Association of organ damage with predicted fat mass in a community-dwelling elderly: the Northern Shanghai study.

BACKGROUND: Body fat mass (FM) is associated with multiple organ damage. However, data regarding the relationship between various organ damage and FM are rare in the elderly. Therefore, we aim to perform an analysis on the relationship between organ damage and FM in a geriatric cohort. METHODS: 3331 participants were included in this analysis. Based on age, body height, body weight, waist circumference, and race, we calculated FM with the established formula. Organ damage, including arterial stiffening, lower extremity atherosclerosis, left ventricular hypertrophy (LVH), micro-albuminuria, and chronic kidney disease (CKD), were measured and calculated with standard methods. RESULTS: All organ damage parameters were significantly related to FM (all p < 0.001). In univariate logistics regression, the highest quartile of FM was tied to the increased risk of arterial stiffening, lower extremity atherosclerosis, LVH, micro-albuminuria, and CKD (all p < 0.05). After adjustment, participants with higher quantiles of FM had a significantly increased odd ratio (OR) for arterial stiffening [OR = 1.51, 95% confidence interval (CI): 1.15-1.99, p = 0.002] and LVH (OR = 1.99, 95% CI: 1.48-2.67, p < 0.001). Moreover, FM was linearly associated with arterial stiffening and LVH in total population and gender subgroups. Independent of confounders, FM was significantly correlated with arterial stiffening, lower extremity atherosclerosis, LVH and CKD in female, while was only related to LVH in male. CONCLUSIONS: Among various organ damage, elevated FM is significantly and independently associated with arterial stiffening and LVH in the elderly. Compared with men, women with increased FM are more likely to have multiple organ damage.

Fat-free mass may play a dominant role in the association between systolic blood pressure and body composition in children and adolescents.

Systolic blood pressure (SBP) is significantly associated with body composition in children and adolescents. However, which one of the components of body composition is the dominant contributor to SBP in children and adolescents remains unclear. We, therefore, aimed to determine the dominant contributor to SBP among components of body composition in a large cohort of American children and adolescents derived from the National Health and Nutrition Examination Survey with cross-sectional analysis. In total, 13 618 children and adolescents (median age 13 years; 6107 girls) with available data on whole-body dual-emission X-ray absorptiometry measurements were included. Multiple linear regression showed that SBP was associated with higher total fat-free mass in boys (ß = 0·49, P < 0·001) and girls (ß = 0·47, P < 0·001) and with higher total fat mass only in boys (ß = 0·12, P < 0·001) after adjustment for covariates. When taking fat distribution into consideration, SBP was associated with higher trunk fat mass (boys: ß = 0·28, P < 0·001; girls: ß = 0·15, P < 0·001) but negatively associated with leg fat mass (Boys: ß = -0·14, P < 0·001; Girls: ß = -0·11, P < 0·001), in both boys and girls. Dominance analysis showed that total fat-free mass was the dominant contributor to SBP (boys: 49 %; girls: 55·3 %), followed by trunk fat mass (boys: 32·1 %; girls: 26·9 %); leg fat mass contributed the least to SBP in boys (18·9 %) and girls (17·8 %). Our findings indicated that total fat-free mass was not only associated with SBP but also the most dominant contributor to SBP variation in American children and adolescents.

Coupling Ti doping with oxygen vacancies in tungsten oxide for high-performance photochromism applications.

A series of Ti-doped W18O49 samples were prepared using a convenient solvothermal route. Due to the synergistic effect of doped Ti and oxygen vacancies, the samples showed excellent visible-light photochromic properties. Their performances as light-printable rewritable paper and smart windows showed great application value and promotion value.

Etiological Diagnosis and Personalized Therapy for Hypertension: A Hypothesis of the REASOH Classification.

With the epidemic of risk factors such as unhealthy lifestyle, obesity and mental stress, the prevalence of hypertension continues to rise across the world. Although standardized treatment protocols simplify the selection of antihypertensive drugs and ensure therapeutic efficacy, the pathophysiological state of some patients remains, which may also lead to the development of other cardiovascular diseases. Thus, there is an urgent need to consider the pathogenesis and selection of antihypertensive drug for different type of hypertensive patients in the era of precision medicine. We proposed the REASOH classification, based on the etiology of hypertension, including renin-dependent hypertension, elderly-arteriosclerosis-based hypertension, sympathetic-active hypertension, secondary hypertension, salt-sensitive hypertension and hyperhomocysteinemia hypertension. The aim of this paper is to propose a hypothesis and provide a brief reference for the personalized treatment of hypertensive patients.

