The Associations of Weekend Warrior Activity Patterns With the Visceral Adiposity Index in US Adults: Repeated Cross-sectional Study

Association between sleep duration, depression and breast cancer in the United States: a national health and nutrition examination survey analysis 2009-2018

OBJECTIVE

Breast cancer is the most common cancer in women, threatening both physical and mental health. The epidemiological evidence for association between sleep duration, depression and breast cancer is inconsistent. The aim of this study was to determine the association between them and build machine-learning algorithms to predict breast cancer.

METHODS

A total of 1,789 participants from the National Health and Nutrition Examination Survey (NHANES) were included in the study, and 263 breast cancer patients were identified. Sleep duration was collected using a standardized questionnaire, and the Nine-item Patient Health Questionnaire (PHQ-9) was used to assess depression. Logistic regression yielded multivariable-adjusted breast cancer odds ratios (OR) and 95% confidence intervals (CI) for sleep duration and depression. Then, six machine learning algorithms, including AdaBoost, random forest, Boost tree, artificial neural network, limit gradient enhancement and support vector machine, were used to predict the development of breast cancer and find out the best algorithm.

RESULTS

Body mass index (BMI), race and smoking were statistically different between breast cancer and non-breast cancer groups. Participants with depression were associated with breast cancer (OR = 1.99, 95%CI: 1.55-3.51). Compared with 7-9h of sleep, the ORs for <7 and >9 h of sleep were 1.25 (95% CI: 0.85-1.37) and 1.05 (95% CI: 0.95-1.15), respectively. The AdaBoost model outperformed other machine learning algorithms and predicted well for breast cancer, with an area under curve (AUC) of 0.84 (95%CI: 0.81-0.87).

CONCLUSIONS

No significant association was observed between sleep duration and breast cancer, and participants with depression were associated with an increased risk for breast cancer. This finding provides new clues into the relationship between breast cancer and depression and sleep duration, and provides potential evidence for subsequent studies of pathological mechanisms.

Whether weekend warriors (WWs) achieve equivalent benefits in lipid accumulation products (LAP) reduction as other leisure-time physical activity patterns? -Results from a population-based analysis of NHANES 2007-2018

BACKGROUND

Obesity is characterized by excessive fat accumulation in the body. Physical activity (PA) is an effective intervention to combat obesity, but the effectiveness of different PA patterns on controlling obesity is unclear. Lipid accumulation product (LAP), derived from waist circumference and triglycerides, is a novel indicator for obesity evaluation. However, the association between PA patterns (i.e., weekend warriors and regularly active) and LAP remains unexplored. This study aims to elucidate the relationship between PA patterns and LAP in US adult population.

METHODS

Adult individuals with complete data on LAP, PA patterns, and other covariates from the National Health and Nutrition Examination Survey (NHANES) database (2007-2018) were included in this study. Multivariate linear regression models were utilized to explore the association between PA patterns and LAP. Subgroup analyses, interaction tests, restricted cubic spline (RCS) regression analyses, and threshold and saturation effect analyses were also performed to investigate the stability and nonlinearity of PA-LAP association, respectively.

RESULTS

A total of 11,212 participants were included in this study. After adjusting for all potential covariates, being regularly active (RA) (β=-8.85, P < 0.05) obtained significantly higher LAP reduction as opposed to being weekend warriors (WWs) (β=-4.70, P = 0.3841). Furthermore, subgroup analyses and interaction tests indicated that the PA-LAP association was more pronounced in individuals with higher education levels (P interaction = 0.0084) and diabetes (P interaction = 0.0062). Additionally, a significant, non-linear, and negative correlation between weekly total PA and LAP in non-inactive individuals was identified by RCS analysis (P for overall < 0.001, P for nonlinearity = 0.009). A threshold of 440 min in weekly total PA was found to arouse favorable LAP reduction.

