Antimony and sleep-related disorders: NHANES 2005-2008

Unveiling the Influence of Antimony Substitution on the Surface Properties and Adsorption Behavior of Ferrihydrite: From Molecular Mechanisms to Environmental Implications

Antimony(V) substitution is common in secondary ferrihydrite, especially in mining areas and tailings. However, its impact on the adsorption behavior of ferrihydrite is still unclear. Therefore, this study investigated the influential mechanisms of Sb(V) substitution on the lattice structure and surface properties of Sb-substituted ferrihydrite (SbFh), and its adsorption of coexisting Sb(OH)6-. Antimony(V) is substituted at Fe1 sites and is primarily distributed on the surface. Substitution has opposing effects on the outer- and inner-sphere complexation of Sb(OH)6-. On one hand, substituted-Sb(V) transfers more positive charges to ≡FeOH, reducing the number of H bonds. Subsequently, the charge saturation of ≡FeOH decreases, surface charge increases, and outer-sphere complexation is promoted. On the other hand, the elevated bond valence of Sb-O increases charge saturation of ≡FeOH, reducing the charge capacity that ≡FeOH can accommodate from inner-sphere complexes. Thus, inner-sphere complexation is inhibited. Inner-sphere complexation plays a more important role, and Sb(OH)6- adsorption is inhibited. Additionally, the primary complexation modes of Sb(OH)6- transform from bidentate to monodentate complexation. This research has important implications for understanding the environmental behavior of ferrihydrite, as well as the fate and bioavailability of antimony in mining areas and tailings.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and obstructive sleep apnea: a cross-sectional study from NHANES

BACKGROUND

Obstructive Sleep Apnea (OSA) is a widespread sleep disturbance linked to metabolic and cardiovascular conditions. The Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratios (NHHR) has been proposed as being a potential biomarker to gauge cardiovascular risk. However, its relationship with OSA remains unclear.

METHODS

This survey investigated the link NHHR to OSA in American citizens aged 20 and older using information collected via the National Health and Nutrition Examination Survey (NHANES) during the years 2017 to 2020. Logistic regression models with multivariable adjustments were employed to assess this relationship. Nonlinear associations were explored using smooth curve fitting, with a two-part linear regression model identifying a threshold effect. Subgroup analyses were conducted to evaluate population-specific differences.

RESULTS

The survey encompassed 6763 participants, with an average age of 50.75 ± 17.32. The average NHHR stood at 2.74, accompanied by a standard deviation of 1.34, while the average frequency of OSA was 49.93%. Upon adjusting for covariates, each unit increase in NHHR may be associated with a 9% rise in OSA incidence. (95% confidence intervals 1.04-1.14; P < 0.0001). Notably, a U-shaped curve depicted the NHHR-OSA relationship, with an inflection point at 4.12. Subgroup analyses revealed consistent associations, with educational attainment and diabetes status modifying the NHHR-OSA relationship.

CONCLUSION

The study highlights NHHR as a potential tool for OSA prediction, presenting avenues for advanced risk evaluation, tailored interventions, personalized treatment approaches, and preventive healthcare.

Association between dietary patterns and the risk of all-cause mortality among old adults with obstructive sleep apnea

BACKGROUND

Obstructive sleep apnea (OSA) was associated with the increased cardiovascular events and all-cause mortality. And anti-inflammatory dietary has potential to improve the prognosis of OSA. This study aimed to investigate the association of anti-inflammatory dietary patterns with all-cause mortality among individuals with OSA.

METHODS

This retrospective cohort study involved 1522 older adults with OSA from 2005 to 2008 in the National Health and Nutrition Examinations Survey (NHANES). Mortality status was determined by routine follow-up through December 31, 2019, using the National Death Index. Anti-inflammatory dietary patterns included Alternate Mediterranean Diet Score (aMED), Healthy Eating Index-2015 (HEI-2015), and Alternate Healthy Eating Index-2010 (AHEI-2010). Weighted Cox proportional hazard regression models were performed to investigate the association between anti-inflammatory dietary pattern and all-cause mortality.

RESULTS

After a median follow-up of 131 months, 604 participants were recorded all-cause mortality. The mean age of OSA patients was 68.99 years old, of whom 859 were male (52.34%). Higher adherence of aMED (HR = 0.61, 95%CI: 0.48 to 0.78) and HEI-2015 (HR = 0.75, 95%CI: 0.60 to 0.95) were associated with lower all-cause mortality risk in the elderly with OSA. Conversely, no association was found between AHEI-2010 dietary pattern and all-cause mortality in individuals with OSA. In the component analysis of aMED, it was found that a higher intake of vegetables and olive oil potentially contributes to the reduction all-cause mortality risk in the elderly with OSA (HR = 0.60, 95%CI: 0.48 to 0.76; HR = 0.67, 95%CI: 0.63 to 0.71).

CONCLUSION

Higher adherence to the aMED and the HEI-2015 was associated with a lower risk of all-cause mortality in OSA. Future interventions in the elderly with OSA should considering adopting anti-inflammatory dietary patterns.

Interaction effects between sleep-related disorders and depression on hypertension among adults: a cross-sectional study

BACKGROUND

Hypertension, sleep disorders, and depression represent notable public health issues, and their interconnected nature has long been acknowledged. The objective of this study is to explore the interplay between sleep disorders and depression in the context of hypertension.

METHODS

This cross-sectional study involved 42,143 participants aged 18 and above from the NHANES database across seven survey cycles between 2005 and 2018. After excluding those with missing data on depression, sleep disorders, and hypertension, as well as incomplete main variables, 33,383 participants remained. We used weighted logistic regression to examine the relationship between sleep disorders, depression, and hypertension. Additionally, we assessed the interaction between sleep disorders and depression on hypertension using both multiplicative and additive approaches to quantify their combined effect.

RESULTS

Compared to individuals without sleep disorders, those with sleep disorders have an increased risk of hypertension (OR = 1.51, 95% CI: 1.37-1.67). Furthermore, individuals with depression experience a significantly higher risk of hypertension compared to those with sleep disorders alone (OR = 2.34, 95% CI: 1.95-2.80). Our study reveals a positive interaction between sleep disorders and depression in relation to hypertension risk (OR = 1.07, 95% CI: 1.02-1.13). In addition, we observed the quantitative additive interaction indicators (RERI = 0.73, 95% CI: 0.56 ~ 0.92; API = 0.31, 95% CI: 0.11 ~ 0.46; SI = 2.19, 95% CI: 1.08-3.46) influencing hypertension risk. Furthermore, our research also identified that individuals with less than 7 h of sleep, a sleep latency period between 5 and 30 min, or a latency period exceeding 30 min experience a significantly increased risk of hypertension.

CONCLUSIONS

Our research uncovered separate links between sleep disorders, depression, and hypertension prevalence. Moreover, we identified an interaction between depression and sleep disorders in hypertension prevalence. Enhancing mental well-being and tackling sleep disorders could help prevent and manage hypertension. Yet, more investigation is required to establish causation and clarify mechanisms.

C-reactive protein-albumin-lymphocyte index as a feasible nutrition-immunity-inflammation marker of the outcome of all-cause and cardiovascular mortality in elderly

BACKGROUND & AIMS

The imbalance of nutrition-immunity-inflammation status might be associated with the mortality risk in the elderly. This study aimed to assess the relationship between the C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index and all-cause and cardiovascular disease (CVD) mortality in the elderly.

METHODS

The data from records of older adults (≥ 60 years) were derived from 1999 to 2010 and 2015-2018 National Health and Nutrition Examination Survey. Weighted Cox proportional hazard regression was used to analyze the relationship between CALLY and all-cause mortality and CVD mortality in three different models, and the linear trend was analyzed. A restricted cubic spline model was used to evaluate the nonlinear dose-response relationship and determine the critical threshold of CALLY to divide the population into two groups. Kaplan-Meier analysis and log-rank test were used to evaluate the cumulative survival rates of different groups. Subgroup analyses and sensitivity analyses were performed to ensure robustness.

RESULTS

Compared to the first quartile of natural log-transformation (ln) CALLY, the highest quartile of ln CALLY was negatively correlated with the risk of all-cause mortality (HR = 0.67, 95% CI: 0.56-0.79. P < 0.05) and CVD mortality (HR = 0.65, 95% CI: 0.47-0.89. P < 0.05) in model 3. Ln CALLY was linear dose-response correlated with mortality. We determined that the critical threshold for ln CALLY in elderly was 1.00. Elderly with higher ln CALLY (≥ 1.00) had significantly increased survival rates (P < 0.05).

