Serum urate levels and neurodegenerative outcomes: a prospective cohort study and mendelian randomization analysis of the UK Biobank.

BACKGROUND: Previous studies on the associations between serum urate levels and neurodegenerative outcomes have yielded inconclusive results, and the causality remains unclear. This study aimed to investigate whether urate levels are associated with the risks of Alzheimer's disease and related dementias (ADRD), Parkinson's disease (PD), and neurodegenerative deaths. METHODS: This prospective study included 382,182 participants (45.7% men) from the UK Biobank cohort. Cox proportional hazards models were used to assess the associations between urate levels and risk of neurodegenerative outcomes. In the Mendelian randomization (MR) analysis, urate-related single-nucleotide polymorphisms were identified through a genome-wide association study. Both linear and non-linear MR approaches were utilized to investigate the potential causal associations. RESULTS: During a median follow-up period of 12 years, we documented 5,400 ADRD cases, 2,553 PD cases, and 1,531 neurodegenerative deaths. Observational data revealed that a higher urate level was associated with a decreased risk of ADRD (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.90, 0.96), PD (HR: 0.87, 95% CI: 0.82, 0.91), and neurodegenerative death (HR: 0.88, 95% CI: 0.83, 0.94). Negative linear associations between urate levels and neurodegenerative events were observed (all P-values for overall < 0.001 and all P-values for non-linearity > 0.05). However, MR analyses yielded no evidence of either linear or non-linear associations between genetically predicted urate levels and the risk of the aforementioned neurodegenerative events. CONCLUSION: Although the prospective cohort study demonstrated that elevated urate levels were associated with a reduced risk of neurodegenerative outcomes, MR analyses found no evidence of causality.

Joint association of serum urate and healthy diet with chronic obstructive pulmonary disease incidence: results from the UK Biobank study.

Background: The role of serum urate (SU) levels in the development of chronic obstructive pulmonary disease (COPD) remains a topic of debate, and it is unclear whether a healthy diet can mitigate the impact of SU on COPD risk. The objective of this study is to examine whether and to what extent a healthy diet can reduce the risk of COPD in relation to SU levels. Methods: The cohort analysis included 155 403 participants from the UK Biobank. SU levels were measured at the time of recruitment. A healthy diet score was calculated based on the consumption of vegetables, fruits, fish, processed meats, unprocessed red meat, whole grains, and refined grains. The Cox proportional hazards model was used to analyze the associations between SU levels, a healthy diet score, and the risk of COPD. Results: During a follow-up period of 1 409 969 person-years, 2918 incident cases of COPD were identified. Compared with the lowest SU level group, the hazard ratio (HR) and 95% confidence interval (CI) for COPD were 1.17 (1.03, 1.34) for participants with the highest SU level (hyperuricemia), indicating a positive association. Additionally, a dose-response relationship was observed between SU levels and the incidence of COPD (P-value for overall <0.0001). In the combined effect analysis, compared to individuals with high SU (hyperuricemia) + a low diet score (diet score <4), those with normal SU + a high diet score (diet score ≥4) had a HR (95% CI) of 0.75 (0.65, 0.87) for COPD. Conclusions: In summary, there is a positive association between SU levels and the risk of COPD. Furthermore, a healthier diet can mitigate the risk of COPD associated with high SU levels.

Ultra-processed food consumption, genetic susceptibility, and the risk of hip/knee osteoarthritis.

BACKGROUND: The associations between ultra-processed food (UPF) consumption, genetic susceptibility, and the risk of osteoarthritis (OA) remain unknown. This study was to examine the effect of UPF consumption, genetic susceptibility, and their interactions on hip/knee OA. METHODS: Cohort analyses included 163,987 participants from the UK Biobank. Participants' UPF consumption was derived from their 24-h dietary recall using a questionnaire. Genetic risk scores (GRSs) of 70 and 83 single nucleotide polymorphisms (SNPs) for hip and knee OA were constructed. FINDINGS: After 1,461,447 person-years of follow-up, 11,540 patients developed OA. After adjustments, compared to participants in the low quartile of UPF consumption, those in the high quartile had a 10 % (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.03-1.18) increased risk of knee OA. No significant association was found between UPF consumption and hip OA. Replacing 20% of UPF diet weight with an equivalent proportion of unprocessed or minimally processed food caused a 6% (HR, 0.94; 95% CI, 0.89-0.98) decreased risk of knee OA, respectively. A significant interaction was found between UPF consumption, genetic predisposition, and the risk of knee OA (P = 0.01). Participants with lower OA-GRS scores experienced higher knee OA risks due to UPF consumption. INTERPRETATION: UPF consumption was associated with a higher risk of knee OA but not hip OA, particularly in those with lower genetic susceptibility. These results highlight the importance of reducing UPF consumption to prevent knee OA.

