CYP19A1 polymorphisms and bladder cancer risk in the Chinese Han population.

BACKGROUND: The expression of CYP19A1 has implications for the prognosis of female bladder cancer. However, this study aimed to explore the association between single nucleotide polymorphisms (SNPs) in CYP19A1 and bladder cancer risk, as no prior research has addressed this association. RESEARCH DESIGN AND METHODS: We selected and genotyped five CYP19A1 SNPs (rs4646, rs6493487, rs1062033, rs17601876, and rs3751599) in 217 patients and 550 controls using the Agena MassARRAY system. Logistic regression analysis was employed to calculate the odds ratio (OR) and 95% confidence intervals (CIs). Bioinformatics predicted SNP functions and CYP19A1 involving pathways. RESULTS: Our study revealed a significant association between bladder cancer risk and four SNPs (rs4646 (AC vs. CC: OR = 1.71, FDR-p = 0.005), rs6493487 (G vs. A: OR = 0.68, FDR-p = 0.011), rs1062033 (G vs. C: OR = 0.36, FDR-p < 0.001), and rs17601876 (GA vs. GG: OR = 1.66, FDR-p = 0.008)) in CYP19A1. The three SNPs (rs4646, rs1062033, and rs17601876) were significantly correlated with CYP19A1 expression levels in normal whole blood (p < 0.05). Moreover, CYP19A1 was found to primarily participate in the steroid hormone biosynthesis and metabolic pathways. CONCLUSIONS: Consequently, CYP19A1 gene polymorphisms may play a crucial role in the genetic susceptibility to bladder cancer.

Impact of Awareness of Sexual Partners' HIV Serostatus on the HIV Acquisition among Men Who Have Sex with Men in Guangzhou, China: A Nested Case-Control Study.

This study aimed to investigate the impact of sexual partners' HIV serostatus awareness on the HIV acquisition among men who have sex with men (MSM) in Guangzhou, China. A nested case-control study was conducted based on a prospective cohort of MSM in Guangzhou. Within the cohort, individuals who underwent HIV seroconversion were identified as the case group, and each case was matched with four controls from the non-seroconverted participants. Information regarding the awareness of sexual partners' HIV serostatus over the preceding 6 months was gathered. Of the 161 participants, 36.0% were aware of the HIV serostatus of all their sexual partners. The practice of engaging in condomless anal sex with partners of unknown HIV serostatus and being aware of the HIV serostatus of only some casual partners were positively correlated with an elevated risk of acquiring HIV. Conversely, being fully aware of the HIV serostatus of all sexual partners, including regular ones, was associated with a diminished risk of HIV incidence. Regular communication with sexual partners regarding HIV testing outcomes, honest disclosure of one's own HIV serostatus, and refusal of sexual contact with partners of unknown HIV serostatus can potentially mitigate the risk of acquiring HIV among MSM.

[Prevalence and risk factors of hyperuricemia among freshmen at Beijing Sport University from 2021 to 2022].

