Prevalence of hypertension, diabetes, obesity, multimorbidity, and related risk factors among adult Gambians: a cross-sectional nationwide study

The Cross-Sectional Association Between Multimorbidity and Sleep Quality and Duration Among the Elderly Community Dwellers in Northwest China

Background

Multimorbidity, defined as the coexistence of two or more chronic diseases, is highly prevalent among the elderly population and is associated with adverse outcomes. However, little is known about its relationship with sleep issues, particularly in this demographic. Therefore, this study aimed to investigate its association with sleep quality and duration among the elderly.

Methods

This cross-sectional study was conducted in Emin County, Xinjiang, China, which included a population aged 60 years and above. We employed the Pittsburgh Sleep Quality Index (PSQI) score to assess sleep quality and duration. Multimorbidity was determined through self-reports, physical examination, blood tests, and imaging. Logistic regression analyses were used to explore the association between multimorbidity and sleep patterns, adjusting for confounders.

Results

A total of 8205 elderly participants were included, of whom 66.8% suffered from multimorbidity. Participants with multimorbidity exhibited higher total PSQI scores [6 (3,9)], and a higher percentage of poor sleep quality (50.6%), compared to those without multimorbidity. Multimorbidity was significantly associated with the presence of poor sleep quality (OR = 1.27, 95% CI: 1.14-1.41, P < 0.001) before and after adjusting for confounders. The risk of having poor sleep quality significantly increased as the number of multimorbidities increased. The OR (95% CI) values were 1.16 (1.02,1.32) for two diseases, 1.54 (1.26,1.90) for ≥5 diseases. In the adjusted model for total participants, having four diseases (OR = 1.26, 95% CI: 1.05-1.51, p = 0.013) and five or more diseases (OR = 1.29, 95% CI: 1.03-1.61, p = 0.029) were associated with shorter sleep duration. Furthermore, those with five or more diseases associated with longer sleep duration (OR = 1.40, 95% CI: 1.00-1.95, p = 0.057).

Conclusion

There is a significant association between multimorbidity and poor sleep quality in older community dwellers, which may provide clues for disease prevention.

New concepts in the roles of AMPK in adipocyte stem cell biology

Obesity is a major risk factor for many life-threatening diseases. Adipose tissue dysfunction is emerging as a driving factor in the transition from excess adiposity to comorbidities such as metabolic-associated fatty liver disease, cardiovascular disease, Type 2 diabetes and cancer. However, the transition from healthy adipose expansion to the development of these conditions is poorly understood. Adipose stem cells, residing in the vasculature and stromal regions of subcutaneous and visceral depots, are responsible for the expansion and maintenance of organ function, and are now recognised as key mediators of pathological transformation. Impaired tissue expansion drives inflammation, dysregulation of endocrine function and the deposition of lipids in the liver, muscle and around vital organs, where it is toxic. Contrary to previous hypotheses, it is the promotion of healthy adipose tissue expansion and function, not inhibition of adipogenesis, that presents the most attractive therapeutic strategy in the treatment of metabolic disease. AMP-activated protein kinase, a master regulator of energy homeostasis, has been regarded as one such target, due to its central role in adipose tissue lipid metabolism, and its apparent inhibition of adipogenesis. However, recent studies utilising AMP-activated protein kinase (AMPK)-specific compounds highlight a more subtle, time-dependent role for AMPK in the process of adipogenesis, and in a previously unexplored repression of leptin, independent of adipocyte maturity. In this article, I discuss historic evidence for AMPK-mediated adipogenesis inhibition and the multi-faceted roles for AMPK in adipose tissue.

Musculoskeletal Multimorbidity Burden and Trajectory in Relation to Later-Life Holistic Well-Being Among Middle-Aged and Elderly Individuals: A Prospective Study

OBJECTIVES

Understanding the patterns and implications of coexisting musculoskeletal conditions is crucial for developing effective management strategies and improving care for older adults. This study aimed to examine the associations between musculoskeletal multimorbidity burden and trajectory and holistic well-being among middle-aged and older adults.

METHODS

This prospective study employed data from nine consecutive waves of the English Longitudinal Study of Aging (ELSA), spanning 2002-2018. We used latent class trajectory models (LCTM) to identify groups based on changes in musculoskeletal multimorbidity status. Subsequently, we employed linear mixed models to investigate the associations between musculoskeletal disease burden, trajectory groups, and seven dimensions of holistic well-being: Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), depression, memory, loneliness, social interactions, and life satisfaction.

