Weekly-specific ambient PM1 before and during pregnancy and the risk of gestational diabetes mellitus.

BACKGROUND: Exposure to fine or respirable particulate matter has been linked to an elevated risk of gestational diabetes mellitus (GDM). However, the association between exposure to particulate matter with an aerodynamic diameter ≤ 1 µm (PM1) and GDM has not been explored. METHODS: We conducted a cohort study involving 60,173 pregnant women from nine hospitals in Beijing, China, from February 2015 to April 2021. Daily concentrations of PM1 and ozone were obtained from a validated spatiotemporal artificial intelligence model. We used a modified Poisson regression combined with distributed lag models to estimate the association between weekly-specific PM1 exposure and the risk of GDM after adjusting for individual-level covariates. RESULTS: Among the 51,299 pregnant women included in the final analysis, 4008 were diagnosed with GDM. Maternal exposure to PM1 during preconception and gestational periods was generally associated with an increased risk of GDM. The most pronounced associations were identified during the 12th week before pregnancy, the 5th-8th weeks of the first trimester, and the 23rd-24th weeks of the second trimester. Each 10 µg/m3 increase in PM1 was associated with a relative risk of GDM of 1.65 (95 % CI: 1.59, 1.72) during the preconception period, 1.67 (95 % CI: 1.61, 1.73) in the first trimester, 1.52 (95 % CI: 1.47, 1.58) in the second trimester, and 2.54 (95 % CI: 2.45, 2.63) when considering the first and second trimester combined. CONCLUSIONS: Exposure to PM1 before and during pregnancy was associated with an increased risk of GDM, particularly during the 12 weeks before pregnancy and gestational weeks 5-8 and 23-24.

Exposure to ambient ozone and sperm quality among adult men in China.

BACKGROUND: Limited evidence exists regarding the association between ozone exposure and adverse sperm quality. We aimed to assess the association between ozone exposure and sperm quality, and identify susceptible exposure windows. METHODS: We recruited 32,541 men aged between 22 and 65 years old attending an infertility clinic in Wuhan, Hubei Province, China from 2014 to 2020. Ozone data were obtained from a satellite-based spatiotemporal model. Generalized linear models were used to estimate the association between ozone exposure and sperm quality parameters, including sperm concentration, sperm count, sperm total motility, and sperm progressive motility during the entire stage of sperm development (0-90 days before ejaculation) and three crucial stages (0-9 days, 10-14 days and 70-90 days before ejaculation). Stratified analyses were performed to evaluate whether associations varied by age, body mass index, and education levels. RESULTS: The final analysis included 27,854 adult men. A 10 µg/m3 increase in ozone concentrations during the entire stage of sperm development was associated with a -4.17 % (95 % CI: -4.78 %, -3.57 %) decrease in sperm concentration, -6.54 % (95 % CI: -8.03 %, -5.60 %) decrease in sperm count, -0.50 % (95 % CI: -0.66 %, -0.34 %) decrease in sperm total motility, and -0.07 % (95 % CI: -0.22 %, 0.09 %) decrease in sperm progressive motility. The associations were stronger during 70-90 days before ejaculation and among men with middle school and lower education for sperm concentration. CONCLUSIONS: Ozone exposure was associated with decreased sperm quality among Chinese adult men attending an infertility clinic. These results suggest that ozone may be a risk factor contributing to decreased sperm quality in Chinese men.

Possible sarcopenia and risk of chronic kidney disease: a four-year follow-up study and Mendelian randomization analysis.