Healthy Lifestyle and the Risk of Metabolic Dysfunction-Associated Fatty Liver Disease: A Large Prospective Cohort Study.

Background: The incidence density of metabolic dysfunction-associated fatty liver disease (MAFLD) and the effect of a healthy lifestyle on the risk of MAFLD remain unknown. We evaluated the prevalence and incidence density of MAFLD and investigated the association between healthy lifestyle and the risk of MAFLD. Methods: A cross-sectional analysis was conducted on 37,422 participants to explore the prevalence of MAFLD. A cohort analysis of 18,964 individuals was conducted to identify the incidence of MAFLD, as well as the association between healthy lifestyle and MAFLD. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) with adjustments for confounding factors. Results: The prevalence of MAFLD, non-alcoholic fatty liver disease, and their comorbidities were 30.38%, 28.09%, and 26.13%, respectively. After approximately 70 thousand person-years of follow-up, the incidence densities of the three conditions were 61.03, 55.49, and 51.64 per 1,000 person-years, respectively. Adherence to an overall healthy lifestyle was associated with a 19% decreased risk of MAFLD (HR, 0.81; 95% CI, 0.72 to 0.92), and the effects were modified by baseline age, sex, and body mass index (BMI). Subgroup analyses revealed that younger participants, men, and those with a lower BMI experienced more significant beneficial effects from healthy lifestyle. Conclusion: Our results highlight the beneficial effect of adherence to a healthy lifestyle on the prevention of MAFLD. Health management for improving dietary intake, physical activity, and smoking and drinking habits are critical to improving MAFLD.

Dietary carbohydrate types, genetic predisposition, and risk of adult-onset asthma: A longitudinal cohort study.

We aimed to investigate the longitudinal associations among carbohydrate intake types, genetic predisposition, and risk adult onset asthma (AOA). A dataset of 96,487 participants from UK Biobank was included with 1830 cases of incident AOA during an average follow-up of 9.68 years. Participants with the highest intake of total sugar, free sugar, and fiber intake, as compared to those with the lowest intake of total sugar, free sugar, and fiber intake, showed a 17 % and 22 % increased risk of incident AOA, and a 16 % decreased risk of AOA, respectively. Substitution of 5 % energy from free sugars with 5 % energy from non-free sugars was associated with a significantly lower risk of AOA (Hazard Ratio [HR] = 0.93, 95 % Confidence Interval [CI]: 0.88, 0.99). Participants with high genetic risk and the highest intake of free sugar showed a 112 % (HR = 2.12, 95%CI: 1.68, 2.68) increased risk of incident AOA. Participants with low genetic risk and highest intake of fiber showed a 50 % (HR = 0.50, 95%CI: 0.39, 0.64) reduced risk of AOA. This study highlights the critical role of carbohydrate types in AOA prevention, with an emphasis on reduced free sugar, moderate non-free sugar, and increased fiber intake.

Metabolic syndrome, genetic susceptibility, and risk of chronic obstructive pulmonary disease: The UK Biobank Study.

AIM: To investigate the effect of metabolic syndrome (MetS), genetic predisposition, and their interactions, on the risk of developing chronic obstructive pulmonary disease (COPD). METHODS: Cohort analyses included 287 868 participants from the UK Biobank Study. A genetic risk score for COPD was created using 277 single nucleotide polymorphisms. Cox proportional hazard models were used to evaluate the hazard ratios (HRs) with 95% confidence intervals (CIs) for COPD in relation to exposure factors. RESULTS: During 2 658 936 person-years of follow-up, 5877 incident cases of COPD were documented. Compared with participants without MetS, those with MetS had a higher risk of COPD (HR 1.24, 95% CI 1.17-1.32). Compared to participants with low genetic predisposition, those with high genetic predisposition had a 17% increased risk of COPD. In the joint analysis, compared with participants without MetS and low genetic predisposition, the HR for COPD for those with MetS and high genetic predisposition was 1.50 (95% CI 1.36-1.65; P < 0.001). However, no significant interaction between MetS and genetic risk was found. CONCLUSIONS: Metabolic syndrome was found to be associated with an increased risk of COPD, regardless of genetic risk. It is crucial to conduct further randomized control trials to determine whether managing MetS and its individual components can potentially reduce the likelihood of developing COPD.

