[Distribution of usual vitamin intake and prevalence of inadequate intake among Chinese adults in 2015].

OBJECTIVE: To estimate the usual vitamin intake and the prevalence of inadequate intakes among Chinese adults in 2015, and to provide a scientific basis for developing nutrition intervention strategies and measures for target populations. METHODS: Data was drawn from the Chinese Nutrition and Health Surveillance 2015-2017, a nationally representative cross-sectional study. The multistage stratified whole-group random sampling method was used to draw participants from 298 surveillance sites in 31 provinces(autonomous regions and municipalities). Participants with no available information or abnormal energy intake were excluded, and finally, a total of 72 231 participants aged 18 years and older were included in the current study. The dietary data of the participants were collected by the 24-hour dietary recall method combined with the condiment weighing method for three consecutive days. The National Cancer Institute method was used to estimate the distribution of the usual intake of vitamin B_1(thiamine), vitamin B_2(riboflavin), niacin, vitamin C(ascorbic acid), and vitamin E(tocopherol), and the prevalence of inadequate intake was evaluated based on estimated average requirement or adequate intake from the Chinese Dietary Reference Intakes 2023. RESULTS: The usual intake of vitamin E, vitamin C, vitamin B_1, vitamin B_2 and niacin were 27.93 mg/d, 77.67 mg/d, 0.78 mg/d, 0.62 mg/d and 13.15 mg/d, respectively. The prevalence of inadequate intake was, in descending order, vitamin B_2(95.98%), vitamin B_1(86.73%), vitamin C(63.70%), niacin(39.81%), and vitamin E(21.17%). The prevalence of inadequate vitamin E, vitamin C, vitamin B_1 and niacin intake among females was higher than among males(P<0.01). Overall, the prevalence of inadequate vitamin intake increased with age. Rural residents had a higher prevalence of inadequate intake of vitamin C, vitamin B_2 and niacin than urban residents(P<0.01). Except for vitamin E, the prevalence of inadequate intake of vitamins decreased with increasing education levels. The prevalence of inadequate intake of these five vitamins was higher among participants with lower income levels than those with middle or high income(P<0.01). Participants with normal weight had a higher prevalence of inadequate intake of vitamin E than those with overweight or obesity and had a higher prevalence of inadequate intake of vitamin C than those with obesity. However, participants with normal weight had a higher prevalence of inadequate intake of vitamin E than those with overweight or obesity, with the differences being statistically significant(P<0.01). Except for vitamin E, the prevalence of inadequate intake of vitamins decreased with increasing physical activity intensity. CONCLUSION: In 2015, the usual intake of dietary vitamins of Chinese adults was low. There are differences in usual intakes of vitamins and prevalence of inadequate vitamin intake for adults aged 18 years and above in males and females, different age groups, urban and rural areas, education levels, household income levels, body mass index and physical activity intensity.

[Association between habitual tea consumption and 10-year cardiovascular risk among Chinese mid-aged and elderly].

OBJECTIVE: To explore the association between habitual tea consumption and 10-year cardiovascular disease risk among middle-aged and elderly Chinese. METHODS: China Nutrition and Health Surveillance 2015 applied a stratified, multistage, and random sampling method. The current study selected middle-aged and elderly participants aged 45 and older, and they were investigated by basic information survey, dietary survey based on the food frequency questionnaire, physical measurements including height, weight, and blood pressure, and a laboratory examination with fasting blood samples. Habitual tea consumption was defined by asking about the number of cups of tea usually consumed per day in the past 12 months, and the risk of cardiovascular disease incidence was calculated using the Framingham risk score over a 10-year period. The association between tea consumption and 10-year risk of cardiovascular disease in this population was analyzed using multiple logistic regression, and further analyzed using gender as a stratification factor. RESULTS: A total of 42 704 Chinese middle-aged and elderly were included in this study, with an average age of(59.4±9.4) years, 20 104 males and 22 600 females, 17 194 in urban areas and 25 510 in rural areas. For tea drinking, there were 12 519(29.32%) tea drinkers in the included sample, of which 4153(9.73%) consumed 1-2 cups/d, 3336(7.81%) 3-4 cups/d, and 5030(11.78%) ≥5 cups/d. For 10-year cardiovascular risk, 28 267 participants(66.19%) were estimated to be low risk, while 14 437(33.81%) were in the high risk. After adjusting for age, sex, body mass index, place of residence, education, income, marital status, smoking, excessive alcohol consumption, physical activity, sedentary behavior, sleep, participation in medical examination within one year, DASH dietary score, energy intake and chronic disease status, the result showed a reduced risk of cardiovascular disease over a 10-year period among those who consumed 3-4 cups/d compared with those who did not consume tea(OR=0.820, 95%CI 0.719-0.934, P_(trend)=0.03). When stratified by gender, both gender showed participants who consumed 3-4 cups/d had a lower risk for cardiovascular disease than those who did not consume tea(males: OR=0.849, 95%CI 0.722-0.997; females: OR=0.697, 95%CI 0.527-0.922). And the result was more pronounced among females. CONCLUSION: Moderate habitual tea consumption could reduce the risk of cardiovascular disease among middle-aged and elderly Chinese people, and its protective effect is more pronounced among females.