CONCLUSION

CALLY showed a significant negative linear association with the risk of all-cause mortality and CVD mortality, and higher CALLY was beneficial to the survival outcomes of the elderly.

Association between the American Heart Association's new "Life Essentials 8" metrics and urgency urinary incontinence and nocturia

BACKGROUND

Despite its widespread adoption in cardiovascular research, the application of LE8 in other health conditions, particularly urgency urinary incontinence (UUI) and nocturia, has not been thoroughly investigated. Our study used the Life's Essential 8 (LE8) score to evaluate the relationship between cardiovascular health (CVH) and urge urinary incontinence and nocturia in adults.

METHODS

This analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011-2018. We used the LE8 score as the independent variable, and UUI and nocturia as the dependent variables. Multivariable logistic regression was conducted to explore the association between the LE8 score and the occurrence of UUI and nocturia.

RESULTS

The study included 12,566 adults aged 20 and older. After adjusting for potential confounders, a higher LE8 score was inversely associated with the risk of UUI (OR = 0.38; 95% CI: 0.27-0.52, p < 0.0001) and nocturia (OR = 0.53; 95% CI: 0.44-0.65, p < 0.0001).

CONCLUSION

This cross-sectional study revealed an inverse relationship between the LE8 score and the likelihood of both UUI and nocturia.

Combined impact of sleep and obesity on female infertility in the NHANES 2017-2020

BACKGROUND

Sleep health and obesity may affect the risk of female infertility. However, few studies focused on the interaction of obesity and sleep health on the female infertility risk. This study aimed to evaluate the combined impact of trouble sleeping / sleep duration and overweight/obesity/ abdominal obesity on the risk of female infertility.

METHODS

The data for this cross-sectional study was obtained from National Health and Nutritional Examination Survey, which provided information on trouble sleeping, sleep duration, overweight/obesity, abdominal obesity, and confounding factors. Adopted weighted univariate and multivariate logistic regression models to explore the relationship between trouble sleeping, sleep duration, overweight/obesity, abdominal obesity, and the risk of infertility, respectively, and the combined effect of trouble sleeping and overweight/obesity, trouble sleeping and abdominal obesity, sleep duration and overweight/obesity, sleep duration and abdominal obesity, on the female infertility risk.

RESULTS

This study included a total of 1,577 women, and 191 were diagnosed with infertility. Women with infertility had a higher proportion of people with overweight/obesity, abdominal obesity, sleep duration ≤ 7 h and trouble sleeping than those with non-infertility. The result indicated that trouble sleeping [odds ratio (OR) = 2.25, 95% confidence intervals (CI): 1.49-3.39], sleep duration ≤ 7 h (OR = 1.59, 95% CI: 1.03-2.48), and the combined impact of abdominal obesity and trouble sleeping (OR = 2.18, 95% CI: 1.28-3.72), abdominal obesity and sleep duration ≤ 7 h (OR = 2.00, 95% CI: 1.17-3.40), overweight/obesity and trouble sleeping (OR = 2.29, 95% CI: 1.24-4.26), and overweight/obesity and sleep duration ≤ 7 h (OR = 1.88, 95% CI: 1.01-3.49) were associated with increased odds of infertility, respectively.

CONCLUSION

There was combined effects of trouble sleeping/sleep duration ≤ 7 h and overweight/obesity/ abdominal obesity on increased odds of female infertility.

Obstructive sleep apnea (OSA) is associated with increased risk of early-onset sarcopenia and sarcopenic obesity: Results from NHANES 2015-2018

OBJECTIVE

This study aims to estimate the prevalence of early-onset sarcopenia and sarcopenic obesity in the United States and its relative risk due to obstructive sleep apnea (OSA).

METHODS

Data in this cross-sectional study were extracted from the National Health and Nutritional Examination Survey (NHANES) 2015-2018. Weighted multistage stratified probability sampling design was considered to estimate the prevalence of early-onset sarcopenia and sarcopenic obesity. Weighted multivariable logistic regression analyses and weighted multivariable mediation models were performed to evaluate the association between OSA and early-onset sarcopenia.

RESULTS

The prevalence of early-onset sarcopenia and early-onset sarcopenic obesity was estimated to be 5.5% and 4.6%, respectively. A higher prevalence of sarcopenia (12% V.S. 5.5%, P < 0.01) and sarcopenic obesity (10.3% V.S. 4.0%, P < 0.01) was observed among participants with OSA than those without OSA. Multivariable logistic regression models suggested that participants with OSA had higher odds ratios of suffering from early-onset sarcopenia [Odds Ratio (OR): 1.5, 95% confidence interval (CI):1.1-2.7] and early-onset sarcopenic obesity [OR: 1.8, 95% CI: 1.1-3.1] after adjusting for potential confounding variables. Mediation analyses suggested serum chronic reaction protein (CRP) mediated 23.7% (P < 0.01) & 26.2% (P < 0.01), homeostasis model assessment insulin resistance index (HOMA-IR) mediated 24.8% (P < 0.01) & 20.7% (P < 0.05), body mass index (BMI) mediated 46.4% (P < 0.05) & 49.9% (P < 0.01), HEI-2015 mediated 23.3% (P < 0.01) & 25.6% (P < 0.01), and Vitamin D mediated 7.5% (P < 0.01) & 8.5% (P < 0.01) of the potential effects of OSA on early-onset sarcopenia and sarcopenic obesity, respectively.

CONCLUSION

Early-onset sarcopenia and sarcopenic obesity were prevalent among young adults in the US. OSA is a significant independent risk factor and may induce muscle loss by unhealthy diet habits, higher BMI, chronic inflammation, insulin resistance, and Vitamin D. It was essential for clinicians to arrange appropriate screening and interventions for patients with OSA to prevent muscle loss as early as possible.

Association Between Home Renovation and Sleeping Problems Among Children Aged 6-18 Years: A Nationwide Survey in China

BACKGROUND

Although the indoor environment has been proposed to be associated with childhood sleep health, to our knowledge no study has investigated the association between home renovation and childhood sleep problems.

METHODS

The study included 186,470 children aged 6-18 years from the National Chinese Children Health Study (2012-2018). We measured childhood sleeping problems via the Chinese version of the Sleep Disturbance Scale for Children (C-SDSC). Information on home renovation exposure within the recent 2 years was collected via parent report. We estimated associations between home renovation and various sleeping problems, defined using both continuous and categorized (binary) C-SDSC t-scores, using generalized mixed models. We fitted models with city as a random effect variable, and other covariates as fixed effects.

RESULTS

Out of the overall participants, 89,732 (48%) were exposed to recent home renovations. Compared to the unexposed group, children exposed to home renovations had higher odds of total sleep disorder (odd ratios [OR] = 1.3; 95% confidence interval [CI] = 1.2, 1.4). Associations varied when we considered different types of home renovation materials. Children exposed to multiple types of home renovation had higher odds of sleeping problems. We observed similar findings when considering continuous C-SDSC t-scores. Additionally, sex and age of children modified the associations of home renovation exposure with some of the sleeping problem subtypes.

CONCLUSIONS

We found that home renovation was associated with higher odds of having sleeping problems and that they varied when considering the type of renovation, cumulative exposure, sex, and age differences.

Association between kidney stones and life's essential 8: a population-based study

BACKGROUND

Kidney stones exhibit a robust correlation with cardiovascular disease (CVD). The objective of this research is to investigate the correlation between kidney stones and Life's Essential 8 (LE8), a newly updated assessment of cardiovascular health (CVH), among adults in the United States.

METHODS

In this study, which analyzed data from the 2007-2018 National Health and Nutrition Examination Survey, we employed LE8 scores (ranging from 0 to 100) as the independent variable, classifying them into low, moderate, and high CVH categories. The research examined the relationship between LE8 scores and kidney stones by using multivariate logistic regression and restricted cubic spline models, with kidney stones as the dependent variable.

RESULTS

Out of the 14,117 participants in this research, the weighted mean LE8 score was 69.70 ± 0.27. After accounting for confounding factors, there was an inverse association between higher LE8 scores and the likelihood of developing kidney stones (OR of 0.81 per 10-point increase, with a 95% confidence interval of 0.77-0.85), demonstrating a non-linear dose-response pattern. Similar patterns were observed for health behaviors, health factor scores, and kidney stones. Stratified analyses demonstrated a stable negative correlation between LE8 scores and kidney stones across different subgroups.

