The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data fro...The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.展开更多
BACKGROUND: Sarcopenia and non-alcoholic fatty liver dis- ease (NAFLD) share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study invest...BACKGROUND: Sarcopenia and non-alcoholic fatty liver dis- ease (NAFLD) share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS: We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index (SMI) was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index (FLI) 〉60 in the absence of other chronic liver disease. RESULTS: Among the included subjects, 18.3% (SE: 1.4%) in men and 7.0% (SE: 0.7%) in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males: odds ratio (OR)=1.35; 95% confidence inter- val (CI): 1.17-1.54; females: OR=1.36; 95% CI: 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males (OR-1.50; 95% CI: 1.22-1.84) than in males less than 45 years of age (OR=1.25; 95% CI: 1.02-1.52) and in premenopausal females (OR=l.50; 95% CI: 1.12-2.03) than in postmenopausal females (OR-1.36; 95% CI: 1.20-1.54).CONCLUSIONS: Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.展开更多
Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed ...Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed out in recent years. Therefore, we examined the presence or absence of NCD and the number of comorbidities according to household income in Japanese, using data from the National Health and Nutrition Survey of 2010. 1287 men and 1659 women aged 20 - 79 years from households at 3 income levels (<2, 2 - 5.9, ≥6 million yen) were analyzed. Participants completed questionnaires regarding whether they had been diagnosed with NCD, as well as undergoing clinical laboratory tests. Logistic regression analyses were used for statistical analysis with adjustment for age, gender, household size, and population of municipalities. The prevalences of participants with high, medium, and low income were 22.3%, 57.6%, and 20.2%, respectively. Participants with the lowest income had the highest odds of hypertension (OR [95% confidence interval (CI)] = 1.71 [1.29 - 2.26], p p = 0.041), and stroke (5.07 [2.04 - 12.60] p < 0.001). Additionally, prevalences of participants with 2 or 3 NCD (hypertension, diabetes, and hypercholesterolemia) were 15.0% and 33.0% in high and low income levels, respectively. A low income could contribute to a high prevalence of NCD and large number of comorbidities among Japanese. Establishing a health policy in Japan is needed to enable an optimal health condition and lifestyle regardless of socioeconomic disparities.展开更多
Aim: To clarify the factors associated with reported dietary fat intake by Japanese male children. Methods: This study is based on the data of a nationally representative cross-sectional study in Japan. Three hundred ...Aim: To clarify the factors associated with reported dietary fat intake by Japanese male children. Methods: This study is based on the data of a nationally representative cross-sectional study in Japan. Three hundred and seventy-seven male children (age, 6 - 11 years) whose households were sampled in the 1995 Comprehensive Survey of Living Conditions of the People on Health and Welfare, and the 1995 National Nutrition Survey and whose parents were identified through record linkage between the 2 survey data sets were enrolled. Results: The final dataset in this study consisted of 377 boys with 329 of their parents. Fifty-two boys were found to be overweight (13.8%). The reported dietary fat intake was higher among the overweight boys than among the non-overweight boys. Maternal obesity was significantly associated with obesity in male children. Boys who frequently consumed foods from the “fats and lipids” group and the “meat” groups, and children from nuclear families rather than 3- generation families reported high dietary fat intake. In addition, parental fat intake was also significantly associated with fat intake of male children. Conclusions: Child and parental dietary habits along with the household status should be considered when implementing nutritional education programmes to control dietary fat intake and reduce the obesity risks of male children.展开更多
BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and const...BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.展开更多