INTRODUCTION: Chronic kidney disease (CKD) is a common risk factor for sarcopenia. However, whether sarcopenia increases the risk of CKD remains unclear. To investigate the longitudinal and causal associations between possible sarcopenia and CKD, this study was performed. METHODS: Possible sarcopenia was defined according to the Asian Working Group for Sarcopenia in 2019. Participants aged ≥ 40 years were recruited from the baseline survey of the China Health and Retirement Longitudinal Study and followed up for four years. Binary logistic regression was used to evaluate the cross-sectional and longitudinal associations between possible sarcopenia, low muscle strength, low physical performance and CKD. Propensity score matching was used to balance the intergroup differences. Subgroup and interactive analyses were adopted to identify potential interactive effects. Mendelian Randomization analysis was used to assess the causal association between appendicular lean mass (ALM) and CKD. RESULTS: After data cleansing, a total of 7296 participants were included in the baseline survey. In the cross-sectional analyses, the odds ratios (ORs) of prevalent CKD were 1.50 (95% CI = 1.23-1.84, p < 0.001) for possible sarcopenia, 1.37 (95% CI = 1.10-1.70, p < 0.01) for low muscle strength and 1.42 (95% CI = 1.16-1.74, p < 0.001) for low physical performance in the full models. No significant interaction effects of covariates were detected (all P for interaction > 0.05). After four years of follow-up, an increased risk of incident CKD was also observed in participants with possible sarcopenia (OR = 1.66, 95% CI = 1.13-2.44, p = 0.010) and low physical performance (OR = 1.69, 95% CI = 1.16-2.45, p = 0.006), but not in participants with low muscle strength (OR = 1.19, 95% CI = 0.75-1.88, p = 0.469). In the Mendelian Randomization analysis, the inverse variance weighted estimator showed that a 1-standard deviation increase of genetically predicted ALM was associated with a lower risk of CKD (OR = 0.92, 95% CI = 0.85-0.99, p = 0.035). All the sensitivity analyses supported the main findings. CONCLUSIONS: Possible sarcopenia is an independent risk factor for CKD and may serve as a predictor of CKD for early identification and intervention.

Hourly Air Pollution Exposure and Emergency Hospital Admissions for Stroke: A Multicenter Case-Crossover Study.

BACKGROUND: Daily exposure to ambient air pollution is associated with stroke morbidity and mortality; however, the association between hourly exposure to air pollutants and risk of emergency hospital admissions for stroke and its subtypes remains relatively unexplored. METHODS: We obtained hourly concentrations of fine particulate matter (PM2.5), respirable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) from the China National Environmental Monitoring Center. We conducted a time-stratified case-crossover study among 86 635 emergency hospital admissions for stroke across 10 hospitals in 3 cities (Jinhua, Hangzhou, and Zhoushan) in Zhejiang province, China, between January 1, 2016 and December 31, 2021. Using a conditional logistic regression combined with a distributed lag linear model, we estimated the association between hourly exposure to multiple air pollutants and risk of emergency hospital admissions for total stroke, ischemic stroke, hemorrhagic stroke, and undetermined type. RESULTS: Hourly exposure to PM2.5, PM10, NO2, and SO2 was associated with an increased risk of hospital admissions for total stroke and ischemic stroke. The associations were most pronounced during the concurrent hour of exposure and lasted for ≈2 hours. We found that the risk was more pronounced among male patients or those aged <65 years old. CONCLUSIONS: Our findings suggest that exposure to PM2.5, PM10, NO2, and SO2, but not CO and O3, is associated with emergency hospital admissions for total stroke or ischemic stroke shortly after exposure. Implementing targeted pollution emission reduction measures may have significant public health implications in controlling and reducing the burden of stroke.

Mitigation role of physical exercise participation in the relationship between blood cadmium and sleep disturbance: a cross-sectional study.

The neurotoxicity of heavy metals received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, the health hazard of heavy metal like cadmium (Cd) exposure on sleep health remained unknown. Rescue strategies like physical exercise (PE) has emerged to mitigate such influence. An epidemiological design with cross-sectional data from National Health and Nutrition Examination Survey 2007-2010 was applied. The relationship between three blood heavy metals [cadmium (Cd), lead (Pb), mercury (Hg)] and sleep disturbance was analyzed. A total of 8,751 participants were finally included in and the weighted participants were 330,239,463. Weighted quantile sum (WQS) regression indicated that mixed blood metals were positively related to risk of sleep disturbance and the mixture effect of exposure to heavy metals was mainly attributable to Cd (89.1%). Weighted logistic regression showed a significant positive association between the highest quartile of blood Cd and sleep disturbance [(OR (95% CI)): 1.191 (1.014,1.400), p = 0.036] in the fully adjusted model, while no association was found under Pb and Hg exposure. In the association between Q3 and Q4 level of blood Cd and sleep disturbance, moderate-to-vigorous physical exercise group had lower risks than none and low exercise group. In the restricted cubic spline model, it was also verified that higher PE participation was associated with the lowest incidence of sleep disturbance with the increment in Cd concentration. Our study suggested that both policy makers and the public should minimize heavy metal exposure. Moreover, conducting moderate to vigorous physical exercise is a protecting factor to mitigate Cd's influence on sleep health.