Ultraprocessed food consumption, genetic predisposition, and the risk of gout: the UK Biobank study.

OBJECTIVE: This study aimed to examine the interactions between ultraprocessed food (UPF) consumption and genetic predisposition with the risk of gout. METHODS: This prospective cohort study analysed 181 559 individuals from the UK Biobank study who were free of gout at baseline. UPF was defined according to the NOVA classification. Assessment of genetic predisposition for gout was developed from a genetic risk score of 33 single nucleotide polymorphisms. Cox proportional hazards were used to estimate the associations between UPF consumption, genetic predisposition and the risk of gout. RESULTS: Among the 181 559 individuals in the study, 1558 patients developed gout over 1 648 167 person-years of follow-up. In the multivariable adjustment model, compared with the lowest quartile of UPF consumption, the hazard ratio (HR) and 95% CI of the highest UPF consumption was 1.16 (1.01, 1.33) for gout risk, and there was a non-linear correlation between UPF consumption and the development of gout. In substitution analyses, replacing 20% of the weight of UPF in the daily intake with an equal amount of unprocessed or minimally processed food resulted in a 13% lower risk of gout (HR: 0.87; 95% CI: 0.79, 0.95). In the joint-effect analysis, the HR (95% CI) for gout was 1.90 (1.39, 2.60) in participants with high genetic predisposition and high UPF consumption, compared with those with low genetic predisposition and low UPF consumption. CONCLUSION: In summary, UPF consumption was found to be associated with a higher risk of gout, particularly in those participants with genetic predisposition to gout. Our study indicated that reducing UPF consumption is crucial for gout prevention.

Adherence to healthy lifestyle was associated with an attenuation of the risk of chronic kidney disease from metabolic dysfunction-associated fatty liver disease: Results from two prospective cohorts.

AIMS: Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) are important risk factors of chronic kidney disease (CKD). Whether adherence to a healthy lifestyle can modify these effects remain unknown. This study aimed to evaluate the modification effects of healthy lifestyle on the associations among NAFLD, MAFLD, and the risk of CKD, with taking into the effect of genetic risk. METHODS: The Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study (TCLSIH), the UK Biobank Study (UKB). The outcome was incident CKD. The exposures including NAFLD, MAFLD, healthy lifestyle, and a genetic risk score (GRS) for CKD. RESULTS: After 1,135,334 person-year follow-up, we documented 2975 incident CKD cases in the two cohorts. MAFLD and NAFLD were associated with a higher risk of CKD, particularly in patients with MAFLD. In the TCLSIH and UKB, the hazard ratios (95% confidence intervals) of incident CKD for MAFLD were 1.47 (1.30, 1.66) and 1.73 (1.57, 1.91), respectively. Adherence to a healthier lifestyle decreased the risk of CKD from MAFLD with significant interaction effects (TCLSIH: Pinteraction = 0.02; UKB: Pinteraction = 0.04). Participants with a lower CKD-GRS experienced a higher risk of CKD from MAFLD, but achieved two healthy lifestyles can significantly decreased the risk of CKD in patients with MAFLD. CONCLUSIONS: MAFLD and NAFLD are associated with a higher CKD risk, particularly MAFLD. Adherence to a healthier lifestyle was associated with a lower risk of CKD from MAFLD. These results highlight the important role of following a healthy lifestyle to prevent CKD.

Meta-analysis of the association between major foods with added fructose and non-alcoholic fatty liver disease.

