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Previous studies have mainly focused on the effects of individual fatty acids on depressive symptoms, while the combined effect of fatty acids on the risk of depressive symptoms has not yet been extensively reported. This study evaluate the associations between individual and multiple fatty acids with depressive symptoms in U.S. adults. Data sets were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 cycles. Both males and females aged above 18 years with complete information about dietary fatty acids intake, depression symptoms, and covariates were included. Weighted linear regression models were conducted to evaluate the relationships between individual fatty acid intake and depressive symptoms, and restricted cubic spline (RCS) models were utilized to explore the corresponding dose-response relationships. Additionally, we implemented the weighted quantile sum (WQS) regression and quantile g-computation (QGC) models to estimate the mixed effects of 19 fatty acids and identify the predominant types. After multivariable adjustments, an increase of one unit in Linoleic acid (LA), Alpha-Linolenic Acid (ALA), Arachidonic acid (AA), Docosapentaenoic acid(DPA), Docosahexaenoic acid(DHA), was associated with a decrease in depressive scores by −0.021 (95 % CI: −0.039,-0.003, p = 0.021),-0.028 (95 % CI: −0.045,-0.011, p = 0.002),-0.026 (95 % CI: −0.044,-0.008, p = 0.005), −0.026 (95 % CI: −0.042,-0.009, p = 0.003), and − 0.022 (95 % CI: −0.041,-0.003, p = 0.022), respectively. However, a per unit increase in Hexanoic acid and Octanoic acid was associated with an increase in depressive scores of 0.020 (95 % CI: 0.002,0.038, p = 0.029) and 0.026 (95 % CI: 0.004,0.048, p = 0.020), respectively. Meanwhile, significant dose-response relationships were supported by the RCS models. As for the mixed effects, both WQS and QGC models demonstrated that the mixture of polyunsaturated fatty acids (PUFAs) was inversely related to depressive symptoms, and ALA and DPA were the most critical contributors. DHA was negatively correlated with depressive symptoms in WQS analysis, but positively correlated with depressive symptoms in QGC analysis. The cross-sectional design limits our ability to establish causality, and 24-hour dietary recall can lead to potential inaccuracies reflecting participants' true eating habits. Our study suggests that the single effects of each PUFA were inversely associated with depressive symptoms, except for octadecatetraenoic acid. Moreover, higher combined intake of dietary PUFAs is inversely associated with depressive symptoms in U.S. adults. Among the mixed effects of PUFAs, ALA and DPA may play predominant roles. However, DHA mixed with other fatty acids may have different effects on depressive symptoms, and further study is needed. • For single effects, almost the intake of all PUFAs were inversely associated with depressive symptoms, and significant dose-response relationships were fond. • Higher combined intake of dietary PUFAs is inversely associated with depression symptoms in U.S. adults, and ALA and DPA may play predominant roles. • DHA mixed with other fatty acids may have different effects on depressive symptoms. [ABSTRACT FROM AUTHOR]

Aim: To assess the association of Life's Essential 8 (LE8) and the presence of abdominal aortic calcification (AAC) with mortality among middle‐aged and older individuals. Methods: Participants aged older than 40 years were enrolled from the National Health and Nutrition Examination Survey 2013‐2014. AAC was assessed using dual‐energy X‐ray absorptiometry. Mortality data were ascertained through linkage with the National Death Index until 31 December 2019. The LE8 score incorporates eight components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose and blood pressure. The total LE8 score, an unweighted average of all components, was categorized into low (0‐49), medium (50‐79) and high (80‐100) scores. Results: This study included 2567 individuals, with a mean LE8 score of 67.28 ± 0.48 and an AAC prevalence of 28.28%. Participants with low LE8 scores showed a significantly higher prevalence of AAC (odds ratio = 2.12 [1.12‐4.19]) compared with those with high LE8 scores. Over a median 6‐year follow‐up, there were 222 all‐cause deaths, and 55 cardiovascular deaths occurred. Participants with AAC had an increased risk of all‐cause (hazard ratio [HR] = 2.17 [1.60‐2.95]) and cardiovascular (HR = 2.35 [1.40‐3.93]) mortality. Moreover, individuals with AAC and low or medium LE8 scores exhibited a 137% (HR = 2.37 [1.58‐3.54]) and 119% (HR = 2.19 [1.61‐2.99]) higher risk of all‐cause mortality, as well as a 224% (HR = 3.24 [1.73‐6.04]) and 125% (HR = 2.25 [1.24‐4.09]) increased risk of cardiovascular mortality, respectively. Conclusions: The LE8 score correlates with AAC prevalence in middle‐aged and older individuals and serves as a valuable tool for evaluating the risk of all‐cause and cardiovascular mortality in individuals with AAC. [ABSTRACT FROM AUTHOR]

