Association between vitamin D status and cardiometabolic risk factors in adults with type 2 diabetes in Shenzhen, China.

Background: Evidence of vitamin D status and cardiometabolic health in adults with type 2 diabetes mellitus (T2DM) is still limited. This study aimed to investigate the association between vitamin D status and cardiometabolic risk factors among adults with T2DM in Shenzhen, China. Methods: This cross-sectional study included 164 adults (aged ≥18 years) with T2DM who were hospitalized at Peking University Shenzhen Hospital from March 1, 2023, to May 31, 2023. Serum 25-hydroxyvitamin D [25(OH)D] concentration, the active marker of vitamin D, and three major cardiometabolic risk factors including blood pressure (BP), glucose metabolism-related indicators, and blood lipid profiles were collected. Vitamin D deficiency (VDD) was defined as 25(OH)D < 20 ng/mL. Correlation, Regression, and Logistic analysis were applied to verify the association among serum 25(OH)D concentration, VDD, and 11 cardiometabolic risk factors. Results: Median 25(OH)D concentration was 21.78 [interquartile range (IQR)=17.51-28.05] ng/mL. The prevalence of VDD was 40.24%. Serum 25(OH)D concentration was significantly negatively correlated with diastolic BP (DBP) and glycated hemoglobin A1c (HbA1c) rather than systolic BP, plasma glucose, plasma C-peptide, and blood lipid profiles among adults with T2DM in both correlation and linear regression analysis. Furthermore, the adjusted odd ratio for poor DBP control (≥90 mmHg) of T2DM patients with VDD was 3.164 (95% confidence interval=1.303, 7.683; P=0.011) compared to those without VDD. Conclusion: In China, VDD was highly prevalent among adults with T2DM and associated with greater cardiovascular risk factors, especially with increased chances of uncontrolled DBP. These findings suggest that vitamin D levels should be monitored in T2DM patients, especially those with high DBP.

Non-high-density lipoprotein cholesterol levels as a risk factor for short-term mortality in elderly Chinese: a large-scale, population-based cohort study.

OBJECTIVES: To explore the association between non-high-density lipoprotein (non-HDL) and mortality risk, both short-term and long-term, in Chinese people. DESIGN: A prospective cohort study. SETTING: The National Basic Public Health Service (BPHS) in China. PARTICIPANTS: Including 621 164 elderly individuals around Hunan Province who underwent healthcare management receiving check-ups in China BPHS from 2010 to 2020. EXCLUSION CRITERIA: (1) missing information on gender; (2) missing records of lipid screening; (3) missing information on key covariates; and (4) missing records of comorbidities (cardiovascular disease, hypertension, diabetes, cancer.) PRIMARY AND SECONDARY OUTCOME MEASURES: The study's primary endpoint was all-cause and cause-specific mortality, sourced from Hunan's CDC(Center for Disease Control and Prevention)-operated National Mortality Surveillance System, tracking participants until 24 February 2021. RESULTS: 26 758 (4.3%) deaths were recorded, with a median follow-up of 0.83 years. Association between non-HDL and mortality was non-linear after multivariable adjustment, with the optimum concentration (OC) being 3.29 and 4.85 mmol/L. Compared with OC, the risk increased by 1.12-fold for non-HDL <3.29 mmol/L (HR: 1.12 (1.09 to 1.15)) and 1.08-fold for non-HDL ≥4.85 mmol/L (HR: 1.08 (1.02 to 1.13)) for all-cause mortality. Furthermore, there is also an increased risk of cardiovascular mortality (HR for non-HDL <3.29: 1.10 (1.06 to 1.32) and HR for non-HDL ≥4.85: 1.07 (1.01 to 1.14)). However, cancer mortality risk was significantly increased only for non-HDL <3.29 mmol/L (HR: 1.11 (1.04 to 1.18)). Non-optimum concentration of non-HDL had significant effects on both the long-term and the short-term risk of mortality, especially for risks of mortality for all-cause (log HR:0 .086 (0.038 to 0.134)), cardiovascular (log HR:0 .082 (0.021 to 0.144)), and cancer (log HR:0 .187 (0.058 to 0.315)) within 3 months. A two-sided value of p <0.05 was considered to be statistically significant. CONCLUSIONS: Non-HDL was non-linearly associated with the risk of mortality, and non-optimal concentrations of non-HDL significantly increased short-term mortality in elderly Chinese, which needs more attention for cardiovascular disease prevention.