Objectives: The relationship between the consumption of foods with added fructose and non-alcoholic fatty liver disease (NAFLD) was inconsistent in previous epidemiological studies, and no meta-analysis has been performed on the pooled results. Hence, this study aims to assess the associations between the consumption of major foods with added fructose and NAFLD in a meta-analysis. Methods: Through PubMed and Web of Science, an extensive literature search of publications before July 2022 was conducted. We included studies that investigated the associations between the intake of ≥1 food sources with added fructose (biscuits and cookies, cake, sugar-sweetened beverages [SSBs], sweets, candies, chocolate, or ice cream) and NAFLD in a general adult population. Random- or fixed-effects models were used to pool odds ratios [ORs, 95% confidence intervals (95% CIs)] depending on the degree of heterogeneity. Results: A total of 15 studies with 65 149 participants were finally brought into the meta-analysis. Based on the results, it seems that the prevalence of NAFLD was higher among those who consumed foods with added fructose (OR = 1.31, 95% CI = 1.17-1.48). Subgroup analysis showed that consumption of foods with added fructose was associated with a greater prevalence of NAFLD in subgroups of cohort and cross-sectional studies, of SSBs, participants from Asia or North America, disease assessment using ultrasound, CT, or MRI, and exposure assessment using dietary recall and food frequency questionnaires. Conclusion: Our results indicated that major foods with added fructose intake have a positive association with the prevalence of NAFLD. Reduction of added fructose consumption may represent an early opportunity to mitigate or prevent NAFLD.

Association Between Serum Uric Acid and Non-Alcoholic Fatty Liver Disease: An Updated Systematic Review and Meta-Analysis.

Objective: Recent epidemiological evidence shows that there is an association between serum uric acid (SUA) levels and nonalcoholic fatty liver disease (NAFLD). The purpose of this meta-analysis is to summarize all available evidence and assess the associations between SUA levels and NAFLD. Methods: Using two databases, Web of Science and PubMed, observational studies were applied from the establishment of the databases to June 2022. We used a random effect model to construct the pooled odds ratio (OR) and 95% confidence interval (CI) to appraise the association between SUA levels and NAFLD. The Begg's test was conducted to appraise publication bias. Results: A total of 50 studies were included, involving 2,079,710 participants (719,013 NAFLD patients). The prevalence and incidence rates (95% CIs) of NAFLD in the patients with hyperuricemia were 65% (57-73%) and 31% (20-41%), respectively. Compared to participants with lower levels of SUA, the pooled OR (95% CI) of NAFLD in those with higher levels of SUA was 1.88 (95% CI: 1.76-2.00). In the subgroup analyses, we found that SUA levels were positively associated with NAFLD in all subgroups, according to study design, study quality, sample size, sex, comparison, age, or country. Conclusion: This meta-analysis shows that increased SUA levels are positively associated with NAFLD. The results suggested that reducing SUA levels can be a potential strategy for the prevention of NAFLD. Registration Number: PROSPERO-CRD42022358431.

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.

Green tea intake and the risk of hypertension in premenopausal women: the TCLSIH cohort study.

Background and aims: Tea polyphenols, such as green tea polyphenols, have been extensively studied as agents that ameliorate cardiovascular disease and blood pressure in vitro and in animal studies. However, epidemiological evidence for the association of green tea consumption with hypertension (HTN) is inconsistent. In addition, such an association has not been prospectively examined in the general adult population, particularly among young women. Therefore, we designed a cohort study to examine whether green tea consumption increases the risk of HTN in premenopausal women. Methods and results: This prospective cohort study investigated 6633 premenopausal female participants without hypertension, cardiovascular disease, and cancer at the baseline. Green tea consumption was measured at the baseline using a validated food frequency questionnaire. Hypertension was confirmed with the SBP ≥140 mm Hg-1 or with the DBP ≥90 mm Hg-1. Cox proportional hazards regression models were used to examine the association of green tea consumption with incident hypertension. A total of 488 first incident cases of hypertension occurred during 24 957 person-years of follow-up (median follow-up of 4.0 years). After adjustment for potential confounding variables, the multivariable hazard ratios (95% confidence intervals) for incident hypertension in premenopausal female participants with different green tea consumption frequencies were 1.00 (reference) for almost never, 0.84 (0.67, 1.07) for 1 cup per week, 1.02 (0.77, 1.35) for 2-6 cups per week, and 0.65 (0.44, 0.96) for ≥1 cup per day. Conclusions: The results from our prospective study indicate that the consumption of green tea is associated with a reduced risk of HTN in premenopausal women.

Prevalence of Diabetes in Patients with Hyperuricemia and Gout: A Systematic Review and Meta-analysis.