BACKGROUND Dyslipidemia is frequently present in patients with diabetes.The associations of remnant cholesterol and mortality remains unclear in patients with diabetes.AIM To explore the associations of remnant choles...BACKGROUND Dyslipidemia is frequently present in patients with diabetes.The associations of remnant cholesterol and mortality remains unclear in patients with diabetes.AIM To explore the associations of remnant cholesterol with all-cause and cardiovas-cular mortality in patients with diabetes.METHODS This prospective cohort study included 4740 patients with diabetes who par-ticipated in the National Health and Nutrition Examination Survey from 1999 through 2018.Remnant cholesterol was used as the exposure variable,and all-cause and cardiovascular mortality were considered outcome events.Outcome data were obtained from the National Death Index,and all participants were followed from the interview date until death or December 31,2019.Multivariate proportional Cox regression models were used to explore the associations between exposure and outcomes,in which remnant cholesterol was modeled as both a categorical and a continuous variable.Restricted cubic splines(RCSs)were calculated to assess the nonlinearity of associations.Subgroup(stratified by sex,age,body mass index,and duration of diabetes)and a series of sensitivity analyses were performed to evaluate the robustness of the associations.RESULTS During a median follow-up duration of 83 months,1370 all-cause deaths and 389 cardiovascular deaths were documented.Patients with remnant cholesterol levels in the third quartile had a reduced risk of all-cause mortality[hazard ratio(HR)95%confidence interval(CI):0.66(0.52-0.85)];however,when remnant cholesterol was modeled as a continuous variable,it was associated with increased risks of all-cause[HR(95%CI):1.12(1.02-1.21)per SD]and cardiovascular[HR(95%CI):1.16(1.01-1.32),per SD]mortality.The RCS demonstrated nonlinear associations of remnant cholesterol with all-cause and cardiovascular mortality.Subgroup and sensitivity analyses did not reveal significant differences from the above results.CONCLUSION In patients with diabetes,higher remnant cholesterol was associated with increased risks of all-cause and cardiovascular mortality,and diabetes patients with slightly higher remnant cholesterol(0.68-1.04 mmol/L)had a lower risk of all-cause mortality.展开更多
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 betwe...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.展开更多
BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions.AIM To evaluate the association between serum estradiol level ...BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions.AIM To evaluate the association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women using population-based data.METHODS This study included 673 postmenopausal women,aged 40-59 years,from the National Health and Nutrition Examination Survey between 2013 and 2016.Weighted multivariable linear regression models were used to evaluate the association between serum E2 Level and appendicular lean mass index(ALMI).When non-linear associations were found by using weighted generalized additive model and smooth curve fitting,two-piecewise linear regression models were further applied to examine the threshold effects.RESULTS There was a positive association between serum E2 level and ALMI.Compared to individuals in quartile 1 group,those in other quartiles had higher ALMI levels.An inverted U-shaped curve relationship between serum E2 Level and ALMI was found on performing weighted generalized additive model and smooth curve fitting,and the inflection point was identified as a serum E2 level of 85 pg/mL.CONCLUSION Our results demonstrated an inverted U-shaped curve relationship between serum E2 levels and ALMI in middle-aged postmenopausal women,suggesting that low serum E2 levels play an important in the loss of muscle mass in middleaged postmenopausal women.展开更多
BACKGROUND Individuals with diabetes mellitus are more likely to experience depression,although most patients remain undiagnosed.The relation between total bilirubin and depression has been increasingly discussed,but ...BACKGROUND Individuals with diabetes mellitus are more likely to experience depression,although most patients remain undiagnosed.The relation between total bilirubin and depression has been increasingly discussed,but limited studies have examined the association of total bilirubin with depression risk in adults with diabetes,which warrants attention.AIM To investigate the association between total bilirubin levels and the risk of depression in adults with diabetes.METHODS The study included adults with diabetes from the National Health and Nutrition