ(2) = 292.892 in 2011; obesity:χ(2) = 158.533 in 2007 and χ(2) = 247.794 in 2011. All P values < 0.05). Further analysis found that significant increases occurred in boys aged 16 and 17 years old and in girls aged 12 years old (boy: 16 years old,χ(2) = 6.820, P < 0.05. 17 years old, χ(2) = 4.893, P < 0.05. girl: 12 years old,χ(2) = 5.921, P < 0.05). RESULTS: of Join-point regression showed that for boys less than 10 years old the prevalence increased with age increasing (in 2007, APC = 3.75; in 2011, APC = 1.76), while over 10 years old the prevalence decreased with age increasing (in 2007, 10-18 years old's APC = -18.58; in 2011, 10-18 years old's APC = -15.95). While for girls the prevalence of obesity increased with age increasing between 7-9 years old (APC = 12.16), decreased with age increasing through 9 to 18 years old (APC = -17.23) in 2007. The prevalence decreased with age increasing for girls in 2011 (APC = -4.66). CONCLUSION: The prevalence of obesity is high and still increasing in children and adolescents in Guangzhou, and it is higher in boys than in girls. It is more likely to become obesity at 10 years for boys, and for girls the prevalence decrease with age increasing.

Bisphenol S, bisphenol F, bisphenol a exposure and body composition in US adults.

Bisphenol S (BPS) and bisphenol F (BPF) are increasingly used to replace bisphenol A (BPA), an endocrine-disrupting chemical with putative obesogenic properties; whether and how BPS and BPF affect adiposity in humans remains to be determined. Therefore, we examined the association of BPA, BPS， and BPF with body composition among US adults. We included 1787 participants aged 20-59 years old in the National Health and Nutrition Examination Survey 2013-2016 who had information on urinary BPA, BPS, and BPF concentrations, and body composition measured using dual-energy x-ray absorptiometry. After full adjustment for potential confounders in linear regression models, BPA was significantly associated with the % body fat of the whole body, arm, and leg, with the ß (95% CI) for the highest quartile vs. the lowest quartile of 1.34 (95%CI [0.11, 2.58], P = 0.03), 1.60 (95%CI [0.20, 3.00], P = 0.03), and 1.63 (95%CI [0.24, 3.02], P = 0.02), respectively. No association between BPA and lean mass was found. For BPS, significant associations were found for % body fat of the whole body (ß [95% CI] = 1.42 [0.49, 2.36], P = 0.004), trunk (ß[95% CI] = 1.92 [0.86, 2.97], P = 0.001), and arm (ß [95% CI] = 1.60 [0.49, 2.70], P = 0.01), as well as lean mass of the whole body (ß [95% CI] = 2610.6 [1324.3, 3896.8], P < 0.001), trunk (ß [95% CI] = 1467.0 [745.3, 2188.7], P < 0.001), arm (ß [95% CI] = 113.4 [10.3, 216.5], P = 0.03), and leg (ß [95% CI] = 431.5 [219.6, 643.4], P < 0.001), comparing the third quartile vs. the lowest quartile. No significant association was observed between BPF and % body fat and lean mass. Results suggest that higher BPA levels were significantly associated with greater % body fat of the whole body and limbs, and there was suggestive evidence that BPS levels were associated with both % body fat and lean mass of the whole body and body parts in a nonmonotonic relationship.

Exposure to Polybrominated Diphenyl Ethers and Risk of All-Cause and Cause-Specific Mortality.

Importance: Polybrominated diphenyl ethers (PBDEs) are an important group of persistent organic pollutants with endocrine-disrupting properties. However, prospective cohort studies regarding the association of PBDE exposure with long-term health outcomes, particularly mortality, are lacking. Objective: To examine the association of environmental exposure to PBDEs with risk of all-cause and cause-specific mortality. Design, Setting, and Participants: This nationally representative cohort study used data from the National Health and Nutrition Examination Survey 2003 to 2004 and linked mortality information through December 31, 2019. Adults aged 20 years or older with available data on PBDE measurements and mortality were included. Statistical analysis was performed from February 2022 to April 2023. Exposures: PBDE analytes in serum samples were measured using solid phase extraction and isotope dilution gas chromatography high-resolution mass spectrometry. Main Outcomes and Measures: All-cause mortality, cancer mortality, and cardiovascular mortality. Results: This study included 1100 participants (mean [SE] age, 42.9 [0.6] years; proportion [SE] female, 51.8% [1.6%]; proportion [SE] Hispanic, 12.9% [2.7%]; proportion [SE] non-Hispanic Black, 10.5% [1.6%]; proportion [SE] non-Hispanic White, 70.8% [3.7%]; proportion [SE] other race and ethnicity, 5.8% [1.1%]). During 16 162 person-years of follow-up (median [IQR] follow-up, 15.8 [15.2-16.3] years; maximum follow-up, 17 years), 199 deaths occurred. Participants with higher serum PBDE levels were at higher risk for death. After adjustment for age, sex, and race and ethnicity, lifestyle and socioeconomic factors, and body mass index, participants with the highest tertile of serum PBDE levels had an approximately 300% increased risk of cancer mortality (HR, 4.09 [95% CI, 1.71-9.79]) compared with those with the lowest tertile of serum PBDE levels. No significant association of PBDE exposure with all-cause mortality (HR, 1.43 [95% CI, 0.98-2.07]) or cardiovascular mortality (HR, 0.92 [95% CI, 0.41-2.08]) was observed. Conclusions and Relevance: In this nationally representative cohort study, PBDE exposure was significantly associated with an increased risk of cancer mortality. Further studies are needed to replicate the findings and determine the underlying mechanisms.

