Intensity-specific physical activity measured by accelerometer and the risk of mortality among individuals with cardiometabolic diseases: A prospective study from the UK Biobank.

BACKGROUND: While the health benefits of physical activity for general population are well-recognized, the prospective associations of physical activity volume and intensity with mortality among cardiometabolic disease individuals remain unclear. OBJECTIVE: The objective of this study was to investigate the associations of accelerometer-measured intensity-specific physical activity with mortality risk among population with cardiometabolic disease. DESIGN: Prospective cohort study. SETTING: Participants were recruited from the United Kingdom (UK) across 22 assessment centers from 2006 to 2010. PARTICIPANTS: A total of 9524 participants from the UK Biobank (median: 67.00 years, interquartile range: 61.00-70.00 years) were included in final study. METHODS: Accelerometer-measured total volume, moderate-to-vigorous and light intensity physical activity collecting from 2013 to 2015 were quantified using a machine learning model. Multivariable restricted cubic splines and Cox proportional hazard models with hazard ratios (HRs) and 95 % confidence intervals (CIs) were employed to examine the associations of interests. RESULTS: During the follow-up period (median: 6.87 years; interquartile range: 6.32-7.39 years), there were 659 (6.92 %) death events with 218 (2.29 %) cardiovascular disease-related deaths and 441 (4.63 %) non-cardiovascular disease-related deaths separately. In the fully adjusted models, compared with participants in the lowest quartiles of total volume, moderate-to-vigorous and light physical activities, the adjusted HRs (95 % CIs) of all-cause mortality for those in the highest quartiles were 0.40 (0.31, 0.52), 0.48 (0.37, 0.61), and 0.56 (0.44, 0.71) while those for cardiovascular diseases-related mortality were 0.35 (0.22, 0.55), 0.52 (0.35, 0.78) and 0.59 (0.39, 0.88), and for non-cardiovascular diseases-related mortality, they were 0.42 (0.30, 0.59), 0.40 (0.29, 0.54) and 0.54 (0.40, 0.73), separately. The optimal moderate-to-vigorous-intensity physical activity level for cardiovascular diseases-related mortality reduction was found to be in the third quartile (17.75-35.33 min/day). Furthermore, the observed inverse associations were mainly non-linear. CONCLUSIONS: Promoting physical activity, regardless of intensity, is essential for individuals with cardiometabolic disease to reduce mortality risk. For both all-cause and cardiovascular disease-related and non-cardiovascular disease-related mortality, the observed decrease in risk seems to level off at a moderate level. The current findings deriving from precise device-based physical activity data provide inference for secondary prevention of cardiometabolic disease.

Biomechanical Effects of the Badminton Split-Step on Forecourt Lunging Footwork.

BACKGROUND: This research investigates the biomechanical impact of the split-step technique on forehand and backhand lunges in badminton, aiming to enhance players' on-court movement efficiency. Despite the importance of agile positioning in badminton, the specific contributions of the split-step to the biomechanical impact of lunging footwork still need to be determined. METHODS: This study examined the lower limb kinematics and ground reaction forces of 18 male badminton players performing forehand and backhand lunges. Data were collected using the VICON motion capture system and Kistler force platforms. Variability in biomechanical characteristics was assessed using paired-sample t-tests and Statistical Parametric Mapping 1D (SPM1D). RESULTS: The study demonstrates that the split-step technique in badminton lunges significantly affects lower limb biomechanics. During forehand lunges, the split-step increases hip abduction and rotation while decreasing knee flexion at foot contact. In backhand lunges, it increases knee rotation and decreases ankle rotation. Additionally, the split-step enhances the loading rate of the initial ground reaction force peak and narrows the time gap between the first two peaks. CONCLUSIONS: These findings underscore the split-step's potential in optimizing lunging techniques, improving performance and reducing injury risks in badminton athletes.

Intake of the different types of dairy products, genetic predisposition, and the risks of nonalcoholic fatty liver disease and cirrhosis: a prospective cohort study.

