Dietary fiber intake and its association with diabetic kidney disease in American adults with diabetes:A cross-sectional study

BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.

Association between composite dietary antioxidant index and stroke among individuals with diabetes

BACKGROUND Recent research has underscored the potentially protective role of dietary antioxidants against chronic conditions,such as cardiovascular diseases and stroke.The composite dietary antioxidant index(CDAI),which reflects the overall intake of key dietary antioxidants,has been identified as a crucial metric for exploring this relationship.Although previous research has shown a negative correlation between CDAI levels and stroke risk in prediabetic individuals,there remains a substantial gap in understanding this association among individuals with diabetes,who are at an inherently greater risk for cerebrovascular events.AIM To investigate the association between CDAI and stroke risk in individuals with diabetes.METHODS Using a cross-sectional study design,this investigation analyzed data from the National Health and Nutrition Examination Survey spanning from 2003 to 2018 that included 6735 participants aged over 20 years with diabetes.The CDAI was calculated from 24-h dietary recalls to assess intake of key antioxidants:Vitamins A,C,and E;carotenoids;selenium;and zinc.Multivariate logistic regression and restricted cubic spline analysis were used to rigorously examine the relationship between CDAI and stroke risk.RESULTS The participant cohort,with an average age of 59.5 years and a slight male majority,reflected the broader demographic characteristics of individuals with diabetes.The analysis revealed a strong inverse relationship between CDAI levels and stroke risk.Remarkably,those in the highest quintile of CDAI demonstrated a 43%lower prevalence of stroke compared to those in the lowest quintile,even after adjustments for various confounders.This finding not only highlights the negative association between CDAI and stroke risk but also underscores the significant potential of antioxidant-rich diets in reducing stroke prevalence among patients with diabetes.CONCLUSION Our findings suggested that CDAI was inversely associated with stroke prevalence among patients with diabetes.These results suggest incorporating antioxidant-rich foods into dietary regimens as a potential strategy for stroke prevention.

Role of relaxin in diastasis of the pubic symphysis peripartum

BACKGROUND Separation of the pubic symphysis can occur during the peripartum period.Relaxin(RLX)is a hormone primarily secreted by the corpus luteum that can mediate hemodynamic changes during pregnancy as well as loosen the pelvic ligaments.However,it is unknown whether RLX is associated with peripartum pubic symphysis separation and if the association is affected by other factors.AIM To study the association between RLX and peripartum pubic symphysis separation and evaluate other factors that might affect this association.METHODS We performed a cross-sectional study of pregnant women between April 2019 and January 2020.Baseline demographic characteristics,including gestational age,weight,neonatal weight,delivery mode and duration of the first and second stages of labor,were recorded.The clinical symptoms were used as a screening index during pregnancy,and the patients with pubic symphysis and inguinal pain were examined by color Doppler ultrasonography to determine whether there was pubic symphysis separation.Serum RLX concentrations were evaluated 1 d after delivery using an enzyme-linked immunosorbent assay,and pubic symphysis separation was diagnosed based on postpartum X-ray examination.We used an independent-sample t test to analyze the association between serum RLX levels and peripartum pubic symphysis separation.Multivariate regression analysis was used to evaluate whether the association between RLX and peripartum pubic symphysis separation was confounded by other factors,and the association between RLX and the severity of pubic symphysis separation was also assessed.We used Pearson correlation analysis to determine the factors related to RLX levels as well as the correlation between the degree of pubic symphysis separation and activities of daily living(ADL)and pain.RESULTS A total of 54 women were enrolled in the study,with 15 exhibiting(observational group)and 39 not exhibiting(control group)peripartum pubic symphysis separation.There were no statistically significant differences in terms of maternal age,gestational age,pre-pregnancy weight,weight gain during pregnancy,delivery modes,or duration of the first or second stages of labor between the 2 groups.We did,however,note a statistically significant difference in serum RLX concentrations and neonatal weight between the observational and control groups(122.3±0.7μg/mL vs 170.4±42.3μg/mL,P<0.05;3676.000±521.725 g vs 3379.487±402.420 g,P<0.05,respectively).Multivariate regression analyses showed that serum RLX level[odds ratio(OR):1.022)and neonatal weight(OR:1.002)were associated with pubic symphysis separation peripartum.The degree of separation of the pubic symphysis was negatively correlated with ADL and positively correlated with pain.There was no statistically significant association between serum RLX levels and the severity of pubic symphysis separation after adjusting for confounding factors.CONCLUSION Serum RLX levels and neonatal weight were associated with the occurrence,but not the severity,of peripartum pubic symphysis separation.