PURPOSE OF REVIEW: To perform a systematic review and meta-analysis of the prevalence of diabetes in patients with hyperuricemia and gout. RECENT FINDINGS: Previous studies have confirmed that hyperuricemia and gout are associated with an increased risk of diabetes. A previous meta-analysis indicated that the prevalence of diabetes in patients with gout is 16%. Thirty-eight studies (458,256 patients) were included in the meta-analysis. The combined prevalence of diabetes among patients with hyperuricemia and gout were 19.10% (95% confidence interval [CI]: 17.60-20.60; I2 = 99.40%) and 16.70% (95% CI: 15.10-18.30; I2 = 99.30%), respectively. Patients from North America showed a higher prevalence of diabetes (hyperuricemia: 20.70% [95% CI: 16.80-24.60], gout: 20.70% [95% CI: 16.80-24.60]) than those from other continents. Older patients with hyperuricemia and those using diuretics showed a higher prevalence of diabetes than younger patients and those who were not using diuretics. Studies with a small sample size, case-control design, and low quality score had a higher prevalence of diabetes than studies with a large sample size, other designs, and a high quality score. The prevalence of diabetes among patients with hyperuricemia and gout is high. Controlling plasma glucose and uric acid levels of patients with hyperuricemia and gout is critical for the prevention of diabetes.

Genetic risk, muscle strength and risk of incident major depressive disorder: results from the UK Biobank.

BACKGROUND: Genetic factors and muscle strength both contribute to the risk of major depressive disorder (MDD), but whether high muscle strength can offset the risk of MDD with different genetic risk is unknown. This study aims to examine whether a higher muscle strength is associated with lower risk of MDD regardless of genetic risk among middle-aged and older adults. METHODS: This cohort study obtained data from the UK Biobank, which includes 345,621 individuals aged 40-69 years (mean (standard deviation): 56.7 (7.99) years) without baseline MDD. Polygenic risk score for MDD was categorised as low, intermediate or high. The mean of the right- and left-hand grip strength values was used in the analysis and was divided into three categories. RESULTS: 9,753 individuals developed MDD within 2,752,461 person-years of follow-up. The multivariable adjusted hazard ratios (HRs) (95% confidence intervals (CIs)) of MDD across increased grip strength categories were 1.00, 0.72 (0.68-0.75) and 0.56 (0.53-0.59) (P for trend <0.0001). The HRs (95% CIs) of incident MDD across the genetic risk categories were 1.00, 1.11 (1.05-1.17) and 1.20 (1.13-1.28) (P for trend <0.0001); 4.07% of individuals with a high genetic risk and low grip strength developed MDD, and 1.72% of individuals with a low genetic risk and high grip strength developed MDD, with an HR (95% CI) of 0.44 (0.39-0.50). CONCLUSIONS: Both muscle strength and genetic risk were significantly associated with incident MDD. A higher muscle strength was associated with a lower MDD risk among individuals with a high genetic risk. Improving muscle strength should be encouraged for all individuals, including individuals with high genetic risk for MDD.

Helicobacter pylori infection increase the risk of subclinical hyperthyroidism in middle-aged and elderly women independent of dietary factors: Results from the Tianjin chronic low-grade systemic inflammation and health cohort study in China.

Background: Prospective studies on the association between Helicobacter pylori (H. pylori) infection and subclinical hyperthyroidism are limited. We, therefore, designed a large-scale cohort study to explore the association between H. pylori infection and the risk of subclinical hyperthyroidism in women. Methods: This prospective cohort study investigated 2,713 participants. H. pylori infection was diagnosed with the carbon 13 breath test. Subclinical hyperthyroidism was defined as serum thyroid-stimulating hormone levels are low or undetectable but free thyroxine and tri-iodothyronine concentrations are normal. Propensity score matching (PSM) analyses and Cox proportional hazards regression models were used to estimate the association between H. pylori infection and subclinical hyperthyroidism. Results: A total of 1,025 PS-matched pairs of H. pylori infection women were generated after PSM. During 6 years of follow-up, the incidence rate of subclinical hyperthyroidism was 7.35/1,000 person-years. After adjusting potential confounding factors (including iodine intake in food and three main dietary patterns score), the multivariable hazard ratio (HR; 95% confidence intervals) of subclinical hyperthyroidism by H. pylori infection was 2.49 (1.36, 4.56). Stratified analyses suggested a potential effect modification by age, the multivariable HR (95% confidence intervals) was 2.85 (1.45, 5.61) in participants aged ≥ 40 years and 0.70 (0.08, 6.00) in participants aged < 40 years (P for interaction = 0.048). Conclusion: Our prospective study first indicates that H. pylori infection is significantly associated with the risk of subclinical hyperthyroidism independent of dietary factors among Chinese women, especially in middle-aged and older individuals.Clinical Trial Registration:https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137, identifier UMIN000027174.