CONCLUSIONS

Being regularly active obtained better LAP reduction as opposed to being WWs. For non-inactive adults, engaging in more than 440 min of PA per week helps to reduce LAP effectively.

Possible non-linear relation between prostate specific antigen and vitamin D: a machine learning study based on cross-section data

Objective: Due to inconsistent results in earlier investigations regarding the relationship between vitamin D and prostate-specific antigen (PSA), this study was conducted to gain a deeper understanding of the association between vitamin D and PSA. Methods: A total of 7174 male samples with 25(OH)D, PSA, and other variables were obtained from the National Health and Nutrition Examination Survey (NHANES) database. Three models, created through stepwise logistic regression, were employed to examine the dose-response association between PSA and 25(OH)D. Subsequently, restricted cubic spline analysis (RCS) was used to explore the nonlinear association between 25(OH)D and PSA. The study also compared the performance of four machine learning models in predicting PSA levels. Results: The dose-response relationship indicated a negative impact of high 25(OH)D levels on PSA (p for trend 0.05). The odds ratio (OR) of Q4 (7.73 with 95% CI (0.26, 15.76)) was significantly higher than Q1 (6.23 with 95% CI (0.24, 12.57)). OR values in Q2 and Q3 were less than 1 (Q2= 0.57 with 95% CI (-6.37, 8.04) and Q3= 0.26 with 95% CI (-5.94, 6.86)), suggesting a potential protective effect of 25(OH)D on PSA. RCS analysis revealed a U-shaped relationship between blood 25(OH)D levels and PSA, with serum 25(OH)D in the range of 20-134 ng/ml showing a potential decrease in PSA levels. Above this range, an increase in 25(OH)D might elevate PSA levels. Age (2.67 with 95% CI 2.24 to 3.1) and BMI (17.52 with 95% CI 7.65 to 26.32), along with the OR of obesity (10.36 with 95% CI 0.68 to 20.18), were identified as potential PSA risk factors. Among the machine learning models, the random forest algorithm performed the best in predicting PSA levels. Conclusion: This study revealed a U-shaped relationship between 25(OH)D and PSA, with PSA potentially declining when 25(OH)D is between 20 and 134 ng/mL and possibly rising above this range. The random forest method proved effective in both predicting PSA levels and guiding vitamin D dosage.

Association between low birth weight and impaired glucose tolerance in children: a systematic review and meta-analysis

Background

A potential association between the onset of diabetes and normal birth weight (NBW) has been discovered. Diverse conclusions and study methodologies exist regarding the connection between low birth weight (LBW) and impaired glucose tolerance in children, underscoring the need for further robust research. Our institution is embarking on this study to thoroughly examine the association between LBW and impaired glucose tolerance in children.

Methods

We conducted searches on Cochrane Library, ScienceDirect, EMBASE, PubMed, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature data (CBM) online database, VIP full-text Database, and Wanfang Database to identify correlation analyses or case-control studies investigating the relationship between LBW and abnormal glucose tolerance in children. The search spanned from January 2010 to September 2023. The quality of observational studies was evaluated using the Newcastle-Ottawa Scale (NOS) tool. Data synthesis was performed using the statistical software RevMan 5.3 for meta-analysis.

Results

Based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, we finally included 10 clinical control studies consisting of a total of 2971 cases. There wasn't considerably change in blood sugar levels among LBW, NBW and high birth weight (HBW) infants (P > 0.05). There was no significant difference in insulin levels between LBW infants and NBW infants (P > 0.05). The HOMA-IR of LBW infants was considerably higher than that of NBW infants (P < 0.05). The risk of abnormal glucose tolerance in LBW infants was 0.42 times higher than that in NBW and HBW infants [Fisher's Z = 0.42, 95% CI = (0.09, 0.75), P = 0.01].

Conclusion

LBW is associated with an increased risk of abnormal glucose tolerance, as indicated by elevated HOMA-IR level in LBW infants compared to NBW and HBW pediatric population. Further research is needed to confirm and expand upon these findings to better understand the complex relationship between LBW and impaired glucose tolerance in children.

