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Objective Patients with chronic kidney disease (CKD) show features of premature ageing. We aimed to evaluate the association between biological ageing and adverse outcomes, including end-stage kidney disease (ESKD), cardiovascular diseases (CVD) and all-cause mortality, in patients with CKD. Methods 23 435 participants with CKD and free of related adverse outcomes at baseline from the UK Biobank were included. Leukocyte telomere length (LTL) was measured by quantitative polymerase chain reaction assay. Clinical biomarker–based biological ages were quantified using Klemera–Doubal method biological age (KDM-BA) and PhenoAge algorithms. Results During a median follow-up of 12 years, 3417 incident CVD, 383 incident ESKD and 3195 all-cause mortality were recorded. Per SD increment of KDM-BA acceleration was associated with a 56% [95% confidence interval (CI): 41%–73%], 26% (95% CI: 21%–31%) and 39% (95% CI: 34%–44%) increase in the risk of incident ESKD, incident CVD and all-cause mortality, respectively. Similar results were found for PhenoAge acceleration. LTL (per SD increment) was inversely associated with the risk of incident CVD [hazard ratio (HR): 0.96, 95% CI: 0.92–0.99] and all-cause mortality (HR: 0.94, 95% CI: 0.91–0.98) and was not significantly associated with the risk of incident ESKD (HR: 0.96, 95% CI: 0.86–1.06). Adding KDM-BA acceleration or PhenoAge acceleration, but not LTL, to the traditional validated clinical prediction models significantly improved the predictive performance for incident ESKD, all-cause mortality and CVD. Conclusion In patients with CKD, both KDM-BA acceleration and PhenoAge acceleration were associated with an increased risk of ESKD, CVD and all-cause mortality, and KDM-BA or PhenoAge may be a better predictor on adverse outcomes than LTL. [ABSTRACT FROM AUTHOR]

• Participants with high genetic risks of kidney stones had a higher risk of new-onset kidney stones. • Habitual fish oil use was associated with a lower risk of new-onset kidney stones in participants with low or intermediate genetic risk of kidney stones. • The findings underscore the importance of fish oil intake against the development of gene-less-determined kidney stones. We aimed to assess the association between habitual fish oil use and new-onset kidney stones in participants with different levels of genetic risks of kidney stones. 477,311 participants free of kidney stones at baseline from the UK Biobank cohort were included. Fish oil use was collected by both food frequency questionnaires and 24-h dietary recalls. A genetic risk score (GRS) for kidney stones was calculated based on 20 single-nucleotide polymorphisms associated with kidney stones. The primary outcome was new-onset kidney stones. During a median follow-up of 12.0 years, 5,637 cases of kidney stones were documented. Participants with high genetic risks of kidney stones had a higher risk of new-onset kidney stones (vs. low or intermediate risks; adjusted HR, 1.52; 95 %CI:1.44–1.60). Compared with non-users, habitual use of fish oil was associated with a lower risk of new-onset kidney stones (adjusted HR, 0.84, 95 %CI, 0.78–0.92) in participants with low or intermediate genetic risks, but not in those with high genetic risks of kidney stones (adjusted HR, 1.02, 95 %CI, 0.93–1.12; P -interaction =0.001). Among those with low or intermediate genetic risks of kidney stones, compared with fish oil constant nonusers, the adjusted HRs (95 %CI) for kidney stones were 0.89 (0.75–1.06), 0.72 (0.58–0.90), and 0.79 (0.64–0.97), for fish oil occasional users, modestly constant users, and moderately and highly constant users (P for trend = 0.001), respectively. Habitual fish oil use was associated with a lower risk of new-onset kidney stones in participants with low or intermediate genetic risk of kidney stones. [ABSTRACT FROM AUTHOR]

Background and Objective The prospective association between dietary zinc (Zn) intake and cognitive decline remains uncertain. We aimed to assess the relationship of dietary Zn intake with the risk of cognitive decline in the Chinese older people, and examine the possible effect modifiers on this association. Methods A total of 3,106 older Chinese adults aged 55 years or older from China Health and Nutrition Survey were included. Dietary nutrients intake information was collected by combined 24-h dietary recalls with weighing food inventory. The cognitive decline was defined as the 5-year decline rate in global and composite cognitive scores, based on a subset of items from the Telephone Interview for Cognitive Status–modified. Results The median follow-up duration was 5.9 years. There was an L-shaped association between dietary Zn intake and the 5-year decline rates in global and composite cognitive scores, with an inflection point at 8.8 mg/day of dietary Zn. For the composite cognitive scores, compared with the first quantile (<7.9 mg/day) of dietary Zn intake, quantiles 2–6 (≥7.9 mg/day) had a significantly slower cognitive decline rate (β : −0.24; 95% confidence interval: −0.40 to −0.07). Similar results were found for the global cognitive scores. Moreover, the inverse association between dietary Zn intake and cognitive decline in composite cognitive scores was significantly stronger in those with lower levels of physical activity (P -interactions = 0.041). Conclusion Dietary Zn intake was negatively associated with cognitive decline in the older people. Maintaining appropriate dietary Zn levels may prevent cognitive decline. [ABSTRACT FROM AUTHOR]