OBJECTIVE: To investigate the prevalence of hyperuricemia among freshmen enrolled in Beijing Sport University and to explore the influencing factors of hyperuricemia in the college population. METHODS: The study period was from September 2021 to February 2022.3372 freshmen of the class of 2021 from Beijing Sport University in Beijing were selected as the study subjects, and two blood uric acid tests were performed on non-same days to calculate the prevalence of the population and to explore the risk factors of hyperuricemia in the college student population using a case-control method.246 people were selected from the hyperuricemia patients of the population to be included in the case group by convenience sampling, and 211 people were selected from the non-hyperuricemia persons of the population to be included in the control group. They were included in the control group, underwent physical and laboratory examinations, and were retrospectively surveyed with questionnaires that included general information such as age, gender, specialty, place of birth, and diet related to hyperuricemia, awareness of hyperuricemia disease, physical activity level, and sleep. Statistical analysis was performed using chi-square analysis, one-way Logistic regression analysis, and multi-factor logistic regression analysis. RESULTS: The number of patients actually diagnosed with hyperuricemia by two blood uric acid tests on non-same days was 479, with a population prevalence rate of 14.21%. Among them, the number of males in the diseased population was 391(22.39%), and the number of females in the diseased population was 88(5.41%). A total of 457 subjects were enrolled in the case-control study, among them, 246 in the case group(218 males and 28 females, average age 19.74 years), 211 in the control group(177 males and 34 females, average age 19.93 years), and 247 in the case group, 211 in the control group, and 2 groups of subjects were included. A total of 211 subjects, and there was no significant difference between the 2 groups in terms of gender composition and age distribution. One-way logistic regression analysis showed that central obesity(OR=31.52, 95%CI 7.59-130.86), obesity(OR=2.59, 95%CI 1.20-5.58), overweight(OR=1.67, 95%CI 1.08-2.59), frequent consumption of fresh vegetables(OR=0.66, 95%CI 0.43-0.99), and drinking 1500-2000 mL of water per day(OR=0.63, 95%CI 0.41-0.95) were associated with hyperuricemia, and multifactorial Logistic regression analyses were performed to analyze the above factors, and finally central obesity(OR=32.05, 95%CI 7.65-134.20), BMI obesity(OR=3.22, 95%CI 1.44-7.20), and daily water intake of 1500-2000 mL(OR=0.60, 95%CI 0.37-0.95) were included in the model at the level of P=0.05. CONCLUSION: The current high prevalence of hyperuricemia in the college student population, which is more prevalent in male college students. Obesity and central obesity are risk factors for hyperuricemia in young college students, and daily water intake of 1500-2000 mL is a protective factor.

Association of psoriasis with geographic and fissured tongue in the Han population in southwestern China.

BACKGROUND: Psoriasis is a common immune-mediated skin disease that can involve other organs and tissues, including the oral mucosa. Some studies have found an increased proportion of geographic tongue (GT) and fissured tongue (FT) in patients with psoriasis, which appears to be region-specific. OBJECTIVES: The association of psoriasis with GT/FT in Eastern Asian populations remains unknown. Thus, the authors aimed to investigate the association of psoriasis with GT/FT in the Han population in southwestern China. METHODS: This study was conducted on 230 psoriatics and 230 healthy controls at West China Hospital. The authors compared the proportion of subjects with GT/FT in the two groups and compared age, gender, smoking, alcohol consumption, age at onset of psoriasis, duration of psoriasis, nail and joint involvement, Psoriasis Area and Severity Index, Body Surface Area, Dermatology Life Quality Index, and proportion using biologics in psoriatics with or without GT /FT. RESULTS: The authors have found a strong association between psoriasis and FT (p < 0.001), and a non-significant association between psoriasis and GT (p = 0.760). Compared to psoriasis patients without FT, the authors found that psoriasis patients with FT were older (p = 0.021) and had an increased frequency of late-onset psoriasis (p = 0.014); they also had more severe psoriasis (p = 0.047) and poorer quality of life (p = 0.045). STUDY LIMITATIONS: GT has periods of exacerbation and remission, so the authors cannot avoid a deviation of the prevalence of GT in this study from the true prevalence rate. Also, biologics have been found to lead to remission of GT and FT, which may have influenced the GT/FT ratio in the case group in this study. CONCLUSIONS: Psoriasis was associated with FT in the Han population in southwestern China, attention must be paid to the treatment of psoriatics with FT and skin diseases in patients with FT.

Is fluorometric sentinel lymph node biopsy in endometrial cancer necessary?

