Dyslipidemia and inflammation often coexist in the progression of kidney failure, with the atherosclerosis index of plasma (AIP) serving as a valuable marker for monitoring dyslipidemia. This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005 to 2018, involving a total of 10,358 participants. AIP was calculated as the logarithmic ratio (base 10) of triglycerides to high-density lipoprotein cholesterol (log10[TG/HDL-C]), while kidney failure was assessed through self-reported physician diagnosis. Logistic regression models and restricted cubic splines (RCS) were utilized to examine the association between AIP and the risk of kidney failure, with additional subgroup analyses performed to explore potential interactions. Mediation analyses were conducted to investigate whether inflammatory markers mediated the relationship between AIP and kidney failure. In logistic regression, after adjusting for all covariates, AIP was found to be positively associated with the risk of kidney failure [OR = 1.74 (95% CI: 1.04-2.92)], and a linear relationship between AIP and kidney failure risk was observed (P-non-linear = 0.4050). Mediation analysis revealed that segmented neutrophils, eosinophils, and monocytes partially mediated the association between AIP and kidney failure, with mediation proportions of 19.65%, 2.44%, and 7.25%, respectively. These findings suggest that Higher AIP was associated with an increased risk of kidney failure, with segmented neutrophils, eosinophils, and monocytes serving as partial mediators. The results provide valuable insights into the role of inflammation in kidney failure and highlight potential avenues for its prevention.

Chronic kidney disease (CKD) prognosis is closely tied to the interplay between nutrition and inflammation. However, comprehensive nutritional-inflammatory indices for prognostic evaluation are rare in CKD. This study explored the association of the advanced lung cancer inflammation index (ALI) with estimated glomerular filtration rate (eGFR) and all-cause mortality in CKD patients.

A total of 1,982 CKD patients from the National Health and Nutrition Examination Survey (NHANES) database (2011-2018) were included in the analysis. Analytical methods included linear regression, cox regression, and restricted cubic spline (RCS) analysis. Subgroup and sensitivity analyses were performed, and further evaluation was conducted using the receiver operating characteristic (ROC) curve and C-index for all-cause mortality across different CKD stages.

Among CKD patients, 1,103 patients (55.7%) were classified as stage I-II, and 879 patients (44.3%) as stage III-V. After adjusting covariates, ALI was found to be positively correlated with eGFR (Beta = 0.11; 95% CI: 0.07-0.15), and negatively related with all-cause mortality (HR = 0.72; 95% CI: 0.63-0.83). Subgroup analysis showed that the positive correlation between ALI and eGFR was stronger in CKD stage III-V compared to stage I-II. However, ALI's protective effect on mortality was weaker in stage III-V. The C-index for ALI was 0.648 in stage I-II and 0.660 in stage III-V.

ALI was significantly associated with eGFR and all-cause mortality in CKD patients. Nutritional and anti-inflammatory interventions in early-stage CKD may improve prognosis, and ALI may have great potential as a multifaceted biomarker to influence the prognosis of CKD, particularly in stages III-V.

Cardiovascular-kidney-metabolic syndrome reflects the complex interplay between metabolic risk factors, cardiovascular and chronic kidney disease. Differences in disease burden by demographics, social determinants of health, and mortality are not well characterized.

Data from adults who completed the National Health and Nutrition Examination Survey between 2011 and 2018 were used to estimate age-adjusted prevalence and 95% confidence intervals (CI) for cardiovascular-kidney-metabolic syndrome stages. Joinpoint regression was used to identify linear trends. Kaplan-Meier curves were used to examine all-cause mortality risk by stages.

Among 8474 adults in the study, the median age was 46.8 years, 49.1% were male, and 65.0% were non-Hispanic White. Age-adjusted prevalence of stages 0-4 were 11.2%, 28.1%, 47.4%, 5.3%, and 8.1%, respectively. The highest proportion of stage 4 was among adults aged ≥60 years, males, and non-Hispanic Black individuals. The advanced stages 3-4 were associated with lower educational attainment, income, and employment and higher mortality with a crude death rate of 188.8 per 1000 person-years.

Approximately 13% of adults were in advanced stages, which disproportionately affect non-Hispanic Black adults and increased over time. These results provide a roadmap for targeted intervention strategies.

Evidence on cardiovascular (CV) risk stratification in Bangladeshi patients with type 2 diabetes mellitus (T2DM) who are asymptomatic for cardiovascular disease (CVD) is limited. This study aimed to assess the 10-year CV risk in newly diagnosed patients with T2DM.

In 2023, a cross-sectional study was carried out at endocrinology clinics in tertiary hospitals throughout Bangladesh, involving newly diagnosed patients with T2DM aged 25 to 84 who had no prior history of CVD and were asymptomatic for the condition. CV risk was assessed and classified using QRISK3.

1617 newly diagnosed patients with T2DM (age 44.92 ± 11.84 years, male 49.5 %) were analyzed. Their median QRISK3 score was 11.0 %, with 46.5 % at low, 25.7 % at moderate, and 27.8 % at high 10-year CV risk, respectively. The QRISK3 score increased with age for both men and women, with men consistently scoring higher than women in every age group. Among the age groups 25-39, 40-64, and 65-84, the percentages of patients with high 10-year CV risk were 3.3 %, 34.0 %, and 94.5 %, respectively. The median relative risk (RR) of CVD was 4.3. RR decreased with age for both sexes, and men had a lower RR than women across all age groups. A sleep duration of 6-9 h was associated with a lower 10-year CV risk.

Many newly diagnosed Bangladeshi patients with T2DM have substantial CV risk. QRISK3 can assist clinicians in predicting 10-year CV risk and choosing appropriate treatments to prevent CVD.

Although previous studies have reported associations between sarcopenic obesity (SO) and metabolic syndrome (MetS), the findings remain inconsistent. This study aimed to investigate the associations between sarcopenia, obesity, and MetS, and to determine whether sarcopenic obesity synergistically increases the risk of MetS.

The data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Participants were categorized into five groups: non-sarcopenia non-obesity, non-sarcopenia obesity, non-obesity sarcopenia, possible SO, and SO. MetS was defined using the diagnostic criteria recommended by the National Cholesterol Education Program Adult Treatment Panel III. Logistic regression models were employed for both cross-sectional and longitudinal analysis.

In 2011, a total of 9322 participants were included in the cross-sectional analysis, with 3674 individuals followed up in 2015. In the cross-sectional study, non-sarcopenia obesity (OR = 9.20, CI: 8.06 to 10.50), possible SO (OR = 2.04, CI: 1.94 to 2.15), and SO (OR = 1.61, CI: 1.47 to 1.77) were associated with a higher prevalence of MetS. In contrast, non-obesity sarcopenia (OR = 0.85, CI: 0.74 to 0.98) was associated with a lower prevalence. In the longitudinal analysis, non-sarcopenia obesity (OR = 2.87, CI: 2.34 to 3.52) and possible SO (OR = 1.41, CI: 1.30 to 1.53) were associated with an increased incidence of MetS, while non-obesity sarcopenia (OR = 0.75, CI: 0.62 to 0.91) was associated with a reduced incidence. Notably, SO (OR = 1.00, CI: 0.80 to 1.25) was not associated with the incidence of MetS.

Possible SO, defined by low muscle mass, was not associated with subsequent new-onset MetS. This study highlights that the obesity component, rather than the muscle mass component, is the primary driver of MetS risk in middle-aged and older adults in China.