Background: The association of dairy product consumption with nonalcoholic fatty liver disease (NAFLD) and cirrhosis remains controversial. This study aimed to prospectively investigate the associations between the consumption of the different types of dairy products, genetic predisposition, and the risks of NAFLD and cirrhosis. Methods: This cohort study included 190 145 participants from the UK Biobank Study. The consumption of the different types of dairy products was assessed based on the Oxford WebQ at baseline and defined as the sum of milk, yogurt, and cheese. NAFLD and cirrhosis were evaluated using hospital inpatient records and death data in the UK Biobank. The weighted genetic risk score (GRS) for NAFLD and cirrhosis was constructed using 5 and 6 single-nucleotide variants (SNVs), respectively. Cox proportional hazards regression models were utilized to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between genetic factors and different types of dairy products with the incidence of NAFLD and cirrhosis. Results: During a median follow-up of 11.6 years, 1512 NAFLD and 556 cirrhosis cases were ascertained. After adjusting for several potential confounders, the HRs (95% CIs) (Q4 vs. Q1) of NAFLD were 0.86 (0.74, 0.995) for total dairy products, 0.96 (0.84, 1.09) for high-fat dairy products, 0.78 (0.67, 0.92) for low-fat dairy products, 0.86 (0.74, 0.99) for unfermented dairy products, and 0.79 (0.68, 0.91) for fermented dairy products. The multivariable-adjusted HRs (95% CIs) (Q4 vs. Q1) of cirrhosis were 0.75 (0.59, 0.96) for total dairy products, 0.97 (0.78, 1.19) for high-fat dairy products, 0.67 (0.51, 0.89) for low-fat dairy products, 0.75 (0.59, 0.96) for unfermented dairy products, and 0.71 (0.56, 0.90) for fermented dairy products. The associations of high-fat dairy products and fermented dairy products with NAFLD and cirrhosis were found to be nonlinear (P for nonlinear <0.05). No interaction was observed between dairy product consumption and NAFLD or cirrhosis genetic susceptibility. Conclusions: Higher consumption of dairy products, except for high-fat dairy, was correlated with lower risks of NAFLD and cirrhosis, regardless of their differences in genetic susceptibility.

Different types of screen time, physical activity, and incident dementia, Parkinson's disease, depression and multimorbidity status.

BACKGROUND: Several previous studies have shown that excessive screen time is associated with an increased prevalence of dementia, Parkinson's disease (PD), and depression. However, the results have been inconsistent. This study aimed to prospectively investigate the association between different types of screen time and brain structure, as well as the incidence of dementia, Parkinson's disease, depression, and their multimorbidity status. METHODS: We included 473,184 participants initially free of dementia, PD, and depression from UK Biobank, as well as 39,652 participants who had magnetic resonance imaging (MRI) data. Screen time exposure variables including TV viewing and computer using were self-reported by participants. Cox proportional hazards regression models were used to estimate the association between different types of screen time and the incidence of dementia, Parkinson's disease, depression, and their multimorbidity status. Multiple linear regression models were used to assess the linear relationship between different types of screen time and MRI biomarkers in a subgroup of participants. RESULTS: During the follow up, 6,096, 3,061, and 23,700 participants first incident cases of dementia, PD, and depression respectively. For moderate versus the lowest computer uses, the adjusted HRs (95% CIs) were 0.68 (0.64, 0.72) for dementia, 0.86 (0.79, 0.93) for PD, 0.85 (0.83, 0.88) for depression, 0.64 (0.55, 0.74) for dementia and depression multimorbidity, and 0.59 (0.47, 0.74) for PD and depression multimorbidity. The multivariable HRs (95% CIs) for the highest versus the lowest group of TV viewing time were 1.28 (1.17, 1.39) for dementia, 1.16 (1.03, 1.29) for PD, 1.35 (1.29, 1.40) for depression, 1.49 (1.21, 1.84) for dementia and depression multimorbidity, and 1.44 (1.05, 1.97) for PD and depression multimorbidity. Moderate computer using time was negatively associated with white matter hyperintensity volume (ß = -0.042; 95% CI -0.067, -0.017), and positively associated with hippocampal volume (ß = 0.059; 95% CI 0.034, 0.084). Participants with the highest TV viewing time were negatively associated with hippocampal volume (ß = -0.067; 95% CI -0.094, -0.041). In isotemporal substitution analyses, substitution of TV viewing or computer using by equal time of different types of PA was associated with a lower risk of all three diseases, with strenuous sports showing the strongest benefit. CONCLUSION: We found that moderate computer use was associated with a reduced risk of dementia, PD, depression and their multimorbidity status, while increased TV watching was associated with a higher risk of these disease. Notably, different screen time may affect the risk of developing diseases by influencing brain structures. Replacing different types of screen time with daily-life PA or structured exercise is associated with lower dementia, PD, and depression risk.

