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1.
Am J Med Sci ; 361(2): 244-252, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33531147

RESUMEN

BACKGROUND: The metabolically unhealthy normal weight (MUN) and metabolically healthy obese (MHO) phenotypes are abnormal metabolic states. The purpose of this study was to report the frequency of the strictly defined MHO and MUN phenotypes and the association between metabolic phenotype and 10-year Framingham cardiovascular disease (CVD) risk score using a sample taken from the 2015-2016 National Health and Nutrition Examination Survey. METHODS: A cross-sectional sample of 2,316 participants age 18-79 years with complete metabolic health information were selected from the 2015-2016 dataset and included in the present analysis. Metabolic health was defined as the absence of all metabolic abnormalities as outlined by the National Cholesterol Education Program Adult Treatment Panel III criteria, excluding waist circumference. Obesity was defined as body mass index ≥30 kg/m2 or waist > 88.9 cm for females or > 101.6 cm for males. RESULTS: Frequency of the MHO phenotype was 5.5% and the MUN was 44.3%. After adjustment for all covariates, Framingham CVD risk score was higher in the MUN (b = 1.74,p < 0.001) and metabolically unhealthy obese (b = 3.32,p < 0.001) phenotypes that used BMI to define obesity, and the MHO phenotype had a slight protective effect (b = -2.25,p < 0.001) when waist circumference was used as the measure of obesity. CONCLUSIONS: Metabolically unhealthy phenotypes had higher CVD risk, while the MHO phenotype was not at any greater risk than the metabolically healthy normal weight.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedades Metabólicas/epidemiología , Obesidad/epidemiología , Adolescente , Adulto , Anciano , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Fenotipo , Estados Unidos , Adulto Joven
2.
Medicine (Baltimore) ; 100(7): e24838, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607853

RESUMEN

ABSTRACT: More than 70% of tuberculosis (TB) cases diagnosed in the United States (US) occur in non-US-born persons, and this population has experienced less than half the recent incidence rate declines of US-born persons (1.5% vs 4.2%, respectively). The great majority of TB cases in non-US-born persons are attributable to reactivation of latent tuberculosis infection (LTBI). Strategies to expand LTBI-focused TB prevention may depend on LTBI positive non-US-born persons' access to, and ability to pay for, health care.To examine patterns of health insurance coverage and usual sources of health care among non-US-born persons with LTBI, and to estimate LTBI prevalence by insurance status and usual sources of health care.Self-reported health insurance and usual sources of care for non-US-born persons were analyzed in combination with markers for LTBI using 2011-2012 National Health and Nutrition Examination Survey (NHANES) data for 1793 sampled persons. A positive result on an interferon gamma release assay (IGRA), a blood test which measures immunological reactivity to Mycobacterium tuberculosis infection, was used as a proxy for LTBI. We calculated demographic category percentages by IGRA status, IGRA percentages by demographic category, and 95% confidence intervals for each percentage.Overall, 15.9% [95% confidence interval (CI) = 13.5, 18.7] of non-US-born persons were IGRA-positive. Of IGRA-positive non-US-born persons, 63.0% (95% CI = 55.4, 69.9) had insurance and 74.1% (95% CI = 69.2, 78.5) had a usual source of care. IGRA positivity was highest in persons with Medicare (29.1%; 95% CI: 20.9, 38.9).Our results suggest that targeted LTBI testing and treatment within the US private healthcare sector could reach a large majority of non-US-born individuals with LTBI. With non-US-born Medicare beneficiaries' high prevalence of LTBI and the high proportion of LTBI-positive non-US-born persons with private insurance, future TB prevention initiatives focused on these payer types are warranted.


Asunto(s)
Prestación de Atención de Salud/economía , Emigrantes e Inmigrantes/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Tuberculosis Latente/epidemiología , Adolescente , Adulto , Anciano , Niño , Estudios Transversales , Prestación de Atención de Salud/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Incidencia , Cobertura del Seguro/tendencias , Ensayos de Liberación de Interferón gamma/métodos , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/prevención & control , Masculino , Medicare/estadística & datos numéricos , Persona de Mediana Edad , Mycobacterium tuberculosis/inmunología , Encuestas Nutricionales/métodos , Prevalencia , Estados Unidos/epidemiología , Adulto Joven
3.
Medicine (Baltimore) ; 100(6): e24746, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578626