Association between Body Iron Status and Cognitive Task Performance in a Nationally Representative Sample of Older Adults.

Iron is an essential micronutrient that is necessary for proper cognitive function. However, the dose-response relationship between body iron status and cognitive function remains unclear. The objective of this study was to investigate the association between serum ferritin concentrations, an indicator of body iron status, and cognitive function in older adults. Based on the National Health and Nutrition Examination Survey (NHANES) 1999 -2002 in the United States, nationally representative data was collected from 2,567 adults aged 60 years and older who had objectively measured serum ferritin levels and cognitive performance. High ferritin levels were defined as a serum ferritin level >200 ng/mL in women and >300 ng/mL in men. Low ferritin levels were defined as a serum ferritin level <30 ng/mL. The digit symbol substitution test (DSST) was employed to assess cognitive function. Multivariable logistic regression analyses with survey weights were performed after the DSST was dichotomized at the median score. The weighted prevalence of adults with normal, low, and high serum ferritin levels were 73.98%, 9.12%, and 16.91%, respectively. A U-shaped association between serum ferritin concentrations and cognitive task performance was observed. After adjusting for demographic, socioeconomic, lifestyle, and C-reactive protein factors, the odds ratio (95% confidence intervals) for lower cognitive performance was 1.39 (1.11, 1.74) in adults with high ferritin levels and 1.38 (0.86, 2.22) in adults with low ferritin levels, compared with those with normal ferritin levels. The association between serum ferritin levels and lower cognitive performance was stronger in adults aged 60 to 69 years old than those aged 70 years and older. In conclusion, in a nationally representative sample of older adults in the United States, a high serum ferritin level was significantly associated with worse cognitive task performance. Thus, the relationship between low serum ferritin concentrations and cognitive task performance warrants further investigation.

Identification of PCB Congeners and their Thresholds associated with Diabetes using Decision Tree Analysis.

Few studies have investigated the potential combined effects of multiple PCB congeners on diabetes. To address this gap, we used data from 1244 adults in the National Health and Nutrition Examination Survey (NHANES) 2003-2004. We used 1) classification trees to identify serum PCB congeners and their thresholds associated with diabetes; and 2) logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes with combined PCB congeners. Of the 40 PCB congeners examined, PCB 126 has the strongest association with diabetes. The adjusted OR of diabetes comparing PCB 126 > 0.025 to ≤ 0.025 ng/g was 2.14 (95% CI 1.30-3.53). In the subpopulation with PCB 126 > 0.025 ng/g, a lower PCB 101 concentration was associated with an increased risk of diabetes (comparing PCB 101 < 0.72 to ≥ 0.72 ng/g, OR = 3.3, 95% CI: 1.27-8.55). In the subpopulation with PCB 126 > 0.025&PCB 101 < 0.72 ng/g, a higher PCB 49 concentration was associated with an increased risk of diabetes (comparing PCB 49 > 0.65 to ≤ 0.65 ng/g, OR = 2.79, 95% CI: 1.06-7.35). This nationally representative study provided new insights into the combined associations of PCBs with diabetes.

Identification of PCB congeners and their thresholds associated with diabetes using decision tree analysis.

Few studies have investigated the potential combined effects of multiple PCB congeners on diabetes. To address this gap, we used data from 1244 adults in the National Health and Nutrition Examination Survey (NHANES) 2003-2004. We used (1) classification trees to identify serum PCB congeners and their thresholds associated with diabetes; and (2) logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes with combined PCB congeners. Of the 40 PCB congeners examined, PCB 126 has the strongest association with diabetes. The adjusted OR of diabetes comparing PCB 126 > 0.025 to ≤ 0.025 ng/g was 2.14 (95% CI 1.30-3.53). In the subpopulation with PCB 126 > 0.025 ng/g, a lower PCB 101 concentration was associated with an increased risk of diabetes (comparing PCB 101 < 0.72 to ≥ 0.72 ng/g, OR 3.3, 95% CI 1.27-8.55). In the subpopulation with PCB 126 > 0.025 & PCB 101 < 0.72 ng/g, a higher PCB 49 concentration was associated with an increased risk of diabetes (comparing PCB 49 > 0.65 to ≤ 0.65 ng/g, OR 2.79, 95% CI 1.06-7.35). This nationally representative study provided new insights into the combined associations of PCBs with diabetes.