The associations of weekend warrior and other physical activity patterns with the risk of all-cause and cardiovascular disease mortality in people with diabetes mellitus and chronic kidney disease: from NHANES 2007-2020

AIM

To investigate the associations of the weekend warrior and other physical activity (PA) patterns with all-cause, cardiovascular disease (CVD) mortality risk in people with diabetes mellitus (DM) and chronic kidney disease (CKD).

METHODS

This study pooled the data from NHANES 2007-2020. Participants with DM and CKD were included. PA was assessed using a self-reported questionnaire. According to the characteristics of recreational activities, individuals were categorized as inactive (no activities), insufficiently active (total PA duration <  150 min/week), weekend warrior (total PA duration ≥  150 min/week for 1-2 sessions), and regularly active (total PA duration ≥  150 min/week for ≥  3 sessions). Weighted Cox regression models with adjusting sociodemographic, behavioral, and metabolic factors were performed to investigate the relationship of PA patterns with all-cause and CVD mortality risk. Stratification and interaction analyses were further performed.

RESULTS

Among 1702 participants (46.53% female; 64 ± 0.46 years old), 536 died (163 cardiovascular) during the follow-up of 68 (39-104) months. The hazard ratio (HR) of all-cause death was 0.618 (95% CI 0.406-0.942) for insufficiently active PA pattern, 0.338 (95% CI 0.116-0.988) for weekend warrior PA pattern, and 0.536 (95% CI 0.395-0.726) for regularly active PA pattern compared with inactive PA pattern. HR of CVD death was 0.545 (95% CI 0.250-1.189) for the PA pattern of insufficiently active, 0.165 (95% CI 0.020-1.343) for weekend warrior, and 0.393 (95% CI 0.218-0.710) for regularly active compared with the inactive PA pattern. The associations present no difference in subgroups. Moreover, there was no discernible difference between weekend warrior and regularly active PA patterns for all-cause and CVD deaths. The risk of death declined relatively quickly When exercise was initiated and to a total of 450 min or 4 times per week.

CONCLUSION

In a population of DM and CKD, the weekend warrior pattern was similar to regular activity to lower the risk of all-cause mortality, compared with inactivity. The weekend warrior pattern was recommended for people who only have time to exercise on the weekend. However, longer and larger sample cohort studies are needed to validate our findings.

Associations of healthy eating index-2015 with osteoporosis and low bone mass density in postmenopausal women: a population-based study from NHANES 2007-2018

Purpose

The current study aimed to explore the associations of diet quality assessed by healthy eating index-2015 (HEI-2015) with risks of osteoporosis and low bone mineral density (BMD) among American postmenopausal women aged 50 years and older.

Methods

Postmenopausal women aged 50 years and older in the National Health and Nutrition Examination Survey from 2007 through 2018 were included in the final sample. Analysis of variance and Rao-Scott adjusted chi-square tests were used to compare the characteristics across tertiles of HEI-2015. Univariate and multivariate weighted logistic regression models were employed to explore the associations of HEI-2015 tertiles and continuous HEI-2015 with the risks of osteoporosis and low BMD. Nonlinear dose-response associations were evaluated using weighted restricted cubic spline analyses, and the contributions of various HEI-2015 components were assessed using weighted quantile sum regression models.

Results

The final sample included 3,421 postmenopausal women aged 50 years and older representative for approximately 28.38 million non-institutionalized U.S. postmenopausal women. Osteoporosis prevalence decreased with HEI-2015 tertiles while the prevalence of low BMD showed no significant decrease. Compared with postmenopausal women in the first tertile of HEI-2015, those with the second (OR: 0.57, 95%CI: 0.38-0.84) and third (OR: 0.48, 95%CI: 0.29-0.78) HEI-2015 tertiles were associated with reduced osteoporosis risk after multivariate adjustments, but no significant association of HEI-2015 with the risk of BMD was identified. Furthermore, similar effects were confirmed in the sensitivity analyses and subgroup analyses and interaction effects. Moreover, significant nonlinear associations were observed between HEI-2015 with osteoporosis risk, and total vegetables, refined grains and greens and beans demonstrated the strongest protective effect among HEI-2015 components against osteoporosis.