This study investigated the relationship between the Hemoglobin, Albumin, Lymphocyte, and Platelets (HALP) score and all-cause and cardiovascular mortality risk in diabetes patients.

An analysis included 2154 individuals with diabetes from the 2003-2016 National Health and Nutrition Examination Survey (NHANES), with mortality data tracked until December 31, 2019. Cox regression models were adopted to evaluate the association of HALP score with mortality. The nonlinear relationship was examined using restricted cubic splines (RCS), and a two-segmented Cox proportional risk model analyzed data around identified threshold values.

During a median follow-up of 90 months, 565 (26.23 %) deaths occurred, of which 166 (7.71 %) caused by cardiovascular disease. In the Cox regression models, participants in the highest quartile of HALP score had lower risks of all-cause mortality (HR = 0.59,95 % CI:0.43-0.83, p = 0.002) and cardiovascular mortality (HR = 0.38,95 % CI:0.22-0.66, p < 0.001) compared to the lowest quartile. Based on the restricted cubic splines (RCS) curve, a L-shaped relationship was found, with thresholds of 49.81 for all-cause and 48.78 for cardiovascular mortality. HALP scores below these thresholds were associated with increased mortality (p < 0.001).

HALP score may serve as a valuable clinical indicator for predicting mortality risk in diabetes patients.

Gallstones affect a significant proportion of U.S. adults and can cause serious complications. We aimed to investigate the association between gallstone disease and common metabolic disorders in a nationally representative sample in the United States.

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) collected from 2017 to 2020. We included 6164 participants meeting the eligibility criteria, which represented 171 407 370 participants. The associations between gallstone disease and six metabolic disorders were analyzed using multivariate logistic regression analyses, accounting for potential confounding factors. Subgroup analyses were conducted by age, gender, and race.

Altogether 10.9% of participants had gallstone disease, with prevalence increasing with age (mean age with vs. without gallstones: 56.435 years vs. 46.896 years, p < 0.001) and a female predominance (75.1% vs. 24.9%, p < 0.001). Non-alcoholic fatty liver disease (NAFLD), obesity, hypertension, and diabetes mellitus were significantly associated with an increased risk of gallstone formation, with adjusted odds ratios (OR) of 1.523 (95% confidence interval [CI] 1.180-1.965, p = 0.002), 1.733 (95% CI 1.265-2.374, p = 0.001), 1.466 (95% CI 1.203-1.785, p = 0.001), and 1.522 (95% CI 1.165-1.989, p = 0.003), respectively. These associations were more pronounced in individuals under 60 years of age and in females. No significant associations were observed with hyperlipidemia or hyperuricemia.

Gallstone disease is significantly associated with obesity, NAFLD, diabetes mellitus, and hypertension, with stronger associations found in younger individuals and females. Sensitivity analyses confirmed the robustness of these findings.

Danshen, Fufang Danshen, Shuxuening and Shuxuetong injections, four traditional Chinese medicine prescriptions, have been widely explored regarding their lipid-lowering property, but the findings were inconsistent and inconclusive. This meta-analysis was to clarify the lipid-lowering effect of the four injections. PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library and CNKI databases were searched, and data including age, sex, ethnicity, disease type, dose, duration, sample size and blood lipids were extracted from each eligible study. The alterations in lipids from pre- to post-treatment were calculated and compared between control and treatment groups, and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the lipid-lowering effect of the injections. Twenty-eight studies (2,624 subjects), 31 studies (3,023 subjects), 17 studies (1,507 subjects) and 54 studies (4,435 subjects) were respectively identified for Danshen, Fufang Danshen, Shuxuening and Shuxuetong injections. All of the four injections could effectively and significantly reduce serum levels of triglycerides (p < 0.001 for all), total cholesterol (p < 0.001 for all) and low-density lipoprotein cholesterol (p < 0.001 for all), and elevate high-density lipoprotein cholesterol level (p ≤ 0.02 for all). Shuxuening injection had the strongest lipid-lowering effect with almost twice that of the other three injections. Danshen, Fufang Danshen and Shuxuening injections showed a good lipid-lowering effect on patients with heart disease, while Shuxuetong injection displayed a powerful lipid-lowering effect among diabetic patients. Unfortunately, all of these injections had a poor lipid-lowering effect in patients with renal disease. The meta-analysis demonstrates that Danshen, Fufang Danshen, Shuxuening and Shuxuetong injections all can effectively reduce blood lipids. Among them, Shuxuening injection has the strongest lipid-lowering effect with almost twice that of the other three injections. In terms of reducing blood lipid levels, Danshen, Fufang Danshen and Shuxuening injections are suitable for patients with cardiovascular disease, Shuxuetong injection is suitable for patients with diabetes, but none of them is suitable for patients with renal disease.

BackgroundChronic lower extremity ulcers (CLEU) are a significant health burden, often linked to complications such as diabetes and vascular diseases. Chronic kidney disease (CKD), a prevalent global health issue, has been increasingly associated with CLEU, though the nature of this relationship remains poorly understood. This study aimed to explore the association between CKD and CLEU in the US adult population.MethodsWe analyzed data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004. The study included adults aged 20 years and older who completed interviews and examinations. CLEU was defined as self-reported ulcers or sores on the leg or foot lasting more than four weeks. CKD was diagnosed based on the 2012 KDIGO guidelines, using estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR). Logistic regression models were used to assess the association between CKD and CLEU, adjusting for demographics, BMI, lifestyle factors, and comorbidities.ResultsAmong 8564 participants, individuals with CKD had a higher likelihood of developing CLEU, with an unadjusted odds ratio (OR) of 2.33 (95% CI: 1.86-2.91). After adjusting for confounders, the association remained significant, with adjusted ORs of 1.64 (95% CI: 1.26-2.12) and 1.57 (95% CI: 1.2-2.04) in Models 2 and 3, respectively. Stratified analyses showed no significant interactions across subgroups defined by age, sex, diabetes, hypertension, hyperlipidemia, and peripheral artery disease (PAD).ConclusionThis study demonstrates a robust association between CKD and CLEU in US adults, suggesting that CKD is an independent risk factor for CLEU. These findings highlight the need for integrated management strategies for CKD patients to reduce the risk of CLEU. Future longitudinal studies are needed to establish causality and inform targeted interventions.

Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with an increased risk of metabolic syndrome (MetS), a cluster of cardiometabolic risk factors. However, the prevalence of MetS in AS remains uncertain. This meta-analysis estimates the global prevalence of MetS in AS patients and identifies factors contributing to its variability.

A systematic search of PubMed, Scopus, Embase, and Web of Science was conducted for studies published up to January 18, 2024. A random-effects model was used to estimate pooled prevalence, while meta-regression and subgroup analyses explored sources of heterogeneity.

Seventeen studies meeting the eligibility criteria were included. The pooled prevalence of MetS in AS patients was 15.5% (95% confidence interval [CI]: 10.9-20.8%). The highest prevalence was reported in Africa (37.0%) and the lowest in Asia (8.0%). Variability in AS diagnostic criteria influenced prevalence estimates, with the highest MetS rates found in studies using the Assessment of SpondyloArthritis International Society (ASAS) criteria (37.0%). Meta-regression identified significant associations between MetS prevalence and older age (β = 0.04, P < 0.01), higher body mass index (β = 0.09, P < 0.01), triglyceride levels (β = 0.01, P < 0.01), waist circumference (β = 0.03, P < 0.01), diastolic blood pressure (β = 0.04, P = 0.02) and disease activity, measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (β = 0.03, P = 0.02). Erythrocyte sedimentation rate was significantly correlated with MetS prevalence (β = 0.01, P = 0.04), while C-reactive protein was not (β = -0.01, P = 0.12).