CONCLUSION

LE8 and its subscale scores exhibited a robust and inverse correlation with the occurrence of kidney stones. Encouraging adherence to optimal CVH levels has the potential to serve as an effective strategy in preventing and minimizing the occurrence of kidney stones.

Independent and combined associations of polycyclic aromatic hydrocarbons exposure and sleep disorders among adults in the U.S. adult population

BACKGROUND

Polycyclic aromatic hydrocarbons (PAHs) are prevalent organic pollutants in the environment; however, limited research has been conducted to explore their potential effects on sleep disorders. This study aims to investigate the relationship between single and mixed PAHs exposures and sleep disorders.

METHODS

This study analyzed National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2016, involving 7730 adult participants. To examine the relationship between PAHs exposure and sleep disorders, we employed survey-weighted multivariate logistic regression models and restricted cubic spline (RCS) models to evaluate single PAHs exposure. Additionally, we employed three mixed-exposure models to examine the relationship between combined PAHs exposure and sleep disorders.

RESULTS

After adjusting for covariates, our analyses revealed positive associations between several urinary PAHs metabolites (1-hydroxynaphthalene (1-NAP), 2-NAP, 3-hydroxyfluorene (3-FLU), 2-FLU, and 1-hydroxypyrene (1-PYR)) and sleep disturbance. Consistency across various analytical methods underscores a discernible positive correlation between simultaneous exposure to PAHs and sleep disorders. This association is predominantly influenced by the presence of NAP and FLU. Remarkably, a positive relationship between combined PAHs exposure and sleep disorders emerged within the younger and middle-aged demographic but did not manifest within the elderly population.

CONCLUSION

In conclusion, our study provides new epidemiological evidence suggesting that both single and mixed PAHs exposures may increase the risk of sleep disorders. Further prospective investigations are necessary to validate these findings.

Sleep-related disorders and lower urinary tract symptoms in middle-aged and elderly males: a cross-sectional study based on NHANES 2005-2008

PURPOSE

Lower urinary tract symptoms (LUTS) and sleep disorders both commonly affect people's quality of life. This study aimed to explore the associations between sleep-related disorders and LUTS through epidemiological investigations.

METHODS

Data were generated from the cross-sectional study called the National Health and Nutrition Examination Survey (NHANES) 2005-2008. Multivariable logistic regression models were conducted to investigate the relationships between sleep-related disorders and LUTS.

RESULTS

A total of 2516 men were included in the study. Participants sleeping ≤ 6 h/night had higher odds ratios of LUTS (OR: 1.38; 95% CI 1.08, 1.77), daytime LUTS (OR: 1.26; 95% CI 1.03, 1.54), and nocturia (OR: 1.23; 95% CI 1.02, 1.49) than those sleeping 7-8 h/night. Participants who required > 30 min to fall asleep had an approximately 39% higher odds ratios of nocturia than those who fell asleep within 6 to 30 min (OR: 1.39; 95% CI 1.12, 1.73). Sleep problems were positively related to LUTS (OR: 1.42; 95% CI 1.11, 1.82), daytime LUTS (OR: 1.32; 95% CI 1.08, 1.61), urinary hesitancy (OR: 1.75; 95% CI 1.31, 2.34), and nocturia (OR: 1.52; 95% CI 1.26, 1.84). Obstructive sleep apnea (OSA) symptoms were positively associated with urinary incontinence (OR: 1.52; 95% CI 1.12, 2.08). In addition, participants with daytime sleepiness were at higher prevalence of LUTS (OR: 1.66; 95% CI 1.29, 2.15), daytime LUTS (OR: 1.44; 95% CI 1.16, 1.78), urinary hesitancy (OR: 1.95; 95% CI 1.45, 2.63), and nocturia (OR: 1.66; 95% CI 1.35, 2.05).

CONCLUSION

The findings suggested that sleep-related disorders were associated with LUTS, daytime LUTS, urinary hesitancy, incomplete emptying, urinary incontinence, and nocturia in middle-aged and elderly males.

Composite dietary antioxidant index and sleep health: a new insight from cross-sectional study

BACKGROUND

Low-quality sleep and obstructive sleep apnea (OSA) can result in series of chronic diseases. Healthy diet has been considered as an effective and simple strategy to optimize sleep quality. However, current evidence on the correlation of dietary composite antioxidant intake with sleep health remained obscure.

AIM OF THE STUDY

To determine the relationship of composite dietary antioxidant index (CDAI) and sleep health.

METHODS

Cross-sectional analyses were based on National Health and Nutrition Examination Survey (NHANES) 2005-2008. Dietary consumption was assessed by trained staff using 24-h diet recall method and CDAI was calculated based on previous validated approach that included six antioxidants. Sleep-related outcomes were self-reported by a set of questionnaires and classified into OSA, day sleepiness, and insufficient sleep. Weighted logistic regression was conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) regressions were also used to evaluate the dose-response of CDAI and three sleep-related outcomes.

RESULTS

A total of 7274 subjects included (mean age: 46.97 years) were enrolled in our study, including 3658 were females (52.54%) and 3616 were males (47.46%). Of them, 70.6%, 29.51%, and 35.57% of the subjects reported that they had OSA, day sleepiness and insufficient sleep, respectively. Logistic regression showed the highest quartile of CDAI was inversely associated with the risk of OSA (OR: 0.69, 95%CI: 0.49-0.97), day sleepiness (OR: 0.64, 95%CI: 0.44-0.94) and insufficient sleep (OR: 0.68, 95%CI: 0.50-0.92) compared with the lowest quartile. RCS showed linear relationship of CDAI and insufficient sleep but non-linear relationship of CDAI with OSA and day sleepiness.

CONCLUSIONS

Our results show that CDAI was non-linearly associated with lower risk of OSA and day sleepiness whereas a linear inverse association between CDAI and insufficient sleep was observed. These findings implicate that combined intake of antioxidants could be a promising and effective approach to optimize sleep quality for public.

The effect of the interaction of sleep onset latency and age on ischemic stroke severity via inflammatory chemokines

Objective

Prolonged sleep onset latency (PSOL) and age have been linked to ischemic stroke (IS) severity and the production of chemokines and inflammation, both of which contribute to IS development. This study aimed to explore the relationship between chemokines, inflammation, and the interplay between sleep onset latency (SOL) and age in influencing stroke severity.

Methods

A cohort of 281 participants with mild to moderate IS was enrolled. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and SOL was recorded. Serum levels of macrophage inflammatory protein-1alpha (MIP-1α), macrophage inflammatory protein-1beta (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured.

Results

NIHSS scores of middle-aged participants with PSOL were significantly higher than those with normal sleep onset latency (NSOL) (p = 0.046). This difference was also observed when compared to both the elderly with NSOL (p = 0.022), and PSOL (p < 0.001). Among middle-aged adults with PSOL, MIP-1β exhibited a protective effect on NIHSS scores (β = -0.01, t = -2.11, p = 0.039, R2 = 0.13). MIP-1α demonstrated a protective effect on NIHSS scores in the elderly with NSOL (β = -0.03, t = -2.27, p = 0.027, R2 = 0.12).

Conclusion

This study reveals a hitherto undocumented association between PSOL and IS severity, along with the potential protective effects of MIP-1β in mitigating stroke severity, especially among middle-aged patients.

Role of sleep in asthenospermia induced by di (2-ethyl-hexyl) phthalate

Di (2-ethyl-hexyl) phthalate (DEHP) mainly enters the human body through the digestive tract, respiratory tract, and skin. At the same time, it has reproductive and developmental toxicity, neurotoxicity, and so on, which can cause the decrease of sperm motility. Asthenospermia is also known as low sperm motility, and the semen quality of men in some areas of China is declining year by year. Interestingly, previous studies have shown that sleep disorders can also lead to asthenospermia. However, the relationship between sleep, DEHP, and asthenospermia is still unclear. Analysis of the National Health and Nutrition Examination Survey (NHANES) population database showed that DEHP was associated with sleep disorders, and subsequent experiments in mice and Drosophila indicated that DEHP exposure had certain effects on sleep and asthenospermia. Furthermore, we analyzed the Comparative Toxicogenomics Database (CTD) to find out the common signaling pathway among the three: hypoxia-inducible factor 1(HIF-1). Then Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) was used to screen out the proteins that DEHP affected the HIF-1 pathway: glyceraldehyde-3-phosphate dehydrogenase (GAPDH), serine/threonine-protein kinase (AKT1), epidermal growth factor receptor (EGFR), and finally Western blot analysis was used to detect the expression levels of the three proteins. Compared with the control group, DEHP decreased the protein expression levels of GAPDH and AKT1 in the HIF-1 pathway, and caused sleep disorders and decreased sperm motility. This study provides preliminary evidence for exploring the mechanism among DEHP, sleep disorders, and asthenospermia.