Conclusions

This study strongly suggests the significant negative associations of HEI-2015 with osteoporosis risk in American postmenopausal women. These findings highlight the importance of adherence to the dietary guidelines for Americans in reducing the risk of osteoporosis.

The association between different physical activity (PA) patterns and cardiometabolic index (CMI) in US adult population from NHANES (2007-2016)

Background

Physical activity (PA) is widely recommended for preventing and combating obesity, but the most effective PA pattern for treating obesity remains unclear. Cardiometabolic index (CMI), derived from waist height ratio and triglycerides to high-density lipoprotein-cholesterol ratio, is a novel indicator for evaluating obesity. However, the relationship between different PA patterns and CMI remains unelucidated.

Objective

This study aimed to explore the association between different PA patterns and CMI in U.S. adults.

Methods

Participants with complete information in CMI, PA patterns, and other covariates in the National Health and Nutrition Examination Survey database (2007-2016) were included in this study. Multivariate linear regression models were utilized to explore the relationship between PA patterns and CMI. Moreover, stratified analyses, interaction tests and restricted cubic spline (RCS) regression analysis were used to investigate the stability and nonlinearity of the association, respectively.

Results

A total of 16,442 adults were included in this study. After adjusting for all potential covariates, only the regularly active group was significantly associated with CMI reduction (β = -0.13, 95% CI: 0.19 to -0.07, P < 0.0001), while the weekend warriors group did not achieve equivalent CMI reduction (β = -0.09, 95% CI: 0.32 to 0.14, P = 0.4204). Subgroup analyses and interaction tests revealed that the CMI-PA association was more pronounced in the subgroup with age≤45 or >60, with higher education level, and who are current drinkers. Furthermore, RCS analysis indicated that total PA in a week was significantly, nonlinearly associated with CMI in non-inactive adults, and that a total of PA more than 330 min can reap favorable CMI reduction.

Conclusion

Being regularly active is associated with significant CMI reduction, while being weekend warriors and insufficiently active do not achieve equivalent benefits. For non-inactive individuals, engaging in PA for more than 330 min weekly helps to reduce CMI effectively.

Reevaluating Adiponectin's impact on obesity hypertension: a Chinese case-control study

BACKGROUND

Obesity and hypertension are major risk factors for cardiovascular diseases that affect millions of people worldwide. Both conditions are associated with chronic low-grade inflammation, which is mediated by adipokines such as adiponectin. Adiponectin is the most abundant adipokine that has a beneficial impact on metabolic and vascular biology, while high serum concentrations are associated with some syndromes. This "adiponectin paradox" still needs to be clarified in obesity-associated hypertension. The aim of this study was to investigate how adiponectin affects blood pressure, inflammation, and metabolic function in obesity hypertension using a Chinese adult case-control study.

METHODS

A case-control study that had finished recruiting 153 subjects divided as four characteristic groups. Adiponectin serum levels were tested by ELISA in these subjects among these four characteristic Chinese adult physical examination groups. Waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), diastolic blood pressure (DB), and other clinical laboratory data were collected. Analyzation of correlations between the research index and differences between groups was done by SPSS.

RESULTS

Serum adiponectin levels in the| normal healthy group (NH group) were significantly higher than those in the newly diagnosed untreated just-obesity group (JO group), and negatively correlated with the visceral adiposity index. With multiple linear egression analysis, it was found that, for serum adiponectin, gender, serum albumin (ALB), alanine aminotransferase (ALT) and high-density lipoprotein cholesterol (HDLC) were the significant independent correlates, and for SB, age and HDLC were the significant independent correlates, and for DB, alkaline phosphatase (ALP) was the significant independent correlate. The other variables did not reach significance in the model.

