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Yu Z, Yan X, Bai X, Ruan G, Han W, Shu H, Yang H. Association Between Cardiovascular Health and Cirrhosis and Mortality: Insights From a Comprehensive Cross-sectional Study. J Clin Gastroenterol 2024:00004836-990000000-00306. [PMID: 38896423 DOI: 10.1097/mcg.0000000000002033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024]
Abstract
GOAL We aim to explore the relationship between the newly introduced CVH indicator "Life's Essential 8 (LE8)" and cirrhosis. BACKGROUND The global burden of cirrhosis is increasing, with a rising number of deaths, leading to significant societal and economic challenges. Cardiovascular health (CVH) has been found to have potential associations with liver diseases. MATERIALS AND METHODS All participants aged 20 and older from National Health and Nutrition Examination Survey 2005 to 2018 were included. CVH was accessed by LE8, consisting of 4 health behaviors (diet, physical activity, nicotine exposure, and sleep health) and 4 health factors (body mass index, lipid levels, blood sugar, and blood pressure). Cirrhosis was determined based on abnormal liver function test results, with an aspartate aminotransferase to platelet ratio index >2. Participants' mortality status was obtained by matching with the National Death Index and all-cause mortality served as the follow-up endpoint. RESULTS This extensive cross-sectional study reveals that LE8 was not associated with cirrhosis. A higher health behaviors score was associated with lower cirrhosis. Moreover, there is an inverse U-shaped relationship between the LE8 score and all-cause mortality in participants with cirrhosis, signifying a decrease in all-cause mortality when LE8 surpasses 60. A greater health behaviors score is linked to a decreased proportion of all-cause mortality in cirrhosis patients. CONCLUSION Maintaining better health behaviors may be beneficial for cirrhosis, especially through a balanced diet, regular exercise, smoking cessation, and quality sleep.
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Affiliation(s)
| | | | | | | | - Wei Han
- Epidemiology and Biostatistics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Yu Z, Guo M, Bai X, Ruan G, Sun Y, Han W, Yang H. Exploring the association between cardiovascular health and bowel health. Sci Rep 2024; 14:11819. [PMID: 38783080 PMCID: PMC11116406 DOI: 10.1038/s41598-024-62715-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/21/2024] [Indexed: 05/25/2024] Open
Abstract
Chronic constipation, diarrhea, and fecal incontinence have high incidence, potential disability, and socioeconomic impact, imposing a heavy burden on the quality of life. We aim to explore the association between cardiovascular health (CVH) and bowel health from National Health and Nutrition Survey 2005-2010. CVH is assessed using Life's Essential 8 (LE8). Chronic constipation, chronic diarrhea, and fecal incontinence are assessed based on Bristol Stool Form Scale classification, bowel movements, and bowel leakage. Better health behaviors (odds ratio [OR]: 0.71, 95% confidence interval [CI] 0.53-0.94, p = 0.02) and worse health factors (OR: 1.45, CI 1.03-2.04, p = 0.04) were associated with less chronic constipation. Less chronic diarrhea is correlated with better CVH (OR: 0.53, 95% CI 0.35-0.79, p = 0.003) and health factors (OR: 0.61, CI 0.46-0.81, p = 0.001). Meanwhile, the proportion of chronic diarrhea significantly decreases when the health behaviors score exceeds 59.42. Lower fecal incontinence was associated with better health behaviors (OR: 0.63, CI 0.44-0.90, p = 0.01) CVH. Better CVH and health behaviors are both linked to lower all-cause mortality in participants with chronic constipation and chronic diarrhea. A higher health behaviors score is also associated with less all-cause mortality in patients with fecal incontinence. Maintaining CVH at the population level contributes to intestinal health, achieving the dual management of both while saving on healthcare costs. However, further prospective research is needed to confirm these associations.