Global burden of type 2 diabetes attributable to non-high body mass index from 1990 to 2019.

BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) currently was increased in some countries of the world like China. However, the epidemiological trends of T2DM attributable to non-high body mass index (BMI) remain unclear. Thus, we aimed to describe the burden of T2DM attributable to non-high BMI. METHODS: To estimate the burden of T2DM attributable to non-high BMI, data from the Global Burden of Disease Study 2019 were used to calculate the deaths and disability-adjusted life years (DALYs) by age, sex, year, and location. The estimated annual percentage change (EAPC) was applied in the analysis of temporal trends in T2DM from 1990 to 2019. RESULTS: Globally in 2019, the number of death cases and DALYs of T2DM attributable to non-high BMI accounted for 57.9% and 48.1% of T2DM-death from all risks, respectively. Asia accounted for 59.5% and 63.6% of the global non-high-BMI-related death cases and DALYs of T2DM in 2019, respectively. From 1990 to 2019, regions in the low-income experienced a rise in DALYs attributable to non-high BMI. As compared to other age groups, older participants had higher deaths and DALYs of T2DM attributable to non-high BMI. The death and DALY rates of T2DM due to non-high BMI were higher in males and people in regions with low socio-demographic index (SDI) countries. CONCLUSIONS: The burden of T2DM attributable to non-high BMI is higher in the elderly and in people in regions with low- and middle-SDI, resulting in a substantial burden on human health and the social cost of healthcare.

Association of joint exposure to various ambient air pollutants during adolescence with blood pressure in young adulthood.

The association of various air pollutants exposure during adolescence with blood pressure (BP) in young adulthood is uncertain. We intended to evaluate the long-term association of individual and joint air pollutants exposure during adolescence with BP in young adulthood. This cross-sectional study of incoming students was conducted in five geographically disperse universities in China during September and October 2018. Mean concentrations of particulate matter with diameters ≤2.5 µm (PM2.5 ), ≤10 µm (PM10 ), nitrogen dioxides (NO2 ), carbon monoxide (CO), sulfur dioxide (SO2 ), and ozone (O3 ) at participants' residential addresses during 2013-2018 were collected from the Chinese Air Quality Reanalysis dataset. Generalized linear mixed models (GLM) and quantile g-computation (QgC) models were utilized to estimate the association between individual and joint air pollutants exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP). A total of 16,242 participants were included in the analysis. The GLM analyses showed that PM2.5 , PM10 , NO2 , CO, and SO2 were significantly positively associated with SBP and PP, while O3 was positively associated with DBP. The QgC analyses indicated that long-term exposure to a mixture of the six air pollutants had a significant positive joint association with SBP and PP. In conclusion, air pollutant co-exposure during adolescence may influence BP in young adulthood. The findings of this study emphasized the impacts of multiple air pollutants interactions on potential health and the need of minimizing pollution exposures in the environment.

Association of long-term ambient fine particulate matter (PM2.5) and incident non-alcoholic fatty liver disease in Chinese adults.

Air pollution is increasingly recognized as an important environmental risk factor for non-alcoholic fatty liver disease (NAFLD). However, epidemiologic evidence on long-term exposure to high air pollution concentrations with incident NAFLD is still very limited. Here, we constructed a population-based dynamic cohort involving 17,106 subjects who were enrolled between 2005 and 2013 and subsequently followed until 2017, combined with a high-resolution ambient fine particulate matter ≤2.5 µm (PM2.5) dataset, to investigate the association of long-term PM2.5 exposure (cumulative annual average levels ranged from 36.67 to 111.16 µg/m3) with NAFLD incidence (N = 4,640). We estimated the adjusted hazard ratio (HR) for incident NAFLD among those exposed to the highest quartile of PM2.5 was 2.04 [95% confidence interval (CI), 1.80-2.30] compared with individuals exposed to the lowest quartile of PM2.5. The dose-response relationships for PM2.5 are non-linear for NAFLD across the exposure distribution. Further stratified analyses revealed that lean (<23 kg/m2), younger (<40-year-old), and women individuals appeared more vulnerable to the harmful effects of PM2.5 exposure. Our study suggests a greater long-term high ambient PM2.5 exposure is associated with an increased risk of NAFLD in Chinese adults, particularly in specific groups, including lean, women, and younger people.