Objective: Obesity is often accompanied by insulin resistance (IR) and diabetes. We explored the association between vitamin D levels and IR in non-diabetic obesity. Methods: We conducted a cross-sectional study based on the data of National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. Non-diabetic individuals (aged ≥20 years) with obesity (BMI ≥ 30kg/m2) were included in the study. And HOMA-IR ≥ 2.5 was defined as IR. The multivariable linear regression models were constructed to evaluate the associations between levels of 25(OH)D and HOMA-IR. We calculated the odds ratio (OR) and 95% confidential intervals (CIs) for associations between 25(OH)D deficiency and IR in obesity using multivariable logistic regression models. Results: Overall, a total of 3887 individuals were included in this study. Serum vitamin D level was significant lower in obesity participants with IR than that of non-IRs. The linear regression models showed that vitamin D level was inversely associated with HOMA-IR in obesity after adjusting for covariables (β=-0.15, 95%CI (-0.28, −0.02), p = 0.028). And the multivariable logistic regression models indicated an association between vitamin D deficiency and IR in obesity ((OR= 1.38, 95%CI (1.09-1.73), p = 0.007)). The further stratified regression analyses among different BMI demonstrated that vitamin D deficiency (OR = 1.4, 95%CI (1.05,1.86), p = 0.022) only contributed to developing IR in class I obesity. Conclusion: This study suggested an association of vitamin D levels with IR in obesity. And vitamin D deficiency contributed to IR in class I obesity. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate how arthritis, including osteoarthritis and rheumatoid arthritis, affects the incidence of nocturia in adults aged 20–59. Methods: This study utilized data from the National Health and Nutrition Examination Survey from 2005 to 2020, involving 18 745 adults aged 20–59. Arthritis, including osteoarthritis and rheumatoid arthritis, was considered as the exposure factor, with nocturia as the outcome variable. We first compared the baseline characteristics of individuals with and without nocturia. The impact of arthritis on nocturia was assessed using weighted multivariate logistic regression models. To ensure the stability of the results, propensity score matching analysis and subgroup analyses were conducted. Results: The incidence of nocturia was approximately 22.31%, and the incidence of arthritis was about 15.32% (2871/18 745), with osteoarthritis accounting for 35.49% (1019/2871) and rheumatoid arthritis accounting for 20.20% (580/2871). Adjusted multivariate logistic regression analysis revealed that the risk of nocturia was increased by arthritis (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.28–1.65, p < 0.0001), including osteoarthritis (OR = 1.45, 95% CI: 1.18–1.78, p < 0.001) and rheumatoid arthritis (OR = 1.51, 95% CI: 1.14–2.00, p = 0.004). After propensity score matching using nearest neighbor methods at a 1:1 ratio, this relationship still exists. Subgroup analyses showed no significant differences in the interactions between arthritis and the risk of nocturia across various factors, such as age, family income to poverty ratio, education level, body mass index, smoking status, hypertension, and diabetes. However, significant differences were observed across different sex groups and sleep trouble groups. Conclusions: This study revealed that arthritis, including osteoarthritis and rheumatoid arthritis, increased the risk of nocturia in adults under the age of 60. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to find out the relation between visceral adipose index (VAI) levels and stress urinary incontinence (SUI) in adult women. Methods: From the National Health and Nutrition Examination Survey (NHANES) 2007–2020, females aged 20 or above were identified for this study. Visceral adiposity was determined using the VAI score, and the assessment of urinary incontinence was carried out through a correlation questionnaire. Logistic regression models and restricted cubic spline (RCS) regression were employed to analyze the relationship between VAI levels and SUI. Results: Among the 6522 participants, 2672 (41.0%) were reported SUI. Multivariate logistic regression revealed significantly higher odds of SUI with increasing VAI levels (Q4 vs. Q1), adjusted odds ratio (aOR) = 1.53 (CI: 1.29−1.81, p < 0.001). RCS regression indicated a curvilinear relationship between VAI and SUI (p = 0.003). In threshold analysis, aOR for developing SUI was 1.18 (CI: 1.11–1.26, p < 0.001) for participants with VAI < 4.73, suggesting an 18% increased risk of SUI with each unit increase in VAI. No association between VAI and SUI was observed when VAI was ≥4.73. Conclusions: Our study has revealed a significant curvilinear relationship between VAI and SUI within a large and representative sample of women. Future research is necessary to evaluate the relationship between the two and explicate the underlying mechanisms of this relationship. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence of a possible correlation between depression and overactive bladder (OAB). However, few studies have classified depression according to its severity. Whether there is an association between different levels of depression and OAB symptoms remains unclear. Methods: Participants with complete information about depression, OAB, and covariates in the National Health and Nutrition Examination Survey (NHANES) 2005–2018 were included in this study. Depression symptoms were assessed by the Patient Health Questionnaire‐9. OAB symptoms were evaluated by the Overactive Bladder Symptom Score. Weighted multivariate logistic regression models were applied to analyze the relationship between depression and OAB. Results: A total of 30 359 participants were included in this study, consisting of 6245 OAB patients and 24 114 non‐OAB participants. The multivariate logistic regression suggested depression independently correlated with OAB (odds ratio [OR] = 2.764, 95% confidence interval [CI] = 2.429–3.146, p < 0.001). Further, mild (OR = 2.355, 95% CI = 2.111–2.627, p < 0.001), moderate (OR = 3.262, 95% CI = 2.770–3.841, p < 0.001), and moderately severe to severe depression (OR = 3.927, 95% CI = 3.246–4.752, p < 0.001) were all associated with OAB. Additionally, depression was also correlated with urgency urinary incontinence (OR = 2.249, 95% CI = 1.986–2.548, p < 0.001) and nocturia (OR = 2.166, 95% CI = 1.919–2.446, p < 0.001). Conclusion: This study indicated different levels of depression, even mild depression, were independent risk factors for OAB. Given the frequent coexistence and potential interactions between depression and OAB, clinicians should be aware of the importance of assessing both physical and psychological symptoms in these patients. Early diagnosis and holistic treatment may improve the treatment outcomes, particularly for those suffering from both conditions. [ABSTRACT FROM AUTHOR]

Purpose: This investigation seeks to determine the triglyceride glucose (TyG) index's link to stress urinary incontinence (SUI) in American females of adult age. Methods: The investigation relied on data acquired via the National Health and Nutrition Examination Survey (NHANES) conducted over the period from 2011 to 2018. The independent relationship between TyG index and SUI was tested using multivariate logistic regression analysis. We applied a smooth curve fitting approach to analyze the interrelation of them. In addition, subgroup analysis was conducted and interaction experiments were conducted. Results: Among 4459 female participants aged 20 and above, TyG index and SUI demonstrated a favorable correlation. Model 3 indicated that with every single‐unit rise in the TyG index, the incidence of SUI increases by 18% [1.18 (1.01, 1.38)]. In contrast to individuals in the lowest tertile, subjects within the highest tertile of the TyG index exhibited a 68% increase in SUI incidence [1.68 (95% CI: 1.26, 2.23), 0.0004]. By using smooth curve fitting, a nonlinear positive evidence of an interconnection of the TyG index to SUI was identified. Conclusions: Women exhibiting increased TyG index levels are at a heightened risk of SUI. TyG index displays a stronger correlation than that observed with BMI. According to our findings, the TyG index is viewed as a potential tool for identifying SUI in women, and monitoring the value of TyG index may be helpful for predicting the occurrence of SUI. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the association between blood lead levels and the prevalence of nocturia in American adults. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020, focusing on individuals aged 20 years or older (n = 11,919). Blood lead levels were categorized into two groups (<2 µg/dL and ≥2 µg/dL), and the presence of nocturia was assessed based on questionnaire responses. We used multivariable logistic regression models to explore the association between blood lead levels and nocturia while adjusting for various covariates, including sex, ratio of family income to poverty (RIP), lipid profile, age, body mass index (BMI), race, citizenship, sleep trouble, diabetes, and hypertension. To verify whether certain covariates influence blood lead levels and the risk of nocturia, we conducted subgroup analyses. Results: Of the study participants, 31.70% reported experiencing nocturia. Individuals