Examination Survey 2007-2018.Depression was determined using the Patient Health Questionnaire-9.Multivariable logistic regression,propensity scorematched analysis and restricted cubic spline models were utilized to investigate the association between total bilirubin levels and depression risk in adults with diabetes.RESULTS The study included 4758 adults with diabetes,of whom 602(12.7%)were diagnosed with depression.After adjusting for covariates,we found that diabetic adults with lower total bilirubin levels had a higher risk of depression(OR=1.230,95%CI:1.006-1.503,P=0.043).This association was further confirmed after propensity score matching(OR=1.303,95%CI:1.034-1.641,P=0.025).Subgroup analyses showed no significant dependence of age,body mass index,sex,race or hypertension on this association.Restricted cubic spline models displayed an inverted U-shaped association of total bilirubin levels with depression risk within the lower range of total bilirubin levels.The depression risk heightened with the increasing levels of total bilirubin,reaching the highest risk at 6.81μmol/L and decreasing thereafter.CONCLUSION In adults with diabetes,those with lower levels of total bilirubin were more likely to have depressive symptoms.Serum total bilirubin levels may be used as an additional indicator to assess depression risk in adults with diabetes.展开更多
Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical I...Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical Information Mart for Intensive Care(MIMIC);however,these data are often characterized by a high degree of dimensional heterogeneity,timeliness,scarcity,irregularity,and other characteristics,resulting in the value of these data not being fully utilized.Data-mining technology has been a frontier field in medical research,as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models.Therefore,data mining has unique advantages in clinical big-data research,especially in large-scale medical public databases.This article introduced the main medical public database and described the steps,tasks,and models of data mining in simple language.Additionally,we described data-mining methods along with their practical applications.The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the leading cause of chronic liver disease in children and adolescents.AIM To determine the prevalence and risk factors of steatosis and advanced fibrosis using tr...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the leading cause of chronic liver disease in children and adolescents.AIM To determine the prevalence and risk factors of steatosis and advanced fibrosis using transient elastography(TE)in the United States’adolescent population.METHODS Using the National Health and Nutrition Examination Survey 2017-2018,adolescent participants aged 13 to 17 years who underwent TE and controlled attenuation parameter(CAP)were included in this study.Forty-one factors associated with liver steatosis and fibrosis were collected.Univariate and multivariate linear regression analysis were used to identify statistically significant predictors.RESULTS Seven hundred and forty participants met inclusion criteria.Steatosis(S1-S3),based on CAP,and advanced fibrosis(F3-F4),based on TE,were present in 27%and 2.84%of the study population,respectively.Independent predictors of steatosis grade included log of alanine aminotransferase,insulin resistance,waistto-height ratio,and body mass index.Independent predictors of fibrosis grade included steatosis grade,non-Hispanic black race,smoking history,and systolic blood pressure.CONCLUSION This study demonstrated a high prevalence of steatosis in the United States’adolescent population.Almost 3%of United States’adolescents had advanced fibrosis.These findings are concerning because a younger age of onset of NAFLD can lead to an earlier development of severe disease,including steatohepatitis,cirrhosis,and liver decompensation.展开更多