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Affiliation(s)
- Ziqing Yu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Mingyue Guo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Xiaoyin Bai
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Gechong Ruan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yinghao Sun
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
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Storz MA, Ronco AL. Serum levels of copper but not zinc are associated with head and chest cold in the NHANES. J Trace Elem Med Biol 2024; 82:127353. [PMID: 38071863 DOI: 10.1016/j.jtemb.2023.127353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/19/2023] [Accepted: 12/03/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Common colds are among the top reasons children miss school and adults miss work. The Centers for Disease Control and Prevention estimates that there are millions of cases of the common cold in the United States each year. The essential trace elements zinc and copper have immunomodulatory functions, and zinc has been reported to reduce the general risk of infection, whereas the copper-to-zinc ratio has been associated with an increased risk of incident infections in middle-aged men. Studies involving these two trace elements are generally scarce and were often limited to men. MATERIAL AND METHODS We used data from the National Health and Nutrition Examination Surveys (NHANES) to examine potential associations between head or chest cold events and serum levels of copper and zinc in n = 2795 NHANES participants enrolled between 2011 and 2016. RESULTS Comparing participants with and without an event of head or chest cold in the last 30 days, no significant differences were found in the serum levels of both trace elements. Notably, copper levels tended to be slightly higher in participants with a recent infection (121.56 (2.69) µg/dl) as compared to participants without infection (117.755 (1.04) µg/dl; p = 0.119). In multivariate logistic regression models adjusting for confounders, copper levels were significantly associated with increased odds for a previous head/chest cold (OR: 1.93 (CI: 1.07-3.47), p = 0.028). Notably, no significant associations were found for zinc and the copper-to-zinc ratio. CONCLUSIONS Elevated copper levels were associated with head and chest cold events in the past 30 days. Whether elevated copper levels reflect a pro-inflammatory infection-predisposing status or whether they were elevated subsequent to the infectious event in some individuals in the sense of a reversed causality remains subject to future research.
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Affiliation(s)
- Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Germany.
| | - Alvaro Luis Ronco
- Unit of Oncology and Radiotherapy, Pereira Rossell Women's Hospital, Montevideo, Uruguay; School of Medicine, CLAEH University, Prado and Salt Lake, 20100 Maldonado, Uruguay; Biomedical Sciences Center, University of Montevideo, Puntas de Santiago 1604, 11500 Montevideo, Uruguay
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Wen C, Wang J, Sun Z, Zhong R, Li M, Shen X, Ye Q, Qin K, Peng X. Dietary Zinc Ameliorates TNBS-Induced Colitis in Mice Associated with Regulation of Th1/Th2/Th17 Balance and NF-κB/NLRP3 Signaling Pathway. Biol Trace Elem Res 2024; 202:659-670. [PMID: 37249802 DOI: 10.1007/s12011-023-03715-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/23/2023] [Indexed: 05/31/2023]
Abstract
Inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis, are chronic relapsing inflammatory gastrointestinal tract diseases of uncertain origin, which are frequently associated with zinc deficiency. Animal models have a considerable value in elucidating the process of IBD. In this study, 50 male C57BL/6 J mice were randomly assigned to five groups: control group (Con), 2,4,6-trinitrobenzenesulfonic acid (TNBS) group, and three zinc supplementation groups, namely 160 ppm group, 400 ppm group, and 1000 ppm group. The results showed that supplementation of dietary zinc with zinc oxide could effectively relieve the severity of ulcerative colitis induced by TNBS in mice. We demonstrate that the protective mechanism involves the immunomodulation of dietary zinc by increasing CD3+, CD3+CD8+, and Th2 cells, suppressing Th1 and Th17 cells, and decreasing the production of serum IL-1β and IL-18. The dietary zinc oxide seems to be able to suppress the NF-κB/NLRP3 signaling pathway by downregulating the mRNA and protein expression of NIK, IKK, NF-κB, and NLRP3. The results suggest that dietary supplementation of zinc oxide may protect against colitis, and proper daily zinc supplementation may reduce the risk of IBD.