RESUMEN

ABSTRACT: There is still debate regarding the pathogenic relationship between alcohol intake and osteoarthritis (OA). This study investigated the association between alcohol consumption and knee OA in a Korean population.Among 8058 subjects who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2012, a total of 2917 subjects over the age of 50 and taken plain radiography was included in this analysis. Knee OA was classified based on the Kellgren-Lawrence (K-L) grading scale. Multivariate logistic regression analyses were used to evaluate the odds ratios (ORs) and 95% confidence intervals (CIs) of variables for knee OA (K-L grade ≥ 2).There were 1022 subjects with knee OA (29.2%). Subjects with knee OA tended to have lower daily alcohol intake (g/day) than did those without knee OA (10.4 [6.2-14.6] vs. 15.8 [12.8-18.8], P = .04). Similarly, those with knee OA demonstrated less makgeolli intake than did those without knee OA (P = .002). Subjects who consumed >0.6 g/day of beer also demonstrated less knee OA than did those who consumed <0.6 g/day of beer (OR 0.68, 95% CI 0.46-0.99). However, knee OA was not associated with the categories of alcohol consumption amount (g/day), including total daily alcohol intake (g/day), soju daily intake (g/day), and makgeolli daily intake (g/day) (P > .05 of all).Alcohol consumption was negatively associated with prevalence of knee OA in a Korean population. This preliminary observation will need to be confirmed in future studies.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Osteoartritis de la Rodilla/epidemiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Osteoartritis de la Rodilla/diagnóstico por imagen , Radiografía , República de Corea/epidemiología
4.
Arch Osteoporos ; 16(1): 22, 2021 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-33527234

RESUMEN

We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but further studies for dose response are required. PURPOSE: Cadmium exposure can exert detrimental effects on bone health, particularly in post-menopausal women. However, previous studies have failed to report an association in Korean post-menopausal women. We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. METHODS: In total, 5432 participants from the 4th and 5th Korean National Health and Nutrition Examination Survey (KNHANES) were randomly sampled for measurements of heavy metal concentrations in the blood, bone mass density (BMD), and nutrient intake. We analyzed data for 1031 post-menopausal women ≥50 years of age. Blood cadmium levels were categorized into quartiles, and a multinomial logistic regression model was used for analysis. RESULTS: There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but the odds ratio (OR) at the 4th level was lower than that at the 3rd level (OR and 95% confidence interval (CI) for osteopenia: 2nd quartile: 1.24, 0.88-1.74; 3rd quartile: 3.22, 2.24-4.64; 4th quartile: 1.27, 0.87-1.85; P for trend <0.001; OR and 95% CI for osteoporosis: 2nd quartile: 1.54, 1.05-2.25; 3rd quartile: 3.63, 2.31-5.69; 4th quartile: 1.70, 1.03-2.81; P for trend <0.001). This trend was consistent in the sensitivity analysis. CONCLUSION: Our findings suggest that there is an association between blood cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. However, further prospective studies are required to determine whether there is a dose-response relationship and address potential selection bias, especially in patients with femoral neck osteoporosis.


Asunto(s)
Enfermedades Óseas Metabólicas , Osteoporosis Posmenopáusica , Osteoporosis , Densidad Ósea , Enfermedades Óseas Metabólicas/inducido químicamente , Enfermedades Óseas Metabólicas/epidemiología , Cadmio , Estudios Transversales , Femenino , Humanos , Encuestas Nutricionales , Osteoporosis/inducido químicamente , Osteoporosis/epidemiología , Osteoporosis Posmenopáusica/epidemiología , Posmenopausia , Estudios Prospectivos , República de Corea/epidemiología
5.
BMC Pulm Med ; 21(1): 59, 2021 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-33593334