BACKGROUND Due to new restrictions on the use of bisphenol A(BPA),industries are beginning to replace it with derived molecules such as bisphenol S and F(BPS and BPF).There is extensive evidence in the academic litera...BACKGROUND Due to new restrictions on the use of bisphenol A(BPA),industries are beginning to replace it with derived molecules such as bisphenol S and F(BPS and BPF).There is extensive evidence in the academic literature on the potential health effects of BPA,which is known to be a diabetogenic molecule.However,there are few publications related to new compounds derived from BPA.AIM To perform an epidemiological study of urinary BPS and BPF in the American National Health and Nutrition Examination Survey(NHANES)cohort,and analyze their possible relationship with diabetes mellitus.METHODS NHANES datasets from 2013 to 2016 were used due to the urinary BPF and BPS availability.Data from 3658 adults were analyzed to perform regression analysis exploring the possible relationship between BPA-derived compounds and diabetes.RESULTS Descriptive statistics,linear regression modeling,and logistic regression analysis revealed a significant relationship between urinary BPS,but not BPF,and diabetes risk.Additionally,a relationship was observed between both compounds and hypertension and a slight relationship between BPF and dyslipidemia.CONCLUSION In the present study,a strong relationship between urinary BPS,not BPF,and diabetes risk has been determined.BPA substitute molecules do not exempt the population from potential health risks.展开更多
BACKGROUND Protein glycosylated hemoglobin,hemoglobin A1c(HbA1c)binds hemoglobin(Hb)in red blood cells to blood glucose.However,the relationship between Hb and HbA1c remains unclear.AIM To elucidate their relationship...BACKGROUND Protein glycosylated hemoglobin,hemoglobin A1c(HbA1c)binds hemoglobin(Hb)in red blood cells to blood glucose.However,the relationship between Hb and HbA1c remains unclear.AIM To elucidate their relationship in a nondiabetic population aged≥16 years in the United States,using data from the 1999-2018 National Health and Nutrition Examination Survey.METHODS This study was based on data from 44560 adults aged≥16 years,excluding those with diabetes.The relationship was estimated using a multivariate regression.We also used piecewise linear regression for subgroup analysis based on age and sex stratification and analysis of the threshold effects of Hb on HbA1c.RESULTS Hb and HbA1c levels were negatively correlated in the unadjusted model(β=-0.01;95%CI:-0.01,-0.01).The correlation was significantly negative when the regression model was minimally regulated and stratified by age and sex,and remained negative when the model was further regulated(more than 10%)to identify covariates with the HbA1c level influence estimates.In subgroup analyses based on age and sex stratification,the association remained negative when the covariates were controlled.A nonlinear relationship was observed between them when the Hb levels reached the tipping point(13.2 g/dL)(adjusted odds ratio,-0.04;95%CI:-0.05,-0.03)and when the Hb levels exceeded 13.2 g/dL(adjusted odds ratio,-0.10;95%CI:-0.10,-0.09).CONCLUSION Our study shows that normal Hb levels are negatively correlated with HbA1c in nondiabetic Americans aged≥16 years.展开更多
目的通过对基于国家健康和营养检查调查(NHANES)数据库在肝脏疾病领域相关研究进行文献计量学统计及可视化分析,分析近20年该领域的热点和挖掘趋势。方法基于Web of Science核心数据库合集(WoSCC)以及CiteSpace分析软件,对1998年12月至2...目的通过对基于国家健康和营养检查调查(NHANES)数据库在肝脏疾病领域相关研究进行文献计量学统计及可视化分析,分析近20年该领域的热点和挖掘趋势。方法基于Web of Science核心数据库合集(WoSCC)以及CiteSpace分析软件,对1998年12月至2022年12月发表文献进行计量学可视化分析,分析内容为发表文章的年度分布、被引情况、关键词的共现、聚类、时间线图和国家、机构、基金等。结果通过对313篇基于NHANES数据库的肝脏疾病领域文献进行可视化分析显示,该领域的发文量呈逐年递增,美国是发文量及中心性居首,伊诺瓦卫生系统为发文量最多的机构,美国卫生部人类服务部是资助该领域最多的基金资助机构,对关键词共现、聚类、时间线图分析提示非酒精性脂肪性肝病、代谢相关脂肪性肝病(MAFLD)、肝纤维化、代谢综合征方面为研究热门。结论代谢性肝病、病毒性肝炎和肝纤维化是肝病的主要研究热点。流行病学调查、危险因素评估和诊断方法是主要的分析方法。营养干预和肝病预防是未来的研究方向。机器学习在数据挖掘中具有广泛的适用性。展开更多
目的探索美国成年人的膳食模式和高尿酸血症(hyperuricemia,HUA)之间的关系。方法本研究基于美国国家健康和营养调查(National Health and Nutrition Examination Survey,NHANES)2007-2018年人群数据开展研究。按纳入排除标准,最终纳入2...目的探索美国成年人的膳食模式和高尿酸血症(hyperuricemia,HUA)之间的关系。方法本研究基于美国国家健康和营养调查(National Health and Nutrition Examination Survey,NHANES)2007-2018年人群数据开展研究。按纳入排除标准,最终纳入25526名美国成年居民。采用主成分分析提取调查对象的膳食模式,利用限制立方样条(restricted cubic spline,RCS)回归模型检测各膳食模式因子得分与HUA之间可能的线性或非线性依赖关系。采用3个节点的RCS进行建模分析,调整了所有混杂因素。将膳食模式因子得分四分位后,以最低四分位为参考,采用多因素logistic回归分析不同的膳食模式与HUA患病风险的关系。logistic回归模型中协变量包括年龄、性别、种族、教育程度、家庭收入贫困率、体质量指数(body mass index,BMI)、吸烟、饮酒、身体活动、膳食补充剂使用、健康饮食指数、总能量和高嘌呤食物摄入。结果利用主成分分析共提取出3种膳食模式,分别为脂肪-加工谷物-奶酪-添加糖(fat-processed-grains-cheese-added sugars,FPCS)模式、油-蔬菜-坚果-全谷物(oil-vegetables-nuts-whole grains,OVNW)模式和油-白薯-饮料-海产品(oil-white potatoes-drink-seafood,OPDS)模式。RCS分析表明,FPCS模式得分与HUA患病风险呈线性关系(P-线性<0.001),FPCS模式得分越高,HUA患病率降低。OVNW模式得分与HUA患病风险呈线性关系(P-线性<0.001),OVNW模式得分越高,HUA患病率降低。OPDS模式得分与HUA患病风险呈线性关系(P-线性<0.001)。OPDS模式得分越高,HUA患病率增加。在多因素logistic回归中,FPCS和OVNW模式与HUA患病风险呈负相关(Q4:OR=0.74,95%CI:0.62~0.87)和(Q4:OR=0.76,95%CI:0.66~0.87)。而OPDS模式与HUA患病风险呈正相关(Q4:OR=1.54,95%CI:1.41~1.70)。结论FPCS和OVNW模式与美国成人HUA患病风险的降低有关,而OPDS模式与HUA患病风险增加有关。展开更多
基金This study was supported by the Jungwon University Research Grant(2021-044).