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Affiliation(s)
- Changlin Wen
- School of Pharmacy, Sichuan Industrial Institute of Antibiotics, Chengdu University, No. 2025, Chengluo Avenue, Chengdu, 610106, Sichuan, China
| | - Jiayu Wang
- School of Pharmacy, Sichuan Industrial Institute of Antibiotics, Chengdu University, No. 2025, Chengluo Avenue, Chengdu, 610106, Sichuan, China
| | - Zhenhua Sun
- Department of Technology, Sichuan Youngster Technology Co., Ltd., No. 733, Furong Avenue, Wenjiang District, Chengdu, 611130, Sichuan, China
| | - Rao Zhong
- School of Pharmacy, Sichuan Industrial Institute of Antibiotics, Chengdu University, No. 2025, Chengluo Avenue, Chengdu, 610106, Sichuan, China
| | - Mengjie Li
- Department of Technology, Sichuan Youngster Technology Co., Ltd., No. 733, Furong Avenue, Wenjiang District, Chengdu, 611130, Sichuan, China
| | - Xuemei Shen
- Department of Technology, Sichuan Youngster Technology Co., Ltd., No. 733, Furong Avenue, Wenjiang District, Chengdu, 611130, Sichuan, China
| | - Qiaobo Ye
- School of Basic Medicine Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, Sichuan, China
| | - Kaihua Qin
- School of Basic Medicine Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, Sichuan, China
| | - Xi Peng
- School of Pharmacy, Sichuan Industrial Institute of Antibiotics, Chengdu University, No. 2025, Chengluo Avenue, Chengdu, 610106, Sichuan, China.
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Zhao X, Wang L, Quan L. Association between dietary phosphorus intake and chronic constipation in adults: evidence from the National Health and Nutrition Examination Survey. BMC Gastroenterol 2023; 23:24. [PMID: 36694113 PMCID: PMC9875444 DOI: 10.1186/s12876-022-02629-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Several studies suggest a link between micronutrients and constipation. However, the relationship between constipation and phosphorus has rarely been examined. The main aim of this study was to investigate the association between changes in the prevalence of chronic constipation and dietary phosphorus intake among adult respondents of the National Health and Nutritional Examination Survey (NHANES). METHODS Data were extracted from the NHANES database for the years 2005-2010. A total of 13,948 people were included in the analysis. Dietary information was collected using the respondents' 24-h dietary records. We conducted multiple logistic regression analyses to examine the correlation between phosphorus intake and poor bowel movement. The primary and secondary outcomes was constipation defined by stool consistency and stool frequency, respectively. RESULTS Following multi-variate adjustment in model III, a significant association between chronic constipation and each additional 0.1-g intake of dietary phosphorus (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95, 1.00; P = 0.034 for stool consistency vs. OR, 0.94; 95% CI, 0.90, 0.99; P = 0.027 for stool frequency) was observed. Following multi-variate adjustment in model III, OR values and 95% CI from the second to fourth quartiles compared to the first quartile (reference group) were 0.92 (0.66, 1.27), 0.73 (0.47, 1.13), and 0.39 (0.20, 0.76), respectively, using the stool frequency definition. CONCLUSIONS This study revealed a negative correlation between phosphorus intake and chronic constipation. This may be due to the fact that dietary phosphorus intake is associated with softer stools and increased stool frequency. Further studies in different settings should be considered to verify these findings.
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Affiliation(s)
- Xuelian Zhao
- grid.464402.00000 0000 9459 9325The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, 250013 Shandong Province People’s Republic of China
| | - Lizhu Wang
- grid.479672.9Department of Anorectal, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014 Shandong Province People’s Republic of China
| | - Longfang Quan
- grid.410318.f0000 0004 0632 3409Department of Anorectal, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, 100091 People’s Republic of China
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Zhang J, Hu J, Zhao J, Li J, Cai X. Serum zinc concentrations and prediabetes and diabetes in the general population. Biol Trace Elem Res 2022; 200:1071-1077. [PMID: 33931825 DOI: 10.1007/s12011-021-02739-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
The association between serum zinc and diabetes development remains uncertain. We examined the associations between serum zinc and prediabetes and diabetes, and adult participants (≥ 20 years) from the 2011-2016 National Health and Nutrition Examination Survey. Serum zinc concentrations were measured with inductively coupled plasma dynamic reaction cell mass spectrometry. Prediabetes and diabetes were defined through questionnaires and fasting plasma glucose and hemoglobin A1c levels. Weighted logistic regression and restricted cubic splines were adopted to explore the dose-response relationships between serum zinc concentrations and prediabetes and diabetes. Comparing the highest to lowest quartile of serum zinc concentrations, the multivariable-adjusted odds ratio (95% confidence interval) of prediabetes and diabetes was 3.24 (2.33-4.52, Pfor trend < 0.01) and 1.64 (1.27-2.11, Pfor trend < 0.01), respectively. In stratified analysis by sex, the association between serum zinc concentrations and prediabetes was found in both men (3.83 (2.60-5.66), Pfor trend < 0.01) and women (2.41 (1.51-3.87), Pfor trend < 0.01), and the association between serum zinc concentrations and diabetes was also found in both men (2.05 (1.34-3.13), Pfor trend < 0.01) and women (1.65 (1.07-2.56), Pfor trend = 0.15). The association between serum zinc and prediabetes was consistent in stratified analyses by body mass index and hypertension, and the association with diabetes was also found in subjects with hypertension. Restricted cubic splines showed that the relationships between serum zinc concentrations and prediabetes and diabetes were linear, respectively. In conclusion, serum zinc concentrations were positively associated with prediabetes and diabetes in the general population, and the associations were linear. The findings need to be confirmed by prospective cohort studies.