Reduced sleep duration increases the risk of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in middle-aged and elderly males: a national cross-sectional study.

BACKGROUND: The prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) remains high in men. However, whether reduced sleep duration enhances the risk of LUTS/BPH remains unknown. MATERIALS AND METHODS: The 2015 China Health and Retirement Longitudinal Study was used in this study. Binary logistic regression was adopted to test the relationship between sleep duration and LUTS/BPH. Restricted cubic spline (RCS) regression was used to examine the non-linear association. In sensitivity analyses, propensity scores matching was performed to verify the robustness of the results. RESULTS: In this study, 8,920 males aged 40 years above were enrolled. In the fully adjusted logistic model, across the quartiles of sleep duration, the odds ratios of LUTS/BPH were 1.00 (reference), 0.94 (95% CI 0.77-1.15), 0.74 (95% CI 0.58-0.94), 0.54 (0.37-0.75), respectively. The results of RCS indicated a non-linear inverted U-shaped association between sleep duration and LUTS/BPH (p for non-linearity <0.05). In the subgroup analyses, no significant effects of settlements, alcohol and cigarette consumption, depression, and hypertension on the association between sleep duration and prevalent LUTS/BPH were observed (p for interaction >0.05). CONCLUSION: Reduced sleep duration is significantly associated with the increases of the LUTS/BPH risk in Chinese middle-aged and elderly males.

Prevalence and associated factors of metabolic syndrome in Chinese middle-aged and elderly population: a national cross-sectional study.

BACKGROUND: Currently, China has an increasingly aging population. However, the prevalence of metabolic syndrome (MetS) in this high-risk population for metabolic diseases remains unknown. This study investigates the age- and gender-specific prevalence and associated factors of MetS in the middle-aged and elderly Chinese population. METHODS: Data were collected and subjected to descriptive statistics. Further, univariate logistic regression was used to evaluate the relevant factors, and then multivariate logistic regression was selected to construct the final model. RESULTS: A total of 10,834 participants were included in the present study. The overall prevalence of MetS is 32.97% as defined by International Diabetes Federation (IDF) and 29.75% under National Cholesterol Education Program-The Adult Treatment Panel III (NCEP-ATP III) criteria. With aging, the prevalence of MetS descends in males while ascends in females. In the >70 years old group, the prevalence of MetS is three times higher in females than that in males (50.43% versus 16.03%). Across all age groups and sexes, the prevalence of MetS in urban areas is significantly higher than in rural areas. Besides, regardless of gender, the prevalence of MetS is the highest for those living in the north region (28.41% for males and 51.74% for females) and the lowest for those living in the southwest region (13.91% for males and 31.58% for females). Finally, an afternoon nap has been identified as a positively associated factor, while blood urea nitrogen (BUN) has been identified as a negatively associated factor (p < 0.05). CONCLUSION: The prevalence of MetS varies in different age groups, sexes, living areas, and regions. An afternoon nap is positively associated with the prevalence of MetS, while BUN is negatively associated with MetS.

The activity of daily living (ADL) subgroups and health impairment among Chinese elderly: a latent profile analysis.

BACKGROUND: Disability in aged people became one of the major challenges in China due to the acceleration of population aging. Nevertheless, there were limited methods to appropriately discriminate the degree of combined basic activity of daily living (BADL) and instrumental activity of daily living (IADL). The present study explored an empirical typology of the activity of daily living (ADL) and its association with health status among the elderly in China. METHODS: Data throughout the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was retrieved and Latent profile analysis (LPA) was conducted to identify the subgroups of ADL for included elderly subjects. Multinomial regression was performed to detect the effect of identified characteristics with ADL subgroups, and the restricted cubic spine was drawn to show the changes in the relationship between age-specific ADL disability and BMI. RESULTS: The overall participants (n=8108) were divided into three ADL classes by LPA - 'no BADL limitation-no IADL limitation' (Class one, n=6062, 75%), 'no BADL limitation- IADL impairment' (Class two, n=1526, 19%), and 'BADL impairment- IADL impairment' (Class three, n=520, 6%). Compared with the participants in Class one, the oldest-old, living without spouse, lacking of exercise, short in social activities, having experience of falls, having comorbidity of diabetes, heart disease, stroke, decreased cognitive function, depression symptom were highly associated with Class two and Class three. Additionally, malnutrition and asthma were associated with combined BADL/IADL impairment (Class three), while illiteracy was only associated with IADL impairment (Class two). Furthermore, a statistically significant U-shape association was detected between age and BADL/IADL disability (Class three vs. Class two) as well as BMI and BADL/IADL disability (Class three vs. Class one). The elderly aged 80-90 with IADL impairment were less likely to evolve into combined BADL/IADL impairment, and the elderly who were underweight or obese may have higher risk of combined BADL/IADL impairment. CONCLUSION: A novel functional assessment was explored based on LPA, by which elderly people could be classified into three distinct classes of combined BADL/IADL. The predictors identified with particular IADL/BADL classes could draw early attention to the onset of functional disability and enlighten targeted interventions to address consequent problems of aged people.