文摘The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.
文摘BACKGROUND: Sarcopenia and non-alcoholic fatty liver dis- ease (NAFLD) share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS: We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index (SMI) was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index (FLI) 〉60 in the absence of other chronic liver disease. RESULTS: Among the included subjects, 18.3% (SE: 1.4%) in men and 7.0% (SE: 0.7%) in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males: odds ratio (OR)=1.35; 95% confidence inter- val (CI): 1.17-1.54; females: OR=1.36; 95% CI: 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males (OR-1.50; 95% CI: 1.22-1.84) than in males less than 45 years of age (OR=1.25; 95% CI: 1.02-1.52) and in premenopausal females (OR=l.50; 95% CI: 1.12-2.03) than in postmenopausal females (OR-1.36; 95% CI: 1.20-1.54).CONCLUSIONS: Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.
文摘Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed out in recent years. Therefore, we examined the presence or absence of NCD and the number of comorbidities according to household income in Japanese, using data from the National Health and Nutrition Survey of 2010. 1287 men and 1659 women aged 20 - 79 years from households at 3 income levels (<2, 2 - 5.9, ≥6 million yen) were analyzed. Participants completed questionnaires regarding whether they had been diagnosed with NCD, as well as undergoing clinical laboratory tests. Logistic regression analyses were used for statistical analysis with adjustment for age, gender, household size, and population of municipalities. The prevalences of participants with high, medium, and low income were 22.3%, 57.6%, and 20.2%, respectively. Participants with the lowest income had the highest odds of hypertension (OR [95% confidence interval (CI)] = 1.71 [1.29 - 2.26], p p = 0.041), and stroke (5.07 [2.04 - 12.60] p < 0.001). Additionally, prevalences of participants with 2 or 3 NCD (hypertension, diabetes, and hypercholesterolemia) were 15.0% and 33.0% in high and low income levels, respectively. A low income could contribute to a high prevalence of NCD and large number of comorbidities among Japanese. Establishing a health policy in Japan is needed to enable an optimal health condition and lifestyle regardless of socioeconomic disparities.
文摘Aim: To clarify the factors associated with reported dietary fat intake by Japanese male children. Methods: This study is based on the data of a nationally representative cross-sectional study in Japan. Three hundred and seventy-seven male children (age, 6 - 11 years) whose households were sampled in the 1995 Comprehensive Survey of Living Conditions of the People on Health and Welfare, and the 1995 National Nutrition Survey and whose parents were identified through record linkage between the 2 survey data sets were enrolled. Results: The final dataset in this study consisted of 377 boys with 329 of their parents. Fifty-two boys were found to be overweight (13.8%). The reported dietary fat intake was higher among the overweight boys than among the non-overweight boys. Maternal obesity was significantly associated with obesity in male children. Boys who frequently consumed foods from the “fats and lipids” group and the “meat” groups, and children from nuclear families rather than 3- generation families reported high dietary fat intake. In addition, parental fat intake was also significantly associated with fat intake of male children. Conclusions: Child and parental dietary habits along with the household status should be considered when implementing nutritional education programmes to control dietary fat intake and reduce the obesity risks of male children.
文摘BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.
基金Supported by Project of National Natural Science Foundation of China,No.82274345 and No.82104907Fundamental Research Funds for the Central public welfare research institutes Grant,No.ZZ13-YQ-016 and No.ZZ13-YQ-016-C1.