Relationship between dietary pattern and depressive symptoms: an international multicohort study.

BACKGROUND: Several previous studies have shown that dietary patterns are associated with the incidence of depressive symptoms. However, the results have been inconsistent. This study aimed to prospectively investigate the association between dietary patterns and the risk of depressive symptoms in two large cohort studies. METHODS: The Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study included a total of 7,094 participants living in Tianjin, China from 2013 to 2019, and the UK Biobank cohort study includes 96,810 participants who were recruited from 22 assessment centers across the UK taken between 2006 and 2010. All participants were free of a history of cardiovascular disease (CVD), cancer, and depressive symptoms at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated food frequency questionnaire in TCLSIH or Oxford WebQ in UK Biobank. Depressive symptoms were evaluated using the Chinese version of the Zung Self-Rating Depression Scale (SDS) in TCLSIH or hospital inpatient records in UK Biobank. Cox proportional hazards regression models were used to estimate the association between dietary patterns and depressive symptoms. RESULTS: A total of 989, and 1,303 participants developed depressive symptoms during 17,410 and 709,931 person-years of follow-up. After adjusting for several potential confounders, the multivariable HRs (95% CIs) of the depressive symptoms were 0.71 (0.57, 0.88) for traditional Chinese dietary pattern, 1.29 (1.07, 1.55) for processed animal offal included animal food dietary pattern, and 1.22 (1.02, 1.46) for sugar rich dietary pattern in TCLSIH (all Q4 vs Q1). In the UK Biobank, the HRs (95% CIs) of depressive symptoms were 1.39 (1.16, 1.68) for processed food dietary pattern (Q4 vs Q1), 0.90 (0.77, 1.00) for healthy dietary pattern (Q3 vs Q1), and 0.89 (0.75, 1.05) for meat dietary pattern (Q4 vs Q1) in the final adjusted model. CONCLUSION: Dietary patterns rich in processed foods were associated with a higher risk of depressive symptoms, and following a traditional Chinese dietary pattern or healthy dietary pattern was associated with a lower risk of depressive symptoms, whereas meat dietary pattern was not associated.

Quality of plant-based diet and the risk of dementia and depression among middle-aged and older population.

BACKGROUND: several previous studies have shown the importance of the plant-based diets. However, not all plant-based foods are necessarily beneficial for dementia or depression. This study aimed to prospectively investigate the association between an overall plant-based diet and the incidence of dementia or depression. METHODS: we included 180,532 participants from the UK Biobank cohort study, free of a history of cardiovascular disease, cancer, dementia and depression at baseline. We calculated an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI) and an unhealthful plant-based diet index (uPDI) based on 17 major food groups from Oxford WebQ. Dementia and depression were evaluated using hospital inpatient records in UK Biobank. Cox proportional hazards regression models were used to estimate the association between PDIs and the incidence of dementia or depression. RESULTS: during the follow-up, 1,428 dementia cases and 6,781 depression cases were documented. After adjusting for several potential confounders and comparing the highest with the lowest quintile of three plant-based diet indices, the multivariable hazard ratios (95% confidence intervals (CIs)) for dementia were 1.03 (0.87, 1.23) for PDI, 0.82 (0.68, 0.98) for hPDI and 1.29 (1.08, 1.53) for uPDI. The hazard ratios (95% CI) for depression were 1.06 (0.98, 1.14) for PDI, 0.92 (0.85, 0.99) for hPDI and 1.15 (1.07, 1.24) for uPDI. CONCLUSION: a plant-based diet rich in healthier plant foods was associated with a lower risk of dementia and depression, whereas a plant-based diet that emphasises less-healthy plant foods was associated with a higher risk of dementia and depression.