with higher blood lead levels (≥2 µg/dL) exhibited a higher likelihood of experiencing nocturia compared to those with lower levels (<2 µg/dL) in all three models (Model 1: OR 1.46, 95% CI 1.29–1.66, p < 0.0001; Model 2: OR 1.25, 95% CI 1.09–1.44, p = 0.002; Model 3: OR 1.22, 95%CI 1.06–1.41, p = 0.01). Subgroup analyses revealed that factors such as age, sex, sleep trouble, diabetes, hypertension, BMI, RIP, and race did not affect the association between blood lead levels and the risk of nocturia (P for interaction >0.05). Conclusions: This study reported the correlation between blood lead levels and nocturia. We found that compared to blood lead levels below 2 µg/dL, when lead levels reached or exceeded 2 µg/dL, the risk of nocturia occurrence increased by 22%. Clinical trial registration: This study is based on existing data from a public database and not from a specific clinical trial; hence, clinical registration information is not provided. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionOxidative stress plays a crucial role in the development of multiple chronic respiratory diseases. Oxidative Balance Score (OBS) composing of 16 dietary factors and 4 lifestyle factors has been developed to evaluate the effect of oxidants/antioxidants produced by dietary intake and lifestyle habits on the overall oxidative balance. However, the relationships between OBS with asthma, COPD, and asthma-COPD overlap (ACO) are still unclear.A total of 10,942 adults aged 20 years and older from the 2013-2018 National Health and Nutrition Examination Survey were included in the analyses. ANOVA and chi-square tests were used to compare characteristics between different OBS subgroups.Multiple multivariate logistic regression was used to analyze the associations between OBS and asthma, COPD, and ACO.RCS curves were used to describe the dose-response effect of the associations. Subgroup analyses and interaction effects were employed to reflect the stability of the associations.In the fully adjusted models, OBS was found to be negatively associated with asthma, COPD, and ACO. OBS at Q2, Q3, and Q4 (OR: 0.66, 95% CI: 0.46-0.97) were negatively associated with the risk of asthma. OBS at Q2 and Q4 were negatively associated with the risk of COPD. OBS at Q2 and Q4 were negatively associated with the risk of ACO. The RCS curves reflected the negative dose-response trend of association. Moreover, the associations were stable in various subgroups.The negative associations between OBS and asthma, COPD, and ACO were found in American adults, providing evidence for dietary and lifestyle prevention. [ABSTRACT FROM AUTHOR]

Background: Frailty often requires intensive care, and the admission outcomes of frail patients are often poor. However, owing to the lack of reliable diagnostic indicators, quickly identifying frailty is challenging. The present study aimed to explore the associations of the platelet/high-density lipoprotein cholesterol ratio (PHR; a novel inflammatory indicator) with frailty and all-cause mortality. Methods: The present study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Frailty was assessed on the basis of the 49-item Frailty Index. The associations of the PHR with frailty and long-term survival prognosis were explored through weighted logistic regression, weighted restricted cubic spline (RCS), and weighted Cox regression, with adjustments for demographic factors, lifestyle, blood lipids, medication history, and complications. In addition, subgroup and interaction analyses were conducted. Finally, several sensitivity analyses were performed. Results: A total of 15,615 adult participants were included, with 7,928 women (53.63%) and an average age of 60.76 years. After fully adjusting for confounding variables, the prevalence of frailty in the highest PHR quartile group of was significantly greater than that in the lowest quartile group (OR: 1.23, 95% CI: 1.04–1.47; P = 0.02). The RCS showed that the inflection point was 166.7. Before and after the inflection point, the PHR was negatively associated (OR: 0.88, 95% CI: 0.80–0.97, P = 0.01) and positively associated (OR: 1.10, 95% CI: 1.02–1.19, P = 0.01) with frailty, respectively. Subgroup analysis suggested that the association between PHR and frailty was stronger in women than in men. A total of 5,544 frail participants were included in the survival analysis. The RCS revealed that the PHR was associated with the all-cause mortality risk of frail participants in a U-shaped manner, with an inflection point of 240.4. Before and after the inflection point, the PHR decreased (HR: 0.89, 95% CI: 0.81–0.97, P = 0.01) and the all-cause mortality risk increased (HR: 1.08, 95% CI: 1.02–1.14, P = 0.01), respectively. Conclusion: The present study suggests that there is a J-shaped association between PHR and frailty in the adult population of the United States and that the association between the PHR and frailty is stronger in women. In addition, the PHR has a U-shaped relationship with the all-cause mortality risk of frail patients. [ABSTRACT FROM AUTHOR]