CONCLUSIONS

Our study reveals that adiponectin's role in obesity-hypertension is multifaceted and is influenced by the systemic metabolic homeostasis signaling axis. In obesity-related hypertension, compensatory effects, adiponectin resistance, and reduced adiponectin clearance from impaired kidneys and liver all contribute to the "adiponectin paradox".

The associations of "weekend warrior" and regularly active physical activity with abdominal and general adiposity in US adults

OBJECTIVE

This study examined the association between physical activity patterns and abdominal and general adiposity.

METHODS

Data were extracted among 20- to 59-year-old participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Abdominal and general adiposity was assessed by dual-energy x-ray absorptiometry (DXA) and anthropometric measures. DXA-measured indicators were further normalized into z scores. Physical activity levels were collected by questionnaire and classified as inactive, "weekend warrior" (WW), and regularly active (RA). Survey linear regression models were used to assess associations between physical activity patterns and adiposity indicators.

RESULTS

Among 9629 participants, 772 (8.2%) reported the WW pattern and 3277 (36.9%) reported the RA pattern. Compared with inactive, both WW and RA had lower DXA-measured abdominal adiposity (WW: β: -0.24, 95% CI: -0.38 to -0.10; RA: -0.18, 95% CI: -0.29 to -0.07), waist circumference (WW: β: -1.94, 95% CI: -3.16 to -0.73; RA: -1.31, 95% CI: -2.32 to -0.29), whole-body fat mass (WW: β: -0.16, 95% CI: -0.25 to -0.08; RA: -0.11, 95% CI: -0.18 to -0.04), and BMI (WW: β: -0.78, 95% CI: -1.27 to -0.28; RA: -0.47, 95% CI: -0.89 to -0.04).

CONCLUSIONS

The WW pattern was associated with similarly lower abdominal and general adiposity to the RA pattern versus the inactive pattern.

Association between serum 25-hydroxyvitamin D level and myopia in children and adolescents: a cross-sectional study

Background

Prior reports have indicated an inconsistent relationship between vitamin D levels and myopia in children and adolescents with limited sample size. This study was undertaken to further clarify this relationship with a repeated cross-section study.

Methods

The National Health and Nutrition Examination Survey (NHANES) database with samples <19 years old was utilized. Data on rates of myopia (spherical equivalent less than or equal to -1.0 D), serum 25-hydroxyvitamin D [25(OH)D] level (high performance liquid chromatography), and other key variables were extracted and analyzed. Three models were utilized to evaluate the dose response of vitamin D levels using stepwise logistic regression. Logistic regressions for sex subgroups and other covariates were also performed, and Forest plots were drawn.

Results

Data were available from 6,814 children (49.5% girls; mean age: 14.9±1.85 years). The myopia and non-myopia differed in serum 25(OH)D level, gender, race, poverty income ratio (PIR), and body mass index (BMI). Serum 25(OH)D levels were negatively correlated with myopia [odds ratio (OR) =0.98, 95% confidence interval (CI): 0.77-0.99, P<0.05] regardless of sex. Although the relationship did not appear to be linear, there was a dose effect with higher serum 25(OH)D levels linked with lower rates of myopia. In addition, rates of myopia were increased in females compared with males (OR =1.12, 95% CI: 1.01-1.24, P=0.03), those with a high PIR (OR =1.08, 95% CI: 1.04-1.11, P<0.001), and those with high BMI (OR =1.19, 95% CI: 1.11-1.27, P<0.001). White ethnicity (OR =0.78, 95% CI: 0.68-0.90, P<0.001) and leisure-time exercise (OR =0.94, 95% CI: 0.92-0.97, P=0.02) were associated with lower rates of myopia.