The prevalence and associated factors of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in aging males.

OBJECTIVE: To investigate the prevalence and associated factors of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in Chinese aging males. METHOD: Data downloaded from the China Health and Retirement Longitudinal Study (CHARLS) was subjected to descriptive statistics followed by univariate logistic regression and multivariate logistic regression. RESULTS: A total of 8563 participants with an overall LUTS/BPH prevalence of 11.97% were enrolled. With aging, the LUTS/BPH prevalence increased (p < 0.001). Men aged over 70 years suffered the highest prevalence of 22.70%. Marital status did nothing to the suffering of LUTS/BPH. Subjects receiving more education or assessed as depression displayed higher incidence of LUTS/BPH (p < 0.001). In rural villages, settlers showed lower prevalence of 10.00% compared to 16.49% for urban residents. Smoking, sleeping time and alcohol consumption seemed to play a protective role in the occurrence of LUTS/BPH. One who slept more than 8 h, was smoking, and drank more than once a month had the lowest prevalence (p ≤ 0.001). CONCLUSIONS: For Chinese aging population, LUTS/BPH prevalence increased with aging and was interfered by educational level, depression, sleeping time, geographical region, smoke and alcohol consumption.

What has changed HIV and syphilis infection among men who have sex with men (MSM) in Southwest China: a comparison of prevalence and behavioural characteristics (2013-2017).

BACKGROUND: Chongqing reportedly has a large MSM population and a high STI prevalence in previous studies. However, most studies are attributed to independent cross-sectional studies, few studies have investigated trends in the prevalence of syphilis and HIV, as well as behavioural characteristics among MSM using serial surveillance surveys. METHODS: Data were collected in Chongqing through face-to-face questionnaire interview and laboratory testing in Chongqing. The respondents were recruited among MSM by snowball sampling from May 2013 to December 2017. The self-report questionnaire primarily included socio-demographics, HIV knowledge, and HIV-related behaviour characteristics over the year. Blood specimens were tested to diagnose HIV and syphilis infection by Chongqing CDC. Cochran-Armitage trend test and multivariate logistic regression were conducted to compare the changes in STI prevalence and independent behavioural factors among MSM. RESULTS: There were 6568 eligible participants (98.4%). The overall HIV prevalence was 20.5% among MSM in Chongqing, with a decrease from 23.0% in 2013 to 19.2% in 2017. The overall syphilis prevalence was 5.8%, with an increase from 3.2% in 2013 to 6.7% in 2017. The proportion of consistent condom use (CCU) during anal intercourse (46.3 to 57.7%, P<0.001),CCU with regular male partners(47.7 to 59.7%, P<0.001), CCU with casual male partners (51.5 to 62.3%, P<0.001) and drug use during anal intercourse (0.3 to 1.4%, P<0.05) were increasing. By contrast, a significant decrease was reported in the percentage of MSM with more than two regular male partners (66.0 to 21.4%, P<0.001) and more than two casual male partners (38.3 to 20.7%, P<0.001). A significant difference was observed in syphilis infection, testing for HIV antibodies and drug use during anal intercourse in the past years between the HIV-positive and HIV-negative respondents. CONCLUSION: A decreasing trend of HIV prevalence was showed during among MSM from 2013 to 2017 in Chongqing. While gradual reduction of high-risk behaviors along with HIV prevalence supported development of STI counselling and testing, increasing syphilis infection and drug use during anal intercourse warrants further understanding.