Background: Endometriosis is a complex disorder with genetic, immune, inflammatory, and multifactorial etiologies. Zinc, an essential trace element, plays a crucial role in various physiological processes. Dysregulation or deficiency of zinc can lead to aberrations in human physiology. However, the association between dietary zinc and endometriosis remains ambiguous. This study aimed to investigate the link between dietary zinc intake and endometriosis. Methods: Utilizing cross-sectional data from the National Health and Nutrition Examination Survey, we analyzed information from American women aged 20–54 years between 1999 and 2006. After adjusting for relevant covariates, multivariable logistic regression analysis was employed to assess correlations. Results: A total of 4315 women were included in the study. The multivariable logistic regression model revealed a positive correlation between dietary zinc intake and the risk of endometriosis, even after controlling for confounding variables. Relative to individuals with lower zinc consumption (≤ 8 mg/day), the adjusted odds ratio (OR) values for dietary zinc intake and endometriosis in the 8–14 mg/day and > 14 mg/day groups were 1.19 (95% CI: 0.92–1.54, p = 0.189) and 1.60 (95% CI: 1.12–2.27, p = 0.009), respectively. Conclusions: Our findings suggest a positive correlation between dietary zinc intake and the prevalence of endometriosis. However, further investigations are necessary to better understand this association and explore the potential role of dietary zinc in endometriosis. [ABSTRACT FROM AUTHOR]

Purpose: The Composite Dietary Antioxidant Index (CDAI) is a novel, inclusive measure for evaluating the antioxidant potential of diets. We aim to explore the link between the CDAI and abdominal aortic calcification (AAC) in U.S. adults aged ≥ 40 years. Methods: This cross-sectional study collected dietary and AAC data for individuals aged ≥ 40 years from the 2013–2014 National Health and Nutrition Examination Survey (NHANES) database. The CDAI was calculated using six dietary antioxidants. AAC was evaluated using a semi-quantitative scoring system known as AAC-24, with an AAC score greater than 6 as severe AAC (SAAC). To examine the association between CDAI and AAC, including SAAC, liner/logistic regression analyses and smooth curve fitting were applied. Results: A total of 2,640 participants were included in this study, and significant decreases in AAC score and SAAC prevalence were observed with ascending CDAI levels (P < 0.01). After adjusting for confounding factors, a clear link was established between the CDAI and both AAC score (β = -0.083, 95% CI -0.144–0.022, P = 0.008) and SAAC (OR = 0.883, 95% CI 0.806–0.968, P = 0.008), respectively. Further smooth curve fitting indicated a negative correlation between CDAI and both AAC score and SAAC. Conclusions: Dietary antioxidant consumption, as quantified by the CDAI, shows an inverse relationship with AAC risk. Additional longitudinal and intervention studies are essential. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is a complication of chronic kidney disease (CKD). Whether malnutrition, assessed via the geriatric nutritional risk index (GNRI), is associated with the incidence and risk of CKD in older individuals remains unclear. Methods: Data from the National Health and Nutrition Examination Survey and the UK Biobank database were used. Older participants over 60 years old with available data for GNRI assessment and CKD diagnosis were enrolled. Logistic regression models and Cox regression models were used to assess associations between the geriatric nutritional risk index and the risk of and mortality associated with CKD. Results: This study enrolled 13,162 participants from the NHANES and 66,326 participants from the UK Biobank. We identified 6,135 and 16,662 CKD patients in the NHANES and UK Biobank, respectively, with the majority being male (74% in the NHANES and 52% in the UK Biobank). The average age of CKD patients was 72.3 (SD 7.2) years in the NHANES and 64.9 (SD 2.9) years in the UK Biobank. The median follow-up times of older CKD patients were 81 months and 162 months in the NHANES and UK Biobank, respectively. According to the cross-sectional analysis, individuals with a lower GNRI had an increased likelihood of having CKD, with odds ratios of 1.38 (95% CI: 1.05–1.80, P = 0.020) in the NHANES and 2.35 (95% CI: 1.89–2.92, P < 0.001) in the UK Biobank. According to our analysis of the risk of incident CKD in the UK Biobank, a lower GNRI was associated with a greater incidence of CKD (HR: 1.11, 95% CI: 1.04–1.18; P = 0.002). According to the analysis of the risk of mortality, a lower GNRI was associated with an increased risk of death among older CKD patients (NHANES: HR: 1.69, 95% CI: 1.13–2.53, P = 0.011; UK Biobank: HR: 2.28, 95% CI: 1.94–2.69, P < 0.001). Conclusion: Malnutrition assessed by the GNRI was significantly and independently associated with the incidence of CKD. Moreover, CKD patients with malnutrition also have a high risk of mortality. [ABSTRACT FROM AUTHOR]