RESULTS

In total, 5272 participants (mean age: 71.9 years; SD: 8.9) were included in the final analysis. Four distinct trajectories were identified: a low-burden group (48.37%), an emerging group (14.76%), a moderate-burden group (26.00%), and a persistent burden group (10.87%). After adjustment, the findings demonstrate that the musculoskeletal disorder burden significantly impacts ADLs, depression, memory, social interactions, and life satisfaction in middle-aged and older adults, with minor effects on IADLs and loneliness. Moreover, with the escalation of the burden, its impact significantly intensifies (p for trend is < 0.001). Compared with the low-burden group, participants in both the moderate and persistent burden groups exhibited significantly lower capabilities in ADLs, poorer memory, increased social interactions, and lower life satisfaction. The emerging group displayed a similar trend, though without statistically significant results.

CONCLUSIONS

Our study suggests that the extent and persistence of musculoskeletal disease burden can significantly affect holistic well-being among middle-aged and older individuals.

Associations of multiple serum metals with the risk of metabolic syndrome among the older population in China based on a community study: A mediation role of peripheral blood cells

Metal exposure has been reported to be associated with metabolic syndrome (MetS), however, the evidence remains inconclusive, particularly in elderly individuals. From May to July 2016, serum levels of 16 metals were measured using inductively coupled plasma mass spectrometry (ICP-MS) in 852 elderly individuals (≥65 years) residing in Wuhan, China. Biological detection and disease recognition were based on individual surveys conducted during health check-ups. Spearman's rank correlation analysis was performed to identify the correlation among serum metals. The data were Ln-transformed to fit a normal distribution for further analyses. Linear and logistic regression were applied to explore the associations between metals and diseases. Restricted cubic spline (RCS) analysis was utilized to examine dose-response relationships. The Weighted Quantile Sum (WQS) score was applied to determine the empirical weights of each heavy metal in the context of their combined effect on metabolic diseases. The prevalence of MetS, hypertension, diabetes, and hyperlipidemia were 46.36 %, 68.90 %, 24.65 %, and 21.60 %, respectively. Serum metal mixture was positively associated with the prevalence of MetS (OR = 1.92, 95 % CI: 1.30-2.82), hypertension (OR = 1.50, 95 % CI: 1.01-2.23), and diabetes (OR = 2.18, 95 % CI: 1.48-3.22). In single metal models, we found that serum zinc levels were associated with an increased risk of MetS, while rubidium had a protective effect against MetS. Interestingly, different metals had distinct effects on specific diseases in this study: lithium and barium were more likely to influence blood pressure, while selenium had a more significant effect on blood glucose. Lipids were more susceptible to the effects of zinc, selenium, and strontium. Platelet count (PLT) and lymphocyte count (LYM) mediated the association between selenium exposure and hyperlipidemia, while neutrophil count (NEU) mediated the relationship between serum rubidium exposure and MetS. Our findings offer valuable etiological insights into the relationship between serum heavy metals and the prevalence of MetS, suggesting that peripheral blood cells may play a mediating role in this association.

Differences in cervical length during the second trimester among normal weight, overweight and obese women: A systematic review and meta-analysis

Objective

Maternal obesity has been previously linked to increased risk of preterm birth; however, the actual pathophysiology behind this observation remains unknown. Cervical length seems to differentiate among overweight, obese and extremely obese patients, compared to normal weight women. However, to date the actual association between body mass index and cervical length remains unknown. In this systematic review, accumulated evidence is presented to help establish clinical implementations and research perspectives.

Methods

We searched Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar, and Clinicaltrials.gov databases from inception till February 2023. Observational studies that reported on women undergone ultrasound assessment of their cervical length during pregnancy were included, when there was data regarding their body mass index. Statistical meta-analysis was performed with RStudio. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS).

Results

Overall, 20 studies were included in this systematic review and 12 in the meta-analysis. Compared to women with normal weight, underweight women were not associated with increased risk of CL < 15 mm or < 30 mm and their mean CL was comparable (MD -1.51; 95% CI -3.07, 0.05). Overweight women were found to have greater cervical length compared to women with normal weight (MD 1.87; 95% CI 0.52, 3.23) and had a lower risk of CL < 30 mm (OR 0.65; 95% CI 0.47, 0.90).

Conclusion

Further research into whether BMI is associated with cervical length in pregnant women is deemed necessary, with large, well-designed, prospective cohort studies with matched control group.