Objective: In this study, we collected perioperative and postoperative follow-up data from patients with endometrial cancer (EC) at different stages to evaluate the role of sentinel lymph node biopsy (SLNB) in endometrial cancer surgery. Methods: A total of 186 endometrial cancer patients undergoing radical hysterectomy from January 2018 to April 2022 were retrospectively analyzed. Patients were classified into four groups. Group A comprised patients diagnosed with stage IA grade 1 and 2 endometrioid EC who underwent SLNB. Group B comprised patients with stage IA grade 1 and 2 endometrioid EC who did not undergo SLNB. Group C comprised patients with higher-grade endometrioid EC, wherein systematic lymph node dissection was performed based on SLNB results. Group D comprised patients with higher-grade endometrioid EC who did not undergo SLNB and instead underwent direct systematic lymph node dissection. Clinical, pathological data, and follow-up information for all patients were collected. Results: In Group A and B, SLNB was performed on 36 out of 67 patients with IA stage 1 and 2 endometrial cancer, yielding a SLN positivity rate of 5.6%. There were no significant differences observed between the two groups regarding perioperative outcomes and postoperative follow-up. Conversely, among 119 patients with higher-grade endometrial cancer, 52 underwent SLNB, with 20 patients exhibiting SLN positivity, resulting in a SLN positivity rate of 38.4%. However, the decision to undergo SLNB did not yield significant differences in perioperative outcomes and postoperative follow-up among these patients. Conclusion: For stage IA grade 1 and 2 endometrioid EC, the incidence of lymph node positivity is low, omitting SLNB in this subpopulation is a feasible option. In other stages of endometrioid EC, there is no significant difference in perioperative and postoperative follow-up data between patients undergoing routine systematic lymphadenectomy and those undergoing systematic lymphadenectomy based on SLNB results. Therefore, if SLNB is not available, the standard procedure of PLND remains an option to obtain information about lymph node status, despite the surgical complications associated with this procedure.

Effectiveness of CoronaVac in the prevention of COVID-19, a test-negative case-control study in Brazil.

The present study aimed to evaluate the effectiveness of two doses of CoronaVac in preventing SARS-CoV-2 symptomatic disease with virological confirmation, as well as in the prevention of COVID-19 moderate and severe cases. A test-negative unmatched case-control design was used, in which cases were patients with suspected COVID-19 (presenting at least two of the following symptoms: fever, chills, sore throat, headache, cough, runny nose, olfactory or taste disorders) with virological confirmation, and controls were those whose SARS-CoV-2 test was negative. As for exposure, participants were classified as unvaccinated, or vaccinated with a complete schedule. Suspected COVID-19 cases were identified from March to November 2021, in two cities located in the State of São Paulo, Brazil. All participants signed the Informed Consent Form before enrollment. RT-PCR results and vaccination data were obtained from the local surveillance systems. Up to two phone calls were made to obtain information on the outcome of the cases. A total of 2981 potential participants were screened for eligibility, of which 2163 were included, being 493 cases and 1670 controls. Vaccination, age, the reported contact with a COVID-19 suspected or confirmed case in the 14 days before symptoms onset, and the educational level were the variables independently associated with the outcome. The adjusted vaccine effectiveness for symptomatic COVID-19 (AVE) was 39.0 % (95 % CI 6.0-60.0 %). The AVE in the prevention of moderate and severe disease was 91.0 % (95 % CI 76.0-97.0 %). Our results were influenced by the waning of the Gamma variant, in the second trimester of 2021, followed by the increase in vaccination coverage, and a drop in the number of cases in the second half of the year. The study demonstrated the high effectiveness of CoronaVac in preventing moderate/severe COVID-19 cases.

Corrigendum: Time for micro-RNAs in steatotic liver disease: a case-control study.

[This corrects the article DOI: 10.3389/fendo.2024.1349524.].

Polyethylene liner dissociation in total hip arthroplasty: a retrospective case-control study on a single implant design.