Staring X-ray backscatter imaging based on ultra-high aspect ratio lobster eye lens.

In contrast to conventional X-ray imaging systems, the lobster eye lens, serving as a pivotal component for X-ray focusing, presents the potential for downsizing X-ray backscatter imaging systems. This study reports the successful implementation of a pioneering non-contact staring X-ray backscatter imaging experiment, with the target positioned 1.5 meters away from the system and employing a tube voltage of 60 kV for the X-ray light source. The system is built upon a novel high aspect ratio (500) meridian lobster eye lens, employing a laboratory low illuminance desktop light source and a commercial X-ray detector to achieve high-resolution focused imaging of hard X-rays. Point spread function testing and a series of imaging experiments were carried out to assess the resolution and optimal imaging photon energy of the proposed system. Furthermore, according to the characteristics of the point spread function of the cross image of the lobster eye lens, we proposed an image processing algorithm. The experimental results demonstrate that, after processing, the Structural Similarity (SSIM) Index of the backscatter image and the ground truth image can be improved from an average of 0.0526 to 0.5758. Our research significantly contributes to the advancement of a new generation of X-ray backscatter imaging systems.

Pyrite-assisted degradation of methoxychlor by laccase immobilized on Fe3S4/earthworm-like mesoporous SiO2.

Laccase immobilized and cross-linked on Fe3S4/earthworm-like mesoporous SiO2 (Fe3S4/EW-mSiO2) was used to degrade methoxychlor (MXC) in aqueous environments. The effects of various parameters on the degradation of MXC were determined using free and immobilized laccase. Immobilization improved the thermal stability and reuse of laccase significantly. Under the conditions of pH 4.5, temperature 40 °C, and reaction time 8 h, the degradation rate of MXC by immobilized laccase reached a maximum value of 40.99% and remained at 1/3 of the original after six cycles. The excellent degradation performance of Fe3S4/EW-mSiO2 was attributable to the pyrite (FeS2) impurity in Fe3S4, which could act as an electron donor in reductive dehalogenation. Sulfide groups and Fe2+ reduced the activation energy of the system resulting in pyrite-assisted degradation of MXC. The degradation mechanism of MXC in aqueous environments by laccase immobilized on Fe3S4/EW-mSiO2 was determined via mass spectroscopy of the degradation products. This study is a new attempt to use pyrite to support immobilized laccase degradation.

SPINK1 is a Potential Diagnostic and Prognostic Biomarker for Sepsis.

