Examining Age-Adjusted Associations between BMI and Comorbidities in Mongolia: Cross-Sectional Prevalence.

(1) Background: This study investigated the association between body mass index (BMI) categories and comorbidities in the context of a developing country, utilizing data from a nationwide health screening in Mongolia. (2) Methods: The study included 181,080 individuals (mean age 47.0 ± 15.3, 42.0% male) from the population-based general health screening. We counted the number of diseases from participants' medical records based on ICD-10 codes, excluding those categorized under Z00-Z99 and codes indicating acute disorders, as well as individuals classified as underweight. (3) Results: Among study participants, the prevalence of two or more comorbidities was 4.2%. The weight distribution comprised 40.4% normal weight; 37.1% overweight; and 16.9%, 4.4%, and 1.2% in the Class I, II, and III obesity categories, respectively. Comorbidities increased with BMI: normal weight (0.222); overweight (0.255); and Class I (0.290), Class II (0.302), and Class III obesity (0.303), suggesting a dose-dependent likelihood of having multiple diseases. Adjusted linear regression (beta coefficients, 95% CIs) showed increased comorbidity risks in overweight (0.017, 0.013-0.021) and obesity (0.034, 0.030-0.039). Interaction analysis with age revealed a significant effect (p < 0.001). While comorbidities tend to increase with higher BMI categories in all age-tertile groups, this association was notably stronger among younger individuals. (4) Conclusions: Obesity is associated with a twofold increase in the prevalence of multiple comorbidities compared to normal weight. Our findings also highlight the critical role of age in the development of multiple diseases, with BMI remaining a significant factor across various age groups, encompassing both younger and older adults.

Molecular epidemiology of SARS-CoV-2 in Mongolia, first experience with nanopore sequencing in lower- and middle-income countries setting.

BACKGROUND: Coronavirus disease (COVID-19) has had a significant impact globally, and extensive genomic research has been conducted on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineage patterns and its variants. Mongolia's effective response resulted in low prevalence until vaccinations became available. However, due to the lack of systematically collected data and absence of whole genome sequencing capabilities, we conducted a two-stepped, nationally representative molecular epidemiologic study of SARS-CoV-2 in Mongolia for 2020 and 2021. METHODS: We used retrospective analysis of stored biological samples from November 2020 to October 2021 and a variant-specific real-time reverse transcription polymerase chain reaction (RT-PCR) test to detect SARS-CoV-2 variants, followed by whole genome sequencing by Nanopore technology. Samples were retrieved from different sites and stored at -70°C deep freezer, and tests were performed on samples with cycle threshold <30. RESULTS: Out of 4879 nucleic acid tests, 799 whole genome sequencing had been carried out. Among the stored samples of earlier local transmission, we found the 20B (B.1.1.46) variant predominated in the earlier local transmission period. A slower introduction and circulation of alpha and delta variants were observed compared to global dynamics in 2020 and 2021. Beta or Gamma variants were not detected between November 2020 and September 2021 in Mongolia. CONCLUSIONS: SARS-CoV-2 variants of concerns including alpha and delta were delayed in circulation potentially due to public health stringencies in Mongolia. We are sharing our initial experience with whole genome sequencing of SARS-CoV-2 from Mongolia, where sequencing data is sparse.

Antibody responses to mRNA versus non-mRNA COVID vaccines among the Mongolian population.

Background: A nationwide vaccination program against coronavirus disease 2019 (COVID-19) was started in Mongolia 4 months after the first local transmission, which occurred in November 2020. Previous studies have reported that two doses of COVID-19 vaccine result in increased antibody against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A study was conducted in Mongolia 2 weeks after the second vaccine dose. In the present study, the serum levels of antibodies of individuals 6 months after natural SARS-CoV-2 infection were compared with those of individuals who had not been infected or had been infected but had received two doses of vaccine, including BNT162b2, ChAdOx1 n-CoV-19, Gam-COVID-Vac, and BBIBP-CorV, which were used for COVID-19 in Mongolia. Methods: Of the 450 participants in this study, 237 (52.66%) were female and 213 (47.33%) were male. Four hundred people with or without SARS-CoV-2 infection who received two doses of 4 different COVID-19 vaccine participated in the vaccine groups and vaccine plus SARS-CoV-2 infection groups (50 in each group) and 50 individuals previously infected with SARS-CoV-2 participated in the unvaccinated group. Total antibody against SARS-CoV-2 infection, anti-SARS-CoV-2 N and S protein human IgG, and antibody inhibiting RBD-ACE2 binding were tested. Results: In the BNT162b2 vaccine group, total antibody against SARS-CoV-2 remained constant until 6 months, while the other vaccine groups showed a significant decrease, as compared to the unvaccinated group. The level of anti-SARS-CoV-2 S-RBD protein IgG was significantly increased in the ChAdOx1 n-CoV-19, Gam-COVID-Vac, and BNT162b2 vaccines groups as compared to the unvaccinated group. Participants in the BNT162b2 vaccine group had higher ACE2 inhibition efficiency compared to the other vaccine groups as well as the unvaccinated group. Conclusions: The BNT162b2 vaccine showed the highest level of antibody against SARS-CoV-2, followed by the BBIBP-CorV, Gam-COVID-Vac, and ChAdOx1 n-CoV-19 vaccines. The level of antibodies was increased in people infected with SARS-CoV-2 after vaccination, as compared to uninfected but vaccinated individuals.