Background: The association between different sedentary behaviors and hypertension risk remains unclear. We aimed to explore the relationship between different domains of sedentary behaviors and new‐onset hypertension, investigate whether genetic susceptibility to hypertension modifies the relationship, and examine the extent to which the relationship is mediated by body mass index (BMI) and grip strength. Methods: 212 714 participants without baseline hypertension in the UK Biobank were enrolled. The three major sedentary behaviors (TV‐watching, nonoccupational computer use, and driving) were measured using touch screen questionnaires. The primary outcome was new‐onset hypertension. Results: During a median follow‐up of 11.9 years, 13 983 participants developed hypertension. There was a linear positive association between TV‐watching time and new‐onset hypertension (p for nonlinearity =0.868). A J‐shaped association was found for nonoccupational computer use time and driving time with new‐onset hypertension, with an inflection point of 0.5 h/day for both (both p for nonlinearity <0.001). Polygenetic risk scores for hypertension (based on 118 related single‐nucleotide polymorphisms) did not significantly modify these associations (all p‐interactions >0.05). Furthermore, the detrimental effects of long‐term sedentary behaviors on hypertension were mediated by BMI by 21%–30%, and the beneficial effects of limited sitting time (within 0.5 h/day) for driving and nonoccupational computer use were mediated by grip strength by 6–25%. Conclusions: There was a positive association for hands‐independence sedentary behavior (TV‐watching), and a J‐shaped association for hands‐dependence sedentary behaviors (nonoccupational computer use and driving) with new‐onset hypertension, regardless of genetic risks of hypertension. These relationships were partly mediated by BMI and grip strength. [ABSTRACT FROM AUTHOR]

The association between dietary Cu intake and mortality risk remains uncertain. We aimed to investigate the relationship of dietary Cu intake with all-cause mortality among Chinese adults. A total of 17 310 participants from the China Health and Nutrition Survey, a national ongoing open cohort of Chinese participants, were included in the analysis. Dietary intake was measured by three consecutive 24-h dietary recalls in combination with a weighing inventory over the same 3 d. The average intakes of the 3-d dietary macronutrients and micronutrients were calculated. The study outcome was all-cause mortality. During a median follow-up of 9·0 years, 1324 (7·6 %) participants died. After adjusting for sex, age, BMI, ever alcohol drinking, ever smoking, education levels, occupations, urban or rural residents, systolic blood pressure, diastolic blood pressure and the intakes of fat, protein and carbohydrate, the association between dietary Cu intake and all-cause mortality followed a J-shape (P for nonlinearity = 0·047). When dietary Cu intake was assessed as quartiles, compared with those in the first quartile (<1·60 mg/d), the adjusted hazard ratios for all-cause mortality were 0·87 (95 % CI (0·71, 1·07)), 0·98 (95 % CI (0·79, 1·21)) and 1·49 (95 % CI (1·19, 1·86)), respectively, in participants in the second (1·60–<1·83 mg/d), third (1·83–<2·09 mg/d) and fourth (≥2·09 mg/d) quartiles. A series of subgroup analyses and sensitivity analyses showed similar results. Overall, our findings emphasised the importance of maintaining optimal dietary Cu intake levels for prevention of premature death. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to investigate the relations of handgrip strength, walking pace and the combination of handgrip strength and walking pace with incident hypertension, and to explore whether this association was modified by the genetic risk of hypertension. Methods: 214 214 participants without prior hypertension in the UK Biobank were included. Handgrip strength was assessed by dynamometer. Walking pace was self‐defined as slow, average, or brisk. The study outcome was incident hypertension. A genetic risk score for hypertension was generated using a Bayesian approach applied to meta‐analyzed summary statistics GWAS data. Results: Over a median follow‐up of 11.9 years, 13 344 (6.2%) participants developed incident hypertension. When handgrip strength was assessed as sex‐specific quartiles, compared with those with the lowest handgrip strength (quartile 1), the adjusted HRs (95% CI) of incident hypertension in quartile 2, quartile 3, and quartile 4 were 0.80 (0.69, 0.93), 0.74 (0.64, 0.86), and 0.72 (0.61, 0.84), respectively. Compared with those with slow walking pace, participants with average (HR, 0.52; 95% CI: 0.40, 0.67) or brisk (HR, 0.43; 95% CI: 0.32, 0.56) walking pace had significantly lower risks of hypertension. Moreover, compared with those with both lower handgrip strength (quartile 1) and slow walking pace, the lowest risk of incident hypertension was observed in participants with both high handgrip strength (quartiles 2–4) and fast (average or brisk) walking pace (HR, 0.36; 95% CI: 0.25, 0.52). Genetic risks of hypertension did not significantly modify the association (p‐interaction = 0.300). Conclusion: Both higher handgrip strength and faster walking pace were significantly associated with a lower risk of incident hypertension, independent of genetic risks of hypertension. [ABSTRACT FROM AUTHOR]