Purpose: There are no satisfactory diagnostic biomarkers for sepsis. Accordingly, this study screened biomarkers valuable for sepsis diagnosis and prognosis using data-independent acquisition (DIA) combined with clinical data analysis. Patients and Methods: Serine protease inhibitor Kazal-type 1 (SPINK1) is a differentially expressed protein that was screened using DIA and bioinformatics in sepsis patients (n = 22) and healthy controls (n = 10). The plasma SPINK1 levels were detected using an enzyme-linked immunosorbent assay (ELISA) in an expanded population (sepsis patients, n = 52; healthy controls, n = 10). The diagnostic value of SPINK1 in sepsis was evaluated using receiver operating characteristic (ROC) curve analysis based on clinical data. The prognostic value of SPINK1 for sepsis was evaluated using correlation and survival analyses. Results: DIA quality control identified 78 differential proteins (72 upregulated and six downregulated), among which SPINK1 was highly expressed in sepsis. The ELISA results suggested that SPINK1 expression was significantly elevated in the sepsis group (P < 0.05). ROC analysis of SPINK1 yielded an area under the curve (AUC) of 0.9096. Combining SPINK1 with procalcitonin (PCT) for ROC analysis yielded an AUC of 1. SPINK1 expression was positively correlated with the Sequential Organ Failure Assessment (SOFA) score (r = 3497, P = 0.0053) and APACHE II score (r = 3223, P = 0.0106). High plasma SPINK1 protein expression was negatively correlated with the 28-day survival rate of patients with sepsis (P = 0.0149). Conclusion: The plasma of sepsis patients contained increased SPINK1 protein expression. Combining SPINK1 with PCT might have a high diagnostic value for sepsis. SPINK1 was associated with the SOFA score, APACHE II score, and the 28-day survival rate in patients with sepsis.

A dynamic individual yak heifer live body weight estimation method using the YOLOv8 network and body parameter detection algorithm.

Live body weight (LBW) is one of the most important parameters for supervising the growth and development of livestock. The yak (Bos grunniens) is a special species of cattle that lives on the Qinghai-Tibetan Plateau. Yaks are more untamed than regular cattle breeds, thus it is more challenging to measure their LBW. In this study, a YOLOv8 yak detection and LBW estimation models were used to automatically estimate yak LBW in real-time. First, the proper posture (normal posture) and individual yak identification was confirmed and then the YOLOv8 detection model was used for LBW estimation from 2-dimensional (2D) images. Yak LBW was estimated through yak body parameter extraction and a simple linear regression between the estimated yak LBW and the actual measured yak LBW. The results showed that the overall detection performance of yak normal yak posture was described by precision, recall, and mean Average Precision 50 (mAP50) indicators, reaching 81.8, 86.0, and 90.6%, respectively. The best yak identification results were represented by precision, recall, and mAP50 values of 97.8, 96.4, and 99.0%, respectively. The yak LBW estimation model achieved better results for the 12 mo old yaks with shorter hair with R2, root mean square error (RMSE), mean absolute percentage error (MAPE), and Multiple R values of 0.96, 2.43 kg, 1.69%, and 0.98, respectively. The results demonstrate that yak LBW can be estimated and monitored in real-time using this approach. This study has the potential to be used for daily yak LBW monitoring in an unstressed manner and to save considerable labor resources for large-scale livestock farms. In the future, to reduce the limitations caused by the impacts of yak hair and light condition data sets of dairy cows and yaks of different ages will be used to improve and generalize the model.

Degradation of trichloroacetic acid by Fe/Ni bimetallic reactive PMS with hierarchical layered structure.

Overuse of chlorinated disinfectants leads to a significant accumulation of disinfection by-products. Trichloroacetic acid (TCA) is a typical carcinogenic disinfection by-product. The efficacy of the conventional degradation process is reduced by the complex nature of its structure, causing a yearly increase in its prevalence within the ecological environment and consequent infliction of significant harm. In this paper, TCA was chosen as the research subject, Fe/Ni bimetallic nanoparticles were employed as the reducing catalyst, ZIF-8@HMON as the catalytic carrier combined with Fe/Ni nanoparticles, and peroxymonosulfate (PMS) was introduced to construct the reducing-advanced oxidation synergistic system and investigated the effect of this system on the degradation performance and degradation pathway of TCA. Various characterization techniques, including TEM, SEM, XRD, FT-IR, XPS, BET, were employed to investigate the morphology, element composition and structure of composite materials analysis. Moreover, the conditions for TCA degradation can be optimized by changing the experimental environment. The results showed that 25 mg of composite catalyst (mole ratio Fe: Ni = 1:1) and 10 mg of PMS effectively degraded TCA within 20-80 mg/L range at pH = 3 and 55 °C, achieving maximum degradation within 20 min. Finally, the potential pathways of TCA degradation were analyzed using EPR and LC-MS, and the corresponding reaction mechanisms were proposed.

Hydrolytic degradation of methoxychlor by immobilized cellulase on LDHs@Fe3O4 nanocomposites.

