Longitudinal association between soft drink consumption and handgrip strength in adults: a prospective analysis from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study.

Soft drink consumption has become a highly controversial public health issue. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. Due to containing high levels of fructose, a soft drink may have a deleterious effect on handgrip strength (HGS) due to oxidative stress, inflammation and insulin resistance. However, few studies show an association between soft drink consumption and HGS in adults. We aimed to investigate the association between soft drink consumption and longitudinal changes in HGS among a Chinese adult population. A longitudinal population-based cohort study (5-year follow-up, median: 3·66 years) was conducted in Tianjin, China. A total of 11 125 participants (56·7 % men) were enrolled. HGS was measured using a handheld digital dynamometer. Soft drink consumption (mainly sugar-containing carbonated beverages) was measured at baseline using a validated FFQ. ANCOVA was used to evaluate the association between soft drink consumption and annual change in HGS or weight-adjusted HGS. After adjusting for multiple confounding factors, the least square means (95 % CI) of annual change in HGS across soft drink consumption frequencies were -0·70 (-2·49, 1·09) for rarely drinks, -0·82 (-2·62, 0·97) for < 1 cup/week and -0·86 (-2·66, 0·93) for ≥ 1 cup/week (Pfor trend < 0·05). Likewise, a similar association was observed between soft drink consumption and annual change in weight-adjusted HGS. The results indicate that higher soft drink consumption was associated with faster HGS decline in Chinese adults.

Nomogram for predicting postoperative pulmonary complications in spinal tumor patients.

OBJECTIVES: Although several independent risk factors for postoperative pulmonary complications (PPCs) after spinal tumor surgery have been studied, a simple and valid predictive model for PPC occurrence after spinal tumor surgery has not been developed. PATIENTS AND METHODS: We collected data from patients who underwent elective spine surgery for a spinal tumor between 2013 and 2020 at a tertiary hospital in China. Data on patient characteristics, comorbidities, preoperative examinations, intraoperative variables, and clinical outcomes were collected. We used univariable and multivariable logistic regression models to assess predictors of PPCs and developed and validated a nomogram for PPCs. We evaluated the performance of the nomogram using the area under the receiver operating characteristic curve (ROC), calibration curves, the Brier Score, and the Hosmer-Lemeshow (H-L) goodness-of-fit test. For clinical use, decision curve analysis (DCA) was conducted to identify the model's performance as a tool for supporting decision-making. RESULTS: Among the participants, 61 (12.4%) individuals developed PPCs. Clinically significant variables associated with PPCs after spinal tumor surgery included BMI, tumor location, blood transfusion, and the amount of blood lost. The nomogram incorporating these factors showed a concordance index (C-index) of 0.755 (95% CI: 0.688-0.822). On internal validation, bootstrapping with 1000 resamples yielded a bias-corrected area under the receiver operating characteristic curve of 0.733, indicating the satisfactory performance of the nomogram in predicting PPCs. The calibration curve demonstrated accurate predictions of observed values. The decision curve analysis (DCA) indicated a positive net benefit for the nomogram across most predicted threshold probabilities. CONCLUSIONS: We have developed a new nomogram for predicting PPCs in patients who undergo spinal tumor surgery.

Adherence to a healthy sleep pattern and risk of urologic cancers: A large prospective cohort study.

OBJECTIVE: A variety of unhealthy sleep behaviors have been shown to be associated with an increased risk of urologic cancers. However, little is known about the association between the overall sleep patterns and urologic cancers. To prospectively investigate the associations between a healthy sleep pattern and the risks of urologic cancers, including bladder cancer (BCa) and renal cell carcinoma (RCC). METHODS: In this prospective cohort study, 377,144 participants free of cancer at baseline were recruited from the UK Biobank. Data on sleep behaviors were collected through questionnaires at recruitment. The incident urologic cancer cases were determined through linkage to national cancer and death registries. We established a healthy sleep score according to five sleep traits (sleep duration, chronotype, insomnia, snoring, and daytime sleepiness). Cox proportional hazard regression models were used to calculate the adjusted hazard ratios and 95% confidence intervals to assess the relationship between the healthy sleep score and the risk of urologic cancers. RESULTS: During a median of ≥9 years of follow-up, we identified 1986 incident urologic cancer cases, including 1272 BCa cases and 706 RCC cases. Compared with the participants with a poor sleep pattern (score of 0-2), the multivariable-adjusted hazard ratio and 95% confidence interval were 0.85 (0.75 to 0.96) for urologic cancers, 0.80 (0.68 to 0.93) for BCa, and 0.91 (0.74, 1.12) for RCC, respectively, for those with the healthier sleep pattern (score of 4-5). CONCLUSION: Our results indicate that a healthy sleep pattern is associated with lower risks of urologic cancers.

