Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course： Systematic Review and Meta-analysis

Background： Malnutrition and tuberculosis （TB） tend to interact with each other. TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions. Nutrition support can promote recovery in the subject being treated for TB. The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy. Methods： English database of the Cocbrane Controlled Trials Register, PubMed, EMBASE, and Chinese database ofCBM, CNKI, VIE and WAN FANG were searched. Randomized controlled trials comparing nutrition support （given tbr more than 2 weeks） with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included. Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer. Data were entered and analyzed by RevMan 5.2 software, and recta-analysis was done using risk ratios （RRs） for dichotomous variables and mean differences （MDs） for continuous variables with 95% confidence intervals （C/s）. Results： A total of 19 studies （3681 participants） were included. In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears- or culture-negative conversion rate and chest X-ray （CXR） absorption rate were 1.10 （1.04, 1.17） and 1.22 （1.08, 1.39）, respectively, the pooled MD and its 95% CI of body mass index （BMI） and time of sputum smears or culture negativity were 0.59 （0.16, 1.2） and - 5.42 （-7.93, -2.92）, respectively, compared with the control group. The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant （P = 0.76, 0.24, 0.28, and 0.20, respectively） between the intervention group and the control group. No systemic adverse events were recorded. Conclusions： During anti-TB course, nutrition support may be helpful in treatment of TB patients by improving both sputum smears-or culture-negative conversion rate and BM1, shortening the time of sputum conversion negative. Whether it can improve the final clinical effect, there still needs high-level quality studies to confirm in the future.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China:results from a national survey

This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.

Maternal Thyroid Hormones as Mediators between Phthalate Exposure and Neonatal Birth Weight:A Cross-Sectional Study from the Zunyi Birth Cohort

Studies have shown that exposure to phthalates can affect neonatal birth weight.However,epidemiological evidence on the mediating role of maternal thyroid hormones is limited.Therefore,this study,based on the Compliance Birth Cohort,aimed to reveal the potential mediating function of maternal thyroid hormones during pregnancy between phthalic acid ester(PAE)exposure and neonatal birth weight.The study included 1274 mother−infant pairs.Linear regression analysis revealed a negative association between MIBP and neonatal birth weight(β=−62.236;95%CI:−118.842,−5.631).Bayesian kernel-machine regression(BKMR)indicated a nonlinear negative association between PAE metabolites(PAEs)and birth weight.Linear regression analysis revealed a positive association between neonatal birth weight and FT3(β=41.605;95%CI:2.631,80.380).The BKMR model also found a positive association between thyroid hormones and birth weight but in a nonlinear manner.Additionally,linear regression analyses showed that TSH,TT3,TT4,FT3,and FT4 were associated with PAEs.The BKMR model revealed an inverted U-shaped association of PAEs with TT3 and FT3 and a nonlinear association with TSH,TT4,and FT4.Structural equation modeling revealed that MMP,MIBP,MBP,MEHP,MOP,MBZP,and MEOHP contributed to a net reduction in neonatal birth weight of 32 g through the TT3,FT3,TT4,and FT4 pathways.The findings suggest that exposure to PAEs during pregnancy leads to a reduction in neonatal birth weight,possibly due to the involvement of maternal thyroid hormones as mediators.Controlling maternal thyroid hormone levels during pregnancy may be a viable method to reduce the harmful effects of phthalate exposure on the developing fetus.