Genetically proxied intestinal microbiota and risk of erectile dysfunction.

BACKGROUND: The interaction between intestinal microbiota and erectile dysfunction (ED) is less investigated. This study was performed to explore the association between intestinal microbiota and ED. METHODS: In this two-sample Mendelian randomization (MR) study, genetic variants of gut microbiota were obtained from MiBioGen consortium containing 18,340 individuals. Six methods including inverse variance weighting (IVW), MR-Egger, weighted median, maximum likelihood, MR robust adjusted profile score, and MR pleiotropy residual sum and outlier were used to investigate the causal links between intestinal microbiota and ED. Furthermore, reverse MR analysis was performed to exclude the causal impact of ED on gut microbiota. RESULTS: As revealed by the IVW estimator, the risks of ED were raised by genetically proxied Lachnospiraceae (OR: 1.27), Lachnospiraceae NC2004 group (OR: 1.17), Oscillibacter (OR: 1.20), Senegalimassilia (OR: 1.32) (All P < 0.05) and Tyzzerella-3 (OR: 1.14, P < 0.05). It was observed that Ruminococcaceae UCG013 exerted protective effect against ED (OR: 0.77, P < 0.05). These results were consistent with other estimators in sensitivity analyses. In reverse MR analyses, genetic liability to ED did not alter the abundances of Lachnospiraceae, Lachnospiraceae NC2004 group, Oscillibacter, Senegalimassilia, Tyzzerella-3, and Ruminococcaceae UCG013 (All P > 0.05). No heterogeneity and pleiotropy were detected by Cochran's Q-test, MR-Egger, and global test (All P > 0.05). CONCLUSIONS: This study provided novel evidence that genetically proxied Lachnospiraceae, Lachnospiraceae NC2004 group, Oscillibacter, Senegalimassilia, Tyzzerella-3, and Ruminococcaceae UCG013 had potentially causal effects on ED. Further studies are needed to clarify the biological mechanisms linking intestinal microbiota to ED.

Ambient fine particulate matter constituents and semen quality among adult men in China.

Exposure to ambient fine particulate matter (PM2.5) was associated with decreased semen quality, but the relationship between PM2.5 constituents and semen quality was unclear. We recruited 27,824 adult men attending an infertility clinic in Wuhan, China, between 2014 and 2020. We used a four-dimensional spatiotemporal deep forest model to estimate concentrations of PM2.5 mass and its chemical constituents, including organic matter (OM), black carbon (BC), sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), and chloride (Cl-). We employed linear regression models to estimate the association between PM2.5 mass and its constituents with various sperm parameters. Exposure to PM2.5 was associated with a reduction in sperm quality, with a percent change of - 5.69% (95% confidence interval [CI]: -8.53%, -2.85%) for sperm density, - 15.09% (95% CI: -22.24%, -7.94%) for sperm total count, - 1.63% (95% CI: -2.36%, -0.91%) for sperm progressive motility, and - 2.30% (95% CI: -3.04%, -1.55%) for sperm total motility. Among specific constituents, exposure to OM, BC, Cl-, or NO3- was associated with a reduction in these four semen quality parameters. The association was more pronounced among older men or individuals with lower levels of education. Our findings suggest that PM2.5 mass and each constituent were associated with decreased semen quality in adult men.

The association between circadian syndrome and chronic kidney disease in an aging population: a 4-year follow-up study.