Dairy product consumption was associated with a lower likelihood of non-alcoholic fatty liver disease: A systematic review and meta-analysis.

Background and aims: Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. Several epidemiological studies attempted to assess the association between dairy product and the likelihood of NAFLD, but the contribution of dairy consumption to NAFLD remains controversial. We conducted a meta-analysis to investigate the association between dairy product consumption and NAFLD. Methods: We conducted a literature search using the PubMed, Web of Science and Scopus databases, we conducted a thorough search of the literature published before January 5, 2023. Combined odds ratios (ORs) and 95% confidence intervals (CIs) of NAFLD in relation to dairy product intake were estimated using random-effects models. Subgroup analysis and meta-regression were performed according to the study design, region, sex, body mass index (BMI), type of exposure, NAFLD diagnostic criteria, and exposure assessment tools. Results: We initially identified 4,634 relevant studies, of which 25 complied with the inclusion criteria, including seven cross-sectional studies, six case-control studies and one cohort study. A total of 51,476 participants (14,546 patients with NAFLD) were included in the meta-analysis. There was an inverse association between dairy product consumption and NAFLD (OR = 0.97, 95% CI = 0.94-0.99). Subgroup analysis demonstrated that lower likelihood of NAFLD was associated with dairy product consumption in subgroups of Asian populations, women, patients diagnosed using NAFLD-related scores, patients with a BMI of 18.5-24.9 kg/m2, dairy intake assessed using a food frequency questionnaire, milk consumption, and yogurt consumption. No noteworthy connection was observed in the other subgroups. Conclusion: Our meta-analysis findings revealed that dairy product consumption is inversely associated with NAFLD. Consumption of dairy products could help prevent the development of non-alcoholic fatty liver disease.

Associations between dietary patterns and nephrolithiasis risk in a large Chinese cohort: is a balanced or plant-based diet better?

Purpose: Individual food items and nutrients are associated with the development of nephrolithiasis. Few studies have investigated the association between dietary patterns, particularly plant-based diets, and this disease. We aim to explore the associations between dietary patterns and incident nephrolithiasis risk. Materials and methods: This prospective cohort study included 26 490 participants. Factor analysis was applied to dietary information to identify three a posteriori dietary patterns, and six a priori plant-based dietary patterns (overall plant-based diet index [PDI], healthful plant-based diet index [hPDI], unhealthful plant-based diet index [uPDI], vegan diet, lacto-ovo-vegetarian diet, and fish-vegetarian diet) were defined. Nephrolithiasis was diagnosed using ultrasonography. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident nephrolithiasis related to dietary patterns. Results: After 101 094 person-years follow-up, we documented 806 incident nephrolithiasis cases. An a posteriori balanced dietary pattern characterized by a higher intake of vegetables, eggs, grains, legumes, legume products, and meat was associated with a lower risk of nephrolithiasis (P for trend = 0.02). Compared to the reference group in the lowest quartile of the balanced pattern, participants in the highest quartile had an adjusted HR (95% CI) of 0.72 (0.53-0.96) for incident nephrolithiasis. Adherence to the uPDI increased the risk of incident nephrolithiasis (P for trend < 0.01; adjusted HR4th quartile vs. 1st quartile, 1.46, 95% CI, 1.14-1.97). No significant association was found between other a posteriori or a priori dietary patterns and incident nephrolithiasis. Conclusions: Adherence to a balanced dietary pattern, but not a plant-based diet, was associated with a lower nephrolithiasis risk. Moreover, higher uPDI consumption increased incident nephrolithiasis risk.

Consumption of ultraprocessed food and development of chronic kidney disease: the Tianjin Chronic Low-Grade Systemic Inflammation and Health and UK Biobank Cohort Studies.