RESUMEN

BACKGROUND: Asthma and osteoarthritis (OA) are medical conditions that inhibit physical activity and adversely affect quality of life. Despite the high prevalence, there are limited studies focusing on the comorbid condition and association between asthma and OA. The aim of this study was to assess the prevalence of OA co-occurring with asthma and to identify the relevant clinical considerations. METHODS: Adult participants aged over 40 years who completed questionnaire assessments and spirometry tests were enrolled from the Korean National Health and Nutrition Examination Survey. Asthma and OA were defined based on the medical history of a diagnosis made by a doctor. Radiographic severities of OA were measured using the Kellgren-Lawrence grading system. Chronic obstructive pulmonary disease (COPD), as a comparative respiratory disease, was diagnosed based on the spirometric results. RESULTS: A total of 9344 subjects were enrolled, and the prevalence of asthma and COPD were 4.6% ± 0.3% and 12.0% ± 0.5%, respectively. The prevalence of OA in the asthma group was 31.9% ± 2.8%, which was significantly higher than that in the COPD (17.8% ± 1.5%) or control (16.2% ± 0.6%) groups. OA was more prevalent in patients with asthma after adjusting for age, sex, body mass index, and smoking status (OR 1.65; 95% CI 1.27-2.13). Furthermore, after adjustment of this model for the prescription of OA medication, OA remained independently associated with asthma (OR 1.56; 95% CI 1.10-2.20). Conversely, the relationship of OA medication with asthma was not significant (P = 0.64). This relationship was evident in patients with asthma without airflow limitation measured by spirometry (OR 1.97; 95% CI 1.32-2.93). Moreover, the radiographic severity of knee OA correlated with asthma (OR 1.10; 95% CI 1.0-||1.21). CONCLUSIONS: OA shows a high prevalence in patients with asthma, higher than in patients with COPD or the controls. The comorbid characteristics of these two conditions need to be considered in clinical practice.


Asunto(s)
Asma/epidemiología , Osteoartritis/epidemiología , Adulto , Anciano , Asma/fisiopatología , Estudios de Casos y Controles , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Osteoartritis de la Cadera/epidemiología , Osteoartritis de la Rodilla/epidemiología , Osteoartritis de la Columna Vertebral/epidemiología , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , República de Corea/epidemiología , Fumar/epidemiología , Espirometría , Capacidad Vital
8.
Wei Sheng Yan Jiu ; 50(1): 37-45, 2021 Jan.
Artículo en Chino | MEDLINE | ID: mdl-33517960

RESUMEN

OBJECTIVE: To analyze the intakes of dietary energy and macronutrients among the elderly aged 65 and above in China in 2015. METHODS: Data was from the China National Chronic Non-communicable Disease and Nutrition Surveillance of adults in 2015. Stratified multistage cluster sampling method was used. The valid dietary data of 18 161 the elderly aged 65 and above were extracted from 302 surveillance sites in 31 provinces. Consecutive 3-day 24-hour dietary recall method and household cooking oils and condiments weighting method were applied to collect dietary intakes data. The intakes of daily energy and macronutrients were calculated using China Food Composition Tables 2004 and 2009, and the dietary quality were evaluated according to 2013 Chinese Dietary Reference Intakes. RESULTS: The study showed that the average intake of daily energy was 1595. 5 kcal, the average intake of carbohydrates, proteins and fats were 208. 7 g, 47. 9 g and 63. 6 g, respectively. The proportion of energy from carbohydrates, proteins and fats were 52. 7%, 12. 1% and 35. 4%, respectively. The carbohydrates intake and proportion of energy from carbohydrates among urban elderly were 202. 3 g and 51. 4%, all lower than that in rural(213. 6 g and 53. 7%, P<0. 05). While the proteins intake and proportion of energy from proteins among urban elderly were 50. 8 g and 12. 9%, all higher than rural elderly(45. 6 g and 11. 5%, P<0. 001). The fats intake and proportion of energy from fats among urban elderly were 64. 1 g and 35. 9%, rural elderly were 63. 3 g and 35. 0%, there were no significant differences in fats intake and proportion of energy from fats between urban elderly and rural elderly(P>0. 05). The dietary intake of energy and macronutrients among the oldest old were lowest, especially those in rural areas, were 1394. 4 kcal, 182. 4 g, 40. 1 g and 56. 4 g. In 2015, the rate of energy lower than EER among the elderly was 75. 8%, and the rate of percentage of energy from carbohydrates lower than DRIs was 41. 5%. The rate of proteins lower than recommended nutrient intake was 76. 6%. The rate of percentage of energy from fats higher than dietary reference intakes was 64. 5%. CONCLUSION: In China, the unreasonable dietary intake among the elderly aged 65 and above is severe, and the oldest old especially those in rural areas have the most serious deficiency in proteins intake.