MetS is a prevalent comorbidity in AS, significantly influenced by inflammation, obesity, and disease activity. Given its strong association with cardiovascular risk, routine metabolic screening should be incorporated into AS management. Clinicians should adopt an integrated approach that includes lifestyle modifications, targeted therapies, and careful cardiovascular risk assessment to mitigate long-term complications. Standardized diagnostic criteria for MetS in AS are needed to improve risk stratification and patient outcomes.

Metabolic-Associated Fatty Liver Disease (MAFLD) is a public health concern that is constantly expanding, with a fast-growing prevalence, and it affects about a quarter of the world's population. This condition is a significant risk factor for cardiovascular, hepatic, and oncologic diseases, such as hypertension, hepatoma, and atherosclerosis. Sarcopenia was long considered to be an aging-related syndrome, but today, it is acknowledged to be secondarily related to chronic diseases such as metabolic syndrome, cardiovascular conditions, and liver diseases, among other comorbidities associated with insulin resistance and chronic inflammation, besides inactivity and poor nutrition. The physiopathology involving MAFLD and sarcopenia has still not been solved. Inflammation, oxidative stress, mitochondrial dysfunction, and insulin resistance seem to be some of the keys to this relationship since this hormone target is mainly the skeletal muscle. This review aimed to comprehensively discuss the main metabolic and physiological pathways involved in these conditions. MAFLD and sarcopenia are interconnected by a complex network of pathophysiological mechanisms, such as insulin resistance, skeletal muscle tissue production capacity, chronic inflammatory state, oxidative stress, and mitochondrial dysfunction, which are the main contributors to this relationship. In addition, in a clinical analysis, patients with sarcopenia and MAFLD manifest more severe hepatitis fibrosis when compared to patients with only MAFLD. These patients, with both disorders, also present clinical improvement in their MAFLD when treated for sarcopenia, reinforcing the association between them. Lifestyle changes accompanied by non-pharmacological interventions, such as dietary therapy and increased physical activity, undoubtedly improve this scenario.

Type 2 Diabetes (T2D) imposes a disproportionate burden on the South Asian population. Their phenotype is characterized by heightened insulin resistance, even in individuals without overt T2D. Commonly used screening tools underestimate the T2D incidence in this population. The Metabolic syndrome (MetS) and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) are indicators of insulin resistance; however, their predictive value for the development of T2D remains unexplored.

Among 698 initially enrolled healthy South Asian adults aged 30 to 65 in a Rotterdam-based cardiovascular disease prevention study, 270 participants were included after a 14-year follow-up. At baseline, an extensive history, physical examination, and metabolic screening were taken. A follow-up assessment of incident T2D was conducted. Multivariable logistic regression models calculated odds ratios (ORs) for MetS, its components, and HOMA-IR and adjusted for confounders.

33 (12.2%) of participants developed T2D. The presence of MetS at baseline showed an adjusted OR of 2.6, (95% confidence interval (CI) 1.2-5.7, p = 0.02) for incident T2D. Fasting plasma glucose was the most strongly associated component of MetS (OR 3.0, CI 1.1-8.6, p = 0.04) HOMA-IR was also associated and showed an OR of 1.2 per point increase (CI 1.0-1.4, p=0.05).

MetS and FPG were the most important predictors of T2D development in this South Asian cohort. These results underscore the value of diverse variables in T2D detection and give insight into which screening tools for T2D prediction should be used in this high-risk population.

Previous studies on associations between polycyclic aromatic hydrocarbons (PAHs) and lipid profiles are limited. We investigated the associations between urinary PAH metabolites and serum lipid profiles using a representative sample of Korean adults.

This study utilized data from the Korean National Environmental Health Survey (2018-2020) (n = 2,516). The associations of PAH metabolites, heavy metals, and per- and polyfluoroalkyl substances (PFASs), which are ubiquitous pollutants, with lipid indicators and dyslipidemia types were evaluated using linear and logistic regression models, respectively. We examined the associations between a mixture of PAH metabolites, heavy metals, and PFASs and lipid profiles using quantile g-computation analyses.

A doubling of 1-hydroxypyrene (1-OHP) concentrations was associated with higher total cholesterol (TC) [β = 2.50 mg/dL, 95% confidence interval (CI): 1.09, 3.91], low-density lipoprotein cholesterol (LDL-C) (β = 2.39 mg/dL, 95% CI: 1.14, 3.63), and non-high-density lipoprotein cholesterol (non-HDL-C) concentrations (β = 2.13 mg/dL, 95% CI: 0.77, 3.49). A doubling of 1-OHP concentrations was also linked to higher odds of high TC [odds ratio (OR) = 1.15, 95% CI: 1.02, 1.30]. Additionally, 2-naphthol concentrations were associated with higher odds of high TC (OR = 1.14, 95% CI: 1.00, 1.29) and high LDL-C (OR = 1.27, 95% CI: 1.06, 1.51). Lead concentrations were associated with higher levels of TC, LDL-C, non-HDL-C, and high-density lipoprotein cholesterol (HDL-C), as well as with higher odds of high TC, high LDL-C, and high non-HDL-C. Mercury concentrations were associated with higher levels of TC, LDL-C, and non-HDL-C, and with higher odds of high TC. Several PFASs, such as perfluorooctanoic acid, perfluorononanoic acid, and perfluorodecanoic acid, were also associated with lipid profiles. A mixture of PAH metabolites, heavy metals, and PFASs was associated with higher TC, LDL-C, non-HDL-C, and HDL-C concentrations. This mixture was also linked to higher odds of high TC and high LDL-C.

Concentrations of PAH metabolites, heavy metals, and PFASs were associated with unfavorable lipid profiles in the general adult population.

Coronary calcification is a well-known predictor of coronary events, yet the impact of carotid artery calcification on systemic vascular events (e.g., cerebral ischemic, coronary, and peripheral artery events) remains unclear. The aim of this study was to determine whether carotid calcification can be used to predict systemic vascular events.

This single-center, retrospective cohort study included 194 patients who had a history of vascular disease, including carotid stenosis or occlusion, coronary artery disease, valvular heart disease, ischemic stroke, or transient ischemic attack. We collected data pertaining to risk factors and laboratory parameters. Calcification of the carotid arteries was assessed via whole-body computed tomography, and the modified carotid Agatston calcium score (CCS) was determined. Participants were divided into two CCS groups according to the cut-off value determined via receiver operating characteristic curve analysis; high CCS ≥ 126 and low CCS < 126. Coronary, ischemic cerebrovascular, and peripheral vascular events were recorded over a 5-year follow-up period, and their incidence was compared between the groups using Cox proportional hazards regression analysis.

Older age, hypertension, and chronic kidney disease had a significant positive impact on the CCS. Systemic vascular events (hazard ratio [HR]: 2.70, CI: 1.07-6.79, p = 0.022), coronary events (HR: 4.29, CI: 0.87-21.1, p = 0.045), and peripheral vascular events (p = 0.032) were significantly more frequent in the high versus low CCS group.

The CCS may be a useful tool for predicting future systemic vascular events, including those related to coronary and peripheral artery diseases.