Introduction: Circadian syndrome (CircS) is proposed as a novel risk cluster based on reduced sleep duration, abdominal obesity, depression, hypertension, dyslipidemia and hyperglycemia. However, the association between CircS and chronic kidney disease (CKD) remains unclear. To investigate the cross-sectional and longitudinal association between CircS and CKD, this study was performed. Methods: A national prospective cohort (China Health and Retirement Longitudinal Study, CHARLS) was used in this study. To define CKD, the estimated glomerular filtration rate (eGFR) was calculated based on the 2012 CKD-EPI creatinine-cystatin C equation. Participants with eGFR <60 mL.min-1/1.73/m2 were diagnosed with CKD. Multivariate binary logistic regression was used to assess the cross-sectional association between CircS and CKD. Subgroup and interactive analyses were performed to determine the interactive effects of covariates. In the sensitivity analysis, the obese population was excluded and another method for calculating the eGFR was used to verify the robustness of previous findings. In addition, participants without CKD at baseline were followed up for four years to investigate the longitudinal relationship between CircS and CKD. Results: A total of 6355 participants were included in this study. In the full model, CircS was positively associated with CKD (OR = 1.28, 95% CI = 1.04-1.59, P < 0.05). As per one increase of CircS components, there was a 1.11-fold (95% CI = 1.04-1.18, P < 0.05) risk of prevalent CKD in the full model. A significant interactive effect of hyperuricemia in the CircS-CKD association (P for interaction < 0.01) was observed. Sensitivity analyses excluding the obese population and using the 2009 CKD-EPI creatinine equation to diagnose CKD supported the positive correlation between CircS and CKD. In the 2011-2015 follow-up cohort, the CircS group had a 2.18-fold risk of incident CKD (95% CI = 1.33-3.58, P < 0.01) in the full model. The OR was 1.29 (95% CI = 1.10-1.51, P < 0.001) with per one increase of CircS components. Conclusion: CircS is a risk factor for CKD and may serve as a predictor of CKD for early identification and intervention.

Plasma proteome analysis implicates novel proteins as potential therapeutic targets for chronic kidney disease: A proteome-wide association study.

Chronic kidney disease (CKD) is prevalent globally with limited therapeutic drugs available. To systemically identify novel proteins involved in the pathogenesis of CKD and possible therapeutic targets, we integrated human plasma proteomes with the genome-wide association studies (GWASs) of CKD, estimated glomerular filtration rate (eGFR) and blood urea nitrogen (BUN) to perform proteome-wide association study (PWAS), Mendelian Randomization and Bayesian colocalization analyses. The single-cell RNA sequencing data of healthy human and mouse kidneys were analyzed to explore the cell-type specificity of identified genes. Functional enrichment analysis was conducted to investigate the involved signaling pathways. The PWAS identified 22 plasma proteins significantly associated with CKD. Of them, the significant associations of three proteins (INHBC, LMAN2, and SNUPN) were replicated in the GWASs of eGFR, and BUN. Mendelian Randomization analyses showed that INHBC and SNUPN were causally associated with CKD, eGFR, and BUN. The Bayesian colocalization analysis identified shared causal variants for INHBC in CKD, eGFR, and BUN (all PP4 > 0.75). The single-cell RNA sequencing revealed that the INHBC gene was sparsely scattered within the kidney cells. This proteomic study revealed that INHBC, LMAN2, and SNUPN may be involved in the pathogenesis of CKD, which represent novel therapeutic targets and warrant further exploration in future research.

Inverted U-shaped relationship between sleep duration and phenotypic age in US adults: a population-based study.

Sleep is a modifiable behavior that can be targeted in interventions aimed at promoting healthy aging. This study aims to (i) identify the sleep duration trend in US adults; (ii) investigate the relationship between sleep duration and phenotypic age; and (iii) explore the role of exercise in this relationship. Phenotypic age as a novel index was calculated according to biomarkers collected from US adults based on the National Health and Nutrition Examination Survey (NHANES). Sleep information was self-reported by participants and discerned through individual interviews. The principal analytical method employed was weighted multivariable linear regression modeling, which accommodated for the complex multi-stage sampling design. The potential non-linear relationship was explored using a restricted cubic spline (RCS) model. Furthermore, subgroup analyses evaluated the potential effects of sociodemographic and lifestyle factors on the primary study outcomes. A total of 13,569 participants were finally included in, thereby resulting in a weighted population of 78,880,615. An examination of the temporal trends in sleep duration revealed a declining proportion of individuals with insufficient and markedly deficient sleep time since the 2015-2016 cycle. Taken normal sleep group as a reference, participants with extreme short sleep [ß (95% CI) 0.582 (0.018, 1.146), p = 0.044] and long sleep [ß (95% CI) 0.694 (0.186, 1.203), p = 0.010] were both positively associated with phenotypic age using the fully adjusted model. According to the dose-response relationship between sleep duration and phenotypic age, long sleep duration can benefit from regular exercise activity, whereas short sleep duration with more exercise tended to have higher phenotypic age. There is an inverted U-shaped relationship between short and long sleep durations and phenotypic age. This study represents an important step forward in our understanding of the complex relationship between sleep and healthy aging. By shedding light on this topic and providing practical exercise recommendations for promoting healthy sleep habits, researchers can help individuals live longer, healthier, and more fulfilling lives.