Asunto(s)
Ingestión de Energía , Encuestas Nutricionales , Adulto , Anciano , Anciano de 80 o más Años , China , Dieta , Grasas de la Dieta , Proteínas en la Dieta , Humanos , Nutrientes
9.
J Am Dent Assoc ; 152(1): 55-64, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33413851

RESUMEN

BACKGROUND: National data indicate that working-aged adults (20-64 years) are more likely to report financial barriers to receiving needed oral health care relative to other age groups. The aim of this study was to examine the burden of untreated caries (UC) and its association with reporting an unmet oral health care need among working-aged adults. METHODS: The authors used National Health and Nutrition Examination Survey data from 2011 through 2016 for 10,286 dentate adults to examine the prevalence of mild to moderate (1-3 affected teeth) and severe (≥ 4 affected teeth) UC. The authors used multivariable logistic regression to identify factors that were associated with reporting an unmet oral health care need. RESULTS: Low-income adults had mild to moderate UC (26.2%) 2 times more frequently and severe UC (13.2%) 3 times more frequently than higher-income adults. After controlling for covariates, the variables most strongly associated with reporting an unmet oral health care need were UC, low income, fair or poor general health, smoking, and no private health insurance. The model-adjusted prevalence of reporting an unmet oral health care need among low-income adults with mild to moderate and severe UC were 35.7% and 45.1%, respectively. CONCLUSIONS: The burden of UC among low-income adults is high; prevalence was approximately 40% with approximately 3 affected teeth per person on average. Reporting an unmet oral health care need appears to be capturing primarily differences in UC, health, and financial access to oral health care. PRACTICAL IMPLICATIONS: Data on self-reported unmet oral health care need can have utility as a surveillance tool for monitoring UC and targeting resources to decrease UC among low-income adults.


Asunto(s)
Caries Dental , Encuestas Nutricionales , Adulto , Anciano , Prestación de Atención de Salud , Caries Dental/epidemiología , Humanos , Seguro de Salud , Persona de Mediana Edad , Salud Bucal , Adulto Joven
10.
Ecotoxicol Environ Saf ; 208: 111625, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33396145

RESUMEN

Data for US adults aged ≥20 years from National Health and Nutrition Examination Survey for the years 2003-2014 were analyzed to evaluate how adjusted (N = 8481) and unadjusted (N = 9080) levels of selected perfluoroalkyl acids (PFAA) vary across the different stages of glomerular function (GF) among those who did not have diabetes, anemia, or albuminuria as compared to those who had diabetes only, anemia only, and albuminuria only. PFAAs selected for analyses were: perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorodecanoic acid (PFDA), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA). Irrespective of GF stage, there was no noticeable evidence to suggest that adjusted levels of PFAA for those with diabetes only are any lower than those with no diabetes, no anemia, and no albuminuria. Those who had anemia only were found to have lower adjusted levels of at least PFOA, PFOS, PFDA, and PFHxS than those who had no diabetes, no anemia, and no albuminuria. These results were seen in the presence (eGFR < 60 mL/min/1.73 m2) as well as the absence of chronic kidney disease. For GF-1 (eGFR > 90 mL/min/1.73 m2), GF-2 (60 ≤ eGFR ≤ 90 mL/min/1.73 m2), and GF-3B/4 (15 < eGFR ≤ 45 mL/min/1.73 m2), those who had albuminuria only had lower adjusted levels of PFOA, PFOS, and PFHxS than those who had no diabetes, no anemia, and no albuminuria. In general, adjusted levels of those who had albuminuria only were lower than those who had anemia only at GF-3 and more often than not at GF-1 and GF-2. Rise in adjusted levels of PFAA from GF-1 to GF-3A (45 < eGFR < 60 mL/min/1.73 m2) was faster for those with anemia only than any other comparison group for the total population and females.


Asunto(s)
Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/toxicidad , Fluorocarburos/toxicidad , Riñón/fisiología , Adulto , Albuminuria/epidemiología , Ácidos Alcanesulfónicos/toxicidad , Anemia/epidemiología , Biomarcadores/metabolismo , Caprilatos/toxicidad , Ácidos Decanoicos/toxicidad , Diabetes Mellitus/epidemiología , Femenino , Humanos , Riñón/efectos de los fármacos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Ácidos Sulfónicos
11.
Arch Osteoporos ; 16(1): 9, 2021 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-33409707