Influence of ligand substitution and the solvent effect on the structures and magnetic properties of dinuclear Dy2 supramolecular architectures constructed with the bis-ß-diketonate-Dy2 building block as a metalloligand.

Based on the bis-ß-diketonate-Dy2 metalloligand [Dy2(pbth)4]·2Et3N (1, pbth = (3z,3'z)-4,4'-(1,3-phenylene)bis(1,1,1-trifluoro-4-hydroxybut-3-en-2-one)), six dinuclear complexes with eight-coordinated geometries were synthesized solvothermally through different capping N-donor coligands or solvent systems. These complexes are namely [Dy2(pbth)3(Phen)2]·2C2H5OH (2), [Dy2(pbth)3(BPhen)2]·2C2H5OH (3), [Dy2(pbth)3(Dppz)2]·2C2H5OH (4), [Dy2(pbth)3(Dppz)2]·2CH3OH (4a), [Dy2(pbth)3(4-Dmbp)2]·CH3OH·C2H5OH (5) and [Dy2(pbth)3(5-Dmbp)2]·CH3OH (6) (Phen = 1,10-phenanthroline, BPhen = 4,7-diphenyl-1,10-phenanthroline, dppz = dipyrido [3,2-a:2',3'-c] phenazine, 4-Dmbp = 4,4'-dimethyl-2,2'-bipyridyl, 5-Dmbp = 5,5'-dimethyl-2,2'-bipyridyl), respectively. In the synthetic processes of 2-6, one of four bis-ß-diketonate ligands in the metalloligand is replaced by two capping N-donor coligands. The coordination geometries, metal distances and M-L-M torsion angles of the synthesized complexes are perceptibly fine-tuned by the modification of the capping N-donor coligands or the latticed solvent molecules. Systematic magnetic investigations indicate the different magnetic relaxation dynamics of 1-6. Complex 1 displays no characteristics of single-molecule magnets (SMMs), while complexes 2-6 exhibit SMM behaviours in the absence of a static magnetic field. Complexes 2 and 3 possess effective energy barriers (Ueff) of 110.18 (2) K and 133.21 (4) K, respectively. Theoretical analysis based on ab initio calculation provides some interpretations of experimental observation.

Monocyte to high-density lipoprotein ratio presents a linear association with atherosclerosis and nonlinear association with arteriosclerosis in elderly Chinese population: The Northern Shanghai Study.

BACKGROUND AND AIMS: Inflammation closely correlates with atherosclerosis and cardiovascular disease (CVD). Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a novel inflammation index that can be obtained by routine blood tests. We aimed to investigate the associations between MHR and atherosclerosis and arteriosclerosis. METHODS AND RESULTS: We enrolled 2451 participants from the Northern Shanghai Study. Atherosclerosis (carotid plaque (CP), lower extremity atherosclerotic (LEA) assessed by ankle-brachial index) and arteriosclerosis (arterial stiffness (AS) assessed by carotid-femoral pulse wave velocity) were measured using standard methods. In the univariable logistic regression model, higher MHR was significantly associated with increased AS, CP, and LEA risk. In the multivariable logistic regression model, after adjustment for age, sex, hypertension, diabetes mellitus, body mass index, smoking habit, low-density lipoprotein cholesterol, and family history of premature CVD, quartile 4 (Q4) of MHR was associated with an increased risk of AS (odds ratio (OR) = 1.41; 95% confidence interval (CI):1.05-1.88; P fortrend = 0.036), CP (OR = 1.35; 95%CI:1.04-1.77; P for trend = 0.044), and LEA (OR = 2.23; 95%CI:1.49-3.35; P for trend< 0.001). Similar results were observed when MHR was analyzed as a continuous variable. The restricted cubic spline (RCS) curve showed that the association between MHR and AS was nonlinear (P nonlinear = 0.021), but not LEA (P nonlinear = 0.177) or CP (P nonlinear = 0.72). CONCLUSION: MHR presents a linear association with atherosclerosis and a nonlinear association with arteriosclerosis in the elderly Chinese population. These findings may indicate the need for early assessment and intervention for inflammation. The registration number for clinical trials: NCT02368938.

The impact of body composition and fat distribution on blood pressure in young and middle-aged adults.