BACKGROUND: Modular acetabular components for total hip arthroplasty (THA) provide intraoperative flexibility; however, polyethylene liner dissociation may occur. This study aimed to examine the incidence and causes of liner dissociation associated with a specific acetabular component design at a single centre. MATERIALS AND METHODS: A retrospective analysis of 7027 patients who underwent primary THA was performed to identify isolated liner dislocations. Patient demographics, clinical presentations, surgical and implant details, and both radiographic and computed tomography (CT) findings were analysed. Patients with liner dislocation were matched to a control group via 2:1 propensity score matching, and a logistic regression analysis was employed to identify associated risk factors. RESULTS: A total of 32 patients (0.45%) experienced liner dislocation at a mean 71.47 ± 60.10 months post surgery. Significant factors contributing to dislocations included the use of a conventional compared with a highly crosslinked polyethylene component (p = 0.049) and screw fixation (p = 0.028). Radiographic and CT analysis highlighted the importance of proper component orientation, revealing that patients experiencing dislocations demonstrated significantly lower acetabular cup anteversion angles (p = 0.001) compared with the control group. Impingement and malposition, identified in 41% and 47% of the cases, respectively, further underscored the multifactorial nature of dislocation risks. CONCLUSIONS: While the overall rate of polyethylene liner dislocation was low, the findings of this study highlight the importance of appropriate cup placement to decrease the risk of dissociation. It further substantiates the influence of impingement and malposition in liner displacement, with increased mechanical stress exerted on the locking mechanism under adverse conditions and the potential risk increase due to screw placement.

Association between highly pathogenic avian influenza outbreaks and weather conditions in Japan.

Highly pathogenic avian influenza (HPAI) poses a significant threat to animal and public health, with outbreaks occurring globally. HPAI poses significant challenges due to its high mortality rate and public health concerns, with outbreaks spreading globally since the emergence of the H5N1 virus in 2003. In Japan, HPAI outbreaks have been particularly prevalent during autumn and winter seasons, with the 2022-2023 winter experiencing the most severe outbreak to date. However, limited research has directly examined the association between HPAI outbreaks and weather conditions in Japan. Here we show that specific weather conditions are associated with an increased risk of HPAI outbreaks on poultry farms in Japan. By analyzing databases of HPAI cases and meteorological data from 2020-2023, we found that higher average air temperatures two to three weeks prior, lower average wind speeds four weeks prior, and longer sunlight hours two and four weeks prior to outbreaks were significantly associated with increased risk of HPAI outbreaks in Japan. These results suggest that weather may influence environmental survival and transmission of the virus, as well as patterns of wild bird movement that could seed new outbreaks. These findings enhance our understanding of the factors influencing HPAI transmission dynamics and highlight the importance of integrating weather forecasts into disease surveillance and prevention strategies.

Gestational diabetes mellitus and the hearing of newborns:A nested case-control study in tropical province of China.

OBJECTIVE: This study aims to determine the association of gestational diabetes mellitus (GDM) and the results of newborn hearing screening(NHS). METHODS: A nested case-control study was conducted in a cohort of newborns who were born between June 2021 to December 2021 and underwent neonatal hearing screening.GDM was diagnosed according to the 75 g 2 h oral glucose tolerance test (OGTT) at 24-28 gestational weeks.A total of 369 pregnant women at the same hospital were individually matched in a 1:2 ratio by maternal age (±2 years), gestational age (±3 days) and sex of newborn.Chi-square test was utilized to evaluate associations between GDM and the results of NHS. RESULTS: Abnormal NHS results in the GDM group was more frequent than non-GDM group.When comparing the two groups (GDM case and contol), we found significant differences (p < 0.05) between them.Whereas the difference was not statistically significant (p > 0.05) by delivery modes in both case and control groups. CONCLUSION: Maternal history of GDM could lead to significantly higher failling rate of NHS.

C-reactive protein and neutrophil-to-lymphocyte ratio as key inflammatory indicators in the diagnosis of cervical necrotizing fasciitis.