Conclusions

These findings indicate that higher serum 25(OH)D levels and increased amounts of leisure-time exercise are associated with lower rates of myopia in this group of children and adolescents. Meanwhile, female gender, high PIR level, and high BMI were associated with greater rates of myopia. The findings indicated that children and adolescents needed leisure-time exercise to lower the risk of myopia.

Association between oxidative balance score and prostate specific antigen among older US adults

Objective

Oxidative Balance Score (OBS) is an index affecting the oxidative stress of dietary and lifestyle factors. We aimed to explore the association of OBS with prostate specific antigen (PSA) among older males.

Methods

A total of 5,136 samples were collected in this study to investigate the relationship between OBS and PSA from the National Health and Nutrition Examination Survey. Logistic regression models and restricted cubic spline were used to assess the associations between OBS and PSA.

Results

Compared with the Q1 group, the odds ratios for the association between OBS and PSA were 1.005 (1.003, 1.009), 1.003 (1.001, 1.006), and 1.001 (0.978, 1.022) for Q2, Q3, and Q4, respectively. In the age-specific analyses, the association was significant among individuals aged 65 years old and over: the odds ratios for the association between OBS and PSA were 1.019 (1.005, 1.028), 1.028 (1.018, 1.039), and 1.038 (1.022, 1.049) for Q2, Q3, and Q4, respectively. But it was not significant among individuals aged less than 65 years old: the odds ratios for the association between OBS and PSA were 1.016 (0.995, 1.026), 1.015 (0.985, 1.022), and 0.988 (0.978, 1.016) for Q2, Q3, and Q4, respectively. The restricted cubic splines also indicated a nonlinear relationship between OBS and PSA among individuals aged 65 years old and over (Poverall = 0.006, Pnonlinear = 0.021).

Conclusion

Our findings provide evidence that OBS is positively associated with higher levels of PSA among older adults. Further large-scale prospective cohort studies are needed to verify our findings.

Associations of oxidative balance score with total abdominal fat mass and visceral adipose tissue mass percentages among young and middle-aged adults: findings from NHANES 2011-2018

Objective

This study aimed to explore the association of the oxidative balance score (OBS) with total abdominal fat mass (TAFM) and visceral adipose tissue mass (VATM) percentages among young and middle-aged U.S. adults.

Methods

Young and middle-aged adults in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 were included. Analysis of variance and Rao-Scott adjusted chi-square tests were used to compare the characteristics across quartiles of OBS. Univariate and multivariate weighted logistic regression models were employed to explore the relationship between OBS and the risks of high TAFM or high VATM percentage in the general population and subgroups, while the interaction effects were tested with a likelihood test. Weighted restricted cubic spline analyses were utilized to assess the non-linear association of OBS with TAFM and VATM percentages.

Results

The final sample included 8,734 young and middle-aged non-institutionalized U.S. adults representing 134.7 million adults. Compared with adults in the first quartile of OBS, those with higher OBS were less likely to have a high TAFM percentage; the ORs and 95% CI for adults in the second, third, and highest quartiles of OBS were 0.70 (0.53-0.94), 0.49 (0.36-0.60), and 0.25 (0.18-0.36), respectively. Similar trends were observed in the association between OBS and VATM percentages. Moreover, similar effects were confirmed in the sensitivity analyses and subgroup analyses according to demographic characteristics. Regarding the OBS subclass, higher dietary OBS and lifestyle OBS were also correlated with decreased ORs of high TAFM and VATM percentages.

Conclusion

This study strongly suggests that higher OBS, as well as higher dietary OBS and lifestyle OBS, are significantly correlated with lower risks of abdominal obesity and visceral fat accumulation. The findings highlight the importance of an antioxidant-rich diet and maintaining a healthy lifestyle in reducing the risks.

The association of blood metals with latent tuberculosis infection among adults and adolescents

Objective

We aimed to investigate the relationship of metal exposure and latent tuberculosis infection (LTBI) among US adults and adolescents.