文摘BACKGROUND Dyslipidemia is frequently present in patients with diabetes.The associations of remnant cholesterol and mortality remains unclear in patients with diabetes.AIM To explore the associations of remnant cholesterol with all-cause and cardiovas-cular mortality in patients with diabetes.METHODS This prospective cohort study included 4740 patients with diabetes who par-ticipated in the National Health and Nutrition Examination Survey from 1999 through 2018.Remnant cholesterol was used as the exposure variable,and all-cause and cardiovascular mortality were considered outcome events.Outcome data were obtained from the National Death Index,and all participants were followed from the interview date until death or December 31,2019.Multivariate proportional Cox regression models were used to explore the associations between exposure and outcomes,in which remnant cholesterol was modeled as both a categorical and a continuous variable.Restricted cubic splines(RCSs)were calculated to assess the nonlinearity of associations.Subgroup(stratified by sex,age,body mass index,and duration of diabetes)and a series of sensitivity analyses were performed to evaluate the robustness of the associations.RESULTS During a median follow-up duration of 83 months,1370 all-cause deaths and 389 cardiovascular deaths were documented.Patients with remnant cholesterol levels in the third quartile had a reduced risk of all-cause mortality[hazard ratio(HR)95%confidence interval(CI):0.66(0.52-0.85)];however,when remnant cholesterol was modeled as a continuous variable,it was associated with increased risks of all-cause[HR(95%CI):1.12(1.02-1.21)per SD]and cardiovascular[HR(95%CI):1.16(1.01-1.32),per SD]mortality.The RCS demonstrated nonlinear associations of remnant cholesterol with all-cause and cardiovascular mortality.Subgroup and sensitivity analyses did not reveal significant differences from the above results.CONCLUSION In patients with diabetes,higher remnant cholesterol was associated with increased risks of all-cause and cardiovascular mortality,and diabetes patients with slightly higher remnant cholesterol(0.68-1.04 mmol/L)had a lower risk of all-cause mortality.
文摘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.
基金The Institutional Review Board of the National Center for Health Statistics(NCHS)approved the survey protocols(Protocol#2011-17).
文摘BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions.AIM To evaluate the association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women using population-based data.METHODS This study included 673 postmenopausal women,aged 40-59 years,from the National Health and Nutrition Examination Survey between 2013 and 2016.Weighted multivariable linear regression models were used to evaluate the association between serum E2 Level and appendicular lean mass index(ALMI).When non-linear associations were found by using weighted generalized additive model and smooth curve fitting,two-piecewise linear regression models were further applied to examine the threshold effects.RESULTS There was a positive association between serum E2 level and ALMI.Compared to individuals in quartile 1 group,those in other quartiles had higher ALMI levels.An inverted U-shaped curve relationship between serum E2 Level and ALMI was found on performing weighted generalized additive model and smooth curve fitting,and the inflection point was identified as a serum E2 level of 85 pg/mL.CONCLUSION Our results demonstrated an inverted U-shaped curve relationship between serum E2 levels and ALMI in middle-aged postmenopausal women,suggesting that low serum E2 levels play an important in the loss of muscle mass in middleaged postmenopausal women.
文摘BACKGROUND Individuals with diabetes mellitus are more likely to experience depression,although most patients remain undiagnosed.The relation between total bilirubin and depression has been increasingly discussed,but limited studies have examined the association of total bilirubin with depression risk in adults with diabetes,which warrants attention.AIM To investigate the association between total bilirubin levels and the risk of depression in adults with diabetes.METHODS The study included adults with diabetes from the National Health and Nutrition Examination Survey 2007-2018.Depression was determined using the Patient Health Questionnaire-9.Multivariable logistic regression,propensity scorematched analysis and restricted cubic spline models were utilized to investigate the association between total bilirubin levels and depression risk in adults with diabetes.RESULTS The study included 4758 adults with diabetes,of whom 602(12.7%)were diagnosed with depression.After adjusting for covariates,we found that diabetic adults with lower total bilirubin levels had a higher risk of depression(OR=1.230,95%CI:1.006-1.503,P=0.043).This association was further confirmed after propensity score matching(OR=1.303,95%CI:1.034-1.641,P=0.025).Subgroup analyses showed no significant dependence of age,body mass index,sex,race or hypertension on this association.Restricted cubic spline models displayed an inverted U-shaped association of total bilirubin levels with depression risk within the lower range of total bilirubin levels.The depression risk heightened with the increasing levels of total bilirubin,reaching the highest risk at 6.81μmol/L and decreasing thereafter.CONCLUSION In adults with diabetes,those with lower levels of total bilirubin were more likely to have depressive symptoms.Serum total bilirubin levels may be used as an additional indicator to assess depression risk in adults with diabetes.