Association between whole-grain consumption and carotid atherosclerosis: the Tianjin chronic low-grade systemic inflammation and health (TCLSIH) cohort study.

Background: Whole-grain contains a range of beneficial nutrients, which are thought to play a role in the prevention of chronic diseases. However, the association between whole-grain consumption and the risk of developing carotid atherosclerosis (CA) has not been sufficiently elucidated. We, therefore, conducted this study to investigate the relationship between whole-grain consumption and CA in the general adult population. Methods: This prospective cohort study included a total of 2166 participants (19.2-84.6 years, 55.0% men) without a history of cardiovascular disease, cancer, and CA at baseline. A validated food frequency questionnaire was used to assess whole-grain consumption. Measurements of CA include carotid intima-media thickness (IMT) and carotid plaque. IMT thickening is defined as: IMT ≥ 1.0 mm or a carotid bifurcation IMT ≥ 1.2 mm. Carotid plaque is defined as: distinct area protruding ≥1.5 mm into the vascular lumen of the carotid artery. Cox proportional hazards regression models were used to examine the association of whole-grain consumption with incident CA. Results: A total of 538 (341 men) first incident cases of CA occurred during 5585 person-years of follow-up (median follow-up: 4.2 years). After adjusting for demographic characteristics, lifestyle factors, dietary intake, individual and family history of disease, the multivariable HRs (95% CIs) for incident CA were 1.00 (reference) for <1 time per week, 1.10 (0.85, 1.43) for 1 time per week, 0.95 (0.75, 1.20) for 2-6 times per week, and 1.12 (0.80, 1.56) for ≥1 times per day, respectively (P for trend = 0.99). Similar results were observed in stratified analyses by the main covariates and sensitivity analyses. Conclusion: Our data indicate that whole-grain consumption had no significant association with the risk of CA in an adult Chinese population. In our study population, there is a low consumption of whole-grain, which may limit our ability to see an association. Further cohort studies or randomized controlled trials are needed to confirm our results.

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

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

Nadir Hemoglobin Concentration After Spinal Tumor Surgery: Association With Risk of Composite Adverse Events.

STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To explore the association of early postoperative nadir hemoglobin with risk of a composite outcome of anemia-related and other adverse events. METHODS: We retrospectively analyzed data from spinal tumor patients who received intraoperative blood transfusion between September 1, 2013 and December 31, 2020. Uni- and multivariate logistic regression was used to explore relationships of clinicodemographic and surgical factors with risk of composite in-hospital adverse events, including death. Subgroup analysis explored the relationship between early postoperative nadir hemoglobin and composite adverse events. RESULTS: Among the 345 patients, 331 (95.9%) experienced early postoperative anemia and 69 (20%) experienced postoperative composite adverse events. Multivariate logistic regression analysis showed that postoperative nadir Hb (OR = .818, 95% CI: .672-.995, P = .044), ASA ≥3 (OR = 2.007, 95% CI: 1.086-3.707, P = .026), intraoperative RBC infusion volume (OR = 1.133, 95% CI: 1.009-1.272, P = .035), abnormal hypertension (OR = 2.199, 95% CI: 1.085-4.457, P = .029) were correlated with composite adverse events. The lumbar spinal tumor was associated with composite adverse events with a decreased odds compared to thoracic spinal tumors (OR = .444, 95% CI: .226-.876, P = .019). Compared to patients with postoperative nadir hemoglobin ≥11.0 g/dL, those with nadir <9.0 g/dL were at significantly higher risk of postoperative composite adverse events (OR = 2.709, 95% CI: 1.087-6.754, P = .032). CONCLUSION: Nadir hemoglobin <9.0 g/dL after spinal tumor surgery is associated with greater risk of postoperative composite adverse events in patients who receive intraoperative blood transfusion.

Association Between Neutrophil-to-Lymphocyte Ratio and Benign Prostatic Hyperplasia: Results from the TCLSIH Cohort Study.