BACKGROUND: Cervical necrotizing fasciitis (CNF) is a life-threatening bacterial infection with a diagnostic challenge. Currently, there is insufficient evidence on the diagnostic accuracy of inflammatory indicators in CNF. OBJECTIVE: This study aims to identify key inflammatory indicators and assess their diagnostic accuracy for CNF. METHODS: A diagnostic case-control study was conducted at a tertiary healthcare facility from January 2020 to December 2023. Laboratory data from patients with CNF and non-CNF at admission were evaluated. Key inflammatory indicators were identified through consistent outcomes from multivariable logistic regression and receiver operating characteristic curves analyses. The diagnostic accuracy of these indicators, with the results of combined tests, were calculated. RESULTS: CNF was confirmed in 21 of the 67 patients investigated. C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) were identified as key inflammatory indicators, with sensitivities of 0.905 and 0.810, and specificities of 0.870 and 0.913, respectively, at CRP threshold of 165.0 mg/L and NLR of 15.8. Combining CRP and NLR in parallel and serial tests increased sensitivity to 0.952 and specificity to 1.0, respectively. CONCLUSIONS AND SIGNIFICANCE: CRP and NLR have been verified as key inflammatory indicators with satisfactory diagnostic abilities for CNF diagnosis, providing a strong foundation for future studies.

Assessment of 11 ß-Hydroxysteroid Dehydrogenase Type I Activity in Patients With Psoriasis Vulgaris: A Novel Insight Into the Pathogenesis of the Disease.

Background Psoriasis is a relapsing dermatologic disease with a complex multifactorial etiology. Accumulating evidence has established the presence of cutaneous steroidogenesis with 11 ß-hydroxysteroid dehydrogenase (11ßHSD) enzyme being the most important final step of this pathway. This enzyme can control local levels of activated glucocorticoids (GCs) in the skin, which is the key to maintaining healthy skin. Methods This case-control study was conducted to evaluate 11ßHSD1 level in psoriasis patients, in both lesional and non-lesional skin, compare it to controls, and correlate its activity with the Psoriasis Area and Severity Index (PASI) and the Perceived Stress Scale (PSS). Results A significant decrease of 11ßHSD1 level in psoriasis patients compared to healthy controls was observed. In addition, decreased 11ßHSD1 level was observed in lesional compared to non-lesional skin in psoriasis patients. There was no significant correlation between the enzyme levels and PASI score or PSS score in patients with psoriasis. However, the PSS score was negatively correlated with 11ßHSD1 level in healthy controls. Further histopathological assessment revealed that lower enzyme levels were associated with greater epidermal acanthosis and inflammation. Conclusion This shows the role of 11ßHSD1 in controlling psoriatic inflammation, including the degree of epidermal proliferation, which might reveal the complex symphony of psoriasis pathogenesis.

Hematological malignancy-associated pyoderma gangrenosum: evaluating the magnitude of the association.

Background: Hematologic malignancies (HMs) are well-known underlying comorbidities of pyoderma gangrenosum (PG). However, studies quantifying the likelihood of PG after HMs are yet to be performed. Objective: To investigate the bidirectional association between PG and several HMs, namely acute leukemia, chronic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma. Methods: A population-based retrospective cohort study was conducted to study the risk of HMs in patients with PG (n = 302) as compared to age-, sex-and ethnicity-matched control subjects (n = 1,799). A case-control design was used to estimate the likelihood of PG in individuals with a preexisting history of HMs. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were estimated by Cox regression and logistic regression, respectively. Results: The prevalence of preexisting HM was higher in patients with PG than in controls (6.7% vs. 0.9%, respectively). The likelihood of having PG was significantly greater among patients with a history of HM (adjusted OR, 7.88; 95% CI, 3.85-16.15; p < 0.001), particularly during the first year following the diagnosis. This association was significant for acute leukemia, chronic leukemia, non-Hodgkin lymphoma, and multiple myeloma but not for Hodgkin lymphoma. The incidence rate of HM was 3.3 (95% CI, 1.2-7.4) and 1.6 (95% CI, 0.9-2.6)/1,000 person-years among patients with PG and controls, respectively. Relative to controls, patients with PG were not more likely to develop subsequent HM (adjusted HR, 2.22; 95%CI, 0.77-6.45; p = 0.142). Compared to other patients with PG, those with HM-associated PG experienced an increased all-cause mortality rate (adjusted HR, 2.19; 95%CI, 1.09-4.40; p = 0.028). Conclusion: HM, particularly acute leukemia and multiple myeloma, are associated with an elevated likelihood of provoking PG.