RESUMEN

Using national representative data, we found the prevalence of and risk factors associated with low BMD differed by race and ethnicity. PURPOSE: Race/ethnicity is an important determinant of osteoporosis risk. The study aims were to (1) estimate the racial and ethnic differences in the prevalence of low BMD, (2) identify factors associated with low BMD by race and ethnic group, and (3) evaluate if the association between sleep duration and low BMD is modified by age, sex, gender, and/or race/ethnicity. METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2014, totally, 7992 participants aged ≥ 50 years were included as the primary cohort. Three race/ethnic groups were included: non-Hispanic Whites, Hispanics, and non-Hispanic Blacks. Low BMD was defined by femoral neck BMD T-scores less than - 1, as measured by DXA scan. Univariate and multivariate analyses were performed to determine associations between participants' demographics, comorbidities, lifestyle characteristics, and prevalent low BMD. RESULTS: Prevalence of low BMD was 50.8% among non-Hispanic Whites, 23.7% among non-Hispanic Blacks, and 44.0% among Hispanics. After adjusting for confounders, advanced age, female gender, and fracture history were significantly associated with increased odds of low BMD in all three race/ethnic groups. Family history of osteoporosis, ever used glucocorticoids daily, and vitamin D deficiency or insufficiency were associated with increased odds of low BMD only among non-Hispanic Whites. Cardiovascular disease (CVD) history and diabetes were associated with low BMD only among non-Hispanic Blacks. Short sleep duration was not associated with low BMD in all ethnic groups, but was significantly associated with low BMD in older adults (> 65 years) and females. CONCLUSIONS: Prevalence of low BMD among three race/ethnic groups in the USA is determined, with race/ethnic disparities in several risk factors associated with low BMD identified. By contrast, advanced age, female gender, and fracture history are associated with increased odds of low BMD across all race/ethnic groups. The association between sleep duration and low BMD is modified by age and sex. Together, these findings may help clinicians and healthcare providers formulate better care for individual's bone health.


Asunto(s)
Densidad Ósea , Enfermedades Óseas Metabólicas , Anciano , Femenino , Cuello Femoral/diagnóstico por imagen , Hispanoamericanos , Humanos , Persona de Mediana Edad , Encuestas Nutricionales , Factores Raciales
12.
Artículo en Inglés | MEDLINE | ID: mdl-33466375

RESUMEN

This study was to investigate the association of long-term fruit and vegetable (FV) intake with all-cause mortality. We utilized data from the China Health and Nutrition Survey (CHNS), a prospective cohort study conducted in China. The sample population included 19,542 adult respondents with complete mortality data up to 31 December 2011. Cumulative FV intake was assessed by 3 day 24 h dietary recalls. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality. Covariates included sociodemographic characteristics, lifestyle factors, health-related factors, and urban index. A total of 1409 deaths were observed during follow-up (median: 14 years). In the fully adjusted model, vegetable intake of the fourth quintile (327~408 g/day) had the greatest negative association with death compared to the lowest quintile (HR = 0.63, 95% CI: 0.53-0.76). Fruit intake of the fifth quintile (more than 126 g/day) had the highest negative association (HR = 0.24, 95% CI: 0.15-0.40) and increasing general FV intake were also negatively associated with all-cause mortality which demonstrated the greatest negative association in the amount of fourth quintile (HR = 0.59, 95% CI: 0.49-0.70) compared to the lowest quintile. To conclude, greater FV intake is associated with a reduced risk of total mortality for Chinese adults. High intake of fruit has a stronger negative association with mortality than differences in intake of vegetables. Our findings support recommendations to increase the intake of FV to promote overall longevity.


Asunto(s)
Dieta , Frutas , Mortalidad , Verduras , Adolescente , Adulto , Anciano , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Estudios Prospectivos , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-33466518

RESUMEN

Close economic ties encourage production and trade of meat between Canada, Mexico, and the US. Understanding the patterns of red and processed meat consumption in North America may inform policies designed to reduce meat consumption and bolster environmental and public health efforts across the continent. We used nationally-representative cross-sectional survey data to analyze consumption of unprocessed red meat; processed meat; and total red and processed meat. Generalized linear models were used to separately estimate probability of consumption and adjusted mean intake. Prevalence of total meat consumers was higher in the US (73.6, 95% CI: 72.3-74.8%) than in Canada (65.6, 63.9-67.2%) or Mexico (62.7, 58.1-67.2%). Men were more likely to consume unprocessed red, processed, and total meat, and had larger estimated intakes. In Mexico, high wealth individuals were more likely to consume all three categories of meat. In the US and Canada, those with high education were less likely to consume total and processed meat. Estimated mean intake of unprocessed red, processed, and total meat did not differ across sociodemographic strata. Overall consumption of red and processed meat remains high in North America. Policies to reduce meat consumption are appropriate for all three countries.