Background: The relative contributions of each component of body composition to blood pressure (BP) remain unclear. Objective: We aimed to comprehensively investigate the impact of body composition and fat distribution on BP and quantify their relative contributions to BP in a large cohort with young and middle-aged adults. Methods: 14,412 participants with available data on whole-body DXA measurement from the National Health and Nutrition Examination Survey were included. Multiple stepwise linear regressions of BP on components of body composition and fat distribution were built. Then, relative importance analysis was performed to quantify the contributions of each component to BP. Results: The median age of participants was 36 years and there were 50.7% women. Linear regression with mutual adjustment showed that total fat mass, total muscle mass, and trunk fat mass significantly and positively associated with BP; however, arm and leg fat mass significantly and negatively associated with BP. In men, after further adjusted for potential covariates, SBP were significantly determined by trunk fat mass (ß = 0.33, P < 0.001), leg fat mass (ß = - 0.12, P < 0.001), and total muscle mass (ß = 0.10, P < 0.001); and DBP were significantly determined by trunk fat mass (ß = 0.52, P < 0.001), leg fat mass (ß = -0.15, P < 0.001), arm fat mass (ß = -0.23, P < 0.001), and total muscle mass (ß = 0.06, P < 0.001). Similar results were observed in women. Relative importance analysis showed that trunk fat mass was the major contributor (38-61%) to both SBP and DBP; meanwhile, total muscle mass also made relatively great contribution (35-43%) to SBP. Conclusion: Both fat mass and muscle mass independently associated with and substantially contributed to SBP in both men and women. After full adjustment, trunk fat mass positively associated with both SBP and DBP, and was the most dominant contributor to BP; however, leg fat mass negatively associated with both SBP and DBP.

Prognostic Value of Arm Circumference for Cardiac Damage and Major Adverse Cardiovascular Events: A Friend or a Foe? A 2-Year Follow-Up in the Northern Shanghai Study.

Background: The high prevalence of cardiovascular diseases globally causes a great social burden and much individual suffering. The effective recognition of high-risk subjects is critical for primary prevention in the general population. In the elderly cohort, anthropometric measurements may have different prognostic values. Our study aimed to find convincing anthropometric measures to supplement conventional risk factors for major adverse cardiovascular events (MACEs) in the elderly cohort. Materials and Methods: A total of 1,576 elderly participants (44.5% male, aged 72.0 ± 6.0 years) recruited into the Northern Shanghai Study (2014-2015) were followed up between 2016 and 2017. Following the standard guideline for cardiovascular risk evaluation, all conventional cardiovascular risk factors were assessed. The body measures were made up of body weight, body height, hip circumference, waist circumference, and middle-upper arm circumference (MUAC). Organ damage (OD) markers for cardiac, vascular, and renal diseases will be evaluated by the standardized methods. Results: After the average 571 (±135) days of follow-up, a total of 90 MACEs (5.7%) occurred, i.e., 13 non-fatal myocardial infarction, 68 non-fatal stroke, and 9 cardiovascular deaths. Univariable COX survival analysis revealed that only MUAC could validly predict MACEs among anthropometric characters [adjusted hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.82-0.96]. In Kaplan-Meier analysis, the group of high MUAC showed the lowest MACE risk (log-rank p = 0.01). Based on OD analysis, MUAC was independently linked to higher risk of left ventricular hypertrophy (LVH) in women and left ventricular diastolic dysfunction (LVDD) in both men and women. In adjusted COX analysis, only MUAC indicated statistical significance, but all other anthropometric parameters such as BMI, waist circumference, and waist-to-hip ratio (WHR) did not indicate significance. The higher level of MUAC remained a protective factor in fully adjusted models (HR: 0.73; 95% CI: 0.59-0.91), with p-values markedly significant in men (HR: 0.69; 95% CI: 0.49-0.97) and marginally significant in women (HR: 0.0.77; 95% CI: 0.59-1.01). After considering all factors (i.e., cardiovascular risk factors, MUAC, BMI, and WHR), the fully adjusted COX regression analysis demonstrated that the increased MUAC level was linked to decreased MACE risk in both men (HR: 0.57; 95% CI: 0.37-0.88) and women (aHR: 0.64; 95% CI: 0.46-0.93). Conclusion: Despite being associated with a higher rate of cardiac damage, higher MUAC independently and significantly conferred protection against the MACE, in the elderly cohort.

Short Sleep Duration Was Associated with Increased Regional Body Fat in US Adults: The NHANES from 2011 to 2018.