Purpose: The prevalence of benign prostatic hyperplasia (BPH) in the general Chinese adult male population has risen sharply over the past few decades. Increasing evidence suggests that inflammation plays an important role in the pathogenesis of BPH. To better understand the role of inflammation in the pathogenesis of BPH, we can use the neutrophil-to-lymphocyte ratio (NLR) because it is a simple and effective marker of inflammation and immunity. This study aims to prospectively investigate the association between NLR levels and the prevalence of BPH in a general Chinese adult male population. Patients and Methods: This study included a total of 15,783 male participants free from BPH at baseline. NLR was measured according to the complete blood count. BPH was defined as total prostate volume (TPV) ≥30 mL, and TPV was determined by transabdominal ultrasonography. Multivariable Cox proportional hazards models were fitted to calculate hazards ratios (HRs) and corresponding 95% confidence intervals (CIs) for BPH risk with NLR levels. Results: During a median follow-up of 2.7 years, 5078 BPH cases were documented. After adjusting for age, body mass index, smoking, alcohol, education, occupation, income, physical activity, total energy intake, personal and family history of disease, and inflammation markers, the multivariable-adjusted HRs of BPH were 1.00 (reference), 1.08 (95% CIs 0.99, 1.17), 1.10 (95% CIs1.02, 1.19), and 1.12 (95% CIs1.03, 1.21), respectively, for participants with NLR in the first, second, third, and fourth quartiles (P for trend <0.01). Conclusion: Higher NLR levels were associated with a higher risk of BPH in Chinese adult male population. Our findings support the notion that NLR levels may be an important target for BPH prevention and intervention.

Dairy intake and risk of type 2 diabetes: results of a large prospective cohort.

Background and aims: Previous studies of primarily Western populations have consistently documented a lower risk of type 2 diabetes (T2D) among people with a higher yogurt intake, but an inconsistent association with milk intake. However, little is known about the association between dairy intake and risk of T2D among Chinese adults who consume considerably less dairy (mainly milk and yogurt) compared with Western populations. The aim is to investigate the associations of dairy intake with the risk of incident T2D in the general adult population in China. Methods: This cohort study consisted of 22 843 participants without prevalent cardiovascular disease, cancer, or diabetes at the baseline. Dietary data were collected using a validated food frequency questionnaire at the baseline (2013-2018); dairy intake was categorized into tertiles after zero consumers were taken as the reference. Incident T2D was ascertained by medical examinations and self-report of physician-diagnosed diabetes during follow-up visits. Cox proportional hazards models were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results: In total, 735 incident T2D cases were recorded over a median follow-up of 4.0 years. Relative to zero consumers, the HRs (95% CIs) for incident T2D among participants in the highest tertiles were 0.70 (0.57, 0.87) for total dairy, 0.73 (0.60, 0.90) for milk, and 0.81 (0.66, 1.00) for yogurt. Such associations were slightly attenuated by additional adjustment for the body mass index. In addition, such inverse associations were robust in sensitivity analyses and consistent in most of the subgroups defined by baseline characteristics. Conclusion: Higher intakes of total dairy, milk, and yogurt were all associated with a lower risk of T2D among Chinese adults.

Association Between Mean Platelet Volume and Benign Prostatic Hyperplasia: A Population Study from the TCLSIH Cohort Study.

Purpose: This study aimed to prospectively investigate the association between mean platelet volume (MPV) levels and risk of benign prostatic hyperplasia (BPH) in a general Chinese adult male population, and assessed this association in metabolic syndrome (MetS) patients. Patients and methods: This study included a total of 14,923 male participants free from BPH at baseline. MPV was measured by the method of laser-based flow cytometric impedance according to the complete blood sample. BPH was defined as total prostate volume (TPV) ≥ 30 mL, TPV was determined by transabdominal ultrasonography. Multivariable Cox proportional hazards models were fitted to calculate hazards ratios (HRs) and corresponding 95% confidence intervals (CIs) for BPH risk with NLR levels. Results: During a median follow-up of 2.7 years, 4848 BPH cases were documented in total male participants, and 1787 BPH cases were documented in MetS participants. After adjusting for age, body mass index, smoking, alcohol and personal and family history of disease, the multivariable-adjusted HRs of BPH were 1.00 (reference), 1.03 (95% CIs 0.96, 1.11), 1.00 (95% CIs 0.92, 1.08) and 0.98 (95% CIs 0.90, 1.06), respectively, for participants with MPV in the 1st, 2nd, 3rd and 4th quartiles (P for trend = 0.47). In MetS patients, the multivariable-adjusted HRs of BPH were 1.00 (reference), 1.03 (95% CIs 0.90, 1.16), 0.99 (95% CIs 0.87, 1.14) and 1.01 (95% CIs 0.89, 1.15) (P for trend= 0.98), respectively. Conclusion: A non-significant association was observed between MPV levels and risk of BPH, and no association in this association in MetS patients. Our findings support the notion that MPV levels may not be a target for BPH prevention and intervention.

Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study.

BACKGROUND AND AIMS: Carotid atherosclerosis indicates an increased risk for cardiac-cerebral vascular disease. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. As soft drinks contain a high amount of fructose, they may be a risk factor of carotid atherosclerosis. A prospective cohort study was conducted to investigate the association between soft drink consumption and the incidence of carotid atherosclerosis in a Chinese adult population. METHODS AND RESULTS: A total of 3828 participants (men: 2007 and women: 1821) were included. Carotid atherosclerosis was measured by using ultrasonography and was defined by increased carotid intima-media thickness and/or carotid plaques. Soft drink consumption was assessed using a validated food frequency questionnaire. Cox proportional hazards regression analysis was used to assess the association of soft drink consumption categories with the incidence of carotid atherosclerosis. During a mean follow-up of 3.20 years, 1009 individuals of the 3828 eligible participants developed carotid atherosclerosis. After adjusting for potential confounding factors, we compared the higher levels to the lowest level of soft drink consumption in women, and we estimated the multivariable hazard ratios and 95% confidence intervals of incident carotid atherosclerosis to be 1.09 (0.80, 1.50), and 1.56 (1.14, 2.13) (P for trend <0.05). However, there was no significant association between soft drink consumption and the incidence of carotid atherosclerosis in men or total population. CONCLUSION: The result indicated that soft drink consumption was associated with a higher incidence of carotid atherosclerosis in women. TRIAL REGISTERED: UMIN Clinical Trials Registry. TRIAL REGISTRATION NUMBER: UMIN000027174. TRIAL REGISTRATION WEBSITE: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.

Anti-inflammatory dietary pattern is associated with handgrip strength decline: a prospective cohort study.

BACKGROUND AND AIMS: Skeletal muscle strength decline is strongly associated with inflammation. While previous research has confirmed that diet can modulate chronic inflammation, little is known about the relationship between an anti-inflammatory dietary pattern and muscle strength. The aim of this study was to investigate the association between an anti-inflammatory dietary pattern and handgrip strength decline in a large-scale adult population. METHODS: During a median follow-up period of 3 years, this prospective cohort study was carried out between 2013 and 2018 and included 2840 participants (60.2% men). Dietary intake was assessed using a validated food frequency questionnaire at baseline, and handgrip strength was measured annually with a handheld digital dynamometer. The dietary inflammatory potential score was calculated using white blood cell count and hypersensitive C-reactive protein as inflammatory markers, and was determined using reduced rank regression and stepwise linear regression. Multivariable linear regression models were used to estimate the association between the dietary inflammatory potential score and the annualized change in handgrip strength and weight-adjusted handgrip strength. RESULTS: After adjusting for multiple confounding factors, significant associations between the dietary inflammatory potential score and the annualized change in handgrip strength and weight-adjusted handgrip strength in women, with values of - 0.8322 kg (95% confidence interval [CI] - 1.6405, - 0.0238; P < 0.0408) and - 0.0171 kg/kg (95% CI - 0.0310, - 0.0032; P < 0.0158), respectively. However, no significant differences were observed between the dietary inflammatory potential score and the annualized change in handgrip strength and weight-adjusted handgrip strength in men, with values of 0.1578 kg (95% CI - 0.6107, 0.9261; P < 0.6874) and - 0.0014 kg/kg (95% CI - 0.0115, 0.0088; P < 0.7933), respectively. CONCLUSION: Our findings suggest that consuming an anti-inflammatory dietary pattern could be a protective strategy against the decline in skeletal muscle strength in women.

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

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

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

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

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.

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

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

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.