Microvascular transit time of the recipient vessels during STA-MCA bypass surgery for athletic patients

Purpose: We investigated the relationship between hemodynamic sources of recipient arteries and the microvascular transit time (MVTT) to explain the underlying mechanisms of cerebral hyperperfusion syndrome (CHS) in individuals with moyamoya disease (MMD). Methods: Forty-two adult individuals with MMD that underwent superficial temporal artery–middle cerebral artery (STA-MCA) bypass surgery between July 2020 and January 2021 were included in the analysis. Enrolled individuals underwent digital subtraction angiography (DSA) to diagnose MMD and determine the hemodynamic sources of recipient arteries (MCA or non-MCA), as well as intraoperative indocyanine green video angiography to measure MVTTs. Correlations between the hemodynamic sources of recipient arteries and the MVTT were analyzed. Results: Seventeen surgical hemispheres (40.5%) displayed a MCA-derived recipient artery and 25 hemispheres (59.5%) a non-MCA-derived recipient artery. Preoperative MVTT and DMVTT (the difference between preoperative and postoperative MVTTs) were significantly prolonged in the MCA-derived group (4.00±1.4 s and 1.96±1.48 s) compared to the non-MCA-derived group (2.79±0.79 s and 1.55±0.86 s). The incidence of CHS was 9.5% (4/42), with 3 CHS cases in the MCA-derived group and 1 CHS case in the non-MCA-derived group. Multivariate linear regression showed that hemodynamic sources of recipient arteries were related to preoperative MVTT (P = 0.004) and DMVTT (P < 0.001). Conclusions: The MVTTs of recipient vessels in the MCA-derived group were in general longer than those in the non-MCA-derived group. This may be due to abnormal hemodynamics. As well, this could account for the higher incidence of CHS in MMD patients with MCA-derived recipient vessels compared to non-MCA-derived vessels after STA-MCA bypass surgery. (AU)

Association of Long-term Ambient Fine Particulate Matter (PM2.5) and Incident CKD: A Prospective Cohort Study in China.

RATIONALE & OBJECTIVE: Increasing evidence has linked ambient fine particulate matter (ie, particulate matter no larger than 2.5 µm [PM2.5]) to chronic kidney disease (CKD), but their association has not been fully elucidated, especially in regions with high levels of PM2.5 pollution. This study aimed to investigate the long-term association of high PM2.5 exposure with incident CKD in mainland China. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 72,425 participants (age ≥18 years) without CKD were recruited from 121 counties in Hunan Province, China. EXPOSURE: Annual mean PM2.5 concentration at the residence of each participant derived from a long-term, full-coverage, high-resolution (1 × 1 km2), high-quality dataset of ground-level air pollutants in China. OUTCOMES: Incident CKD during the interval between the baseline examination of each participant (2005-2017) and the end of follow-up through 2018. ANALYTICAL APPROACH: Cox proportional hazards models were used to estimate the independent association of PM2.5 with incident CKD and the joint association of PM2.5 with temperature or humidity on the development of PM2.5-related CKD. Restricted cubic splines were used to model exposure-response relationships. RESULTS: Over a median follow-up of 3.79 (IQR, 2.03-5.48) years, a total of 2,188 participants with incident CKD were identified. PM2.5 exposure was associated with incident CKD with an adjusted hazard ratio of 1.71 (95% CI, 1.58-1.85) per 10-µg/m3 greater long-term exposure. Multiplicative interactions between PM2.5 and humidity or temperature on incident CKD were detected (all P < 0.001 for interaction), whereas an additive interaction was detected only for humidity (relative risk due to interaction, 3.59 [95% CI, 0.97-6.21]). LIMITATIONS: Lack of information on participants' activity patterns such as time spent outdoors. CONCLUSIONS: Greater long-term ambient PM2.5 pollution is associated with incident CKD in environments with high PM2.5 exposure. Ambient humidity has a potentially synergetic effect on the association of PM2.5 with the development of CKD. PLAIN-LANGUAGE SUMMARY: Exposure to a form of air pollution known as fine particulate matter (ie, particulate matter ≤2.5 µm [PM2.5]) has been linked to an increased risk of chronic kidney disease (CKD), but little is known about how PM2.5 affects CKD in regions with extremely high levels of PM2.5 pollution. This longitudinal cohort study in China investigates the effect of PM2.5 on the incidence of CKD and whether temperature or humidity interact with PM2.5. Our findings suggest that long-term exposure to high levels of ambient PM2.5 significantly increased the risk of CKD in mainland China, especially in terms of cumulative average PM2.5. The associations of PM2.5 and incident CKD were greater in high-humidity environments. These findings support the recommendation that reducing PM2.5 pollution should be a priority to decrease the burden of associated health risks, including CKD.