Asunto(s)
Dieta , Encuestas Nutricionales , Carne Roja , Adolescente , Adulto , Anciano , Canadá , Estudios Transversales , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Estados Unidos , Adulto Joven
14.
Ecotoxicol Environ Saf ; 208: 111670, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33396180

RESUMEN

Exposure to excessive fluoride has been associated with a number of adverse health outcomes; however, there is a lack of evidence on the relation between fluoride exposure and serum uric acid levels, especially in human populations. The present study examined a potential relationship between fluoride exposure, measured as both plasma and water fluoride concentrations, and uric acid levels in an adolescent population. A nationally representative subsample of 1933 adolescents, aged 12-19 years, in the 2013-2016 National Health and Nutrition Examination Survey was analyzed for the association of fluoride concentrations with serum uric acid levels using multivariate general linear and logistic regression models, adjusting for potential confounders. Since uric acid levels change during development, hyperuricemia was defined in this study as over the mean plus one standard deviation for each sex and age group of adolescents. Of the study participants, 276 adolescents (weighted prevalence, 16.56%) had hyperuricemia. A significant and dose-dependent increase in prevalence of hyperuricemia was seen among the participants cross increasing quartiles of plasma fluoride (p-trend = 0.0017). After adjusting for potential confounders, we found that adolescents in the higher quartiles of plasma fluoride (≥0.32 µmol/L) and in the highest quartile of water fluoride (≥0.73 mg/L) had significantly increased odds of hyperuricemia compared with those in the lowest quartile. A 1.95-fold increased odds (95% CI: 1.37, 2.77) of hyperuricemia was also observed when analyzing plasma fluoride concentrations as continuous variable. A general linear model revealed that a 1 µmol/L increase in ln-plasma fluoride was associated with a 0.212 mg/dL (p < 0.0001) increased serum uric acid level. Furthermore, a positive relationship was observed between water and plasma fluoride concentrations (ß = 0.1907; p < 0.0001). Our study demonstrates a potential relation between fluoride exposure and hyperuricemia in adolescents. Further studies are warranted to overcome the limitations of this study to examine the impact of long-term exposure to low levels of fluoride during development on hyperuricemia and its related health outcomes.


Asunto(s)
Exposición Dietética/efectos adversos , Fluoruros/efectos adversos , Hiperuricemia/inducido químicamente , Adolescente , Niño , Estudios Transversales , Exposición Dietética/análisis , Exposición Dietética/estadística & datos numéricos , Relación Dosis-Respuesta a Droga , Agua Potable/química , Femenino , Fluoruros/análisis , Humanos , Hiperuricemia/sangre , Hiperuricemia/epidemiología , Masculino , Encuestas Nutricionales , Prevalencia , Estados Unidos/epidemiología , Adulto Joven
15.
Medicine (Baltimore) ; 100(1): e23994, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33429760

RESUMEN

ABSTRACT: To date research investigating the associations between handgrip strength and multimorbidity when stratifying by age and sex is limited. Furthermore, this is the first study in a Korean population, and the first to include adults ≥ 19 years of age. Here we investigated the associations between handgrip strength and multimorbidity in Korean adults aged ≥ 19 years.In this cross-sectional study data from the Korean National Health and Nutrition Examination Survey were used. Multimorbidity was defined as having 2 or more chronic diseases. A total of 19,779 participants were eligible for the study (8730 male and 11,049 female). We grouped and analysed participants based on age and sex (men and women aged 19-49 years, men and women aged 50-80 years) and examined the associations between handgrip strength and multimorbidity using multivariate logistic regressions using stratification by age, sex and body mass index (BMI).Multivariate logistic regressions revealed a significant inverse association irrespective of sex, between relative handgrip strength and multimorbidity. Participants with the lowest handgrip strength had a significantly higher odds ratio (OR) of multimorbidity (men aged 19-49 years: 3.76 and aged 50 years to 80 years: 2.11; women aged 19 years to 49 years: 1.52 and aged 50-80 years: 2.15) when compared to those with highest handgrip strength after adjusting for confounding variables. The highest OR was observed in men aged 19 years to 49 years with a BMI ≥ 25 kg/m2.In the current study we observed a significant inverse relationship between handgrip strength and multimorbidity in males and females with 2 or more chronic diseases. Male participants with a low handgrip strength aged between 19 years to 49 years with a BMI ≥25 kg/m2 may be at greater risk of multimorbidity. This study highlights the need for further longitudinal studies to investigate the effects of increasing handgrip strength combined with weight loss, as an effective strategy to reduce the incidence of multimorbidity.