To introduce ObMetrics, a free and user-friendly Shiny app that simplifies the calculation, data analysis, and interpretation of Metabolic Syndrome (MetS) outcomes according to multiple definitions in epidemiological studies of paediatric populations. We illustrate its usefulness using ethnically different populations in a comparative study of prevalence across cohorts and definitions.

We conducted a case study using data from two ethnically diverse paediatric populations: a Hispanic-American cohort (N = 1759) and a Hispanic-European cohort (N = 2411). Using ObMetrics, we computed MetS classifications (Cook, Zimmet, Ahrens) and component-specific z-scores for each participant to compare prevalences.

The analysis revealed significant heterogeneity in MetS prevalence across different definitions and cohorts. According to Cook, Zimmet, and Ahrens's definitions, MetS prevalence in children with obesity was 25%, 12%, and 48%, respectively, in the Hispanic-European cohort, and 38%, 27%, and 66% in the Hispanic-American cohort. Calculating component-specific z-scores in each cohort also highlighted ethnic-specific differences in lipid metabolism and blood pressure. By automating these complex calculations, ObMetrics considerably reduced analysis time and minimised the potential for errors.

ObMetrics proved to be a powerful tool for paediatric research, generating detailed reports on the prevalence of MetS and its components based on various definitions and reference standards. Our case study further provides valuable insights into the challenges of characterising metabolic health in paediatric populations. Future efforts should focus on developing unified consensus guidelines for paediatric MetS. Meanwhile, ObMetrics enables earlier identification and targeted intervention for high-risk children and adolescents.

Korea National Health and Nutrition Examination Survey (KNHANES) triglyceride testing changed from the glycerol blanking method (2005-2021) to the glycerol nonblanking method (2022). We converted triglyceride data from 2005-2021 to that obtained since 2022 with different analytical methods.

To develop a conversion equation, 98 fresh serum specimen pairs were compared using Passing-Bablok regression analysis. Implications of the conversion equation on epidemiological data were evaluated using KNHANES data from 2019-2021. Bias estimations determined using the Lipid Standardization Program (LSP) of the United States Centers for Disease Control and Prevention (CDC) enhanced the accuracy and comparability of the triglyceride results.

Triglyceride concentrations measured via the glycerol non-blanking method were 10.7 mg/dL (0.12 mmol/L, 10.0%) higher than those from the glycerol blanking method, with a 9.9 mg/dL (0.11 mmol/L, 5.0%) difference at a concentration of 200 mg/dL (2.26 mmol/L, N=98). The conversion equation y (glycerol non-blanking, 2022)=11.94+0.99x (glycerol blanking, 2005-2021) changed the mean triglyceride concentrations of the KNHANES 2019-2021 data (N=16,015) from 123.7 mg/dL (1.40 mmol/L, 95% confidence interval [CI]: 122.2-125.1 mg/dL [1.38-1.41 mmol/L]) to 134.3 mg/dL (1.52 mmol/L, 95% CI: 132.9-135.8 mg/dL [1.50-1.53 mmol/L]). Since 2022, bias monitoring using the CDC's LSP has remained within a 5.0% limit.

KNHANES triglyceride values in 2022 (non-blanking) were substantially higher than those from 2005-2021 (blanking). Conversion equations helped effectively adjust 2005-2021 data. Researchers should consider adjusting the KNHANES triglyceride data based on their study characteristics.

Myosteatosis has been associated with sarcopenia, and increased mortality risk in patients on hemodialysis. We aimed to explore the associations between myosteatosis, as assessed by computed tomography (CT), with demographic parameters, body composition metrics, muscle strength, metabolic parameters and mortality in patients with chronic kidney disease (CKD).

We enrolled 216 patients (age 60.3 ± 10.6 years, 63% men) with CKD stages 3-5. Abdominal CT scans at the third lumbar vertebra (L3) were used to assess body composition. Abdominal obesity was determined by abdominal adipose tissue (AT), sarcopenia by low skeletal muscle area (SMA) and low handgrip strength. Myosteatosis was evaluated by two parameters using CT scans at L3: mean muscle attenuation and percentage of intermuscular adipose tissue (%IMAT) within SMA. We evaluated the correlation between parameters of myosteatosis with demographic, clinical and metabolic variables. To determine independent predictors of myosteatosis, a multiple linear regression model was fitted. Mortality risk was evaluated with Cox-regression analysis.

Both parameters of myosteatosis were independently associated with age, metabolic syndrome, abdominal AT and SMA in the multiple linear regression analysis (adjusted R2 for multiple linear regression: muscle attenuation model 0.535, P < 0.001; %IMAT model 0.462, P < 0.001). Moreover, higher %IMAT and lower attenuation were associated with a higher mortality risk.

In patients with CKD, increased myosteatosis, as assessed by abdominal CT, was associated with old age, adiposity, metabolic dysfunction, and higher mortality risk.

There are limited data on the progression of liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) in people with type 2 diabetes mellitus (T2DM) versus those without T2DM in biopsy-proven metabolic dysfunction-associated steatotic liver disease. We examined LSM progression in participants with T2DM versus those without T2DM in a large, prospective, multicenter cohort study.

This study included 1231 adult participants (62% female) with biopsy-proven metabolic dysfunction-associated steatotic liver disease who had VCTEs at least 1 year apart. LSM progression and regression were defined by a ≥20% increase and an upward or downward change, respectively, in the LSM category in the Baveno VII categories for compensated advanced chronic liver disease, compared between participants with T2DM (n = 680) versus no T2DM (n = 551) at baseline. The mean (±SD) age and body mass index were 51.8 (±12.0) years and 34.0 (±6.5) kg/m 2 , respectively. The median (IQR) time between the first and last VCTE measurements was 4.1 (2.5-6.5) years. Participants with T2DM had higher LSM progression at 4 years (12% vs. 10%), 6 years (23% vs. 16%), and 8 years (50% vs. 39%), p = 0.04. Using a multivariable Cox proportional hazards model adjusted for multiple confounders, the presence of T2DM remained an independent predictor of LSM progression (adjusted HR: 1.35, 95% CI: 1.01-1.81, p = 0.04). T2DM was not associated with LSM regression ( p = 0.71). Mean HbA1c was significantly associated with LSM progression ( p = 0.003) and regression ( p = 0.02).

Using serial VCTE data from a multicenter study of participants with biopsy-proven metabolic dysfunction-associated steatotic liver disease, we demonstrate that T2DM and HbA1c are associated with LSM progression.

Fenofibrate is a serum lipid-modifying agent that is commonly used to treat dyslipidemia. This study aimed to compare the pharmacokinetics (PKs) and establish bioequivalence of two 145-mg fenofibrate formulations, AD-104 (test) and TRICOR® (reference). This randomized, open-label, two-sequence, two-period crossover study was conducted in healthy Korean participants. Forty participants were enrolled and received either the test or reference formulation during each period, with a 14-day washout between doses. Blood samples were collected pre-dose and up to 72 h post-dose. PK parameters were assessed using non-compartmental analysis with Phoenix WinNonlin®. Bioequivalence was determined if the 90% confidence intervals (CIs) for the geometric mean ratios (GMRs) of the maximum plasma concentration (Cmax) and the area under the concentration-time curve from time zero to the last measurable plasma concentration (AUClast) were within the bioequivalence limits of 0.80 to 1.25. Thirty-eight participants completed the study and were included in the PK analysis. The GMR and 90% CIs for the Cmax and AUClast of the test compared to the reference formulation were 0.8643 (0.8283-0.9019) and 0.9930 (0.9631-1.0239), respectively, both within the bioequivalence limits. No serious adverse events were reported during the study. This study demonstrates that the test formulation is bioequivalent to the reference formulation in healthy Korean participants. Both formulations were safe and well-tolerated; therefore, AD-104 is expected to benefit Korean patients with dyslipidemia. Clinical Research Information Service No. is as follows: KCT0009332 (April 12, 2024).