基金the National Social Science Foundation of China(No.16BGL183).
文摘Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical Information Mart for Intensive Care(MIMIC);however,these data are often characterized by a high degree of dimensional heterogeneity,timeliness,scarcity,irregularity,and other characteristics,resulting in the value of these data not being fully utilized.Data-mining technology has been a frontier field in medical research,as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models.Therefore,data mining has unique advantages in clinical big-data research,especially in large-scale medical public databases.This article introduced the main medical public database and described the steps,tasks,and models of data mining in simple language.Additionally,we described data-mining methods along with their practical applications.The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the leading cause of chronic liver disease in children and adolescents.AIM To determine the prevalence and risk factors of steatosis and advanced fibrosis using transient elastography(TE)in the United States’adolescent population.METHODS Using the National Health and Nutrition Examination Survey 2017-2018,adolescent participants aged 13 to 17 years who underwent TE and controlled attenuation parameter(CAP)were included in this study.Forty-one factors associated with liver steatosis and fibrosis were collected.Univariate and multivariate linear regression analysis were used to identify statistically significant predictors.RESULTS Seven hundred and forty participants met inclusion criteria.Steatosis(S1-S3),based on CAP,and advanced fibrosis(F3-F4),based on TE,were present in 27%and 2.84%of the study population,respectively.Independent predictors of steatosis grade included log of alanine aminotransferase,insulin resistance,waistto-height ratio,and body mass index.Independent predictors of fibrosis grade included steatosis grade,non-Hispanic black race,smoking history,and systolic blood pressure.CONCLUSION This study demonstrated a high prevalence of steatosis in the United States’adolescent population.Almost 3%of United States’adolescents had advanced fibrosis.These findings are concerning because a younger age of onset of NAFLD can lead to an earlier development of severe disease,including steatohepatitis,cirrhosis,and liver decompensation.
基金Supported by the Instituto de Salud Carlos III,No. PI15/02139Comunidad Autónoma de Madrid,No. B2017-BMD-3686
文摘BACKGROUND Due to new restrictions on the use of bisphenol A(BPA),industries are beginning to replace it with derived molecules such as bisphenol S and F(BPS and BPF).There is extensive evidence in the academic literature on the potential health effects of BPA,which is known to be a diabetogenic molecule.However,there are few publications related to new compounds derived from BPA.AIM To perform an epidemiological study of urinary BPS and BPF in the American National Health and Nutrition Examination Survey(NHANES)cohort,and analyze their possible relationship with diabetes mellitus.METHODS NHANES datasets from 2013 to 2016 were used due to the urinary BPF and BPS availability.Data from 3658 adults were analyzed to perform regression analysis exploring the possible relationship between BPA-derived compounds and diabetes.RESULTS Descriptive statistics,linear regression modeling,and logistic regression analysis revealed a significant relationship between urinary BPS,but not BPF,and diabetes risk.Additionally,a relationship was observed between both compounds and hypertension and a slight relationship between BPF and dyslipidemia.CONCLUSION In the present study,a strong relationship between urinary BPS,not BPF,and diabetes risk has been determined.BPA substitute molecules do not exempt the population from potential health risks.