Background: The relationship between sleep duration and different regional fat is unclear. We aimed to investigate the association between sleep duration and different regional fat mass (FM) among a population of US adults. Methods: 9413 participants were included from the National Health and Nutrition Examination Survey (NHANES), from 2011 to 2018. The sleep duration was divided into short sleep (<7 h/day), normal sleep (7−9 h/day) and long sleep (>9 h/day). Different regional FM was measured by dual-energy X-ray absorptiometry, including trunk FM, arms FM and legs FM. Fat mass index (FMI) was obtained by dividing FM (kg) by the square of body height (m2). Multiple linear regression was used to evaluate the relationship between sleep duration and regional FMI. Results: The mean sleep duration was 7.1 ± 1.5 h/day. After adjusting for socio-demographic, lifestyle information, comorbid diseases and medications, short sleepers had higher trunk FMI (ß = 0.134, 95% confidence interval (CI): 0.051−0.216, p = 0.001), arms FMI (ß = 0.038, 95% CI: 0.016−0.06, p < 0.001) and legs FMI (ß = 0.101, 95% CI: 0.044−0.158, p < 0.001) compared to normal sleepers, whereas no significant difference was found in long sleepers. The similar results were also observed in men, while short sleepers only had higher arms FM in women (all p < 0.01). In addition, compared to normal sleepers, short sleepers had higher arms FMI and legs FMI in the obese group (all p < 0.05), while no relationship was observed in non-obese group. Conclusions: Short sleep duration, but not long sleep duration, was independently related to the increased different regional body fat in US adults, especially in men and those with obesity.

Comparison of preoperative angle kappa measurements in the eyes of cataract patients obtained from Pentacam Scheimpflug system, optical low-coherence reflectometry, and ray-tracing aberrometry.

BACKGROUND: Angle kappa plays a vital role in the implantation of multifocal intraocular lens (MIOL). Large angle kappa is related to a higher risk of postoperative photic phenomena. This study aims to compare preoperative angle kappa in the eyes of cataract patients obtained from the Pentacam Scheimpflug system (Pentacam), optical low-coherence reflectometry (Lenstar), and ray-tracing aberrometry (iTrace). METHODS: One hundred thirteen eyes of 113 patients with cataracts were included. Each eye was examined 3 times using all devices to obtain angle kappa and pupil diameter. When considering dependent eyes for one individual, angle kappa in both right eyes and left eyes should be analysed separately. The repeatability and reproducibility were evaluated using the within-subject standard deviation (Sw), repeatability (2.77 Sw), and intraclass correlation coefficient (ICC). The difference, correlation, and agreement between devices were evaluated by paired t-tests, Pearson tests, and Bland-Altman analysis, respectively. RESULTS: Intraoperator repeatability and interoperator and intersession reproducibility of angle kappa showed an Sw of less than 0.05 mm, a 2.77 Sw of 0.14 mm or less, and an ICC of more than 0.96. Angle kappa was not significantly different between Pentacam and Lenstar (P > 0.05), while angle kappa was significantly different between Pentacam and iTrace and between Lenstar and iTrace (P < 0.05). There was a strong correlation between Pentacam and Lenstar for angle kappa (r =0.907 to 0.918) and a weak or moderate correlation between Pentacam and iTrace and between Lenstar and iTrace (r =0.292 to 0.618). There were narrow 95% limits of agreement (LoA) between Pentacam and Lenstar for angle kappa and wide 95% LoA between Pentacam and iTrace and between Lenstar and iTrace. No significant differences in pupil diameter were found between Pentacam and Lenstar in either eye (P > 0.05). Positive angle kappa (nasal light reflex) was found in most cataract patients (79.25% to 84.91%) through 3 different devices in both eyes. CONCLUSIONS: The 3 devices provided high intraoperator repeatability and interoperator and intersession reproducibility for angle kappa measurements. The measurement of preoperative angle kappa in the eyes of patients with cataracts by Pentacam and Lenstar has good agreement.

Early albumin level and mortality in hemodialysis patients: a retrospective study.