The association between caffeine intake and constipation remains inconclusive. This study aims to investigate whether caffeine intake is associated with constipation.

This cross-sectional study included 13 941 adults from the 2005-2010 National Health and Nutrition Examination Survey. The weighted logistic regression analyses were exerted to evaluate the association between caffeine intake and constipation. Besides, stratified analyses and interaction tests were conducted to determine the potential modifying factors.

After adjusting for confounders, increased caffeine intake by 100 mg was not associated with constipation, as defined by stool frequency (OR, 1.01; 95% CI, 0.94-1.10) or stool consistency (OR, 1.01; 95% CI, 0.98-1.05). Subgroup analyses showed that cholesterol intake modified the relationship between increased caffeine by 100 mg and stool frequency-defined constipation (P for interaction = 0.037). Each 100 mg increase in caffeine intake was associated with a 20% decreased risk of constipation defined by stool frequency in participants who consumed high cholesterol (OR, 0.80; 95% CI, 0.64-1.00), but no association in the other 2 cholesterol level groups. Furthermore, the association between caffeine intake and stool consistency-defined constipation was not found in different cholesterol groups.

Caffeine consumption is not associated with stool frequency or consistency-defined constipation. Nevertheless, increased caffeine intake may decrease the risk of constipation (defined by stool frequency) among participants in the high-cholesterol intake group.

Background/Objectives: Childhood obesity is a growing global concern linked to metabolic disorders such as nonalcoholic fatty liver disease (NAFLD). Small intestinal bacterial overgrowth (SIBO) may exacerbate these conditions by promoting systemic inflammation and metabolic dysfunction. This review evaluates the prevalence of SIBO in obese children, its association with inflammatory and metabolic markers, and the efficacy of diagnostic and therapeutic strategies. Methods: A systematic search of PubMed, Scopus, and Web of Science (2010-present) was conducted using Boolean operators: ('small intestinal bacterial overgrowth' OR 'SIBO') AND 'prevalence' AND ('low-grade inflammatory markers' OR 'metabolic status') AND 'gut microbiome' AND 'dysbiosis' AND 'obese children'. Results: The data show that SIBO is frequently observed in obese pediatric populations and is associated with gut dysbiosis, impaired nutrient absorption, and reduced production of short-chain fatty acids. These changes contribute to increased intestinal permeability, endotoxemia, and chronic low-grade inflammation. Several microbial taxa have been proposed as biomarkers and therapeutic targets. Diagnostic inconsistencies persist, but treatments such as probiotics, prebiotics, dietary interventions, and selective antibiotics show potential, pending further validation. Conclusions: Early identification and treatment of SIBO with tailored strategies may help reduce metabolic complications and improve outcomes in children with obesity.

Antipsychotic (AP) medications are the primary treatment for severe mental illnesses, including schizophrenia and severe mood disorders. APs are currently categorized into typical or first-generation APs and atypical or second-generation APs. Although both first-generation and second-generation APs are considered effective in treating psychotic symptoms in severe mental disorders, they differ in their mechanisms, treatment strategies, and side effect profiles. Because of their potential motor and metabolic side effects, which often compromise patient adherence and clinical outcomes, whether and how to use APs remains controversial. The use of dietary interventions in combination with APs is emerging as a viable strategy to reduce AP adverse effects while maintaining their efficacy and enhance patient adherence to treatment. In contrast to drugs that possess a well defined molecular mechanism of action, dietary interventions act in pleiotropic ways by nature. While providing a holistic approach to patient care this pleiotropy needs to be analyzed and systematized to enhance the efficacy and safety of the combination of them with APs. Guidelines for this type of treatment are still needed. In this review, we explore the pharmacological properties, therapeutic applications, and limitations of APs, and discuss the potential benefits and limitations of those dietary interventions that are employed to improve the efficacy and counteract side effects of APs discussing also their mechanisms of action. Finally, we critically discuss the main results of clinical studies combining APs and dietary interventions and provide a view on future directions in terms of research and clinical use of these combinations. SIGNIFICANCE STATEMENT: Antipsychotic drugs are useful in a variety of psychiatric conditions, yet their use is hampered by issues of efficacy and safety. An important step toward therapy optimization is their use in combination with dietary interventions (ie, dietary supplements and nutraceuticals) that have shown promising results in clinical trials.

This study aimed to examine the association between isolated maternal hypothyroxinemia (IMH) during the first and second trimesters and the risk of gestational diabetes mellitus (GDM), as well as its association with adverse perinatal outcomes.

The study included 2,741 pregnant women who visited the obstetric outpatient clinic at Shanghai General Hospital and underwent routine obstetric examinations between January 2020 and June 2021. Participants diagnosed with IMH in the first trimester were categorized as H1(+), while those without as H1(-). Similarly, those diagnosed with IMH in the second trimester were categorized as H2(+), and those without as H2(-). Based on these classification, four groups were formed: group A H1(-) H2(-), (n = 1,886); group B H1(+) H2(-), (n = 99); group C H1(-) H2(+), (n = 613); and group D H1(+) H2(+), (n = 143). Retrospective analysis was performed to examine clinical data, including pregnancy complications, across all four groups.

The incidence of GDM was significantly higher in groups B, C, and D compared to group A (all p < 0.001), with the following trend: group D > group C > group B > group A. Specifically, group D exhibited the highest incidence of GDM [n% = 93.01 %, p3 < 0.001]). Logistic regression analysis, adjusted for confounding factors identified IMH during the first trimester, IMH during the second trimester, and persistent IMH across both trimesters as significant risk factors for GDM. Notably, the risk of GDM in cases of persistent IMH was 73.97 times higher than the normal risk (aOR = 73.97, p < 0.001). The study also found that isolated maternal hypothyroxinemia (IMH) was significantly associated with adverse perinatal outcomes.

IMH during either the first or second trimester, and particularly persistent IMH across both trimesters, is strongly associated with a higher risk of GDM and insulin resistance. Our findings highlight the importance of monitoring and managing IMH during pregnancy to mitigate the risk of adverse perinatal outcomes. Early intervention may improve both maternal and neonatal health.

This pilot study investigated the impact of Integrative Health Coaching (IHC) frequency on biometrics, dietary intake, and physical activity changes among participants of the Loma Linda University Health (LLUH) Intensive Therapeutic Lifestyle Change (ITLC) program. This retrospective cohort design analyzed the effects of IHC frequency on pre-post participant behaviors and health outcomes among forty-four participants (aged 35-78). Participants engaged in the 8-week ITLC program and received individual and group health coaching sessions. Assessments included an InBody scan, various laboratory panels, and the American College of Lifestyle Medicine (ACLM) lifestyle forms. Weak positive correlations were observed between IHC frequency and pre-post physical activity, and fruit and vegetable intake, but were not statistically significant. Clinically significant changes were noted in physical activity levels among participants with hyperlipidemia and diabetes/prediabetes. High physical activity was associated with a reduction in high-density lipoproteins (HDL-C) levels and showed slight decreases in body mass index (BMI), HbA1c, and low-density lipoproteins (LDL-C). The change in HbA1c was positively associated with a similar change in BMI (rho = .42, P < .01). Clinically significant changes were observed in BMI, total cholesterol, and LDL due to lifestyle changes which included modifying physical activity and nutrition.