Asunto(s)
Fuerza de la Mano/fisiología , Multimorbilidad , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud/organización & administración , Programas Nacionales de Salud/tendencias , Encuestas Nutricionales/métodos , República de Corea
16.
Chemosphere ; 262: 128309, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33182091

RESUMEN

BACKGROUND: The general population is exposed to the group of endocrine disrupting chemicals persistent organic pollutants (POPs), that includes polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). OBJECTIVES: The aim of this research was to evaluate the associations of serum levels of PCB, PCDD, and PCDF congeners with follicle stimulating hormone (FSH) and luteinizing hormone (LH) in postmenopausal women not taking exogenous hormones. We hypothesized that associations of POPs with these gonadotropins could be modified by factors affecting endogenous hormones. METHODS: Cross-sectional analyses were conducted on data from 89 postmenopausal women using data from the National Health and Nutrition Examination Survey (NHANES). POPs were summarized based on classification schemes thought to reflect toxicological properties. Associations of POPs and gonadotropin hormones were modeled with multivariable regression models. When evidence of interaction was found, conditional effects were estimated. RESULTS: We found inverse associations of LH, but not FSH, with exposure to anti-estrogenic and/or dioxin-like POPs, but not with non dioxin-like PCBs. A doubling of dioxin-like toxic equivalents (TEQs) was associated with a decrease in LH of 11.9% (95% CI = -21.3%, -1.4%, p = 0.03). Inverse associations were enhanced by potential effect modifiers related to both direct and indirect estrogenicity, including obesity and the obesity-related condition inflammation. CONCLUSIONS: These investigations support a pattern of endocrine-disrupting effects by dioxin-like POPs among postmenopausal women, especially those with conditions related to peripheral estrogenicity.


Asunto(s)
Dibenzofuranos Policlorados/análisis , Disruptores Endocrinos/análisis , Contaminantes Ambientales/análisis , Hormona Folículo Estimulante/sangre , Hormona Luteinizante/sangre , Bifenilos Policlorados/análisis , Dibenzodioxinas Policloradas/análisis , Posmenopausia/sangre , Adulto , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Encuestas Nutricionales , Estados Unidos
17.
Environ Pollut ; 270: 116178, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33341554

RESUMEN

Epidemiological studies have reported association of urinary 3-phenoxybenzoic acid (3-PBA), a major metabolite of pyrethroid insecticides (PYRs), with respiratory disease. However, knowledge regarding its effect on pulmonary function in susceptible children is limited. This study aimed to assess the associations between environmental 3-PBA concentrations and pulmonary function in children aged 6-17 years. Using data on 1174 children aged 6-17 years from the U.S. National Health and Nutrition Examination Survey (NHANES) 2007-2012, the exposure to PYRs was assessed by measuring urinary 3-PBA concentrations and pulmonary function was assessed by spirometry. Multivariable linear regression and generalized linear models (GLMs) were used to examine the associations between 3-PBA concentrations and pulmonary function in children, controlling for confounders. We found that 3-PBA concentrations were inversely associated with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) in the pediatric population (p-trends < 0.05). When stratified by age (6-10 and 11-17 years) and gender (boys and girls), the adverse effects of PYR exposures on pulmonary function were more pronounced among boys aged 11-17 years. Among this age group, 3-PBA concentrations were negatively associated with FEV1, FVC, forced expiratory flow between 25% and 75% of FVC (FEF25-75%), and PEF. However, among children aged 6-10 years, no associations were found between 3-PBA concentrations and any of the pulmonary function measures, in either boys or girls. Our findings suggest that environmental PYR exposures may adversely affect children's pulmonary function, with the strongest associations among 11-17 years old boys.