Development and Application of Indolines in Pharmaceuticals.

In recent years, the incidence of cancer is high around the world, and the resistance of bacteria is increasing. To cope with the potentially adverse side effects of cancer chemotherapy and surgery, researchers are turning to the construction of new drug scaffolds. The indoline structure exists in a huge number of natural products, but drugs with indoline have only been formally studied in recent years. With the deepening of research, drugs containing indoline have played important roles in more disease treatment aspects, such as anti-tumor, anti-bacterial, anti-inflammatory and have been used as analgesics, to treat cardiovascular diseases and so on. The synthesis and pharmacological activity of indoline derivatives is summarized in this review in order to support the addition of the indoline component to the toolbox of medicinal chemists. This review focuses on the advantages of indoline compounds in development and synthesis of and for the use as anticancer drugs, antibacterial drugs, to treat cardiovascular diseases and as anti-inflammatory and analgesic drugs. Indoline structures are commonly found in natural and synthetic compounds with medicinal value and are now beginning to be exploited as the basic backbone of various drugs. As research continues, dihydroindoles and their derivatives will play a greater role in the medical field.

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).

There is a significantly inverse relationship between dietary riboflavin intake and prevalence of osteoporosis in women but not in men: Results from the TCLSIH cohort study.

Background: Epidemiological evidence for the relationship between riboflavin intake and bone health is inconsistent, and this relationship has not been examined in Chinese population. This study aimed to investigate the relationship between dietary intake of riboflavin and prevalence of osteoporosis in a Chinese adult population. Methods: A total of 5,607 participants (mean age, 61.2 years; males, 34.4%) were included in this cross-sectional study. We calculated the riboflavin intake by using the food frequency questionnaire (FFQ) in combination with Chinese food composition database. Bone mineral density (BMD) was detected by an ultrasound bone densitometer. Multivariable logistic regression models were used to evaluate the relationship between dietary riboflavin intake and prevalence of osteoporosis. Results: In this population, the dietary intake of riboflavin ranged from 0.13 to 1.99 mg/d, and the proportion of abnormal BMD was 36.6%. The prevalence of osteoporosis decreased gradually with increasing quartiles of riboflavin intake, before and after adjustment for a range of confounding factors. In the final model, the multivariate-adjusted ORs (95% CI) across the quartiles of riboflavin intake were 1.00 (reference), 0.84 (0.54, 1.31), 0.59 (0.34, 1.04), and 0.47 (0.22, 0.96), respectively (P for trend < 0.05). In sex-disaggregated analysis, similar results to the total population were observed in women, while no significant results were found in men. Conclusion: The dietary riboflavin intake was negatively associated with the prevalence of osteoporosis. However, the association was significant in women but not in men. Our findings indicated that women are more sensitive to riboflavin intake in maintaining a normal BMD.

Soy Food Consumption Is Inversely Associated with Handgrip Strength: Results from the TCLSIH Cohort Study.

Background: Soy foods contain high levels of soy protein or isoflavones, which can stimulate muscle protein synthesis and increase antioxidant capacity, and thus ameliorate muscle strength decline. However, data from epidemiological studies investigating the association of habitual soy food consumption with muscle strength decline among general Chinese adults are limited. Methods: This study included 29,525 participants (mean age: 41.6 years; 16,933 (53.8%) males). Soy food consumption was evaluated using a validated 100-item food frequency questionnaire. Handgrip strength (HGS) was assessed with a hand dynamometer. Analysis of covariance were performed to assess the multivariable-adjusted least square means (LSM) and 95% confidence interval (CI) for HGS. Results: The multiple adjusted LSM (95% CI) of HGS across soy food consumption were 35.5 (34.2, 37.1) kg for <1 time per week, 36.1 (34.6, 37.6) kg for 1 time per week, 36.3 (34.8, 37.8) kg for 2−3 times per week, and 36.6 (35.1, 38.0) kg for ≥4 times per week (p for trend < 0.001). Compared to participants with soy food consumption less than one time per week, the multiple adjusted odds ratio (95% CI) of low HGS was 0.638 (0.485, 0.836) when the weekly consumption was ≥ 4 times (p for trend < 0.01). Conclusions: Higher habitual soy food consumption was positively associated with HGS in general Chinese adults. Consumption of soy foods may have beneficial effects on muscle health.