Association between the intake of animal offal and depressive symptoms: a TCLSIH cohort study.

Background: Previous cohort studies on the association between animal offal intake and depressive symptoms are limited, especially in Asian populations. This study aimed to prospectively investigate the association between animal offal intake and the risk of depressive symptoms in a general Chinese adult population. Methods: This prospective cohort study included a total of 7745 (57.6% males) inhabitants living in Tianjin, China. Participants without a history of CVD, cancer, and depressive symptoms at the baseline were followed up for 1.5 to 5 years with a median of 3 years follow-up. Animal offal was assessed using a validated self-administered food frequency questionnaire. Depressive symptoms were evaluated using the Chinese version of the Zung Self-Rating Depression Scale (SDS) and the cutoff score was set at 45. Cox proportional hazards regression models were used to estimate the association between animal offal intake and depressive symptoms. Results: A total of 1101 (630 men) people developed depressive symptoms during 19 074 person-years of follow-up. After adjusting for several potential confounders and setting "almost never" as the control group, the multivariable hazard ratios (95% confidence intervals) of the depressive symptoms were 0.96 (0.81, 1.15) for tertile 1, 1.04 (0.87, 1.24) for tertile 2, and 1.34 (1.13, 1.58) for tertile 3, respectively (P for trend <0.001). Conclusion: The results from our prospective study demonstrated that the intake of animal offal is positively associated with depressive symptoms.

Damage of uremic myocardium by p-cresyl sulfate and the ameliorative effect of Klotho by regulating SIRT6 ubiquitination.

Uremic cardiomyopathy (UCM) is a common complication in patients with chronic kidney disease (CKD) and an important risk factor for death. P-Cresyl sulfate (PCS) is a damaging factor in UCM, and Klotho is a protective factor. However, the molecular mechanisms of Klotho and PCS in UCM and the relationship between PCS and Klotho are unclear. In vitro, Klotho treatment inhibited PCS-induced cardiomyocyte hypertrophy and apoptosis by blocking mTOR phosphorylation and inhibiting DNA double-strand breaks (DSBs), respectively. Moreover, PCS increased SIRT6 protein ubiquitination and downregulated SIRT6 protein expression, while Klotho inhibited SIRT6 protein ubiquitination and upregulated SIRT6 protein expression. In a mouse model of 5/6 nephrectomy (5/6Nx)-induced UCM, the expression of Klotho in the kidney and serum was decreased, and the expression of SIRT6 protein in myocardial tissues was lower. PCS further reduced Klotho and SIRT6 expression, aggravated heart structure and function abnormalities, and increased myocardial cell apoptosis in UCM mice. Administration of Klotho protein inhibited the downregulation of SIRT6 protein expression and improved cardiac structure and function. Furthermore, serum PCS level was associated with the left ventricular mass (LVM) and left ventricular mass index (LVMI) in hemodialysis patients. In conclusion, the uremic toxin PCS injures cardiomyocytes via mTOR phosphorylation and DSBs, and Klotho antagonizes the damaging effects of PCS. Moreover, the SIRT6 protein plays an important role in UCM, and Klotho suppresses SIRT6 ubiquitination induced by PCS, further improves cardiac structure and function in UCM and exerts protective effects.

Relationship between the consumption of wholegrain and nonalcoholic fatty liver disease: The TCLSIH cohort study.