In this study, we synthesized Fe3O4 using the co-precipitation method and then prepared magnetic carrier LDHs@Fe3O4 by immobilizing layered double hydroxide on Fe3O4 by in situ growth method. Cellulase was immobilized on this magnetic carrier by using glutaraldehyde as a coupling agent, which can be used for degrading Methoxychlor (MXC). The results demonstrated the maximum MXC removal efficiency of 73.4% at 45 °C and pH = 6.0 with excellent reusability. Through kinetic analysis, it was found that the degradation reaction conforms to the Langmuir-Hinshelwood model and is a first-order reaction. Finally, according to the EPR analysis, the active radicals in the system were found to be OH· and the degradation mechanism was proposed in combination with LC-MS. This study provides a feasible method for degrading organochlorine pesticides, which can be used for groundwater purification.

Parameter-by-parameter estimation method for adsorption isotherm in hydrophobic interaction chromatography.

Hydrophobic interaction chromatography (HIC) is used as a critical polishing step in the downstream processing of biopharmaceuticals. Normally the process development of HIC is a cumbersome and time-consuming task, and the mechanical models can provide a powerful tool to characterize the process, assist process design and accelerate process development. However, the current estimation of model parameters relies on the inverse method, which lacks an efficient and logical parameter estimation strategy. In this study, a parameter-by-parameter (PbP) method based on the theoretical derivation and simplifying assumptions was proposed to estimate the Mollerup isotherm parameters for HIC. The method involves three key steps: (1) linear regression (LR) to estimate the salt-protein interaction parameter and the equilibrium constant; (2) linear approximation (LA) to estimate the stoichiometric parameter and the maximum binding capacity; and (3) inverse method to estimate the protein-protein interaction parameter and the kinetic coefficient. The results indicated that the LR step should be used for dilution condition (loading factor below 5%), while the LA step should be conducted when the isotherm is in the transition or nonlinear regions. Six numerical experiments were conducted to implement the PbP method. The results demonstrated that the PbP method developed allows for the systematic estimation of HIC parameters one-by-one, effectively reducing the number of parameters required for inverse method estimation from six to two. This helps prevent non-identifiability of structural parameters. The feasibility of the PbP-HIC method was further validated by real-world experiments. Moreover, the PbP method enhances the mechanistic understanding of adsorption behavior of HIC and shows a promising application to other stoichiometric displacement model-derived isotherms.

A standard procedure for rapid toxicity evaluation of carbon dots both in vitro and in vivo.

Carbon dots (CDs) are an emerging class of fluorescent quantum dot nanomaterials that have attracted considerable scientific attention for biomedical or bioimaging applications due to their physicochemical and biochemical properties. With the emergence of massive novel synthetic CDs applying to biomedical fields of science, evaluating their biosafety before any biological application is essential. However, there is no universal protocol or routine procedures for toxicity detection and biosafety assessment of CDs in general biological environments. Herein, we provide an ideal and fast operating system to detect the biotoxicity of CDs, which has been preliminary practiced. Briefly, the obtained CDs will be evaluated by in vitro cytotoxicity assay using cell counting kit-8, lactate dehydrogenase assay kit, and flow cytometry. Meanwhile, the model creature zebrafish is employed to perform in vivo evaluation by measuring body length, hatching rate, heart rate, and morphological observation. Our operating procedure condenses previous scattered biosafety detection methods into a rapid standard evaluation protocol that can be applied to early biotoxicity screening of CDs. This protocol will accelerate CDs biological exploitation and guide future industrialized biosafety assessment in large-scale applications.

Association of the Protective Dietary Pattern for Blood Pressure with Elevated Blood Pressure and Hypertension among Chinese Children and Adolescents Aged 6-17 Years Old: Data from China Nutrition and Health Surveillance (2015-2017).

