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Guo HJ, Ye YL, Gao YF, Liu ZH. Age at first birth is associated with the likelihood of frailty in middle-aged and older women: A population-based analysis from NHANES 1999-2018. Maturitas 2024; 181:107904. [PMID: 38157686 DOI: 10.1016/j.maturitas.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES This study examined whether age at first birth (AFB) is associated with the prevalence of frailty in middle-aged and older women. METHODS The study included 10,828 women (age ≥ 45 years) from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) in the United States. AFB data were collected using a standardized reproductive health questionnaire. Frailty was measured using a 53-item frailty index and was diagnosed if the score on that index was over 0.21. Survey-weighted logistic regression models were used to assess the association between AFB and the prevalence of frailty. A survey-weighted restricted cubic spline (RCS) model was used to determine the dose-response relationship between AFB and frailty. Mediation analyses were performed to estimate the mediated effects of education levels, family poverty income ratio, and parity on the association between AFB and the likelihood of frailty. Finally, sensitivity and subgroup analyses were conducted to validate the robustness of our findings. RESULTS Among the 10,828 women, 3828 (35.4 %) had frailty. The RCS depicted a U-shaped association between AFB and frailty. Compared with the women in the reference group (AFB: 33-35 years), women in the other groups (AFB: < 18, 18-20, 21-23, and 24-26 years) had a higher likelihood of frailty, with respective odds ratios (95 % confidence intervals) of 3.02 (1.89-4.83), 2.32 (1.54-3.50), 1.83 (1.19-2.81), and 1.64 (1.07-2.53). However, no statistically significant differences were detected for women with AFB of 27-29, 30-32, or > 35 years compared with the reference group. Education levels, family poverty income ratio, and parity significantly mediated the approximately linear negative association between AFB and frailty in the subset of women with AFB of ≤32 years and the mediation proportions were 23.4 %, 32.4 %, and 18.3 %, respectively (all p < 0.001). CONCLUSIONS Based on our results, we conclude that early AFB is associated with a higher likelihood of frailty in middle-aged and older women.
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Affiliation(s)
- Hui-Jie Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong 511400, China
| | - Yi-Lu Ye
- Department of Rehabilitation Medicine, Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510700, China
| | - Yun-Fei Gao
- Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510080, China; Department of Gynecology and Obstetrics, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 511300, China.
| | - Zhi-Hua Liu
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510080, China.
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Jin F, Wang YF, Zhu ZX. Association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women. World J Orthop 2024; 15:45-51. [PMID: 38293265 PMCID: PMC10824069 DOI: 10.5312/wjo.v15.i1.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/13/2023] [Accepted: 12/13/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions. AIM To evaluate the association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women using population-based data. METHODS This study included 673 postmenopausal women, aged 40-59 years, from the National Health and Nutrition Examination Survey between 2013 and 2016. Weighted multivariable linear regression models were used to evaluate the association between serum E2 Level and appendicular lean mass index (ALMI). When non-linear associations were found by using weighted generalized additive model and smooth curve fitting, two-piecewise linear regression models were further applied to examine the threshold effects. RESULTS There was a positive association between serum E2 level and ALMI. Compared to individuals in quartile 1 group, those in other quartiles had higher ALMI levels. An inverted U-shaped curve relationship between serum E2 Level and ALMI was found on performing weighted generalized additive model and smooth curve fitting, and the inflection point was identified as a serum E2 level of 85 pg/mL. CONCLUSION Our results demonstrated an inverted U-shaped curve relationship between serum E2 levels and ALMI in middle-aged postmenopausal women, suggesting that low serum E2 levels play an important in the loss of muscle mass in middle-aged postmenopausal women.
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Affiliation(s)
- Fang Jin
- Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou 311200, Zhejiang Province, China
| | - Yan-Fei Wang
- Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou 311200, Zhejiang Province, China
| | - Zhong-Xin Zhu
- Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou 311200, Zhejiang Province, China
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Shi K, Chen Y, Zhu X, Wu J, Chen J, Hu J, Sun X, Zhang J. Biscuit consumption and diabetic retinopathy incidence in adults in the United States. Diabetol Metab Syndr 2022; 14:94. [PMID: 35794635 PMCID: PMC9258145 DOI: 10.1186/s13098-022-00860-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foods have a considerable influence on human health and were directly related to glycemic control for diabetes patients. However, little is known about the effects of biscuits, a traditional food consumed in large amounts in several countries, on diabetic retinopathy. This study aimed to explore the association between biscuit consumption and diabetic retinopathy prevalence in adults of the United States population. METHODS A cross-sectional study with 1904 participants from the National Health and Nutrition Examination Survey database were included in this population-based, cross-sectional study. The association between different consumption frequencies of biscuit and diabetic retinopathy prevalence was evaluated using a binary logistic regression model. Trend test, stratified and interaction analyses were also performed. RESULTS After possible confounders including sex, age, ethnicity, education, marital status, family poverty income ratio, smoking and alcohol consumption habit, fasting blood glucose level, hemoglobin A1c level, diagnosis of diabetes, insulin use, blood pressure, body mass index were adjusted, the participants who consumed biscuit 1-11 times a year, 1-3 times a month, and more than once a week had a 139.8% (95% confidence interval, 1.003-5.734), 182.1% (95% confidence interval, 1.106-7.191), and 236.2% (95% confidence interval, 1.335-9.844) higher risk of diabetic retinopathy prevalence, respectively, compared with those who never ate biscuit. For male, non-Hispanic, and overweight (body mass index ≥ 25 kg/m2) subgroups, the trend test demonstrated that the diabetic retinopathy prevalence significantly elevated with increased frequency of biscuit consumption (P trend = 0.021, 0.009, and 0.002, respectively). The interaction analysis suggested that no aforementioned confounders played an interactive role in the relationship between biscuit consumption and diabetic retinopathy prevalence. CONCLUSIONS The risk of diabetic retinopathy was positively associated with biscuit consumption. Moreover, for male, non-Hispanic, or overweight individuals, the risk of diabetic retinopathy significantly increased with the frequency of biscuit consumption.