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Affiliation(s)
- Junguo Zhang
- Department of Clinical Laboratory, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Jianwei Hu
- Department of Group Health, Maternal and Child Health Institution, Kunshan, Jiangsu, China
| | - Ji Zhao
- Department of Group Health, Maternal and Child Health Institution, Kunshan, Jiangsu, China
| | - Jin Li
- Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Xiaoqin Cai
- Department of Clinical Laboratory, Kunshan Hospital of Traditional Chinese Medicine, No.189, Chaoyang Road, Kunshan, 215300, Jiangsu, China.
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Chen F, Yang D, Wang Z. Associations Between Iron Intake and Serum Iron with Inflammatory Bowel Disease and Chronic Diarrheal Symptoms in Adults: the National Health and Nutrition Examination Survey, 2007-2010. Biol Trace Elem Res 2021; 199:4084-4091. [PMID: 33409918 DOI: 10.1007/s12011-020-02550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 12/17/2020] [Indexed: 11/24/2022]
Abstract
Iron may be involved in the etiology of inflammatory bowel disease (IBD) and chronic diarrhea by modulating gut microbiota and immune responses, but data from epidemiological studies in adults examining this relationship are limited. Thus, the aim of this study was to evaluate the association between iron intake and serum iron levels with IBD and chronic diarrhea in adults. Data from the National Health and Nutritional Examination Surveys (NHANES) between 2007 and 2010 for adults ≥ 20 years were obtained. Chronic diarrheal symptoms were determined by using the 2007-2010 NHANES questionnaire which included questions pertaining to bowel health. The presence of IBD was analyzed from the NHANES data, directly querying the presence or absence of ulcerative colitis (UC) and Crohn's disease (CD). A total of 9605 participants were initially included in this study. Multivariable logistic regression analysis was used and stratified by gender. Compared with quartile 1 (the lowest quartile), the multivariate-adjusted ORs (95% CI) for risk of having chronic diarrheal symptoms were 1.01 (0.86-1.18), 1.29 (1.07-1.56) and 1.25 (1.02-1.54) across quartiles 2 to 4 of iron intake. This significant association remained among men, but not among women in subgroup analyses. No significant association between either iron intake or serum iron level and the risk of IBD was observed. Generally, there was a positive association between iron intake and chronic diarrheal symptoms in adults that was modified by sex.
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Affiliation(s)
- Fen Chen
- Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhi Zao Ju Road, Shanghai, 200011, China
| | - Dongliang Yang
- Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhi Zao Ju Road, Shanghai, 200011, China
| | - Zhenlong Wang
- Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
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Clarke K. Addressing Fecal Incontinence in Inflammatory Bowel Disease Patients: A Messy Problem. CROHN'S & COLITIS 360 2021; 3:otab014. [PMID: 36778943 PMCID: PMC9802160 DOI: 10.1093/crocol/otab014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kofi Clarke
- Penn State College of Medicine, Milton S Hershey Medical Center, Hershey, Pennsylvania, USA,Address correspondence to: Kofi Clarke, MD, FACP, FRCP (Lond), AGAF, Department of Medicine, Penn State College of Medicine, Milton S Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA ()
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