文摘BACKGROUND Protein glycosylated hemoglobin,hemoglobin A1c(HbA1c)binds hemoglobin(Hb)in red blood cells to blood glucose.However,the relationship between Hb and HbA1c remains unclear.AIM To elucidate their relationship in a nondiabetic population aged≥16 years in the United States,using data from the 1999-2018 National Health and Nutrition Examination Survey.METHODS This study was based on data from 44560 adults aged≥16 years,excluding those with diabetes.The relationship was estimated using a multivariate regression.We also used piecewise linear regression for subgroup analysis based on age and sex stratification and analysis of the threshold effects of Hb on HbA1c.RESULTS Hb and HbA1c levels were negatively correlated in the unadjusted model(β=-0.01;95%CI:-0.01,-0.01).The correlation was significantly negative when the regression model was minimally regulated and stratified by age and sex,and remained negative when the model was further regulated(more than 10%)to identify covariates with the HbA1c level influence estimates.In subgroup analyses based on age and sex stratification,the association remained negative when the covariates were controlled.A nonlinear relationship was observed between them when the Hb levels reached the tipping point(13.2 g/dL)(adjusted odds ratio,-0.04;95%CI:-0.05,-0.03)and when the Hb levels exceeded 13.2 g/dL(adjusted odds ratio,-0.10;95%CI:-0.10,-0.09).CONCLUSION Our study shows that normal Hb levels are negatively correlated with HbA1c in nondiabetic Americans aged≥16 years.
文摘目的通过对基于国家健康和营养检查调查(NHANES)数据库在肝脏疾病领域相关研究进行文献计量学统计及可视化分析,分析近20年该领域的热点和挖掘趋势。方法基于Web of Science核心数据库合集(WoSCC)以及CiteSpace分析软件,对1998年12月至2022年12月发表文献进行计量学可视化分析,分析内容为发表文章的年度分布、被引情况、关键词的共现、聚类、时间线图和国家、机构、基金等。结果通过对313篇基于NHANES数据库的肝脏疾病领域文献进行可视化分析显示,该领域的发文量呈逐年递增,美国是发文量及中心性居首,伊诺瓦卫生系统为发文量最多的机构,美国卫生部人类服务部是资助该领域最多的基金资助机构,对关键词共现、聚类、时间线图分析提示非酒精性脂肪性肝病、代谢相关脂肪性肝病(MAFLD)、肝纤维化、代谢综合征方面为研究热门。结论代谢性肝病、病毒性肝炎和肝纤维化是肝病的主要研究热点。流行病学调查、危险因素评估和诊断方法是主要的分析方法。营养干预和肝病预防是未来的研究方向。机器学习在数据挖掘中具有广泛的适用性。
文摘目的探索美国成年人的膳食模式和高尿酸血症(hyperuricemia,HUA)之间的关系。方法本研究基于美国国家健康和营养调查(National Health and Nutrition Examination Survey,NHANES)2007-2018年人群数据开展研究。按纳入排除标准,最终纳入25526名美国成年居民。采用主成分分析提取调查对象的膳食模式,利用限制立方样条(restricted cubic spline,RCS)回归模型检测各膳食模式因子得分与HUA之间可能的线性或非线性依赖关系。采用3个节点的RCS进行建模分析,调整了所有混杂因素。将膳食模式因子得分四分位后,以最低四分位为参考,采用多因素logistic回归分析不同的膳食模式与HUA患病风险的关系。logistic回归模型中协变量包括年龄、性别、种族、教育程度、家庭收入贫困率、体质量指数(body mass index,BMI)、吸烟、饮酒、身体活动、膳食补充剂使用、健康饮食指数、总能量和高嘌呤食物摄入。结果利用主成分分析共提取出3种膳食模式,分别为脂肪-加工谷物-奶酪-添加糖(fat-processed-grains-cheese-added sugars,FPCS)模式、油-蔬菜-坚果-全谷物(oil-vegetables-nuts-whole grains,OVNW)模式和油-白薯-饮料-海产品(oil-white potatoes-drink-seafood,OPDS)模式。RCS分析表明,FPCS模式得分与HUA患病风险呈线性关系(P-线性<0.001),FPCS模式得分越高,HUA患病率降低。OVNW模式得分与HUA患病风险呈线性关系(P-线性<0.001),OVNW模式得分越高,HUA患病率降低。OPDS模式得分与HUA患病风险呈线性关系(P-线性<0.001)。OPDS模式得分越高,HUA患病率增加。在多因素logistic回归中,FPCS和OVNW模式与HUA患病风险呈负相关(Q4:OR=0.74,95%CI:0.62~0.87)和(Q4:OR=0.76,95%CI:0.66~0.87)。而OPDS模式与HUA患病风险呈正相关(Q4:OR=1.54,95%CI:1.41~1.70)。结论FPCS和OVNW模式与美国成人HUA患病风险的降低有关,而OPDS模式与HUA患病风险增加有关。