BACKGROUND: Hypoalbuminemia is a significant risk factor of cardiovascular disease and all-cause death in patients undergoing conventional hemodialysis (HD). However, the albumin (ALB) level of these dialysis patients runs through the whole process of dialysis, and the prognostic value of serum ALB in the early stage of HD and the relationship between the early ALB value and death in HD patients has not been reported. METHODS: The data of 447 patients with HD were retrospectively analyzed. The patients were stratified into three ALB (g/L) groups: low, ALB ≤34.2; moderate, 34.3< ALB <40.1; high, ALB ≥40.2. Survival trends of the three groups were analyzed by the Kaplan-Meier method. RESULTS: Comparison of the clinical data among the three groups showed a positive correlation between Hb, RBC, K+, Ca2+, Mg2+, and PHOS (P<0.05), but a negative correlation between age and high-sensitivity C-reactive protein (hsCRP) (P<0.05). The ALB level in early HD patients was an independent predictor of death [hazard ratio (HR) =0.945; 95% confidence interval (CI): 0.916-0.976; P=0.000], while age and hsCRP were protective factors (HR =1.048, 95% CI: 1.028-1.067, P=0.000; HR =1.049, 95% CI: 1.024-1.075, P=0.000). The estimated median overall survival (OS) at early HD was 56.00 months in the low ALB group, 83.00 months in the moderate ABL group, and 95.00 months in the high ALB group. The Kaplan-Meier estimate of survival showed a significant difference in OS among the three groups (log-rank P=0.000). CONCLUSIONS: The early ALB level not only reflects the nutritional and chronic inflammation status of HD patients, but can also predict the prognosis, which has guiding significance for the management of HD patients.

Association Between Lipid Accumulation Product and Target Organ Damage in Elderly Population: The Northern Shanghai Study.

INTRODUCTION: Lipid accumulation product (LAP), calculated from waist circumference (WC) and triglycerides (TG), is a novel index that correlates cardiovascular disease. We aimed to investigate the relationship between LAP and target organ damage (TOD) in elderly Chinese community-dwelling individuals. MATERIALS AND METHODS: We enrolled 3363 participants whose age was ≥65 years old. TOD, including left ventricular hypertrophy (LVH), arterial stiffness (AS), lower extremity atherosclerotic (LEA), micro-albuminuria (MAU) and chronic kidney disease (CKD), was measured using standard methods. LAP was calculated as (WC-65) × TG in men and (WC-58) × TG in women. Both quartiles and continuation of LAP were analyzed. RESULTS: Age-sex adjusted partial correlation analysis showed that LAP was significantly associated with CVD risk factors. With the first quartile (Q1) as a reference, in univariate logistic regression, the fourth quartile (Q4) of LAP was associated with all TOD. In multivariate model, Q4 of LAP was only associated with an increased risk of AS (odds ratio (OR) = 1.88, 95% confidence interval (CI): 1.37-2.58, P for trend < 0.001), MAU (OR = 1.33, 95% CI: 1.01-1.75, P for trend = 0.02) and CKD (OR = 2.39, 95% CI: 1.39-4.12, P for trend < 0.001). But, Q4 of LAP was not associated with an increased risk of LVH (OR = 1.19, 95% CI: 0.85-1.65, P for trend = 0.25) or LEA (OR = 0.87, 95% CI: 0.58-1.29, P for trend = 0.96). Similar associations were found when analyzed continuously. CONCLUSION: The novel metabolic parameter LAP is significantly and independently associated with an increased risk of arterial stiffness, chronic kidney disease and micro-albuminuria in Chinese community-dwelling elderly individuals.

Cardiac, Macro-, and Micro-Circulatory Abnormalities in Association With Individual Metabolic Syndrome Component: The Northern Shanghai Study.

Objective: This study investigated the association of metabolic syndrome (MS) and its components with cardiac, macro-, and micro-circulatory abnormalities in an elderly Chinese population. Methods: This cross-sectional study was conducted using data for 1,958 participants from the Northern Shanghai Study aged over 65 years without a history of cardiovascular disease. MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III in 2005 (NCEPIII 2005). Asymptomatic cardiovascular impairment parameters, including the left ventricle mass index (LVMI), peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid-femoral pulse wave velocity (cf-PWV), ankle-brachial index (ABI), carotid intima-media thickness (CIMT), arterial plaque, and urinary albumin-creatinine rate (UACR), were evaluated. Results: LVMI, E/Ea, cf-PWV, and the proportion of UACR > 30 mg/g exhibited increasing trends while ABI exhibited a decreasing trend according to the number of MS components (all p for trend < 0.01). Logistic regression analysis revealed that MS was significantly associated with LV hypertrophy (LVH), LV diastolic dysfunction, arteriosclerosis, and microalbuminuria (all p < 0.001). Central obesity and high blood pressure were associated with all cardiovascular abnormalities (all p < 0.05), whereas elevated plasma glucose was associated with arteriosclerosis and microalbuminuria (both p < 0.001). In addition, high triglyceride levels were associated with microalbuminuria (p < 0.05). Conclusions: MS is significantly associated with cardiac, macro-, and micro-circulatory abnormalities in elderly Chinese. Moreover, the presence of individual MS components may have specific prognostic significance.