A terrifying sound stress inhibits hippocampal neurogenesis in the adult male mice.

Stress impairs hippocampal neurogenesis. The traditional animal model of stress contains a mixture of physical and psychological stress factors. This leads to difficulty in the evaluation of the effect of pure psychological stress on neurogenesis. In this study, we investigated the effect of pure psychological stress on hippocampal neurogenesis. The pure psychological stress model and the mixed stress model were carried out by terrifying sound and restraint, respectively. The open field test showed that restraint treatment improved the general locomotor activity levels, while terrifying sound treatment had opposite effects. Compared with a normal condition, both terrifying sound stimulation and restraint treatment significantly decreased the number of BrdU and Ki-67 and reduced the positive rate of SOX2/GFAP in the hippocampus. These phenomena indicated that pure psychological stress could decrease the number of neural stem cells and inhibit cell proliferation in the hippocampus of a mouse. Furthermore, compared with the restraint treatment, the neurotransmitters including norepinephrine (NE), 5-hydroxytryptamine (5-HT), and gamma-aminobutyric acid (GABA) had not been affected drastically by terrifying sound stimulation. Our results suggest that the terrifying sound stimulation can be considered as a novel and effective pure psychological stress animal model for the further research on the hippocampus.

Distinct uric acid trajectories are associated with incident diabetes in an overweight Chinese population.

AIM: To explore uric acid (UA) trajectories in different body mass index (BMI) populations and to determine their associations with incident diabetes. METHODS: A total of 4566 adults without diabetes in 2011 were enrolled. All participants underwent a medical examination every year until 2016, and were classified into three subgroups based on BMI: non-obese (BMI<24kg/m2); overweight (BMI ≥24kg/m2 but<28kg/m2); and obese (BMI ≥28kg/m2). Distinct UA trajectories were identified through group-based trajectory modelling (GBTM). Cox proportional-hazards models were applied to evaluate the associations between UA trajectories and risk of incident diabetes. RESULTS: UA trajectories were identified in the three BMI subgroups: 'low' (42.4% in non-obese, 22.1% in overweight, 22.0% in obese); 'moderate' (32.5%, 41.1%, 34.8%); 'moderate-high' (18.6%, 29.5%, 30.8%); and 'high' (6.5%, 7.3%, 12.4%). After a 5-year follow-up, 170 (3.7%) participants had developed diabetes. The prevalence of new-onset diabetes increased progressively with the higher UA trajectories in the BMI groups (P values<0.05). Whereas compared with the low trajectory, a significant association between a high UA trajectory and incidence of diabetes was observed only in the overweight population [hazard ratio (HR): 6.95, 95% confidence interval (CI): 1.90-25.45], with no significant associations found in either the non-obese (HR: 0.67, 95% CI: 0.13-3.52) or obese (HR: 0.40, 95% CI: 0.06-2.64) populations, in the fully adjusted model. CONCLUSION: Higher UA trajectories are significantly associated with an increased risk of incident diabetes, thereby suggesting that monitoring UA trajectories over time may assist in the identification of prediabetes and diabetes, particularly in the overweight population.

High-efficiency chirality-modulated spoof surface plasmon meta-coupler.

Efficiently exciting surface plasmon polaritons (SPP) is highly desired in many photonic applications, but most approaches (such as prism and grating couplers) cannot control flexibly their SPP excitation directions. While Pancharatnam-Berry (PB) metasurfaces were recently proposed to achieve direction-controllable SPP excitations, such scheme suffers from low-efficiency issue due to both direct reflections at the coupler surface and the mode mismatch between the coupler and the guiding-out plasmonic structure. In this article, we solve these issues via imposing two criterions to guide design both the metasurface and the plasmonic metal, based on which a direction-controllable SPP excitation with very high efficiency can be realized. As a proof of concept, we designed/fabricated a realistic device working in the microwave regime, and performed both near-field and far-field measurements to demonstrate that it can achieve an spoof SPP conversion efficiency ~78%, much higher than previous devices. Full-wave simulations are in good agreement with experiments, showing that the efficiency can be further pushed to 92% with optimized designs. Our findings can stimulate spoof SPP-related applications, particularly can help enhance the spin-dependent light-matter interactions in low frequency regime.