Assessing fatigue in women over 50 years with rheumatoid arthritis: a comprehensive case-control study using the FACIT-F scale.

Introduction: Data on prevalence of fatigue in rheumatoid arthritis (RA) patients in the era of biological treatments remains scarce, with a lack of case-control studies. This study evaluates the prevalence of fatigue in Spanish women over 50 years with RA using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, explores its association with RA-related variables, and seeks to identify the primary factors influencing fatigue. Ultimately, our objective is to underscore the clinical significance of fatigue as a comorbidity and to advocate for its systematic evaluation in routine clinical practice. Methods: In a case-control study at a tertiary university hospital, 191 women over 50 years (mean age: 67.5 ± 8.8 years) meeting ACR 2010 criteria for RA and age-matched controls were assessed using the FACIT-F scale, SF-12 questionnaire, and RA-related clinical measures. Results: Fatigue was significantly more prevalent in the RA group (61%) compared to controls (37%, p < 0.001), with RA patients showing lower mean FACIT-F scores (36.0 ± 10.6 vs. 40.0 ± 0.6, p < 0.001). Correlations were noted between FACIT-F scores and C-reactive protein, DAS28, RAPID3, HAQ, and SF-12 scores. A multivariate analysis was performed and four models generated. The final model, with an R2 of 0.817, indicates that fatigue is significantly influenced by disease activity (RAPID 3) and mental and physical health (SF12) and age, explaining 81.7% of the variance in fatigue. Conclusion: Fatigue remains significantly prevalent and severe in women over 50 years with RA, strongly linked to disease activity, disability, and diminished quality of life. Systematic fatigue assessment and targeted strategies in clinical settings are essential to address this widespread issue. Future research should explore targeted interventions tailored to this demographic to enhance quality of care.

Age-stratified risk of suicide in patients with schizophrenia.

OBJECTIVES: Schizophrenia is associated with an increased risk of suicide. Few studies have investigated the risk of suicide across different ages, likely due to limitations around sample size. METHODS: From the National Health Insurance Research Database in Taiwan, this study identified 195,787 patients with schizophrenia from January 1, 2000, to December 31, 2019. During the study period, 3848 patients died from suicide. We calculated the standardized mortality ratio (SMR) for suicide stratified by age. In this age-stratified, nested case-control study, risk set sampling was used to match each case with 4 living controls by age, sex, and the year of the first diagnosis with schizophrenia. Conditional logistic regression was used for estimating age-stratified risk profiles. RESULTS: The SMR was the highest in the <25 years age group (52.8) and inversely correlated with age. Unemployment was associated with an increased risk of suicide in the 25 to 34, 35 to 44, 45 to 54, and 55 to 64 years age groups. Depressive and sleep disorders before suicide were more common among suicide cases with schizophrenia than among controls across all age groups. Drug-induced and alcohol-induced mental disorders were significantly associated with suicide but were observed only in the age group younger than 54. Heart disease, pneumonia, and moderate or severe renal disease were risk factors for suicide in the age groups less than 65. CONCLUSIONS: The risk factors for suicide differ by age. This study's findings can be used to optimize health-care interventions for preventing suicide in patients with schizophrenia.

The predictive role of the total potassium intake and odds of breast cancer: a case-control study.

BACKGROUNDS: Dietary potassium can play an important role in decreasing inflammatory factors as a protective factor for cancers. In this case-control study, we aimed to assess the possible association between dietary potassium intake and the risk of breast cancer (BC) among Iranian adult women. METHODS: The present case-control study was conducted at Shohada and Imam Hossain hospitals, in Tehran. The study included 134 newly diagnosed cases of BC and 267 controls. A validated semi-quantitative 168-item food frequency questionnaire was used to compute the potassium intake. Logistic regression, adjusted for potential confounders, was used to estimate odds ratios(ORs) and 95% confidence intervals(CI) of BC according to tertiles of potassium intake. RESULTS: The mean(M) ± standard deviation(SD) of age and body mass index (BMI) were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. Also, the M ± SD of potassium intake for the control and case groups was 1616 ± 293 and 1542 ± 338 (mg/1000 Kcal), respectively. In the multivariable-adjusted model for potential confounders, the higher total potassium intake was associated with decreased odds of BC (OR: 0.35, 95%CI: 0.19-0.62, P for trend < 0.001). Moreover, an inverse relationship was observed between potassium from plant sources (OR: 0.39, 95%CI: 0.22-0.69, P for trend = 0.001) and fruit and vegetable sources (OR: 0.49, 95%CI: 0.28-0.87, P for trend = 0.016) and odds of BC. CONCLUSIONS: Our findings suggested that diet rich in potassium may have a predictive role to reduce the odds of BC.