Hypertension-Mediated Organ Damage Correlates With Serum Homocysteine Level in Community-Dwelling Elderly Chinese: The North Shanghai Study.

Introduction: Serum homocysteine (Hcy) level is associated with cardiocerebrovascular disease. However, the relationship between Hcy and hypertension-mediated organ damage (HMOD) in non-hospitalized residents has not been elucidated. We aimed to investigate the association of HMOD with Hcy in elderly Chinese. Methods: One thousand seven hundred and forty-four community-dwelling elderly Chinese (age ≥65 years) participated in the Northern Shanghai Study from Jun. 2014 to Aug. 2015. Hyperhomocysteinemia (HHcy) was defined as serum Hcy ≥15 mmol/L, and HMOD was estimated as arterial stiffness [carotid-femoral pulse wave velocity (CF-PWV) and ankle-brachial index (ABI)], cardiac impairment [left ventricular (LV) hypertrophy and LV diastolic dysfunction], and renal dysfunction [estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio]. Linear and logistic regression models were built to explore the associations of HMOD with Hcy. Results: Among 1,744 participants, 632 (36.2%) were diagnosed as HHcy. HHcy group had more men (61.2 vs. 35.3%), with higher age (73.7 ± 6.7 vs. 70.4 ± 5.3 years) and BMI (24.2 ± 3.4 vs. 23.7 ± 3.5 kg/m2). Linear regression analysis showed that serum Hcy level was positively associated CF-PWV and negatively associated with ABI and eGFR. By logistic regression, HHcy was significantly associated with abnormal CF-PWV [odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.08-2.16] and ABI (OR = 1.55, 95% CI 1.17-2.04), and decreased eGFR (OR = 7.09, 95% CI 4.03-12.47) after adjustment for covariates. Moreover, similar associations of serum Hcy level with CF-PWV and eGFR were observed in subgroups by gender and hypertensive state. Conclusion: HMOD, particularly renal dysfunction and arterial stiffening, was significantly and independently associated with increased serum Hcy level in the elderly Chinese. Clinical Trial Registration: [ClinicalTrial.gov], identifier [NCT02368938].

Association between hypertension-mediated organ damage and obesity defined by novel anthropometric indices in community-dwelling elderly individuals.

OBJECTIVE: Body mass index (BMI), the most common anthropometric index, has recently been challenged by two emerging parameters: a body shape index (ABSI) and body roundness index (BRI). The purpose of this study was to explore the associations of hypertension-mediated organ damage (HMOD) with conventional and novel anthropometric parameters. METHODS: This is a multistage community-based observational and cross-sectional study. A total of 3077 elderly Chinese individuals (mean age 70.92 ± 5.84, 1329 (43%) men) from the communities in the northern area of Shanghai were enrolled from June 2014 to August 2019. Waist-to-hip ratio (WHR), ABSI and BRI were calculated with validated formulas. HMOD, including left ventricular hypertrophy (LVH), arterial stiffness (AS), lower limb atherosclerosis (LLA), and microalbuminuria (MAU), was assessed using standardized methods. Correlation and multivariable linear and logistic regression analyses were performed to detect the relations between HMOD and anthropometric indices. RESULTS: In the total population, compared to those with ABSI, BRI and WHR in the lowest quartiles, participants with values in the highest quartiles exhibited a significantly higher risk of LVH, AS and MAU independent of BMI and other confounders (all P for trend <0.01). In females but not in males, compared to BMI, BRI and WHR had a greater area under the curve (AUC) for detecting HMOD. In the further stepwise logistic regression with all anthropometric indices put into models simultaneously, only BRI remained in the LVH (odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.30-1.55) and LLA (OR: 1.48, 95% CI: 1.23-1.77) models, and WHR remained in the AS (OR: 1.30, 95% CI: 1.18-1.43) and MAU (OR: 1.48, 95% CI: 1.28-1.72, all P < 0.01) models. CONCLUSION: Compared to BMI, the novel anthropometric parameter BRI, together with the conventional parameter WHR, exhibits a closer relationship with HMOD in the elderly population, especially in females.

In Situ Ligand Formation in the Synthetic Processes from Mononuclear Dy(III) Compounds to Binuclear Dy(III) Compounds: Synthesis, Structure, Magnetic Behavior, and Theoretical Analysis.