Obesity, characterized by excess body fat, has been recognized as one of the main global health problems of the current times. This article, based on the data from the Cohort study of risk factors for non-communicable diseases in Indonesia (FRPTM), aims to analyze the food consumption patterns and their association with the risk of obesity and related non-communicable diseases (NCDs) in the Indonesian population.

The article presents data collected from 867 respondents aged 25 years and above observed for 5 years: 2011, 2013, 2015, 2017 and 2019. It includes sociodemographic characteristics, consumption (1 × 24-h recall), anthropometry, and biomedical data (lipid profile, blood glucose, blood pressure).

The study identified cereals as the food group consumed in the largest amount and the largest contributor to energy, protein, carbohydrates and fiber intake. The fats and oils group exceeded the recommended intake, while vegetable and fruit consumption, and consequently the fiber intake, were far below the recommendations. The energy and macronutrient intake, and the percentage of respondents with excessive intake levels, were consequently increasing during the studied years. The consumption patterns were associated with the incidence of obesity, which increased from 43.9% in 2011 to 69.9% (central obesity) and 67.9% (BMI-based obesity) in 2019.

The dynamics of the consumption patterns clearly impacted the obesity prevalence. At the same time, the NCDs biomarkers measured remained relatively stable despite increasing obesity and macronutrient intake over the study period. The study provides important insights into diet-related risks for obesity in Indonesia, with a potential to inform public health policies and relevant intervention strategies.

This review aims to address current research gaps and evaluate the effectiveness and safety of probiotic and synbiotic supplementation in patients with metabolic syndrome (MetS).

Four databases (PubMed, Cochrane, Embase, and Web of Science) were searched to find the randomized controlled trials published up to October 20, 2023. Anthropometric measurements, glucose, blood pressure and lipid metabolism were main outcomes, inflammatory markers, liver function, and etc. were the secondary outcomes. A meta-analysis was conducted by Review Manager 5.4 and STATA 15.0. In addition, sensitivity analysis and subgroup analysis were conducted to assess the stability of outcomes and potential sources of heterogeneity. Twenty-four full-text articles met the inclusion criteria, involving 1186 patients. The pooled analysis demonstrated significant reductions in body weight (WMD: -0.79 kg; p = 0.001), waist circumference (WMD: -1.04 cm; p = 0.0007), total cholesterol (SMD: -0.14; p = 0.03), triglyceride (SMD: -0.25; p = 0.0001), fasting blood glucose (SMD: -0.20; p = 0.003), and insulin levels (SMD: -0.17; p = 0.03). Additionally, the probiotic and synbiotic group showed increased high-density lipoprotein cholesterol (SMD: 0.15; p = 0.02). Subgroup analysis implied that age <50 years, intervention duration <12 weeks, and Asian patients may have better curative effects. No significant increase in adverse reactions was reported.

Probiotic and synbiotic supplementation can effectively improve body composition, lipid metabolism, and glucose metabolism in MetS patients without increasing adverse reactions. Further rigorous and long-term trials are required to validate these results and refine intervention details.

Despite increased cardiovascular (CV) disease risks after pre-eclampsia, guidelines remain indefinite on the necessity, timing, and frequency of CV risk assessment in these women. We aimed to provide prevalence-based recommendations on systematic follow-up after pre-eclampsia by evaluating the age-related prevalence of CV risk factors in former pre-eclamptic women compared to women with a history of normotensive gestation.

A retrospective cohort study was performed amongst parous women, up to 30 years postpartum. Prevalence of CV risk constituents was assessed based on standardized clinical measurements and medical history, including hypertension, diabetes mellitus, hypercholesterolaemia, obesity, insulin resistance, chronic kidney disease, and micro-albuminuria We included 1040 women after pre-eclampsia and 518 normotensive gestated controls. Higher development rates of either/combined hypertension, diabetes mellitus, or hypercholesterolaemia were observed after pre-eclampsia than normotensive gestation (aHR 2.6 (95% CI 2.1-3.2)). These factors occurred on average 8 years earlier after pre-eclampsia (39 ± 9 years) than normotensive gestation (47 ± 8 years). With ageing, hypertension prevalence increased more steeply after pre-eclampsia (P-value interaction = 0.044). Cumulative proportion of hypertension exceeded the 10% cut-off for CV risk assessment initiation from 35 years onwards in women after pre-eclampsia, with an increase above the 5% cut-off for re-assessment every five years.

Cardiovascular risk factors occur almost a decade earlier in former pre-eclamptic women compared to women after normotensive gestation, predominantly, but not exclusively, due to the early and accelerated development of hypertension. Systematic CV risk (re-)assessment is recommended at least five yearly in former pre-eclamptic women from 35 years of age onwards.

Social determinants of health (SDOH) and metabolic syndrome (MetS) are related, but their combined effect on mortality risk remains unclear.

We analyzed data from NHANES (National Health and Nutrition Examination Survey) cycles between 2005 and 2018. The composite SDOH score was calculated by summing the weighted scores for each SDOH, categorizing participants into four groups: Q1 (0-1), Q2 (2-3), Q3 (4) and Q4 (≥ 5). Kaplan-Meier survival curves and multivariate Cox proportional hazards models were used to examine the relationship between SDOH and mortality outcome. Restricted cubic spline (RCS) analyses were conducted to explore nonlinear relationships. Subgroup analyses assessed the consistency and robustness of the findings across various demographic and clinical factors.

Of the 7,366 patients with MetS, 1,193 died, including 407 from cardiovascular and cerebrovascular diseases and 269 from cancer. Cox regression analyses, using fully adjusted Model 2, revealed that higher SDOH levels had increased hazards for all-cause mortality (HR = 2.41, 95% CI: 1.87,3.12), cancer-related death (HR = 2.45, 95% CI: 1.54,3.89), and Cardio - cerebrovascular disease (HR = 2.62, 95% CI: 1.79,3.84). Kaplan-Meier analyses further supported these findings, demonstrating that participants with higher SDOH scores had lower survival rates. Additionally, RCS modeling confirmed a linear relationship between SDOH and mortality, with no indication of a nonlinear relationship (P for nonlinear > 0.05).

Our findings indicate that adverse social determinants of health are strongly linked to an increased risk of all-cause mortality in individuals with MetS. However, due to the observational and cross-sectional nature of this study, it is important to interpret these results as associations rather than implying any causal relationships.

Serum uric acid (SUA), a byproduct of purine metabolism, exerts both antioxidant and pro-inflammatory effects, making its role in aging and chronic diseases a subject of ongoing debate. Despite this, the mechanisms by which SUA influences the aging process remain poorly understood.

We analyzed data from the NHANES (1999-2010) and CHARLS (2011-2015) cohorts to investigate SUA's impact on biological aging. Generalized linear regression models assessed SUA's effect on biological aging markers [ΔKDM-BA, ΔPhenoAge, and allostatic load (AL)], while Cox regression models estimated its association with all-cause and premature mortality. Dose-response relationships between SUA levels and aging markers (ΔKDM-BA, ΔPhenoAge, and AL), as well as all-cause and premature mortality, were evaluated using restricted cubic splines (RCS).