Studies focused on the association between dietary patterns and elevated blood pressure (BP) and hypertension (HTN) among children and adolescents remain insufficient. This study aimed to explore a dietary pattern that could be helpful for the prevention of abnormal BP and to investigate the association between this dietary pattern and elevated BP and HTN among Chinese children and adolescents. A total of 52,080 Chinese children and adolescents aged 6~17 years old from the China Nutrition and Health Surveillance (CNHS) 2015-2017 were included in the current study. The reduced rank regression (RRR) method was applied to derive a dietary pattern that is associated with BP. Multivariable logistic regression was used to assess the association between dietary pattern (DP) and elevated BP and HTN. The Dietary Approach to Stop Hypertension (DASH) score was also calculated for each participant as a comparative method to validate the dietary pattern derived with the RRR method. A protective dietary pattern (PDP) for BP among Chinese children and adolescents was derived, which was characterized by high intakes of dairy products, mushrooms/edible fungi, fresh vegetables, fresh fruits, fresh eggs, aquatic products, mixed legumes, soybeans and related products, offal, dried fruits, and coarse cereals, with low intakes of refined grains. After multiple adjustments, there were significant inverse associations between PDP scores and the odds of elevated BP and HTN (elevated BP: Q5 vs. Q1, OR = 0.849, 95%CI = 0.755-0.931, P-trend < 0.05; HTN: Q5 vs. Q1, OR = 0.795, 95%CI = 0.694-0.911, P-trend < 0.05). The DASH diet was also observed to have protective effects on elevated BP in model I (Q5 vs. Q1, OR = 0.899, 95%CI = 0.828-0.975, P-trend < 0.05), but was not observed to have protective effects on HTN (HTN: Q5 vs. Q1, OR = 0.958, 95%CI = 0.876-1.048, P-trend > 0.05). The current study suggested that greater adherence to the PDP for BP among Chinese children and adolescents might be associated with lower odds of elevated BP and HTN.

Electrical impedance tomography: a review on hardware systems and circuits.

Electrical impedance tomography (EIT) is a widely used functional imaging technology in the field of biomedical engineering with the characteristics of non-radiation, high temporal resolution, real-time, miniaturization, and low cost, but with relatively poor spatial resolution, which makes it become an effective complementary imaging alternative in conjunction with structural imaging technologies such as MRI and CT for bedside monitoring. The hardware systems and circuits (HSC) are the physical basis for EIT, and have major impacts on imaging speed, accuracy, cost and other key performance specifications. This review attempts to provide researchers with a relatively comprehensive picture of HSC for different EIT systems, which is organized as follows. Firstly, the general EIT hardware systems are classified as serial, fully parallel and semi-parallel types, respectively, according to their hardware architecture. Secondly, the main analogy front-end circuits of EIT hardware systems are summarized, in which the current drive circuits are divided into open loop, linear closed-loop and nonlinear closed-loop based on different feedback types. Thirdly, the common error sources and evaluation indicators on EIT measurements are summarized. Finally, the future development trends and research challenges of EIT are discussed. This review is expected to promote the development of EIT technology, especially on the design of HSC.

Immune indices and oral health in patients infected with the human immunodeficiency virus.

BACKGROUND: The human immunodeficiency virus (HIV) is the causative agent of acquired immunodeficiency syndrome (AIDS). During the incubation period of AIDS, oral manifestations may precede systemic symptoms; therefore, it is vitally important to explore the relationship between HIV and oral health and other indicators. This study aimed to further assess the correlation between demographic risk factors, the dental health of HIV-infected patients, and the correlation of oral health indicators with CD4+ T-cell counts (CTCCs) and HIV viral loads (HIV-VLs). METHODS: Demographic data on 108 HIV-infected patients were first recorded by questionnaire from March 2016 to November 2018. Patients' dental health and oral lesions were assessed by a dental specialist; in addition, they were tested for CTCCs and HIV-VLs by flow cytometry and NucliSENS EasyQ® HIV-1 virometer. Finally, the links between CTCC, HIV-VL, and the dental health (including oral lesions) of the patients were analyzed. RESULTS: We found that age, marital status, and body mass index (BMI) were relevant to the patient's dental health (P < 0.05) and that their oral hygiene was relevant to their dental health (P < 0.05). However, HIV-VL was not directly related to periodontal/dental clinical indicators (P > 0.05). We discovered that the oral lesions in HIV-infected patients were related to decreased CTCCs and increased HIV-VLs (P < 0.05). CONCLUSIONS: We concluded that HIV-infected patients with severely impaired immune function tend to have poor dental health. Moreover, the prevalence of oral lesions was negatively correlated with CTCC and positively correlated with HIV-VL.

Sensitive Aluminum SPR Sensors Prepared by Thermal Evaporation Deposition.