Methods

Participants from the National Health and Nutrition Examination Surveys (NHANES 2011 ~ 2012) were included. Multiple logistic regression models were used to explore the associations between metal exposure and LTBI. A total of 5,248 adults and 1,860 adolescents were included in the present analysis.

Results

For adults, we only found a positive association between total mercury and LTBI (OR: 1.411; 95% CI: 1.164 ~ 1.710) when used as a continuous variable. Compared with Q1, Q4 increased the prevalence of LTBI (2.303; 1.455 ~ 3.644) when used as a quartile. The OR of total mercury and LTBI was higher among females (1.517; 1.009 ~ 2.279), individuals aged 45 ~ 64 (1.457; 1.060 ~ 2.002), and non-Hispanic White individuals (1.773; 1.316 ~ 2.388). A relationship was observed among only participants with obesity (1.553; 1.040 ~ 2.319) or underweight (1.380; 1.076 ~ 1.771), with college or above (1.645; 1.184 ~ 2.286), with PIR > 3.0 (1.701; 1.217 ~ 2.376), reported smoking (1.535; 1.235 ~ 1.907) and drinking (1.464; 1.232 ~ 1.739). For adolescents, blood manganese was positively associated with LTBI. The OR and 95% CIs for each one-unit increase in the log-transformed level of blood manganese with LTBI were 9.954 (1.389 ~ 71.344).

Conclusion

Significant associations were observed in girls, aged ≥12 years and in the non-Hispanic white population. In conclusion, total mercury is associated with an increased prevalence of LTBI among adults and positive association between blood manganese and LTBI was observed among adolescents. Further studies should be conducted to verify the results and explore potential biological mechanisms.

Association of anxiety, depression symptoms and sleep quality with chronic kidney disease among older Chinese

This study aimed to explore the association of anxiety, depression symptoms and sleep quality with chronic kidney disease (CKD) among older Chinese adults. A total of 1025 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2011-2012) were included in our study. The Generalized Anxiety Disorder scale was used to assess anxiety and the Center for Epidemiologic Studies Depression Scale was used to evaluate depressive symptoms. Logistic regression models were conducted to explore the odds ratios (ORs) and 95% confidential intervals (CIs). We found that anxiety, depression symptoms and poor sleep quality were positively associated with albuminuria, impaired estimated glomerular filtration (eGFR) and CKD, after adjusting for other covariates. For anxiety symptom, the ORs and 95% CIs were 1.20 (1.15-1.38) for albuminuria, 1.16 (1.12-1.35) for impaired eGFR and 1.18 (1.12-1.36) for CKD, respectively. For depression symptom, the ORs and 95% CIs were 1.15 (1.05-1.23) for albuminuria, 1.14 (1.05-1.20) for impaired eGFR and 1.14 (1.05-1.22) for CKD, respectively. Compared with good sleep quality, the OR and 95% CI of poor sleep quality were 1.12 (1.04-1.35) for albuminuria, 1.10 (1.02-1.30) for impaired eGFR and 1.11 (1.03-1.32) for CKD, respectively. And the positive association was more evident among females, body mass index ≥ 28, smoking and drinking adults. Anxiety, depression symptoms and poor sleep quality are positively associated with CKD. Future cohort studies are needed to confirm the results.

Association of Serum Vitamin D With Periodontal Disease

OBJECTIVE

There are conflicting reports on the relationship between vitamin D and periodontal disease. Our research is intended to further analyse the association between serum 25(OH)D3, a vitamin D precursor and periodontal disease based on a large national survey sample in Japan.

METHODS

We downloaded the 2009-2018 National Health and Nutrition Examination Survey (NHANES) cycle, which included a total of 23,324 samples. Logistic regression of factors influencing perioral disease including periodntal disease, and subgroup logistic regression were performed to analyse the relationship between serum vitamin D and perioral disease, using WTMEC2YR as weights for regression analysis. Then machine learning model-based prediction of perioral disease onset was performed, and the machine learning algorithms used included boost tree, artificial neural network, AdaBoost, and random forest.