BACKGROUND & AIMS: Wholegrain contributes a range of beneficial nutrients and is considered to play a role in the prevention of chronic diseases, but evidence of their influence on nonalcoholic fatty liver disease (NAFLD) is limited. We conducted this study to investigate the prospective association between daily wholegrain consumption and NAFLD in the general population. METHODS: This prospective cohort study included a total of 14,968 (42.2% men) inhabitants living in Tianjin, China. Participants without a history of CVD, cancer, alcoholic fatty liver disease, other liver diseases, or NAFLD were followed up for 1-6 years with a median follow-up duration of 4.2 years. Wholegrain consumption was assessed using a validated self-administered food frequency questionnaire. NAFLD was diagnosed with the results of liver ultrasonography without significant alcohol consumption and other causes of liver disease. Cox proportional hazards regression models were used to estimate the association between wholegrain consumption and NAFLD. RESULTS: A total of 3505 (2171 men) first incident cases of NAFLD occurred during 53,303 person-years of follow-up (median follow-up of 4.2 years). After adjusting for several potential confounders and setting "almost never" as the control group, the multivariable hazard ratios (95% confidence intervals) of the NAFLD were 0.82 (0.73, 0.92) when they consuming ≤1 time/week, 0.78 (0.69, 0.88) when they consuming 2-6 time/week and 0.77 (0.66, 0.90) when they consuming ≥1 time/day (p for trend <0.001). CONCLUSION: The results from our prospective study demonstrated that the higher consumption of wholegrain is associated with a decreased risk of NAFLD in Chinese adults.

The consumption of wholegrain is related to depressive symptoms among Chinese adults: a cross-sectional study.

BACKGROUND: Wholegrains contribute a range of beneficial nutrients, such as dietary fiber and several minerals and vitamins, that are beneficial to depressive symptoms. However, there are a few studies aimed at exploring whether a wholegrain diet is related to depressive symptoms. We conducted this study to investigate the relationship between wholegrains consumption and depressive symptoms. METHODS: This cross-sectional study included a total of 24,776 (mean age: 39.9 years, age range: 18.1-91.3 years; males, 54.1%) inhabitants living in Tianjin, China. Wholegrains consumption was assessed using a valid self-administered food frequency questionnaire. Depressive symptoms were evaluated using the Chinese version of Zung Self-Rating Depression Scale (SDS) and the cutoff point was set at 45. Multiple logistic regression analysis was used to estimate the relationship between wholegrains consumption and depressive symptoms. RESULTS: The prevalence of depressive symptoms was 19.1% and 22.4% in males and females, respectively. After adjustments for potential confounding factors, the odds ratios (95% confidence intervals) of depressive symptoms across wholegrains consumption were 0.77 (0.65-0.91) for <1 time/week, 0.73 (0.62-0.86) for 1 time/week and 0.68 (0.59-0.79) for ≥2 time/week in males compared with the control group (almost never). In females, the odds ratios (95% confidence intervals) were 0.86 (0.71-1.04) for <1 time/week, 0.94 (0.78-1.13) for 1 time/week, and 0.76 (0.65-0.91) for ≥2 time/week. Similar results were observed when we use other cut-offs (SDS ≥ 40 and 50) to define depressive symptoms. CONCLUSION: This study first demonstrated that the higher consumption of wholegrains might have effects on the prevention and improvement of depressive symptoms. Prospective or intervention studies are needed to confirm these findings.

Uraemic Cardiomyopathy in Different Mouse Models.

Uraemic cardiomyopathy (UCM) is one of the most common complications in chronic kidney disease (CKD). Our aim was to compare characteristics of various UCM mouse models. Mice were assigned to the following groups: the pole ligation group, 5/6 nephrectomy group (5/6Nx), uninephrectomy plus contralateral ischemia followed by reperfusion group (IR), adenine group, and sham group. Mice were sacrificed at 4, 8, and 16 weeks after surgery in the pole ligation, 5/6Nx, and IR groups, respectively. In the adenine group, mice were sacrificed at 16 weeks after the adenine diet. The structure and function of the heart and the expression of fibroblast growth factor 23 (FGF-23) and growth differentiation factor 15 (GDF-15) in hearts were assessed. The mortality in the 5/6 Nx group was significantly higher than that in the pole ligation, IR, and adenine groups. Echocardiogram and histological examination showed cardiac hypertrophy in the adenine,5/6Nx, ligation group, and IR group. In addition, cardiac fibrosis occurred in all CKD modeling groups. Interestingly, cardiac fibrosis was more serious in the IR and adenine groups. FGF-23 expression in sham mice was similar to that in modeling groups; however, the GDF-15 level was decreased in modeling groups. Our results suggest that the four models of UCM show different phenotypical features, molding time and mortality. GDF-15 expression in the hearts of UCM mice was downregulated compared with sham group mice.