We used straightforward thermal evaporation deposition to form thin Al films on fused silica slides as surface plasmon resonance (SPR) sensors in the blue visible region. Compared to other studies, we achieved high-quality Al SPR sensors with a low vacuum level at 7 × 10-4 Pa and a low deposition rate between 1.47 and 3.41 nm/s. These Al films have an atomic-level surface roughness. With our recipe, the requirements for deposition conditions are relaxed, and the operation time is reduced remarkably. The experimental sensitivity of the bulk refractive index measurements using 405 nm probing light is as high as 149.9°/RIU. Compared with other studies, our blue visible Al SPR completes the Al SPR working frequency range from deep UV to near-infrared which is much broader than the working range of Au SPR sensors. The cost of Al material is cheap, and the deposition instrument is also economic and operation easy. Considering the compatibility with most of the nanofabrication procedures and stability from the native oxide layer, Al SPR sensors have a huge potential to replace Au SPR sensors as the new golden standard of SPR sensing technology.

Association of fine particulate matter and its constituents with hypertension: the modifying effect of dietary patterns.

BACKGROUND: Studies have shown that nutritional supplements could reduce the adverse effects induced by air pollution. However, whether dietary patterns can modify the association of long-term exposure to fine particulate matter (PM2.5) and its constituents with hypertension defined by the 2017 ACC/AHA guideline has not been evaluated. METHODS: We included 47,501 Chinese adults from a nationwide cross-sectional study. PM2.5 and five constituents were estimated by satellite-based random forest models. Dietary approaches to stop hypertension (DASH) and alternative Mediterranean diet (AMED) scores were calculated for each participant. Interactions between dietary patterns and air pollution were examined by adding a multiplicative interaction term to logistic models. RESULTS: Long-term exposure to PM2.5 and its constituents was associated with an increased risk of hypertension and stage 1-2 hypertension. The DASH and AMED scores significantly modified these associations, as individuals with higher scores had a significantly lower risk of air pollution-related hypertension and stage 1-2 hypertension (P-interaction < 0.05), except for interaction between PM2.5, sulfate, nitrate, ammonium, and AMED score on stage 1 hypertension. For each IQR increase in PM2.5, participants with the lowest DASH and AMED quintiles had hypertension risk with ORs (95%CI) of 1.20 (1.10, 1.30) and 1.19 (1.09, 1.29), whereas those with the highest DASH and AMED quintiles had lower risks with 0.98 (0.91, 1.05) and 1.04 (0.97, 1.11). The stratified analysis found modification effect was more prominent in the < 65 years age group. Consuming more fresh vegetables, fruits, whole grains, and dairy would reduce the risk of hypertension caused by PM2.5 and its constituents. CONCLUSIONS: Dietary patterns rich in antioxidants can reduce long-term exposure to PM2.5 and its constituents-induced hypertension defined by the 2017 ACC/AHA guideline, especially in young and middle-aged individuals. Compared to the Mediterranean diet, the DASH diet offers superior dietary guidance to prevent stage 1 hypertension caused by air pollution.

A clinical decision support system to predict the efficacy for EGFR-TKIs based on artificial neural network.

BACKGROUND: The efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) was affected by numerous factors. In the study, we developed and validated an artificial neural network (ANN) system based on clinical characteristics and next-generation sequencing (NGS) to support clinical decisions. METHODS: A multicenter retrospective non-interventional study was conducted. 240 patients from three hospitals with advanced non-small cell lung cancer (NSCLC) and EGFR mutation were tested by NGS before the first treatment. All patients received formal EGFR-TKIs treatment. Five different models were individually trained to predict the efficacy of EGFR-TKIs based on one medical center with 188 patients. Two independent cohorts from other medical centers were collected for external validation. RESULTS: Compared with logistic regression, four machine learning methods showed better predicting abilities for EGFR-TKIs. The inclusion of NGS tests improved the predictive power of models. ANN performed best on the dataset with mutations TP53, RB1, PIK3CA, EGFR mutation sites, and tumor mutation burden (TMB). The prediction accuracy, recall and AUC were 0.82, 0.82, and 0.82, respectively in our final model. In the external validation set, ANN still showed good performance and differentiated patients with poor outcomes. Finally, a clinical decision support software based on ANN was developed and provided a visualization interface for clinicians. CONCLUSION: This study provides an approach to assess the efficacy of NSCLC patients with first-line EGFR-TKI treatment. Software is developed to support clinical decisions.