Insights into modifiable risk factors of erectile dysfunction, a wide-angled Mendelian Randomization study.

INTRODUCTION: The causal association between modifiable risk factors and erectile dysfunction (ED) remains unclear, which hinders the early identification and intervention of patients with ED. The present study aimed to clarify the causal association between 42 predominant risk factors and ED. METHODS: Univariate Mendelian Randomization (MR), multivariate MR, and mediation MR analyses were used to investigate the causal association between 42 modifiable risk factors and ED. Combined results were pooled from two independent ED genome-wide association studies to verify the findings. RESULTS: Genetically predicted body mass index (BMI), waist circumference, trunk fat mass, whole body fat mass, poor overall health rating, type 2 diabetes, basal metabolic rate, adiponectin, cigarette consumption, insomnia, snoring, hypertension, stroke, ischemic stroke, coronary heart disease, myocardial infarction, heart failure, and major depressive disorder were found to increase the risk of ED (all P < 0.05). Additionally, genetic liability to higher body fat percentage and alcohol consumption were suggestively associated with an increased risk of ED (P < 0.05 and adjusted P > 0.05). Genetic predisposition to higher sex hormone-binding globulin (SHBG) levels could decrease the risk of ED (P < 0.05). No significant association was detected between lipid levels and ED. Multivariate MR identified type 2 diabetes, basal metabolic rate, cigarette consumption, hypertension, and coronary heart disease as risk factors for ED. The combined results confirmed that waist circumference, whole body fat mass, poor overall health rating, type 2 diabetes, basal metabolic rate, adiponectin, cigarette consumption, snoring, hypertension, ischemic stroke, coronary heart disease, myocardial infarction, heart failure, and major depressive disorder could increase the risk of ED (all P < 0.05), while higher SHBG decreased the risk of ED (P = 0.004). There were suggestive significances of BMI, insomnia, and stroke on ED (P < 0.05 and adjusted P > 0.05). CONCLUSION: This comprehensive MR study supported the causal role of obesity, type 2 diabetes, basal metabolic rate, poor self-health rating, cigarette and alcohol consumption, insomnia and snoring, depression, hypertension, stroke, ischemic stroke, coronary heart disease, myocardial infarction, heart failure, SHBG, and adiponectin in the onset and development of ED.

The Association between the Platelet to White Blood Cell Ratio and Chronic Kidney Disease in an Aging Population: A Four-Year Follow-Up Study.

INTRODUCTION: The platelet to white blood cell ratio (PWR) has been reported to be a prognostic factor for some diseases, such as subarachnoid hemorrhage. However, the association between the PWR and chronic kidney disease (CKD) remains unknown. To investigate the cross-sectional and longitudinal association between the PWR and CKD, this study was performed. METHODS: This study used datasets from a national prospective cohort in China (China Health and Retirement Longitudinal Study). A retrospective cohort from 2011 to 2015 was constructed. The PWR was stratified as a categorical variable according to tertiles (T1-T3 groups). CKD was defined as an estimated glomerular filtration rate < 60 mL min-1/1.73/m2. Univariate and multivariate logistic regressions and restricted cubic spline regression were adopted to assess the linear and non-linear association between the PWR and CKD. Propensity score matching was used to balance the discrepancies between covariates. Subgroup and interactive analyses were performed to explore potential interactive effects of covariates. Missing values were interpolated using random forest. The PWR was also stratified according to the median and quartiles as sensitivity analyses. RESULTS: A total of 8600 participants were included in this study. In the full model, the odds ratios (ORs) of prevalent CKD were 0.78 (95% CI = 0.62-0.97, p < 0.05) for the T2 group and 0.59 (95% CI = 0.46-0.76, p < 0.001) for the T3 group. There were significant interactive effects of marital status and smoking in the PWR-CKD association (both p for interaction < 0.05). An L-shaped, non-linear association was detected between the PWR and prevalent CKD in the overall population, participants ≥ 60 years, and females subgroups (all p for non-linear < 0.05). All sensitivity analyses supported the negative association between the PWR and prevalent CKD. In the 2011-2015 follow-up cohort, the ORs of incident CKD were 0.73 (95% CI = 0.49-1.08, p > 0.05) and 0.31 (95% CI = 0.18-0.51, p < 0.001) for the T2 and T3 groups, respectively, in the full model. CONCLUSIONS: A high PWR is associated with a reduced risk of prevalent and incident CKD. The PWR may serve as a predictor for CKD, facilitating the early identification and intervention of kidney function decline.