The Association Between Obesity and Risk of Acute Kidney Injury After Cardiac Surgery.

Objective: To determine the relationship between obesity and the risk of AKI after cardiac surgery (CS-AKI) in a cohort study. Methods: A total of 1,601 patients undergoing cardiac surgery were collected and their incidence of CS-AKI was recorded. They were divided into underweight, normal weight, overweight, and obese groups. Logistic regression was used to estimate the association between BMI (body mass index) and CS-AKI risk. Then, a meta-analysis of published cohort studies was conducted to confirm this result using PubMed and Embase databases. Results: A significant association was observed in this independent cohort after adjusting age, gender, hypertension and New York Heart Association classification (NYHA) class. Compared with normal BMI group (18.5 ≤ BMI < 24.0), the individuals with aberrant BMI level had an increased AKI risk (OR: 1.68, 95% CI: 1.01-2.78) for BMI < 18.5 group and (OR: 1.43, 95% CI: 0.96-2.15) for BMI ≥ 28.0. Interestingly, the U-shape curve showed the CS-AKI risk reduced with the increasing of BMI when BMI ≤ 24.0. As BMI increases with BMI > 24.0, the risk of developing CS-AKI increased significantly. In the confirmed meta-analysis, compared with normal weight, overweight group with cardiac surgery had higher AKI risk (OR: 1.28, 95% CI: 1.16-1.41, Pheterogeneity = 0.49). The similar association was found in obesity subgroup (OR: 1.79, 95% CI: 1.57-2.03, Pheterogeneity = 0.42). Conclusion: In conclusion, the results suggested that abnormal BMI was a risk factor for CS-AKI independently.

Predictive value of renal resistive index for the onset of acute kidney injury and its non-recovery: A systematic review and meta-analysis
.

BACKGROUND: The predictive value of Doppler-based renal resistive index (RRI) for acute kidney injury (AKI) has not been fully elucidated. The present meta-analysis was carried out to disclose the correlation between AKI and RRI, and to investigate the predictive value of RRI for the onset of AKI and its recovery. MATERIALS AND METHODS: We searched PubMed, Embase, and Cochrane Library databases from inception to March 2019. The weighted mean difference (WMD) with a 95% confidence interval (CI) was used to assess the difference in RRIs between AKI and non-AKI patients. Moreover, the sensitivity and specificity were calculated, and summary receiver operating characteristic (SROC) curves were constructed. Meta-Disc and STATA were used for all statistical analyses. RESULTS: A total of 20 studies (14 for prediction of the onset of AKI and 6 for prediction of AKI short-term non-recovery) were included in our meta-analysis. The values of RRI (WMD = 0.07; 95% CI: 0.05 - 0.09; p < 0.0001) were significantly higher in AKI patients compared with non-AKI patients. The overall sensitivity and specificity of RRI for prediction of the onset of AKI were 72% (95% CI, 64 - 80%) and 79% (95% CI, 71 - 85%), respectively. As for prediction of AKI short-term non-recovery, the pooled sensitivity was 81% (95% CI: 64 - 91), and the pooled specificity was 80% (95% CI: 72 - 85). For the onset of AKI, the best predictive performance was observed for the RRI measured immediately after major surgery, and a cut-off value ≥ 0.715 also achieved superior predictive value. CONCLUSION: This study showed that the elevation of RRI may be related to the progression of AKI, and RRI could have good overall predictive value for the onset of AKI and its short-term non-recovery. Further studies in different clinical settings and patient groups are warranted before it could be widely used in clinical practice.