Asunto(s)
Encuestas Nutricionales , Piretrinas , Adolescente , Benzoatos , Niño , Femenino , Humanos , Masculino , Capacidad Vital
18.
Arch Gerontol Geriatr ; 92: 104181, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32971397

RESUMEN

OBJECTIVES: This study evaluated clinical and cardiometabolic markers associated with relative hand-grip strength (HGS), and investigated odds ratios (ORs) for chronic cardiometabolic and musculoskeletal diseases according to relative HGS. METHODS: This cross-sectional observational study enrolled subjects from the Korea National Health and Nutrition Examination Survey who were 50 years and older (N = 2451). Information on chronic diseases was taken by individual surveys and other proper criteria were applied for undiagnosed subjects. Absolute HGS was calculated from the maximal bilateral HGS (kg) as measured by a dynamometer and relative HGS was calculated by dividing absolute HGS by body mass index (BMI). Associated clinical and cardiometabolic markers to relative HGS were investigated and ORs for chronic diseases according to relative HGS tertiles were estimated from multivariate linear or logistic regression analyses. RESULTS: The mean relative HGS (kg/BMI) was 3.1 ± 0.6 for men and 1.9 ± 0.5 for women. Insulin-resistance parameters and high-sensitivity C-reactive protein were negatively and high-density lipoprotein cholesterol was positively related with relative HGS in both sexes adjusting for age and lifestyle factors, while systolic blood pressure showed negative relationship in women. High ORs for various chronic diseases were observed in the lowest relative HGS tertile of both sexes, but high OR for hyperlipidemia was observed only in women. CONCLUSIONS: Relative HGS is a convenient measure for overall muscle strength according to body size and may have an influence on chronic disease development or aggravation. Thus, relative HGS might be a cost-effective and useful tool to screen for prevalent chronic diseases in elderly population.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedades Musculoesqueléticas , Anciano , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Fuerza de la Mano , Humanos , Masculino , Enfermedades Musculoesqueléticas/epidemiología , Encuestas Nutricionales , República de Corea/epidemiología
19.
Ecotoxicol Environ Saf ; 209: 111787, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33333342

RESUMEN

The potential association of exposure to phthalates with muscle strength was reported in previous animal experiments. However, their association was rarely directly investigated in general populations. Thus, we aimed to ascertain the association of exposure to phthalates with grip strength using cross-sectional analysis which included 2436 individuals aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) during 2011-2014. The multivariable linear regression models were performed with the adjustment of related covariates. The results suggested that a one-unit increase in log-transformed phthalate metabolites (µg/g creatinine) was inversely associated with grip strength, including Mono-(2-ethyl)-hexyl phthalate (ß: -2.727 kg, 95% CI: -3.452, -2.002), Mono-(2-ethyl-5-hydroxyhexyl) phthalate (ß: -3.721 kg, 95% CI: -4.836, -2.607), Mono-(2-ethyl-5-oxohexl) phthalate (ß: -4.669 kg, 95% CI: -5.761, -3.577), Mono-2-ethyl-5-carboxypentyl phthalate (ß: -4.756 kg, 95% CI: -5.957, -3.554), Mono-carboxyoctyl phthalate (ß: -1.324 kg, 95% CI: -2.412, -0.235), Mono-carboxynonyl phthalate (ß: -2.036 kg, 95% CI: -3.185, -0.886), Mono-benzyl phthalate (ß: -2.940 kg, 95% CI: -3.853, -2.026), Mono-n-butyl phthalate (ß: -2.100 kg, 95% CI: -3.474, -0.726), Mono-isobutyl phthalate (ß: -2.982 kg, 95% CI: -4.331, -1.633), and Mono-ethyl phthalate (ß: -1.709 kg, 95% CI: -2.368, -1.050). In subgroup analyses, the associations remained largely unchanged when the samples were stratified by gender and age; However they became ambiguous among underweight subjects when the samples were stratified by BMI status. Overall, exposure to phthalates was inversely associated with grip strength among US adults, regardless of their genders and ages. The suggestive potential BMI status-specific effects of phthalates on grip strength were observed.


Asunto(s)
Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/toxicidad , Contaminación Ambiental/estadística & datos numéricos , Ácidos Ftálicos/toxicidad , Adulto , Anciano , Estudios Transversales , Contaminantes Ambientales/metabolismo , Femenino , Fuerza de la Mano , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Estados Unidos
20.
J Urol ; 205(1): 298-300, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33164627
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