Association between life's essential 8 and periodontitis: a population-based study

BACKGROUND

The American Heart Association has developed a novel cardiovascular health indicator called Life's Essential 8 (LE8). However, no one has reported using LE8 to assess periodontitis. This study aimed to investigate the association between LE8 and periodontitis in American adults.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014 were used for this investigation. LE8 was the independent variable, and it is divided into three grades: high, moderate, and low. Periodontitis was the dependent variable, and the classification of periodontitis was based on the criteria of Eke in 2012. Multivariable logistic regression models were used to explore the relationship between LE8 and periodontitis.

RESULTS

A total of 9,039 participants with an average age of 52.16 ± 14.21 years were enrolled in this study, of whom 48.29% were male and 51.71% were female. The mean and standard deviation of LE8 was 66.29 ± 14.57, and the prevalence of periodontitis was 50.48% overall. The LE8 score and periodontitis in the fully adjusted logistic regression model showed a negative correlation (OR = 0.98; 95% CI, 0.98-0.99, p < 0.001). This result persisted when Life's Essential 8 was categorized into low, moderate, and high groups. Compared with those in the lowest group, those in the highest LE8 group had a 47% decreased risk of periodontitis (OR = 0.53; 95% CI, 0.46-0.66, P < 0.001).

CONCLUSIONS

This cross-sectional investigation revealed a negative relationship between the LE8 score and the likelihood of periodontitis.

Per- and polyfluoroalkyl substances and sleep health in U.S. adults, NHANES 2005-2014

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals that induce oxidative inflammatory responses and disrupt the endocrine and central nervous systems, all of which can influence sleep.

OBJECTIVE

To investigate the association between PFAS exposure and sleep health measures in U.S. adults.

METHODS

We analyzed serum concentration data of four PFAS [perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)] reported for 8913 adults in NHANES 2005-2014. Sleep outcomes, including trouble sleeping, having a diagnosis of sleep disorder, and recent daily sleep duration classified as insufficient or excessive sleep (<6 or >9 h/day) were examined. Weighted logistic regression was used to estimate the association between the sleep outcomes and each PFAS modeled continuously (log2) or in exposure tertiles. We applied quantile g-computation to estimate the effect of the four PFAS as a mixture on the sleep outcomes. We conducted a quantitative bias analysis to assess the potential influence of self-selection and uncontrolled confounding.

RESULTS

We observed some inverse associations between serum PFAS and trouble sleeping or sleep disorder, which were more consistent for PFOS (e.g., per log2-PFOS (ng/ml) and trouble sleeping OR = 0.93, 95%CI: 0.89, 0.98; sleep disorder OR = 0.89, 95%CI: 0.83, 0.95). Per quartile increase of the PFAS mixture was inversely associated with trouble sleeping and sleep disorder. No consistent associations were found for sleep duration across analyses. Our bias analysis suggests that the finding on sleep disorder could be explained by a moderate level of self-selection and negative confounding effects.

CONCLUSIONS

We found no evidence to suggest exposure to four legacy PFAS worsened self-reported sleep health among U.S. adults. While some inverse associations between specific PFAS and sleep disorder were observed, self-selection and uncontrolled confounding biases may play a role in these findings.

Analysis of the relationship between sleep-related disorder and systemic immune-inflammation index in the US population

BACKGROUND

The association between sleep-related disorders and inflammation has been demonstrated in previous studies. The systemic immune-inflammation index (SII) is a novel inflammatory index based on leukocytes, but its relationship with sleep-related disorder is unclear. We aimed to investigate the relationship between sleep-related disorder and SII in a nationally representative nonhospitalized sample.

METHODS

Data were obtained from the 2005-2008 National Health and Nutrition Examination Survey (NHANES). Exposure variables included self-reported sleep-related disorders, such as sleep duration, sleep problems, high risk of OSA, and daytime sleepiness. SII and other traditional markers of inflammation were considered as outcome variables, including platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). Multiple linear regression models were employed to examine the correlation between sleep-related disorders and inflammatory markers. Subgroup interactions were analyzed using likelihood ratio tests, and nonlinear relationships were explored by fitting restricted cubic splines.

RESULTS

A total of 8,505 participants were enrolled in this study. Overall, sleep-related disorders were found to have a stronger association with SII compared to the PLR and NLR. The results of multiple linear regression analysis revealed that participants who experienced sleep problems (β: 21.421; 95% CI 1.484, 41.358), had symptoms of OSA (β: 23.088; 95% CI 0.441, 45.735), and reported daytime sleepiness (β: 30.320; 95% CI 5.851, 54.789) exhibited a positive association with higher SII. For the analysis of other inflammatory markers, we only found that daytime sleepiness was associated with increased NLR levels (β: 0.081; 95% CI 0.002, 0.159).

CONCLUSION

Sleep problems, symptoms of OSA, and daytime sleepiness were found to have a positive association with the SII in US adults. However, further prospective studies are necessary to establish whether there is a causal relationship between these factors.

Relationship between sleep disorders and female infertility among US reproductive-aged women

PURPOSE

Sleep disorders are a risk factor for a wide variety of dysfunctions of endocrine, metabolic, cardiovascular, and neurological diseases. However, the risk of sleep disorders to female infertility has not been thoroughly explored. Our study aimed to examine whether or not sleep disorders increase the risk of female infertility.

METHODS

Cross-sectional data on sleep disorders and fertility history were obtained from the National Health and Nutrition Examination Survey 2013-2018. Women aged 20 to 40 years old were enrolled in our study. Weighted multivariable logistic regression models and stratified analysis by age, smokers, and patient health questionnaire-9 (PHQ-9) score were conducted to estimate the effect of sleep disorders on female infertility.

RESULT

Among 1820 reproductive-age females, 248 individuals had infertility and 430 individuals had sleep disorders. Two weighted logistic regression models found that sleep disorders were an independent risk factor for infertility. After adjusting for the covariates (age, race/ethnicity, marital status, education level, poverty income ratio, body mass index (BMI), waist circumference, PHQ-9 score, smokers, drinkers, and sleeping hours), the risk of infertility was 2.14-fold higher in individuals with sleep disorders than in those without. The further stratified analysis demonstrated that the relationship between sleep disorders and infertility was maintained and that the risk was higher particularly in infertile women aged 40-44 years, with PHQ-9 score greater than 10, and smokers.

CONCLUSION

A strong association was found between sleep disorders and female infertility, and the association remained after adjusting for other confounding factors.

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.

Urinary polycyclic aromatic hydrocarbon metabolites were associated with short sleep duration and self-reported trouble sleeping in US adults: data from NHANES 2005-2016 study population

Background

The aim of the current study was to investigate the link between human exposure to PAHs with short sleep duration (SSD) and self-reported trouble sleeping.

Methods

A total of 9,754 participants and 9,777 participants obtained from NHANES 2005-2016 were included in this cross-sectional study about SSD and self-reported trouble sleeping, respectively. The association between urinary PAHs metabolites with the prevalence of SSD and self-reported trouble sleeping by the weighted multivariate logistic regression model, restricted cubic spline (RCS) curves, and weighted quantile sum (WQS) regression.

Results

After adjusting for all covariates, 1-hydroxynapthalene, 2-hydroxynapthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxyphenanthrene demonstrated positive associations with SSD prevalence. Besides, 1-hydroxynapthalene, 2-hydroxynapthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxyphenanthrene exhibited positive associations with the prevalence of self-reported trouble sleeping following the adjustment for all covariates. RCS curves confirmed the non-linear associations between 1-hydroxynapthalene, 2-hydroxynapthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, and 1-hydroxyphenanthrene with the prevalence of SSD, and 1-hydroxynapthalene, 3-hydroxyfluorene, and 2-hydroxyfluorene with the prevalence of self-reported trouble sleeping. The WQS results showed that mixed exposure to PAH metabolites had a significant positive association with the prevalence of SSD (OR: 1.087, 95% CI: 1.026, 1.152, p = 0.004) and self-reported trouble sleeping (OR: 1.190, 95% CI: 1.108, 1.278, p < 0.001).