Achievement of Guideline-Recommended Targets in Diabetes Care in China : A Nationwide Cross-Sectional Study.

BACKGROUND: Nationwide achievement of guideline-recommended diabetes care targets has not been comprehensively assessed in China. OBJECTIVE: To estimate the proportions of adults with diabetes achieving major clinical risk factor control, body mass index (BMI), lifestyle, and dietary targets specified in the Chinese diabetes guidelines. DESIGN: Nationwide cross-sectional survey. SETTING: China, 2015 to 2017. PARTICIPANTS: A national sample of 8401 adults with self-reported diabetes and a subset of 3531 with dietary data. MEASUREMENTS: The assessed targets included 1) ABC targets (individualized hemoglobin A1c [HbA1c] target; blood pressure [BP] <130/80 mm Hg; and low-density lipoprotein cholesterol [LDL-C] level <2.6 or <1.8 mmol/L [<100 or <70 mg/dL], depending on the presence of atherosclerotic cardiovascular disease), 2) BMI below 24 kg/m2, 3) lifestyle targets (not currently smoking or drinking, guideline-recommended leisure time activity level, and sleep duration of 7 to 8 hours), and 4) dietary targets (50% to 65% of energy from carbohydrate, 15% to 20% from protein, 20% to 30% from fat, ≥14 g of fiber per 1000 kcal, and <2000 mg of sodium per day). RESULTS: The proportion of adults with self-reported diabetes achieving each ABC target was 64.1% (95% CI, 61.4% to 66.8%) for HbA1c, 22.2% (CI, 20.2% to 24.1%) for BP, and 23.9% (CI, 21.9% to 25.9%) for LDL-C. The proportion achieving a BMI below 24 kg/m2 was 32.2% (CI, 30.3% to 34.2%). The proportion achieving each lifestyle target was 75.8% (CI, 73.9% to 77.7%) for smoking, 66.7% (CI, 64.4% to 69.1%) for drinking, 17.9% (CI, 15.8% to 20.1%) for leisure time activity, and 52.0% (CI, 49.6% to 54.3%) for sleep duration. The proportion achieving each dietary target was 39.1% (CI, 36.0% to 42.2%) for carbohydrate, 20.1% (CI, 16.9% to 23.3%) for protein, 20.5% (CI, 17.6% to 23.4%) for fat, 9.0% (CI, 7.0% to 10.9%) for sodium, and 2.5% (CI, 1.3% to 3.6%) for fiber. Only 4.4% (CI, 3.5% to 5.2%) of participants achieved all 3 ABC targets, 5.1% (CI, 4.3% to 6.0%) achieved all 4 lifestyle targets, and 4 participants achieved all 5 dietary targets. LIMITATIONS: Self-reported data and age of the data. CONCLUSION: Achievement of guideline-recommended diabetes care targets in Chinese adults with self-reported diabetes was exceedingly low. The findings highlight the need for immediate national health actions to improve diabetes care. PRIMARY FUNDING SOURCE: Shanghai Municipal Education Commission, National Key R&D Program of the People's Republic of China, and the National Health Commission of the People's Republic of China.

[Association between cooking fuel and chronic diseases among Chinese housewives from 2015 to 2017].