Applications of artificial intelligence in the diagnosis and prediction of erectile dysfunction: a narrative review.

Despite the high prevalence of erectile dysfunction, patients are reluctant to seek medical advice, which leads to low diagnostic rates in clinical practice. Artificial intelligence has been widely applied in the diagnosis of many diseases and may alleviate the situation. However, the applications of artificial intelligence in erectile dysfunction have not been reviewed to date. Therefore, the assistance from artificial intelligence needs to be summarized. In this review, 418 publications before January 10, 2021, regarding artificial intelligence applications in diagnosing and predicting erectile dysfunction, were retrieved from five databases, including PubMed, EMBASE, the Cochrane Library, and two Chinese databases (WANFANG and CNKI). In addition, the reference lists of the included studies or relevant reviews were checked to avoid bias. Finally, 30 articles were reviewed to summarize the current status, merits, and limitations of applying artificial intelligence in diagnosing and predicting erectile dysfunction. The results showed that artificial intelligence contributed to developing novel diagnostic questionnaires, equipment, expert systems, classifiers by images and predictive models. However, most of the included studies were not subjected to external validations, resulting in doubt on the generalizability. In the future, more rigorously designed studies with high-quality datasets for erectile dysfunction are required.

Association between ambient PM1 and semen quality: A cross-sectional study of 27,854 men in China.

BACKGROUND: Exposure to ambient fine and respirable particulate matter is associated with poor sperm quality, but evidence for particulate matter with an aerodynamic diameter ≤ 1 µm (PM1) is scarce. We aimed to estimate the association between PM1 exposure and sperm concentration, sperm count, sperm total motility, and sperm progressive motility in Chinese men. METHODS: We conducted a cross-sectional study of 33,221 men attending an infertility clinic in Hubei, China, between 2014 and 2020. Daily concentrations of PM1 data were estimated from a validated spatiotemporal artificial intelligence model. We used multivariate linear regression to estimate the association between PM1 exposure and sperm parameters during the spermatogenesis period after adjusting for age, body mass index (BMI), education, ever having fathered a child, and season of semen collection. In addition, we performed stratified analysis to assess whether the association was varied by age, BMI, and educational attainment. RESULTS: A total of 27,854 participants were included in the final analysis. An interquartile range (17.2 µg/m3) increase in PM1 during the entire period of semen development was associated with declined semen concentration [-4.39% (95% CI: -7.67%, -1.12%)] and sperm count [-23.56% (95% CI: -28.95%, -18.18%)], reduced total motility [-0.86% (95% CI: -1.66%, -0.06%)] and progressive motility [-2.22% (95% CI: -3.00%, -1.43%)]. The associations were homogeneous across subgroups defined by age and education, but were more pronounced among men with underweight for sperm concentration and sperm count. We identified a critical exposure window of 0-9 lag days, 10-14 lag days, and 70-90 lag days before semen collection for sperm count and progressive motility. CONCLUSIONS: Among men attending an infertility clinic in China, exposure to PM1 was associated with poor semen quality, especially during the 70-90 days before ejaculation. These results suggest that exposure to PM1 might be a novel risk factor for impaired semen quality.

Association between Selenium Intake and Optimal Sleep Duration: A National Longitudinal Study.

Inconsistent findings have been discovered in studies examining the link between dietary selenium (Se) and sleep. Data were obtained from 17,176 people aged 20 and over who participated in the China Health and Nutrition Survey (CHNS) from 2004 to 2011. Face-to-face interviews were used to measure sleep duration in 2004, 2006, 2009, and 2011. To track dietary Se consumption, a 3-day, 24-h recall was undertaken. In the analysis, multilevel mixed-effects logistic regression was employed. The odds ratios (95% confidence intervals) of optimal sleep duration (7-9 h/day) in the regression of Model 4 were 1.00, 1.01 (0.89-1.15) and 1.19 (1.02-1.38) for the three tertiles of selenium consumption, respectively. Only overweight patients displayed a substantial positive connection between Se intake and the optimal sleep duration in the subgroup analysis. In summary, Se intake was significantly associated with optimal sleep duration.