Conclusion

Urinary concentrations of PAH metabolites exhibited a close association with the prevalence of SSD and self-reported trouble sleeping in US adults. More emphasis should be placed on the importance of environmental effects on sleep health.

Dietary Intake of Flavonoids Associated with Sleep Problems: An Analysis of Data from the National Health and Nutrition Examination Survey, 2007-2010

Flavonoids possess the latent ability to protect against sleep disorders. We examined the correlation between daily flavonoid intake and sleep duration, and sleep disorders. We enrolled 8216 participants aged ≥ 20 from the National Health and Nutrition Examination Survey (NHANES, 2007-2010), carrying out a cross-sectional study. Flavonoid intake was collected by dietary intake interview recalls. Logistic regression was utilized to evaluate the association between flavonoid intake sleep duration, and sleep disorders. We used subgroup and interaction analysis to explore differences between subgroups. When adjusting covariates in model 2, anthocyanidins, flavan-3-ols, flavones, flavonols, and the sum of flavonoids were considerably related to insufficient sleep duration (odds ratio (OR) (95% confidence interval (CI)); 0.83 (0.72, 0.95); 0.91 (0.83, 0.98); 0.63 (0.41, 0.98); 0.78 (0.64, 0.94); 0.85 (0.76, 0.95), respectively); the converse association was observed between flavanones, and flavones and the risk of sleep disorders (OR (95% CI); 0.85 (0.77, 0.95); 0.61 (0.41, 0.90), respectively). In relation to insufficient sleep, there were statistically significant interactions between flavonoid consumption and race/ethnicity, and education level. In relation to insufficient sleep, there were statistically significant interactions between flavonoid consumption and working status. In this study, we found that certain flavonoids were linked to increased sleep duration and a lower risk of sleep problems. Our research indicated that flavonoids might be a preventive factor for sleep disorders.

Association of urinary heavy metals co-exposure and adult depression: Modification of physical activity

OBJECTIVE

This study aimed to evaluate the association between urinary heavy metal mixture exposure and depression, and the modifying role of physical activity in the effects of heavy metal mixture on depression risk was also considered.

METHODS

Data of this study were derived from the National Health and Nutrition Examination Survey 2011-2016. Depression was measured by the Patient Health Questionnaire. We first selected 6 (cadmium, cobalt, tin, antimony, thallium, and mercury) from 14 heavy metals through elastic net regression for further analysis. Then binomial logistic regression, generalized additive model, environment risk score (ERS), and weighted quantile sum (WQS) regression were adopted to assess the effects of six metals individual and cumulative exposure on depression risk. Finally, we also examined whether physical activity could mitigate the effects of heavy metal co-exposure on depression risk.

RESULTS

Totally, 4212 participants were included and 7.40% of subjects were with depression. We found urinary tin and antimony were separately associated with increased odds of depression (Sb: OR = 1.285, 95% CI: 1.064-1.553; Sn: OR = 1.281, 95% CI: 1.097-1.495), and a linear dose-response relationship between tin and depression was also noticed (P < 0.05). Meanwhile, urinary heavy metals co-exposure was positively related to depression risk (ERS_Q4: OR = 2.691, 95% CI: 1.399-5.174; WQS_positive: OR = 1.465, 95% CI: 1.063-2.021), in which tin, antimony, and cadmium were identified with greater contributions to the overall mixture effect. In both ERS and WQS models, the significant positive association between the metal mixture and depression risk remained only in those who were inactive in physical activity.

CONCLUSION

Our study concluded the detrimental effect of heavy metals in combined exposure on the risk of depression, which might be attenuated by physical activity.

Association of sleep problems with urinary concentrations of personal care and consumer product chemicals: a nationally representative, population-based study

Sleep problems are common in modern society and may be related to environmental chemicals. The objective of this study is to investigate the association between exposure to personal care and consumer product chemicals (PCCPCs) and sleep-related disorders. Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) were used in this study (N=2415). Sleep-related variables, including sleep duration, snoring, and self-reported sleep problems, were included as outcome variables to assess sleep quality. Urinary PCCPC concentrations were used to assess the association of PCCPCs with sleep problems and adjusted for variables similar to those used in related studies. PCCPC levels were analysed as quartiles. Multivariate logistic regression and weighted quantile sum (WQS) regression were used to analyse the association of urinary PCCPCs with sleep problems. Nine of the 12 kinds of PCCPCs with a detection rate greater than 50% were included in our study. Specifically, the concentrations of bisphenol A (BPA), bisphenol F (BPF), methyl paraben (MP) and triclosan (TCS) were significantly related to insufficient sleep. Based on the WQS model, combined exposure to PCCPCs was also significantly related to insufficient sleep; TCS, BPA, and MP were the compounds with the greatest impact regarding combined exposure. A variety of PCCPCs were associated with insufficient sleep in participants but were not significantly associated with the other sleep problems reported in the NHANES. As poor quality sleep is associated with multiple adverse health outcomes, our study provides insight into the health risks of PCCPC exposure.

Association of Pyridoxal 5′-Phosphate with Sleep-Related Problems in a General Population

The evidence on the relationship of pyridoxal 5′-phosphate (PLP) with sleep-related problems is limited and controversial. Notably, there is a lack of studies on the general population and studies of the dose–response relationship. Therefore, we conducted a cross-sectional study to examine the associations between serum PLP concentration and sleep-related problems (sleep quality and sleep duration) in adults, using the data of the National Health and Nutrition Examination Survey 2005–2010. High-performance liquid chromatography (HPLC) was used to test PLP in blood samples. Sleep quality and sleep duration were based on self-reported data, with sleep quality categorized as sleep disorder, trouble falling asleep, waking up during the night, and daytime sleepiness. The primary analyses utilized logistic regression models and restricted cubic spline. Compared with the first quartile (Q1), the odds ratios (ORs) and 95% confidence intervals (CIs) of daytime sleepiness for the Q2 and Q3 of serum PLP concentrations were 0.76 (0.59–0.99) and 0.78 (0.62–0.98), respectively. The relationship was only significant for males. Furthermore, a non-linear dose–response relationship was observed between serum PLP concentration and the risk of daytime sleepiness. Compared with the normal sleep duration group, serum PLP concentrations were negatively associated with the risks of very short, short, and long sleep duration, with relative risk ratios (RRRs) of 0.58 (0.43–0.81) (Q4), 0.71 (0.61–0.83) (Q4) and 0.62 (0.34–0.94) (Q3), respectively. The average serum PLP concentrations were higher in people with normal sleep duration, suggesting a non-linear dose–response relationship. Our study indicated that serum PLP concentrations were negatively associated with daytime sleepiness, and this association may only exist in males. Moreover, it was also inversely related to abnormal sleep duration (very short, short, long) compared to normal sleep duration.

Association of sleep-related disorders with cardiovascular disease among adults in the United States: A cross-sectional study based on national health and nutrition examination survey 2005–2008

Background and objective

The association between sleep-related disorders and cardiovascular diseases (CVDs) remains controversial and lacks epidemiological evidence in the general population. We investigated whether sleep-related disorders are related to CVDs in a large, nationally representative, diverse sample of American adults.

Materials and methods

Data were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Logistic regression was performed to explore associations of sleep-related disorders with the prevalence of total and specific CVDs. Stratified subgroup analysis was performed to exclude interactions between variables and sleep-related disorders. Non-linearity was explored using restricted cubic splines.