In both cohorts, elevated SUA levels were significantly associated with accelerated aging. In the NHANES cohort, for each 1 mg/dL increase in SUA, ΔKDM-BA increased by 0.52 years (95% CI: 0.43-0.61, p < 0.0001), and AL increased by 0.38 (95% CI: 0.29-0.47, p < 0.0001). In the CHARLS cohort, SUA was similarly linked to an increase in ΔKDM-BA by 0.65 years (95% CI: 0.57-0.74, p < 0.0001) and AL by 0.15 (95% CI: 0.12-0.18, p < 0.0001). RCS analysis revealed a nonlinear association between SUA and ΔKDM-BA in NHANES, with a more pronounced acceleration of aging when SUA levels exceeded 4.16 mg/dL (nonlinear p < 0.0001). In CHARLS, SUA showed a nonlinear relationship with ΔKDM-BA (nonlinear p = 0.01). Additionally, in NHANES, SUA levels were associated with increased all-cause (HR: 1.04, 95% CI: 1.01-1.07, p = 0.01) and premature mortality (HR: 1.06, 95% CI: 1.00-1.13, p = 0.046). RCS analysis further demonstrated a U-shaped nonlinear relationship between SUA levels and both all-cause and premature mortality. In contrast, SUA did not show a significant association with mortality outcomes in the CHARLS cohort.

Elevated SUA is associated with accelerated biological aging in both U.S. and Chinese populations, but its link to mortality was evident only in the NHANES cohort. These findings highlight SUA as a potential aging marker and call for further population-specific investigation.

Subclinical hypothyroidism is associated with metabolic diseases; however, it remains controversial in older individuals.

This work aimed to investigate the relationship between thyrotropin (TSH) levels and metabolic diseases.

In this cross-sectional study, sampling was conducted from nationally representative general communities from 31 provinces in mainland China. A total of6791 older (aged ≥65 years) and 55 303 young participants (aged 18-64 years) were selected after excluding individuals with overt hyperthyroidism or overt hypothyroidism. According to the kit, TSH reference range (0.27-4.2 mU/L) and the age-specific TSH range previously formulated (an upper limit of 8.86 mU/L for older adults and 6.57 mU/L for young adults), the older adults and young adults were separately divided into 4 groups based on their TSH levels. Main outcome measures included anthropometric assessments, serum concentrations of thyroid functions, and various metabolic parameters.

In contrast to young adults, there was no significant increase in the prevalence of any metabolic disorders assessed in the slightly elevated TSH group (TSH 4.21-8.86 mU/L) compared to the euthyroid group (TSH 0.27-4.2 mU/L) among older adults. After adjusting for interference factors, a TSH level higher than 8.86 mU/L was found to be an independent risk factor for low high-density lipoprotein cholesterol (OR, 1.84; 95% CI, 1.14-2.98) and dyslipidemia (OR, 1.49; 95% CI, 1.09-2.04) when compared to the euthyroid group in older adults.

Slightly elevated TSH levels are not associated with an increased risk of metabolic diseases in older adults. Therefore, we recommend raising the upper limit of the TSH range for individuals aged 65 years and older.

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder with reproductive and metabolic dysregulation. PCOS has been associated with inflammation and metabolic syndrome (MetS); however, the moderating effects of inflammation as measured by C-reactive protein (CRP) and menopause on the PCOS-MetS association have not been studied in Hispanic/Latinas with PCOS who have a higher metabolic burden.

We studied the cross-sectional association between PCOS and (1) MetS in 7316 females of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), (2) subcomponents of MetS including impaired fasting glucose (IFG) and elevated triglycerides (TGL), and (3) effect modification by menopausal status and CRP.

The HCHS/SOL is a multicenter, longitudinal, and observational study of US Hispanic/Latinos. Our study sample included females from visit 2 with self-reported PCOS and MetS (ages 23-82 years).

PCOS (prevalence = 18.8%) was significantly associated with MetS prevalence [odds ratio [odds ratio (OR) = 1.41 (95% confidence interval: 1.13-1.76)], IFG and TGL (OR = 1.42 (1.18-1.72), OR = 1.48 (1.20-1.83), respectively]. We observed effect modification by menopausal status (ORpre = 1.46, Pint= .02; ORpost = 1.34, Pint= .06) and CRP (ORelevated = 1.41, Pint= .04; ORnormal = 1.26, Pint= .16) on the PCOS-MetS association. We also observed a superadditive interaction between CRP and PCOS, adjusting for which resulted in an attenuated effect of PCOS on MetS (OR = 1.29 [0.93-1.78]).

Hispanic/Latino females with PCOS had higher odds of MetS, IFG, and elevated TGL than their peers without PCOS. Interaction analyses revealed that the odds of MetS are higher among PCOS females who have premenopausal status or high inflammation. Interventions in Hispanic/Latinas should target these outcomes for effective management of the disease.

Background/Objectives: The current study aims to estimate the frequency of abnormal renal status (ARS, defined as chronic kidney disease (CKD) diagnosis in electronic medical records or current albuminuria) in people with newly diagnosed diabetes mellitus (DM), to determine the associated risk factors, and to evaluate the level of compliance with good clinical practice recommendations. Methods: Cross-sectional study with 1030 adults diagnosed with DM in the last 4 years. Anthropometric, clinical, analytical, and lifestyle variables were collected. Multivariate analyses were performed to determine the factors associated with ARS. Results: Hypercholesterolaemia, metabolic syndrome, hypertension, obesity, hypertriglyceridaemia, and cardiovascular disease (CVD) were the most prevalent comorbidities. ARS was present in 11.5% of patients. The variables associated with ARS were male sex (OR: 1.78; 95% CI, 1.16-2.75), age ≥70 years (OR: 2.96; 95% CI: 1.92-4.56), hypertension (OR: 1.59; 95% CI: 1.03-2.44), CVD (OR: 1.73; 95% CI: 1.03-2.90), and hemoglobin A1c (HbA1c) ≥8% (OR: 2.26; 95% CI, 1.19-4.27). Among patients with hypertension and albuminuria, 80% received angiotensin-converting enzyme inhibitors (ACE inhibitor) or an angiotensin receptor blocker (ARB), compared to 60% of those with albuminuria without hypertension. The 42.4% patients with ARS were treated with sodium-glucose cotransporter type 2 inhibitors (SGLT2i) and 72% with statins, but only 31.5% achieved the target low density lipoproteins cholesterol (LDLc) < 70 mg/dL. Conclusions: ARS in newly diagnosed patients with DM is less common than described in the literature, but risk factors for its development are highly prevalent. Adherence to good clinical practice recommendations was poor, especially in LDL cholesterol targets and the use of SGLT2i.

It has been reported that periodontitis was a risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this study is to investigate the impact of periodontitis on all-cause and cause-specific mortality of MASLD patients.

We included 11,019 individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) from the National Health and Nutrition Examination Survey. Multivariable Cox proportional hazards models were utilized to analyze the estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality and cause-specific mortality among participants with different periods of periodontitis status. Additionally, we employed restricted cubic splines (RCS) curves to explore the dose-response relationship between clinical attachment level (CAL) and pocket probing depth (PPD) and mortality rates. Finally, a series of sensitivity analyses and stratification analyses were conducted to test the reliability and robustness of the results.