OBJECTIVE: To analyze the association between the use of different household cooking fuels(including solid fuels and clean fuels) and hypertension, stroke, chronic obstructive pulmonary disease, and asthma among Chinese housewives. METHODS: 15616 housewives aged over 18 years were selected from China Nutrition and Health Surveillance 2015-2017, and their basic information investigation, physical examination and laboratory examination were carried out. Using multiple adjustment logistic regression analysis to compare the risk of using clean fuels and solid fuels in hypertension, stroke, chronic obstructive pulmonary disease and asthma. And living areas(urban or rural) were used as stratified factors for stratified logistic regression analysis. RESULTS: Among 15616 Chinese housewives, 9539(61.08%) used clean cooking fuels and 6077(38.92%) used solid cooking fuels at that time. There were significant differences in the composition of urban and rural areas, age groups, body mass index, education level, household annual income, smoking and drinking, second-hand smoke exposure level and whether to participate in physical examination within one year. After multivariable adjustment, using solid cooking fuels increased the risk of hypertension(OR=1.14, 95% CI 1.05-1.23), stroke(OR=1.44, 95% CI 1.18-1.75), chronic obstructive pulmonary disease(OR=1.20, 95% CI 1.03-1.40) and asthma(OR 1.33, 95% CI 1.09-1.63). After stratified by urban and rural areas, the result showed that using solid cooking fuels among rural housewives significantly increased the risk of the above four diseases(hypertension: OR=1.11, 95% CI 1.01-1.22; stroke: OR=1.49, 95% CI 1.17-1.91; chronic obstructive pulmonary disease: OR=1.20, 95% CI 1.00-1.42; asthma: OR=1.40, 95% CI 1.09-1.79). While in urban housewives, except that using solid cooking fuels might increase the risk of hypertension, the risk of stroke, chronic obstructive pulmonary disease and asthma has not increased significantly, but there was still an increasing tendencies(hypertension: OR=1.18, 95% CI 1.02-1.36; stroke: OR=1.37, 95% CI 0.99-1.90; chronic obstructive pulmonary disease: OR=1.20, 95% CI 0.89-1.60; asthma: OR=1.20, 95% CI 0.82-1.74). CONCLUSION: The use of solid cooking fuels is a risk factor for Chinese housewives in hypertension, stroke, chronic obstructive pulmonary disease, and asthma, and is more significant among rural housewives.

Comparison of Several Adiposity Indexes in Predicting Hypertension among Chinese Adults: Data from China Nutrition and Health Surveillance (2015-2017).

The current study is to explore the association of the Chinese visceral adiposity index (CVAI) with hypertension, and to compare the predictive power of different adiposity indexes regarding hypertension among Chinese adults aged over 45 years. A total of 99,201 participants aged over 45 years from the China Nutrition and Health Surveillance 2015-2017 were included in this study. Multivariate adjusted logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of hypertension. Multivariate adjusted restricted cubic spline analyses were applied to explore the association of adiposity indexes with hypertension. Receiver operating characteristic (ROC) analyses were used to compare the predictive powers of different adiposity indexes of hypertension. All eight adiposity indexes included in this study were positively associated with hypertension. Compared with those in the lowest quartile of the CVAI, the participants in the highest quartile showed a significantly higher risk of hypertension (OR = 3.70, 95% CI = 3.54-3.86) after multiple adjustments. The ROC analyses suggested that the CVAI was the strongest predictor of hypertension compared to other adiposity indexes in both genders. The findings supported that the CVAI could serve as a reliable and cost-effective method for early identifying hypertension risk.

Associations of cardiovascular risk factors and lifestyle behaviors with neurodegenerative disease: a Mendelian randomization study.

Previous observational studies reported that midlife clustering of cardiovascular risk factors and lifestyle behaviors were associated with neurodegenerative disease; however, these findings might be biased by confounding and reverse causality. This study aimed to investigate the causal associations of cardiovascular risk factors and lifestyle behaviors with neurodegenerative disease, using the two-sample Mendelian randomization design. Genetic variants for the modifiable risk factors and neurodegenerative disease were extracted from large-scale genome-wide association studies. The inverse-variance weighted method was used as the main analysis method, and MR-Egger regression and leave-one-out analyses were performed to identify potential violations. Genetically predicted diastolic blood pressure (DBP: OR per 1 mmHg, 0.990 [0.979-1.000]), body mass index (BMI: OR per 1 SD, 0.880 [0.825-0.939]), and educational level (OR per 1 SD, 0.698 [0.602-0.810]) were associated with lower risk of late-onset Alzheimer's disease (LOAD), while genetically predicted low-density lipoprotein (LDL: OR per 1 SD, 1.302 [1.066-1.590]) might increase LOAD risk. Genetically predicted exposures (including LDL and BMI) applied to familial AD showed the same effect. The association of LDL was also found with Amyotrophic lateral sclerosis (ALS) (LDL: OR per 1 SD, 1.180 [1.080-1.289]). This MR analysis showed that LDL, BMI, BP, and educational level were causally related to AD; a significant association between LDL and ALS risk, as well as the potential effect of sleep duration on PD risk, were also revealed. Targeting these modifiable factors was a promising strategy of neurodegenerative disease prevention.