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Affiliation(s)
- Ke Shi
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xinyue Zhu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Jiali Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Jieqiong Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Jing Hu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
| | - Jingfa Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Hai Ning Road, 200080, Shanghai, People's Republic of China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
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Mazidi M, Mikhailidis DP, Banach M. Higher dietary acid load is associated with higher likelihood of peripheral arterial disease among American adults. J Diabetes Complications 2018; 32:565-569. [PMID: 29674134 DOI: 10.1016/j.jdiacomp.2018.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/22/2018] [Accepted: 03/05/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To explore the association between dietary acid load, potential renal acid load (PRAL) and net endogenous acid production (NEAP), and peripheral arterial disease (PAD) in a national representative sample of American adults. METHODS The National Health and Nutrition Examination Survey (NHANES) database (for 1999-2002) was used. PAD was diagnosed by ankle brachial index assessment. Analysis of covariance was used to examine adjusted mean of different dietary acid load by PAD status; multivariable logistic regression was used to relate dietary acid load with prevalent PAD. Sample weighting was accounted for in all analyses. RESULTS Of the 4864 eligible participants aged 40-85, 2482 (51.0%) were men, and 269 (5.5%) had PAD. After adjustment for age-, sex-, race-, estimated glomerular filtration rate (eGFR), smoking, dietary fat, carbohydrates, protein, saturated fat, and dietary fiber, and energy intake, body mass index, hypertension, cholesterol, triglyceride and diabetes, estimated glomerular filtration rate, participants with PAD had higher mean of (PRAL: 16.2 vs 9.1mEq/d, NEAP: 56.2 vs 50.1mEq/d, both p<0.001) than PAD-free participants. In logistic regression with same cofounders, the top quarter of PRAL (more acidic) was associated with 31% higher odds of the PAD compared with the bottom quarter (more alkaline) [odds ratio: 1.31, 95% confidence interval: 1.11-1.57]. CONCLUSION Our findings, for the first time, suggest that dietary acids load, an index of acid-base balance, is associated with the likelihood of PAD after adjustment for main clinical and anthropometrical confounding factors. These results support the hypothesis that diet plays an important role in chronic disease occurrence.
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Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China; Institute of Genetics and Developmental Biology, International College, The University of Chinese Academy of Science, Beijing 100101, China.
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
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Xu X, Hu H, Kearney GD, Kan H, Sheps DS. Studying the effects of polycyclic aromatic hydrocarbons on peripheral arterial disease in the United States. Sci Total Environ 2013; 461-462:341-7. [PMID: 23747551 DOI: 10.1016/j.scitotenv.2013.04.089] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/15/2013] [Accepted: 04/26/2013] [Indexed: 05/06/2023]
Abstract
PURPOSE Polycyclic aromatic hydrocarbons are a group of prevalent pollutants which are produced by incomplete combustion of organic materials such as coal, fuel, tobacco smoking and food cooking. The associations between exposures to polycyclic aromatic hydrocarbons (PAHs) and peripheral arterial disease (PAD) have not been well studied. METHODS We used the 2001-2004 National Health and Nutrition Examination Survey (NHANES) to investigate the associations between eight monohydroxy urinary metabolites of four PAHs and PAD. RESULTS In a logistic regression model, subjects within the middle and highest tertiles of fluorene metabolites, 2-hydroxyfluorene (2-FLUO) and 3-hydroxyfluorene (3-FLUO), and phenanthrene metabolites, 1-hydroxyphenanthrene (1-PHEN) and 2-hydroxyphenanthrene (2-PHEN), had significantly higher prevalence of PAD as compared to subjects within the lowest tertile after adjusting for cigarette smoking, diabetes mellitus and other covariates (For 2-FLUO, the 3rd tertile: OR=2.22, 95% CI=1.13-4.37, p for trend=0.02; For 3-FLUO, the 3rd tertile: OR=2.36, 95% CI: 1.16-4.77, p for trend=0.02; For 1-PHEN, the 3rd tertile: OR=1.84, 95% CI: 1.01-3.37, p for trend=0.04; For 2-PHEN, the 3rd tertile: OR=1.76, 95% CI: 1.07-2.88, p for trend=0.03). CONCLUSIONS Our findings suggest that exposure to PAHs may increase the risk of PAD. Further studies are necessary to explore the associations between PAHs and PAD.
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Affiliation(s)
- Xiaohui Xu
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, United States.
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