Guided by the self-assembled process and mechanism, the strategy of in situ Schiff base reaction would be capable of bringing a feasible method to construct and synthesize lanthanide compounds with distinct structures and magnetic properties. A mononuclear Dy(III) compound was synthesized through a multidentate Schiff base ligand and a chelating ß-diketonate ligand, which was named as [Dy(L)(bppd)]·CH3OH [1; H2L = N,N'-bis(2-hydroxy-5-methyl-3-formylbenzyl)-N,N'-bis(pyridin-2-ylmethyl)ethylenediamine and bppd = 3-bis(pyridin-2-yl)propane-1,3-dione]. Furthermore, a new binuclear Dy(III) compound, [Dy2(H2Lox)(bppd)3]·8CH3OH [2; H4Lox = N,N'-bis[2-hydroxy-5-methyl-3-(hydroxyiminomethyl)benzyl]-N,N'-bis(pyridin-2-ylmethyl)ethylenediamine], was obtained via an in situ synthetic process. Under similar synthetic conditions, [Dy(L)(ctbd)] [3; ctbd = 1-(4-chlorophenyl)-4,4,4-trifluoro-1,3-butanedione] and [Dy2(H2Lox)(ctbd)3]·CH3OH·C4H10O (4) were synthesized by modifying the ß-diketonate ligand and in situ Schiff base reaction. Compound 3 is a mononuclear configuration, while compound 4 exhibits a binuclear Dy(III) unit. Therein, formylbenzyl groups of H2L in 1 and 3 were changed to (hydroxyiminomethyl)benzyl groups in 2 and 4, respectively. In isomorphous 2 and 4, two Dy(III) centers are connected through two phenol O- atoms of the H2Lox2- ligand to form a binuclear structure. Eight-coordinated Dy(III) ions with different distortions can be observed in 1-4. The crystals of 1 and 3 suffered dissolution/precipitation to obtain 2 and 4, respectively. The relationship between the structure and magnetism in compounds 1-4 was discussed through the combination of structural, experimental, and theoretical investigations. Especially, the rates of quantum tunneling of magnetization of 1-4 were theoretically predicted and are consistent with the experimental results. For 2 and 4, the theoretically calculated dipolar parameters Jdip are consistent with the experimental observation of weak ferromagnetic coupling.

Solvent responses and substituent effects upon magnetic properties of mononuclear DyIII compounds.

Solvent responsive magnets comprise a class of molecule-based materials where lattice solvent driven structural transformation leads to the switching of magnetic properties. Herein, we present a special type of magnet where single-crystal to single-crystal (SCSC) transformations within mononuclear DyIII compounds result in the switching of DyIII single-molecule magnets (SMMs). This structural transformation involves lattice solvents which leads to significant changes in the color and magnetic properties. Additionally, the relaxation dynamics of mononuclear DyIII compounds are perceptibly fine-tuned by the modification of ß-diketonate ligands. The uniaxial magnetic anisotropies, magneto-structural correlations and the relaxation mechanism were investigated by magnetic studies and ab initio calculations. These experimental and theoretical studies indicate that compound 2 exhibits the best magnetic properties in compounds 1-4. The experimental observation is supported by the theoretical prediction of QTM time (τZeeQTM) as theτZeeQTM of 2 is remarkably longer than those of the other three compounds by an order of magnitude. This means that, compared with 1, 3, and 4, the magnetic relaxation of 2 is significantly slower. Meanwhile, 2 has the largest value of axial ESP (the axial electrostatic potential), which supports the smallest gXY value in these compounds, resulting in better SMM properties. The present results offer a systematic synthesis regulation to change the magnetization dynamics and further understand magneto-structural correlations for DyIII SMMs.

The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review.

BACKGROUND: Depression is highly prevalent among Haemodialysis (HD) patients and is known to results in a series of adverse outcomes and poor quality of life (QoL). Although cognitive behavioural therapy (CBT) has been shown to improve depressive symptoms and QoL in other chronic illness, there is uncertainty in terms of the effectiveness of CBT in HD patients with depression or depressive symptoms. METHODS: All randomised controlled trials relevant to the topic were retrieved from the following databases: CINHAL, MEDLINE, PubMed, PsycINFO and CENTRAL. The grey literature, specific journals, reference lists of included studies and trials registers website were also searched. Data was extracted or calculated from included studies that had measured depression and quality of life using valid and reliable tools -this included mean differences or standardised mean differences and 95% confidence intervals. The Cochrane risk of bias tool was used to identify the methodological quality of the included studies. RESULTS: Six RCTs were included with varying methodological quality. Meta-analysis was undertaken for 3 studies that employed the CBT versus usual care. All studies showed that the depressive symptoms significantly improved after the CBT. Furthermore, CBT was more effective than usual care (MD = - 5.28, 95%CI - 7.9 to - 2.65, P = 0.37) and counselling (MD = - 2.39, 95%CI - 3.49 to - 1.29), while less effective than sertraline (MD = 2.2, 95%CI 0.43 to 3.97) in alleviating depressive symptoms. Additionally, the CBT seems to have a beneficial effect in improving QoL when compared with usual care, while no significant difference was found in QoL score when compared CBT with sertraline. CONCLUSIONS: CBT may improve depressive symptoms and QoL in HD patients with comorbid depressive symptoms. However, more rigorous studies are needed in this field due to the small quantity and varied methodological quality in the identified studies.

Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study.

PURPOSE: There have been few recent studies regarding vascular aging and its relationship with left ventricular (LV) geometry. Moreover, the association of abnormal LV geometry with various kinds of vascular aging has not yet been systematically analyzed. Thus, this study aimed to further elucidate this relationship. MATERIALS AND METHODS: In this study, 3363 older participants (43.6% male, aged 71.1±5.9 years; 56.4% female, aged 71.1±6.1 years) derived from the Northern Shanghai Study were enrolled. Vascular aging criteria included arteriosclerosis, defined as carotid-femoral pulse wave velocity >10 m/s or brachial-ankle pulse wave velocity >1800 cm/s, and peripheral atherosclerosis, defined as ankle-brachial index <0.9, carotid artery intima-media thickness (cIMT) greater than 0.9 mm, or carotid plaque indicating carotid artery abnormality. Micro-albuminuria was defined as urinary albumin-to-creatinine ratio >30 mg/g. Decreased estimated glomerular filtration rate (eGFR) was defined as eGFR <60 mL/min/1.73 m2. RESULTS: When vascular aging parameters were respectively adjusted for age and sex, arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis were significantly associated with concentric remodeling, eccentric LV hypertrophy (LVH), and concentric LVH (P<0.045) but not with decreased eGFR or abnormal cIMT and presence of plaque. Peripheral atherosclerosis was strongly associated with LV concentric geometry (LVCG) when considering other covariates (risk factors, diseases, and treatments) (P<0.012). CONCLUSION: Vascular aging parameters such as arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis are significantly and independently associated with LVCG in community-dwelling older Chinese population, suggesting the importance of vascular aging during early clinical assessment of abnormal LV geometry change and serious cardiovascular events.

Does healthy obesity exist in the elderly? Findings from the Northern Shanghai Study.

BACKGROUND AND AIMS: Metabolic unhealthiness and obesity are both associated with an increased risk of cardiovascular disease. We aimed to investigate the significance of metabolic unhealthiness and obesity in organ damages in a community-based elderly cohort. METHODS AND RESULTS: A total of 3325 elderly participants (>65 years old) were recruited in northern Shanghai. Associations of metabolic status and obesity with organ damages were investigated. In all, 1317 (39.6%) participants were metabolically unhealthy and 481 (14.5%) were obese. Compared with metabolically healthy nonobese (MH-nonobese) individuals, metabolically healthy obese subjects had a greater left ventricular mass index (LVMI) and pulse wave velocity (PWV). Metabolically unhealthy subjects, regardless of their obesity status, had greater organ damage parameters including E/Ea, LVMI, PWV, and urine albumin-creatinine ratio (UACR) than MH-nonobese subjects (all P < 0.05). After multivariate adjustments, both metabolic unhealthiness and obesity increased the risk of left ventricular hypertrophy (LVH) (OR 1.31, 95% CI 1.10-1.57 and OR 1.63, 95% CI 1.30-2.04), diastolic dysfunction (OR 1.33, 95% CI 1.06-1.67 and OR 1.51, 95% CI 1.14-1.99), and lower extremity atherosclerosis (OR 1.44, 95% CI 1.11-1.85 and OR 2.01, 95% CI 1.49-2.70). Metabolic unhealthiness was also associated with arterial stiffness, microalbuminuria and chronic kidney disease (all P < 0.05). In a subgroup analysis, metabolic unhealthiness was associated with more organ damages in nonobese subjects, and obesity was associated with LVH and lower extremity atherosclerosis regardless of metabolic status. CONCLUSION: Both obesity and metabolic unhealthiness were associated with organ damages. Metabolic unhealthiness was associated with more organ damages, especially in nonobese individuals. Even healthy obesity was significantly associated with cardiac and vascular impairment. REGISTRATION NUMBER FOR CLINICAL TRIALS: NCT02368938.