Codes used in the UK Biobank to identify dementia cases b HT

We aimed to evaluate the relationship of the variety and duration of different sedentary behaviors (TV-watching, driving, and nonoccupational computer use) with the risk of dementia in older participants, and examine whether inflammation and genetic susceptibility may modify the relationship. A prospective cohort study. 173,829 older participants (≥60 years) without prior dementia in the UK Biobank were enrolled. A healthy sedentary behavior score was calculated as the number of the 3 major sedentary behaviors with a duration associated with the lowest risk of dementia. The primary outcome was new-onset all-cause dementia. During a median follow-up of 12.4 years, 4965 (2.9%) participants developed new-onset dementia. There were U-shaped associations for TV-watching and driving time, and a reversed J-shaped association for nonoccupational computer use time with new-onset all-cause dementia, with the lowest dementia risk at >0-<2 hours/day for all the 3 sedentary behaviors. Moreover, a higher healthy sedentary behavior score was significantly associated with a lower risk of all-cause dementia (per 1 score increment: hazard ratio 0.78, 95% CI 0.75-0.81), with a stronger inverse association in those with higher levels of high-sensitivity C-reactive protein and monocytes (both P -interactions <.05). Genetic risks of dementia did not significantly modify the association. Similar trends were found for new-onset Alzheimer's disease and vascular dementia. The associations between the duration of different sedentary behaviors and new-onset dementia were different in the older population. Moreover, the variety of sedentary behavior was inversely associated with new-onset dementia, especially among those with higher levels of inflammation. [ABSTRACT FROM AUTHOR]

Background: Depression and chronic kidney disease (CKD) often coexist. However, both the relations of depression with CKD development and CKD with depression risk were still elusive. We aimed to investigate the bidirectional relations between renal function and depression in a cohort of young and middle-aged adults.Methods: Using data from the Coronary Artery Risk Development in Young Adults study, the analysis of depressive symptoms and incident CKD (analysis 1) was performed in 3,731 participants without CKD, and the analysis of renal function and incident depression (analysis 2) was performed in 2,994 participants without depression. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (-CES-D), and depression was defined as CES-D scores ≥16 or self-reported history of depression or antidepressant medication use. CKD was defined as estimated glomerular filtration rate <60 ml/min/1.73 m2 or urinary albumin to creatinine ratio ≥30 mg/g.Results: In analysis 1, 485 participants developed incident CKD during 61,202 person-years of follow-up, and CES-D scores (≥16 vs. <16; adjusted HR, 1.28; 95% CI, 1.04 to 1.59) were significant positive associated with incident CKD. In analysis 2, 1,029 participants developed incident depression during 42,927 person-years of follow-up, and CKD was significantly associated with a 36% increased risk of incident depression compared to non-CKD (HR, 1.36; 95% CI, 1.05 to 1.76).Limitations: Depressive symptoms were only assessed using CES-D score, which is not the gold standard for the clinical diagnosis of depression.Conclusions: This prospective cohort study monitored over 20 years indicated a bidirectional association between depression and CKD. [ABSTRACT FROM AUTHOR]

Background: The relation of domestic physical activity with hypertension remains uncertain. We aimed to evaluate the prospective relation of domestic physical activity and new-onset hypertension among Chinese males and females.Methods: A total of 9254 adults who were free of hypertension at baseline were enrolled from the China Health and Nutrition Survey. Data on domestic physical activity were obtained by using self-reported questionnaires, and calculated as metabolic equivalent task (MET)-hours/week. Metabolic equivalent task-hours/week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up.Results: A total of 2892 participants developed hypertension during 81996 person-years of follow-up. Overall, there were reversed J-shaped associations between the domestic physical activity and new-onset hypertension in both males and females (both P values for nonlinearity < .001). Consistently, when domestic physical activity was assessed as categories (<10, 10 -< 20, 20 -< 30, 30 -< 40, 40 -< 50, 50 -< 60, 60 -<70, 70 -< 80, 80 -< 90, 90 -< 100, ≥100 MET-hours/week), compared with those with domestic physical activity < 10 MET-hours/week, the lower and similar risks of new-onset hypertension were found in participants with domestic physical activity 30 -< 90 MET-hours/week in both males and females.Conclusions: Moderate domestic physical activity was associated with a lower risk of new-onset hypertension among both males and females. [ABSTRACT FROM AUTHOR]