Results

In total, 7,850 participants aged over 20 years were included. After controlling for confounders, multivariate regression analysis showed that sleep problems were associated increases in risk of 75% for CVD (OR: 1.75; 95% CI 1.41, 2.16), 128% for congestive heart failure (CHF) (OR: 2.28; 95% CI 1.69, 3.09), 44% for coronary heart disease (CHD) (OR: 1.44; 95% CI 1.12, 1.85), 96% for angina pectoris (AP) (OR: 1.96; 95% CI 1.40, 2.74), 105% for heart attack (OR: 2.05; 95% CI 1.67, 2.53) and 78% for stroke (OR: 1.78; 95% CI 1.32, 2.40). Daytime sleepiness was associated increases in risk of 54% for CVD (OR: 1.54; 95% CI 1.25, 1.89), 73% for CHF (OR: 1.73; 95% CI 1.22, 2.46), 53% for AP (OR: 1.53; 95% CI 1.12, 2.10), 51% for heart attack (OR: 1.51; 95% CI 1.18, 1.95), and 60% for stroke (OR: 1.60; 95% CI 1.09, 2.36). Participants with insufficient sleep had a 1.42-fold higher likelihood of CVD (OR: 1.42; 95% CI 1.13, 1.78) and a 1.59-fold higher likelihood of heart attack (OR: 1.59; 95% CI 1.19, 2.13) than participants with adequate sleep. Prolonged sleep-onset latency was associated with an increased risk of CVD (OR: 1.59; 95% CI 1.17, 2.15), CHF (OR: 2.08; 95% CI 1.33, 3.23) and heart attack (OR: 1.76; 95% CI 1.29, 2.41). Short sleep-onset latency was associated with a 36% reduction in stroke risk (OR: 0.64; 95% CI 0.45, 0.90). The association of sleep problems with CVD risk was more pronounced in the group younger than 60 years (p for interaction = 0.019), and the relationship between short sleep-onset latency and total CVD differed by sex (p for interaction = 0.049). Additionally, restricted cubic splines confirmed a linear relationship between sleep-onset latency time and CVD (p for non-linearity = 0.839) and a non-linear relationship between sleep duration and CVD (p for non-linearity <0.001).

Conclusion

According to a limited NHANES sample used to examine sleep-related disorders and CVD, total and specific CVDs could be associated with certain sleep-related disorders. Additionally, our study uniquely indicates that CVD risk should be considered in participants younger than 60 years with sleep problems, and shortened sleep-onset latency may be a CVD protective factor in females.

Antimony and sleep health outcomes: NHANES 2009-2016

OBJECTIVES

Following an earlier National Health and Nutrition Examination Survey (NHANES) 2005-2008 analysis, we investigated the association between urine antimony and sleep health using more recent data, new measures of sleep health, and multiple measures of urine density adjustment in NHANES 2009-2016.

DESIGN

A cross-sectional study.

SETTING

United States, national population-based survey.

MEASUREMENTS

Multinomial logistic regression (sleep duration) and a generalized linear model with log-binomial regression (OSA, daytime sleepiness, sleep problems) were used to analyze the association of urinary antimony with sleep health outcomes. Urine creatinine and osmolality were considered, combined with statistical adjustment and standardization to account for urine density.

PARTICIPANTS

A total of 8133 adult participants over 20 years of age were used using NHANES 2009-2016.

RESULTS

We did not observe associations between urine antimony and short sleep duration or sleep problems. We observed mixed results for long sleep duration; there was a negative association in NHANES 2015-2016 and no association in NHANES 2009-2014. For self-reported symptoms of OSA, which were only available in 2015-2016, we observed a positive association for upper quartile urine antimony compared with the first quartile (RR = 1.24; 95% CI: 1.03, 1.50) and a test for trend, P= .02.

CONCLUSION

Urinary antimony was not consistently associated with short sleep duration, long sleep duration, or sleep problems, despite the findings from a relatively recent scientific article using earlier waves of NHANES. We observed a positive association between antimony and symptoms of OSA; this cross-sectional analysis requires confirmation.

The Association Between Habitual Sleep Duration and Blood Pressure Control in United States (US) Adults with Hypertension

Purpose

This study examined the relationship between habitual sleep duration and blood pressure (BP) control in adults with hypertension.

Methods

This cross-sectional study used data of 5163 adults with hypertension obtained from the 2015–2018 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression was used to analyze the association between habitual sleep duration and BP control. Habitual sleep duration was self-reported and defined as the amount of sleep usually obtained in a night or main sleep period during weekdays or workdays. It was categorized as <6, 6 - <7, 7–9, and >9 hours. BP control was defined as average systolic BP <130mmHg and diastolic BP <80mmHg.

Results

Results from the fully adjusted models show that among all adults with hypertension, habitual sleep duration of <6 hours night/main sleep period was associated with reduced odds of BP control (OR = 0.53, 95% CI: 0ss.37–0.76, P = 0.001) when compared to 7–9 hours. In the subpopulation of adults who were on antihypertensive medication, those with a sleep duration of <6 hours had lower odds of BP control than those with a sleep duration of 7–9 hours (OR = 0.53, 95% CI: 0.36–0.77, P = 0.002). No significant differences were noted in all adults with hypertension and in the subpopulation of those on antihypertensive medication in BP control between the reference sleep duration group (7–9 hours) and the 6 - <7 or >9 hours groups. There were no significant differences across age groups or gender in the relationship between habitual sleep duration and BP control.

Conclusion

Sleep duration of <6 hours is associated with reduced odds of hypertension control. These significant findings indicate that interventions to support adequate habitual sleep duration may be a promising addition to the current hypertension management guidelines.

GPX4 degradation via chaperone-mediated autophagy contributes to antimony-triggered neuronal ferroptosis

Exposure to antimony (Sb), recently identified as a nerve pollutant, can result in neuron damage; but, associated-neurotoxicological mechanisms were still not clear. Herein, we assessed the role of ferroptosis in Sb-mediated neurotoxicity and clarified the underlying mechanism. Following Sb exposure, ferroptosis was significantly promoted in vivo and in vitro. Moreover, following use of ferrostatin-1 (fer-1) to inhibit ferroptosis, Sb-induced ferroptosis in PC12 cells was effectively attenuated. Sb accelerated lysosomal transport and subsequent degradation of glutathione peroxidase 4 (GPX4), resulting in ferroptosis. Furthermore, chaperone-mediated autophagy (CMA) was activated following treatment with Sb, while inhibition of CMA by lysosomal associated protein 2 A (LAMP2A) knockdown attenuated Sb-induced GPX4 degradation. Sb treatment also increased expression of the chaperones heat shock cognate protein 70 (HSC70) and heat shock protein 90 (HSP90) and the lysosome receptor LAMP2A, and increased binding of HSP90, HSC70, and LAMP2A with GPX4 was observed, indicating increased formation of the chaperone-GPX4 complex. Finally, GPX4 overexpression significantly protected PC12 cells from activation of Sb-stimulated ferroptosis and subsequent cytotoxicity. Collectively, our results provide a original mechanism by which Sb triggers neurotoxicity, to concluded that Sb stimulates neuronal ferroptosis through CMA-mediated GPX4 degradation.

Allergy-related outcomes and sleep-related disorders in adults: a cross-sectional study based on NHANES 2005-2006

Background

Epidemiological evidence between the sleep disorders and allergy-related outcomes is limited.

Objectives

The purpose of the present study was to estimate the relationship between sleep disorders and allergy-related outcomes in adults.

Methods

We built logistic regression models to examine the associations between sleep disorders and allergy-related outcomes in adult participants using the 2005–2006 NHANES database. Allergy-related outcomes included sIgE levels, asthma, hay fever, sneezing, wheezing, and eczema. Sleep disorders included sleep latency, sleep length, sleep problems, OSA symptoms, and daytime sleepiness. A t-test was used for between-group comparisons.

Results

Participants with OSA symptoms had 2.72 × higher odds of experiencing hay fever and 1.54 × higher odds of having eczema compared to Non-OSA symptoms participants. Participants with insufficient sleep (≤ 6 h/night) had 1.27 × higher odds of developing allergic sensitisation compared to participants with adequate sleep (7–8 h/night). Sneezing was positively associated with sleep problems (OR: 1.706; 95% CI 1.386, 2.099), OSA symptoms (OR: 1.297; 95% CI 1.049, 1.605), and daytime sleepiness (OR: 1.569; 95% CI 1.205, 2.04).

Conclusion

Our findings suggest a positive association between allergy-related outcomes and sleep disorders. In particular, OSA symptoms, daytime sleepiness, and sleep problems are strongly associated with allergic conditions.