The risk of long-term opioid use among immigrants: a national registry-linkage study.

AIMS: We aimed to investigate the association between being an immigrant and long-term prescription opioid use in Norway in 2010-2019. METHODS: Nested case-control study. The cases were all persons 18 years of age or older with long-term opioid use - that is, the use of prescription opioids longer than 3 months (N=215,642). Cases were matched to four controls who filled at least one opioid prescription, but never developed long-term opioid use in the study period (N=862,568) on sex, age and year of starting long-term/short-term opioid use. Being an immigrant was defined as being born outside of Norway to two foreign-born parents and four foreign-born grandparents. Adjusting for socioeconomic variables and clinical confounders, analyses were stratified on three age groups (18-44 years, 45-67 years and ⩾68 years). RESULTS: For the youngest age group, being an immigrant was inversely associated with long-term opioid use (adjusted odds ratio 0.75; 95% confidence interval [0.72-0.77]) compared with being native-born people. For this age group, the odds ratio differed between people born in Africa (0.56 [0.52-0.62]), Central or South America (0.70 [0.62-0.79]), Europe outside the European Union (EU) (0.71 [0.65-0.77]), Asia including Turkey (0.80 [0.77-0.84]) and EU/European Economic Area (EEA) (0.81 [0.77-0.85]). For the middle age group, increased odds were found for immigrants versus natives (1.05 [1.02-1.08]) in particular for those born in North America (1.26 [1.13-1.40]) and the EU/EEA (1.13 [1.09-1.18]). There was no association in the oldest group. CONCLUSIONS: Compared with native-born people, immigrants had lower odds of long-term opioid use among younger adults, higher odds among middle-aged and similar odds among older adults.

Immunometabolic profiling related with gestational diabetes mellitus: a nested case-control study of CD4+ T cell phenotypes and glycemic traits.

AIMS: To investigate immunometabolic associations of CD4+ T cell phenotypes with gestational diabetes mellitus (GDM). METHODS: A nested case-control study was conducted comprising 53 pairs of GDM patients and matched controls within a prospective cohort. Metabolomic signatures related to both CD4+ T cell phenotypes and glycemic traits among pregnant women were investigated by weighted gene co-expression network analysis (WGCNA). Multivariable-adjusted generalized linear models were used to explore the associations of CD4+ T cell phenotypes and selected metabolites with GDM. Mediation analysis was conducted to evaluate the mediating effect of selected metabolites on the relationship between CD4+ T cell phenotypes and glycemic traits. RESULTS: Higher levels of Treg cells (OR per SD increment (95%CI): 0.57 (0.34, 0.95), p = 0.031) and increased expression of Foxp3 (OR per SD increment (95%CI): 0.59 (0.35, 0.97), p = 0.039) and GATA3 (OR per SD increment (95%CI): 0.42 (0.25, 0.72), p = 0.002) were correlated with a decreased risk of GDM. Plasma pyruvaldehyde, S-adenosylhomocysteine (SAH), bergapten, and 9-fluorenone mediated the association between Tregs and fasting plasma glucose (FPG), with mediation proportions of 46.9%, 39.6%, 52.4%, and 56.9%, respectively. CONCLUSIONS: Treg cells and Foxp3 expressions were inversely associated with GDM risk, with potential metabolic mechanisms involving metabolites such as pyruvaldehyde and SAH.