RESULTS

We evaluated the vitamin D, age, sex, race, education, marriage, body mass index, ratio of family income to poverty (PIR), smoking, alcohol consumption, diabetes, and hypertension as variables in the included samples. Vitamin D was negatively associated with perioral disease; compared with Q1, the odds ratios and 95% CI were 0.8 (0.67-0.96) for Q2, 0.84 (0.71-1.00) for Q3, and 0.74 (0.6-0.92) for Q4 (P for trend <.05), respectively. The results of the subgroup analysis showed that the effect of 25(OH)D3 on periodontal disease was more pronounced in women younger than 60 years. Based on the accuracy and receiver operating characteristic curve, we concluded that a boost tree was a relatively good model to predict periodontal disease.

CONCLUSIONS

Vitamin D might be a protective factor for periodontal disease, and boost tree analysis we emplyed was a relatively good model to predict perioral disease.

Primary antibiotic resistance in Helicobacter pylori in China: a systematic review and meta-analysis

OBJECTIVES

The incidence of Helicobacter pylori (HP) is 25-50% in developed countries and 80% in developing countries, including 56.2% in China. However, antibiotic resistance of HP is a threat to HP control. The purpose of this study was to comprehensively evaluate primary drug resistance of HP in China.

METHODS

The full text of reports of the primary antibiotic resistance prevalence of HP was obtained from multiple databases (PubMed, Web of Science, Evimed, Cochrane Library, and China National Knowledge Internet). Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis, and bias analysis. The Newcastle-Ottawa Scale was used to assess the article quality.

RESULTS

In total, 38804 HP samples from 22 trials were extracted. The results suggested that the overall prevalence of amoxicillin, clarithromycin, metronidazole, and levofloxacin resistance among HP in adults was as follows: mean difference (MD) = 1.35%, 95% confidence interval (CI) [1.03%, 1.68%]; MD = 23.76%, 95% CI [20.23%, 27.3%]; MD = 69.32%, 95% CI [64.85%, 73.8%]; and MD = 29.45%, 95% CI [4.90, 176.96], respectively. From the results of sensitivity and publication bias, we find that these results are robust and had little publication bias.

CONCLUSION

Our research showed that in China, the prevalence of HP resistance to primary antibiotics warrants attention, especially with regard to metronidazole, levofloxacin, and clarithromycin.

Analysis of misdiagnosed or delayed-diagnosed Leprosy bacillus infection from 1990 to 2020 with a prophet time series prediction in Hubei Province, China

To analyze the misdiagnosis or delayed diagnosis of leprosy in Hubei Province, China during the past 30 years, which can provide a scientific basis for improving the prevention and treatment of leprosy by proposing targeted intervention measures. A retrospective study was conducted to compile 161 cases of misdiagnosed or delayed diagnosis of leprosy in Hubei Province during 1990 to 2020 from the National Leprosy Prevention and Control Management Information System and the background information of regional leprosy control centers in Hubei Province. Among 161 study subjects, the shortest delay period was 25.30 months for cases aged 15 to 20 years, the longest delay period was 67.09 months for cases aged 51 to 60 years, the shortest delay period was 35.33 months for type TN cases, and the longest delay period was 75.17 months for type I cases. There were 71 cases (44.10%) misdiagnosed, and the top 5 misdiagnosed disease names were rash 23 cases (32.39%). Top 5 misdiagnosed cases were rash 23 (32.39%), rheumatism 10 (14.08%), skin ulceration 9 (12.68%), dermatitis 9 (12.68%), neuritis 9 (12.68%). In the prophet prediction, the overall trend of leprosy misdiagnosis was increasing and within 1 year the number is fluctuant. The training of medical personnel at all levels on leprosy prevention and treatment should be strengthened, and the public awareness of leprosy prevention and treatment should be enhanced.