Graphical Abstract

Interactions of antimony with biomolecules and its effects on human health

Antimony (Sb) pollution has increased health risks to humans as a result of extensive application in diverse fields. Exposure to different levels of Sb and its compounds will directly or indirectly affect the normal function of the human body, whereas limited human health data and simulation studies delay the understanding of this element. In this review, we summarize current research on the effects of Sb on human health from different perspectives. First, the exposure pathways, concentration and excretion of Sb in humans are briefly introduced, and several studies have revealed that human exposure to high levels of Sb will cause higher concentrations in body tissues. Second, interactions between Sb and biomolecules or other nonbiomolecules affected biochemical processes such as gene expression and hormone secretion, which are vital for causing and understanding health effects and mechanisms. Finally, we discuss the different health effects of Sb at the biological level from small molecules to individual. In conclusion, exposure to high levels of Sb compounds will increase the risk of disease by affecting different cell signaling pathways. In addition, the appropriate form and dose of Sb contribute to inhibit the development of specific diseases. Key challenges and gaps in toxicity or benefit effects and mechanisms that still hinder risk assessment of human health are also identified in this review. Systematic studies on the relationships between the biochemical process of Sb and human health are needed.

Relationships between urinary antimony concentrations and depressive symptoms in adults

BACKGROUND

Antimony is widely used in industrial production. The general population may be exposed to long-term low-dose antimony, and there are no studies on antimony and depression symptoms. This study aims to explore the relationships between urinary antimony concentrations and depressive symptoms in adults.

METHODS

We conducted a cross-sectional study using data from U.S. National Health and Nutrition Examination Survey (NHANES) 2007-2016 for urinary antimony (N = 8538). Depressive symptoms were assessed through Patient's Health Questionnaire (PHQ-9). In order to determine the relationships between urinary antimony concentrations and depressive symptoms, binary logistic regression model and restricted cubic spline were used. Dominance analysis was used to explore the relative importance between variables associated with depressive symptoms.

RESULTS

There was a significant positive relationship between urinary antimony concentrations and depressive symptoms in the general population, and OR with 95% CI was 1.72 (1.15, 2.60). This relationship also occurred in participants without disease status, and OR with 95% CI was 2.05 (1.10, 3.82). After stratified gender, the urinary antimony concentrations were positively correlated with depressive symptoms in the highest tertiles of female participants, and OR with 95% CI was 1.74 (1.06, 2.86). After adjusted urinary lead, arsenic, cadmium, and mercury as covariates, the result was still statistically significant, and OR with 95% CI was 1.83 (1.23, 2.72). Restricted cubic spline showed a nonlinear positive relationship between urinary antimony and depressive symptoms. Based on the result of dominance analysis, the relative importance of urinary antimony concentration accounted for 3.58%.

CONCLUSION

This study indicated that urinary antimony was positively related to depressive symptoms, especially in female.

Source identification of pollution and health risks to metals in household indoor and outdoor dust: A cross-sectional study in a typical mining town, China

Dust is regarded as an important pathway of heavy metal(loid)s to the human body. Health risks posed by metal(loid)s from household dust are of particular concern. However, the contamination and sources of heavy metal(loid)s in household dust environments, as well as source identification of health risks related to heavy metal(loid)s from household dust for vulnerable populations such as children, have not been thoroughly studied in China, particularly for the areas involved with industrial activities such as ore mining. Thus, a cross-sectional study was conducted in a rural area famous for Pb/Zn ore mining, to assess the pollution sources and health risks of heavy metal(loid)s from household indoor and outdoor dust and to identify the contribution of household dust to the health risks for children. The results indicated that household environment was heavily contaminated by metal(loid)s, which were mainly attributed to mining activity. Meanwhile, the indoor/outdoor ratio and the redundancy analysis indicated that there were other pollution sources in indoor environments such as coal combustion, materials for interior building and decoration. Vapor inhalation was the main exposure pathway for Hg, while ingestion was the predominant pathway for other metal(loid)s. Although the cancer risks were relatively low, the HIt from household indoor and outdoor dust (2.19) was about twice the acceptable limit (1) and was primarily from Pb (64.52%) and As (23.42%). Outdoor dust was a larger contributor to the HI of Sb, As, Cr, Cd, Zn and Pb, which accounted for 51.37%, 58.63%, 52.14%, 59.66%, 52.87% and 64.47%, respectively, and the HIt was mainly from outdoor dust (60.76%). These results indicated that non-cancer health risks were largely from outdoor dust exposure, and strengthened the notion that concern should be given to the potential health risks from metal(loid)s in household dust both originating from mining activity and indoor environmental sources.

Association of urinary arsenic and sleep disorder in the US population: NHANES 2015-2016

Arsenic is a known carcinogen and neurotoxin and is found in the natural earth crust. Arsenic exposure can develop depression, memory dysfunction, and neurodegenerative disorder. The mechanism of arsenic toxicity on the nervous system is not known. There is a lack of research on the association between arsenic exposure and sleep disturbance in humans. This study aims to investigate the relationship between six types of urinary speciated arsenic exposure and sleep disturbance in adults from the general population using the National Health and Nutrition Examination Survey (NHANES) 2015-2016 dataset. Sleep disturbance was measured using self-reported questionnaires, asking participants if they had ever told a doctor they had trouble sleeping. We utilized multivariate logistic regression analysis using complex survey procedures to examine the association between six types of urinary arsenic concentration and trouble sleeping. The total sample included 1,611 adults who were 20 years and older. Of the study participants, 30.0% had trouble sleeping. Compared to individuals with urinary arsenous acid below the lower level of detection (LLOD), those with urinary arsenous acid at or above the detection limit had lower odds of trouble sleeping [odds ratio: 0.72 (95% confidence interval 0.51-1.00, p-value: 0.05)]. The other five types of urinary speciated arsenic studied (arsenic acid, arsenobetaine, arsenocholine, dimethylarsinic acid, monomethylarsonic acid) were not associated with a sleep disorder. More studies are required to confirm or refute these findings.

Environmental exposures and sleep outcomes: A review of evidence, potential mechanisms, and implications

Environmental exposures and poor sleep outcomes are known to have consequential effects on human health. This integrative review first seeks to present and synthesize existing literature investigating the relationship between exposure to various environmental factors and sleep health. We then present potential mechanisms of action as well as implications for policy and future research for each environmental exposure. Broadly, although studies are still emerging, empirical evidence has begun to show a positive association between adverse effects of heavy metal, noise pollution, light pollution, second-hand smoke, and air pollution exposures and various sleep problems. Specifically, these negative sleep outcomes range from subjective sleep manifestations, such as general sleep quality, sleep duration, daytime dysfunction, and daytime sleepiness, as well as objective sleep measures, including difficulties with sleep onset and maintenance, sleep stage or circadian rhythm interference, sleep arousal, REM activity, and sleep disordered breathing. However, the association between light exposure and sleep is less clear. Potential toxicological mechanisms are thought to include the direct effect of various environmental toxicants on the nervous, respiratory, and cardiovascular systems, oxidative stress, and inflammation. Nevertheless, future research is required to tease out the exact pathways of action to explain the associations between each environmental factor and sleep, to inform possible therapies to negate the detrimental effects, and to increase efforts in decreasing exposure to these harmful environmental factors to improve health.

Characteristics, Accumulation, and Potential Health Risks of Antimony in Atmospheric Particulate Matter

Antimony (Sb), a priority pollutant listed by the U.S. Environmental Protection Agency (USEPA), can cause adverse effects on human health, with particular impacts on skin, eyes, gastrointestinal tract, and respiratory system. In this study, a database of Sb concentrations in the global atmosphere was developed through a survey of measurements published in more than 600 articles, which was then used to assess the health risks of Sb exposure based on a USEPA assessment model. Most measurements showed Sb concentrations of less than ∼10 ng m-3, but those at several contaminated sites exhibited Sb concentrations of more than 100 ng m-3. For measurements conducted in urban environments, Sb concentrations in the total suspended particles (TSP) and particles of less than 10 (PM10) or 2.5 μm (PM2.5) were the highest in Asia, followed by Europe, South America, and North America. Sb concentrations were generally higher in winter and fall than during other seasons in TSP and PM10 samples. A significant correlation was observed between Sb and As in TSP and PM2.5 on a global scale. Sb was mainly derived from anthropogenic sources, especially traffic emission, industrial emission, and fossil combustion. Hazard quotients (HQ) of Sb in TSP, PM10, and PM2.5 were higher for children than adults because of their lighter body weight, inferior physical resistance, and higher ingestion probability. The global database for atmospheric Sb concentrations demonstrates a relatively low noncarcinogenic risk in most regions. Long-term monitoring is still required to identify the sources and growth potentials of Sb so that effective control policies can be established.