BACKGROUND: Many ultraprocessed food (UPF)-derived by-products may play a role in the development of chronic kidney disease (CKD). Although several studies have assessed the association of UPFs with kidney function decline or CKD in various countries, no evidence has been shown in China and the United Kingdom. OBJECTIVES: This study aims to evaluate the association between UPF consumption and risk of CKD in 2 large cohort studies from China and the United Kingdom. METHODS: In total, 23,775 and 102,332 participants without baseline CKD were enrolled in the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) and UK Biobank cohort studies, respectively. Information on UPF consumption was obtained from a validated food frequency questionnaire in the TCLSIH and 24-h dietary recalls in the UK Biobank cohort. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2, albumin-to-creatinine ratio ≥30 mg/g, or as having a clinical diagnosis of CKD in both cohorts. Multivariable Cox proportional hazard models were used to examine the association between UPF consumption and the risk of CKD. RESULTS: After a median follow-up of 4.0 and 10.1 y, the incidence rates of CKD were around 1.1% and 1.7% in the TCLSIH and UK Biobank cohorts, respectively. The multivariable hazard ratio [95% confidence interval] of CKD across increasing quartiles (quartiles 1-4) of UPF consumption were 1 (reference), 1.24 (0.89, 1.72), 1.30 (0.91, 1.87), and 1.58 (1.07, 2.34) (P for trend = 0.02) in the TCLSIH cohort and 1 (reference), 1.14 (1.00, 1.31), 1.16 (1.01, 1.33), and 1.25 (1.09, 1.43) (P for trend < 0.01) in the UK Biobank cohort, respectively. CONCLUSIONS: Our finding indicated that higher UPF consumption is associated with a higher risk of CKD. Moreover, restricting UPF consumption may potentially benefit the prevention of CKD. Further clinical trials are required to clarify the causality. This trial was registered at UMIN Clinical Trials Registry as UMIN000027174 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137).

Genetic Risk, Adherence to a Healthy Lifestyle, and Hyperuricemia: The TCLSIH Cohort Study.

BACKGROUND: Genetic factors have been associated with hyperuricemia in large studies, but the extent to which this can be offset by a healthy lifestyle is unknown. This study aimed to examine whether healthy lifestyle could reduce hyperuricemia risk among individuals with different genetic profiles. METHODS: We defined a lifestyle score using body mass index, smoking, alcohol consumption, physical activities, and diets in 2796 unrelated individuals from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Polygenic risk scores (PRS) were constructed based on uric acid loci. Associations of combined lifestyle factors and genetic risk and incident hyperuricemia were estimated using Cox proportional hazard regression. RESULTS: Of 2796 individuals, 747 participants (26.7%) developed hyperuricemia. Genetic risk and lifestyle were predictors of incident events, and they showed an interaction for the outcome. Compared with high PRS, low PRS reduced risk of incident hyperuricemia by 40%, and compared with unhealthy lifestyle, healthy lifestyle reduced risk of incident hyperuricemia by 41%. Compared with unhealthy lifestyle and high genetic risk, adherence to healthy lifestyle was associated with a 68% (95% confidence interval, 44%-81%) lower risk of hyperuricemia among those at a low genetic risk. CONCLUSIONS: In this prospective cohort study, we observed an interaction between genetics and lifestyle and the risk of hyperuricemia. The public health implication is that a healthy lifestyle is important for hyperuricemia prevention, especially for individuals with high genetic risk scores.

Association Between Handgrip Strength and Type 2 Diabetes: A Prospective Cohort Study and Systematic Review With Meta-analysis.

BACKGROUND: Both absolute (kg) and relative (kg per kg of body weight) handgrip strength (HGS) have been used as indicators of HGS. Multiple studies have explored HGS associations with type 2 diabetes (T2DM); however, prognostic values were inconsistent. We aimed to examine the associations between both absolute and relative HGS and incident T2DM. METHODS: A total of 12,957 participants aged 40 years and older (mean age 51.0 years, 58.4% men) were followed and enrolled in the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Cox proportional hazards regression models were used to examine the association of HGS with incident T2DM. Other prospective studies on HGS and risk of T2DM were identified by searching several electronic databases up to November 31, 2021. Meta-analysis was performed by combining the results from the TCLSIH study and previous prospective cohort studies. RESULTS: From the TCLSIH Cohort study, after adjustment, relative HGS was inversely associated with T2DM (hazard ratio per 0.1 higher relative HGS 0.667, 95% confidence interval [CI] 0.616, 0.722). However, no significant association between absolute HGS and incident T2DM was found. The meta-analyses showed that per 5 kg higher HGS was associated with a 5% (95% CI 2%, 8%) lower risk of T2DM and each 0.1 higher relative HGS was associated with a 22% (95% CI 14%, 29%) lower risk of T2DM. CONCLUSION: The results from our cohort study and meta-analysis suggest that relative HGS was better than absolute HGS in predicting incident T2DM. Adiposity was an important factor that mediates the association between HGS and T2DM.