In this study, moderate to severe periodontitis significantly increased the all-cause mortality (HR 1.29, 95% CI 1.08-1.55; P = 0.003) and cardiovascular disease (CVD)-related mortality (HR 1.41, 95% CI 1.10-1.79; P = 0.006) among MASLD participants. However, no significant effects of different periodontal statuses on cancer mortality were observed among MASLD participants.

A nationwide large-sample longitudinal study indicated that MASLD patients with moderate to severe periodontitis experienced significantly higher all-cause and CVD-related mortality rates compared to those with no or mild periodontitis.

Down syndrome (DS) stands as the most frequent chromosomal abnormality leading to intellectual disability. A prevalence rate of 6.1-13.1 per 10 000 births has been estimated. Although life expectancy has been increasing from 25 years in 1983 to 60 years in 2020 in this population, their quality may be impaired by the development of diseases. However, it has also opened the possibility of carrying out a significant number of cardiovascular risk studies in DS. This includes comparisons of biochemical cardiometabolic risk factors, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), between normal-weight children with DS and age- and gender-matched children without DS.

In this cross-sectional study, with parental consent, 25 children with DS and 30 age-matched controls (8-12 years old) participated. Body mass index (BMI) was calculated from anthropometric assessments, while glucose and lipid profiles were measured from the obtained blood samples.

According to the World Health Organization BMI criteria, all individuals from both groups had normal weight. The DS group exhibited higher TC (179.4 ± 50.4 mg/dL vs. 120.7 ± 31.6 mg/dL, p < 0.000), TG (125.2 ± 42.5 mg/dL vs. 86.5 ± 54.1 mg/dL, p < 0.005) and LDL-C (108.1 ± 40.8 mg/dL vs. 120.8 ± 53.5 mg/dL, p = 0.373), while HDL-C was lower (46.3 ± 12.3 mg/dL vs. 54.7 ± 11.8 mg/dL, p = 0.008) compared with the control group.

The present study suggests that children with DS have a higher prevalence of cardiometabolic risk factors compared with the general population, regardless of weight, highlighting the importance of studying dyslipidaemias in the DS population independently of body weight.

Previous studies suggested that decreased saliva lactoferrin (LF) levels might be used to differentiate subjects with mild cognitive impairment (MCI) from subjects with normal cognitive function (NCF). Here, we aimed to assess differences in plasma LF concentrations between subjects with NCF and MCI.

In total, 113 NCF subjects and 113 MCI individuals were included in this study. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, and anthropometric parameters, body composition, physical activity, cardio-metabolic parameters, and LF levels were measured.

MCI subjects had significantly lower LF levels than NCF participants (p < 0.0001). There were also significant differences between the study groups in the smoking history (p = 0.0190), alcohol consumption (p = 0.0036), intake of hypoglycaemic drugs (p = 0.0140), vigorous activity (MET-min/day: p = 0.0223, min/day: p = 0.0133), and energy expenditure associated with activity (p = 0.0287). Moreover, the MoCA test results significantly correlated with LF levels (p = 0.0026), and there were significant differences between MoCA tertiles and LF levels (p = 0.0189). Also, adjusted logistic regression analysis results showed that LF concentrations (p = 0.0382), alcohol consumption (p = 0.0203), and intake of hypoglycaemic drugs (p = 0.0455) were independent predictors of MCI prevalence.

In conclusion, MCI subjects are characterised by lower plasma LF concentrations than NCF individuals, but further studies are needed to confirm these findings.

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease which predominantly affects joints, but it can also lead to significant extra-articular complications, particularly cardiovascular disease (CVD). Chronic systemic inflammation promotes endothelial dysfunction and accelerates atherosclerosis, increasing cardiovascular risk.

Current data were analyzed to explore the mechanisms between RA and CVD, focusing on systemic inflammation, pro-inflammatory cytokine patways (IL-1, IL-6, TNF, and JAK-STAT), and their interactions with traditional cardiovascular risk factors. Recent studies and clinical guidelines were reviewed to highlight gaps and advances in risk assessment and management.

Persistent disease activity and the presence of autoantibodies significantly increase cardiovascular risk in RA contributing to atherosclerosis and major cardiovascular events. Data also suggest that anti-inflammatory treatments, including methotrexate and biologic agents, may lower this risk.

This review highlights the pathophysiological mechanisms between RA and CVD, and the need for early diagnosis and active monitoring to identify and assess cardiovascular risk. A multidisciplinary approach, involving rheumatologists and cardiologists is essential for optimizing cardiovascular risk management and improving patient outcomes. Optimization of cardiovascular risk management strategies in patients with RA should be an essential component of current medical practice, with the main goal of reducing morbidity and mortality from cardiovascular complications.

The Cardiac Metabolic Index (CMI) is a comprehensive metabolic indicator, but studies on its relationship with Diabetic Kidney Disease (DKD) are limited. We aim to explore the association between CMI and DKD.

We obtained participant-related data from the National Health and Nutrition Examination Survey (NHANES), including complete information on DKD, CMI, and other covariates. We employed weighted multivariable logistic regression models, restricted cubic spline (RCS) regression analysis, subgroup analyses, and interaction tests to explore the relationship between CMI and DKD. Additionally, we utilized receiver operating characteristic (ROC) curves to compare the performance of CMI in identifying DKD relative to a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), and lipid accumulation product (LAP) indices.

According to the logistic regression analysis, a positive correlation between CMI and DKD was observed among the 2371 participants included in the study (OR: 1.40, 95% CI: 1.19-1.66). RCS analysis indicated that this relationship is nonlinear. When CMI was converted from a continuous variable to quartiles, the prevalence of DKD in the highest quartile group showed a significant 84% increase compared to the lowest quartile group (OR: 1.84, 95% CI: 1.24-2.72). The area under the ROC curve of CMI for identifying DKD was 0.67, outperforming other indices. The results of subgroup analyses and interaction tests were stable.

Elevated CMI is associated with an increased risk of DKD and can serve as a low-cost screening tool, allowing physicians to potentially identify high-risk diabetic patients early and implement timely interventions to slow the progression of DKD.

The albumin-globulin ratio (AGR) is considered an important indicator reflecting an individual's immune function and nutritional status, and it is closely associated with various health conditions. However, despite its widely studied correlations in numerous health fields, the link between AGR and Overactive Bladder (OAB) is still not completely comprehended.

Data were sourced from the National Health and Nutrition Examination Survey (NHANES) database, selecting adult samples spanning from 2007 to 2018. Through comprehensive questionnaires and laboratory tests, we gathered data pertinent to OAB and the AGR. To explore the association between AGR levels and the likelihood of developing OAB, we utilized advanced statistical techniques, such as weighted multivariate logistic regression and restricted cubic spline (RCS) models. Furthermore, we carried out subgroup analyses to assess the uniformity of this association across various demographics.

After adjusting for relevant covariates, we discovered a marked negative correlation between AGR levels and the risk of OAB. As AGR increased, the incidence of OAB showed a declining trend (OR = 0.69; 95% CI 0.56-0.85). Furthermore, significant nonlinear dose-response relationship was observed between AGR levels and the risk of OAB (P < 0.001), and this association remained stable in stratified analyses.

Our results indicate that elevated AGR levels could be linked to a reduced risk of OAB. This observation highlights the potential role of AGR in assessing and preventing the occurrence of OAB.