Association between household fuel use and sleep quality in the oldest-old: Evidence from a propensity-score matched case-control study in Hainan, China

STUDY OBJECTIVES

Emerging evidence has documented that poor sleep quality associated with adverse effects with physical, psychological and neurological disorders, which impeded healthy aging. There is limited knowledge regarding the association of household air pollution (HAP) from solid fuel use with sleep quality, particularly among the population at advanced ages. The aim of this study is to investigate this association in oldest-old (≥80 years) populations.

METHODS

China Hainan Centenarian Cohort Study was conducted in the 18 cities and counties of Hainan Province from 2015 to 2017. A total of 1725 individuals aged 80 years and older were included in the study. We used the Pittsburgh sleep quality index (PSQI) to measure individuals' sleep quality with a score of PSQI >8 indicating poor sleep quality. Solid fuel users were defined as those who primarily use coal, biomass charcoal, wood or straw for cooking in their daily life. The propensity score matching (PSM) was adopted and logistic regressions were performed based on the matched sample to estimate the association between the two factors. We adjusted for a wide range of covariates, including demographic, socioeconomic, health-related, and environmental factors.

RESULTS

After matching, a total of 1616 participants (mean [SD] age, 94.5 [9.5] years; 72.5% women) were included in the final analysis. About 50.9% of the participants used solid fuel for cooking. The average global PSQI score was 8.26 (SD = 3.3), 49.0% of them were detected as poor sleep quality with a global PSQI score >8. We found significantly higher risk of having poor sleep quality among those who were currently solid fuel users than among clean fuel users, with an odds ratio (OR) of 1.43 (95% CI: 1.14-1.80), adjusting for a wide range of confounders. The associations were more pronounced in those who did not use any ventilation (compared to those who used either mechanical or natural cooking ventilation; 1.79 [1.30-2.47] vs. 1.27 [1.01-1.53], P for interaction = 0.016) and in those who were frequent cooking at home (compared to those who never cooked; 1.65 [1.21-2.26] vs. 1.18 [0.93-1.40], P for interaction = 0.025).

CONCLUSIONS

Exposure to HAP from solid fuel combustion increases the risk of poor sleep quality at oldest-old ages. Our findings point to the need of reducing HAP from polluted fuel combustion and implementing cooking ventilation as a public health priority for healthy aging initiatives.

Associations of Urinary Phytoestrogen Concentrations with Sleep Disorders and Sleep Duration among Adults

Current evidence on the relationship of phytoestrogens with sleep is limited and contradictory. In particular, studies on individual phytoestrogens and sleep have not been reported. Thus, this study aimed to appraise the associations of individual phytoestrogens with sleep disorders and sleep duration. This cross-sectional study comprising 4830 adults utilized data from the National Health and Nutrition Examination Survey 2005-2010. Phytoestrogens were tested in urine specimens. Sleep disorders and sleep duration were based on a self-reported doctor's diagnosis and usual sleep duration. The main analyses utilized logistic and multinomial logistic regression models and a restricted cubic spline. In the fully adjusted model, compared with tertile 1 (lowest), the odds ratios (95% confidence intervals (CIs)) of sleep disorders for the highest tertile of urinary concentrations of enterolactone, enterodiol, and O-desmethylangolensin were 0.64 (0.41-1.00), 1.54 (1.07-2.21), and 1.89 (1.26-2.85), respectively. Linear inverse, approximatively linear positive, and inverted L-shaped concentration-response relationships were found between enterolactone, enterodiol, and O-desmethylangolensin and sleep disorders, respectively. Compared with normal sleep (7-8 h/night), the relative risk ratio (RRR) (95% CI) of very short sleep for enterolactone was 0.56 (0.36-0.86), and the RRR (95% CI) of long sleep risk for genistein was 0.62 (0.39-0.99). Furthermore, negative associations of genistein with sleep disorders and enterolactone with long sleep risk, as well as positive associations of enterodiol with both long and very short sleep, were observed in the stratified analysis by age or gender. Finally, a notable finding was that urinary O-desmethylangolensin concentration was positively related to sleep disorders in both females aged 40-59 years and non-Hispanic Whites but inversely associated with sleep disorders in both females aged 60 years or over and other Hispanics. Our findings suggested that enterolactone and genistein might be beneficial for preventing sleep disorders or non-normal sleep duration among adults, and enterodiol might be adverse toward this goal. However, the association of O-desmethylangolensin with sleep disorders might be discrepant in different races and females of different ages.

Air pollution exposure and adverse sleep health across the life course: A systematic review

An increasing number of epidemiological studies have examined air pollution as a possible contributor to adverse sleep health, but results are mixed. The aims of this systematic review are to investigate and summarize the associations between exposures to air pollutants and various sleep measures across the lifespan. PubMed, CINAHL, Cochrane, Scopus, Web of Science, and PsycInfo were searched through October 2019 to identify original data-based research examining direct epidemiological associations between ambient and indoor air pollution exposures and various sleep health measures, including sleep quality, sleep duration, sleep disturbances, and daytime sleepiness. Twenty-two articles from 2010 to 2019 were selected for inclusion in this review, including a wide range of study populations (from early childhood to elderly) and locations (10 Asian, 4 North American, 3 European, 5 other). Due to variation in both exposure and outcome assessments, conducting a meta-analysis was not plausible. Twenty-one studies reported a generally positive association between exposure and poor sleep quality. While most studies focused on ambient air pollutants, five assessed the specific effect of indoor exposure. In children and adolescents, increased exposure to both ambient and indoor pollutants is associated with increased respiratory sleep problems and a variety of additional adverse sleep outcomes. In adults, air pollution exposure was most notably related to sleep disordered breathing. Existing literature generally shows a negative relationship between exposures to air pollution and sleep health in populations across different age groups, countries, and measures. While many associations between air pollution and sleep outcomes have been investigated, the mixed study methods and use of subjective air pollution and sleep measures result in a wide range of specific associations. Plausible toxicological mechanisms remain inconclusive. Future studies utilizing objective sleep measures and controlling for all air pollution exposures and individual encounters may help ameliorate variability in the results reported by current published literature.

Characterization of urinary concentrations of heavy metals among socioeconomically disadvantaged black pregnant women

The objective of this study was to characterize exposures to metals using biological samples collected on socioeconomically disadvantaged black pregnant women. We obtained 131 anonymous urine samples provided by black pregnant women visiting a Medicaid-serving prenatal clinic in Houston, TX, from March 27, 2017 to April 11, 2017. We analyzed urine samples for 15 metals including cadmium (Cd), arsenic (As), lead (Pb), and nickel (Ni) and for creatinine and cotinine. We found that median concentrations of zinc (Zn), selenium (Se), and aluminum (Al) among black pregnant women in this study were 1.5 to 3 times higher than levels reported among a cohort of well-educated non-Hispanic white pregnancy planners. We also observed elevated levels of urinary Cd and antimony (Sb) as compared with those reported for a nationally representative sample of adult women in the USA. Based on the results of an exploratory factor analysis, potential sources of metal exposures in this population may arise in home environments or be due to diet, industrial and natural sources, or traffic.

Risk Factors for Depression in Empty Nesters: A Cross-Sectional Study in a Coastal City of Zhejiang Province and China

The elderly are susceptible to depression, especially empty nesters. This study investigated the risk factors associated with depression in empty nesters. The participants were selected via multi-stage random cluster sampling. Depression symptoms were assessed using the Geriatric Depression Scale. The questionnaire surveyed demographic characteristics, underlying diseases, behaviors and lifestyles, negative life experiences, social support, self-care ability, etc. Chronic health conditions, such as being overweight/obese, smoking cessation, cancer, and chronic pain, as well as negative life experiences, such as the death of a loved one and financial loss, increased the risk of depression in empty nesters. In addition, the incapability of performing self-care also increased the risk of depression in empty nesters. The prevalence of depression in empty nesters was high. Being overweight/obese, cancer, chronic pain, smoking cessation, the death of a loved one, financial loss, and the incapability to deliver self-care were risk factors for depression in empty nesters. It is recommended that comprehensive measures be taken to enhance health interventions for this population, including encouraging a proper diet and physical activity for weight control, providing psychological counseling after negative life experiences, and teaching correct methods of smoking cessation.