The purpose of this research was to examine the relationship between the hemoglobin-to-red blood cell distribution width ratio (HRR) and cardiovascular disease (CVD)-related mortality in people who have diabetes.Data derived from the National Health and Nutrition Examination Survey (NHANES), between the years 1999 to 2018, were meticulously analyzed. Mortality data, encompassing events until December 31, 2019, were systematically collected. A comprehensive group comprising of 8,732 participants were subjected to scrutiny, and subsequently, classified into four distinct groups predicated upon quartiles of baseline HRR levels: Q1 (n = 2,183), Q2 (n = 2,181), Q3 (n = 2,185), and Q4 (n = 2,183). The correlation between HRR and CVD-related mortality was examined through the use of survival curves and Cox proportional hazard regression models, the latter incorporating weights as advised by NHANES.Among the 8,732 participants in the study cohort, CVD-related mortality was identified in 710 cases. The Kaplan-Meier analysis demonstrated a significant association, indicating that a decreased HRR was correlated with a reduction in survival in cases with CVD. Both univariate and multivariable Cox proportional hazard regression analyses consistently indicated that patients exhibiting a lower HRR exhibited a markedly elevated risk of CVD-related mortality in comparison to those with higher HRR. Notably, the correlation between HRR and decreasing CVD-related mortality was discerned to be non-linear.In patients with diabetes, a decreased HRR was associated with an increased risk of CVD-related mortality. [ABSTRACT FROM AUTHOR]

Background: Emerging studies reveal a shared pathophysiological underpinning for metabolic problems and mental illnesses. The present study aimed to determine the association between atherogenic index of plasma (AIP) and the incidence of major depressive disorder (MDD). Methods: 7,951 subjects of US adults were collected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. MDD was evaluated through the Patient Health Questionnaire (PHQ-9). Multivariate logistic regression, sensitivity analysis, and spline smoothing plot method were used to identify the relationship between AIP and MDD. The cut-off point was calculated using recursive partitioning analysis when segmenting effects emerged. The area under the receiver operating characteristic (ROC) curve (AUC) and Hosmer-Lemeshow test were conducted to evaluate the performance of AIP in identifying MDD. Subgroup analyses and interaction tests were used to explore whether the association was stable in different populations. Results: A positive correlation between AIP and PHQ-9 score and MDD was both observed in 7,951 subjects included in the study, with a significant threshold of -0.42 determined using recursive partitioning analysis. In the fully adjusted model, a positive association between AIP and PHQ-9 score and MDD was observed (b=0.46, 95% CI 0.14~0.78; OR=1.42, 95% CI 1.04~1.93). Individuals in the highest AIP quartile had a 0.39-unit higher PHQ-9 score (b=0.39, 95% CI 0.12~0.66) and a significantly 33% greater risk of MDD than those in the lowest AIP quartile (OR=1.33, 95% CI 1.02~1.73). Spline smoothing plot analysis further confirmed the positive and non-linear association between AIP and PHQ-9 and MDD. ROC analysis (AUC=0.771) and the Hosmer-Lemeshow test (c2 = 14.239, P=0.076) suggested an excellent performance and goodness-of-fit of the relatively optimal model. DCA and CIC analysis also revealed a favorable overall net benefit and clinical impact of the model. Subgroup analyses and interaction tests revealed that the association between AIP and PHQ-9 score and MDD remained consistent across different subgroups and was not modified by other covariates, and this positive correlation was more pronounced in those with diabetes or hypertension. Results: A positive correlation between AIP and PHQ-9 score and MDD was both observed in 7,951 subjects included in the study, with a significant threshold of -0.42 determined using recursive partitioning analysis. In the fully adjusted model, a positive association between AIP and PHQ-9 score and MDD was observed (b=0.46, 95% CI 0.14~0.78; OR=1.42, 95% CI 1.04~1.93). Individuals in the highest AIP quartile had a 0.39-unit higher PHQ-9 score (b=0.39, 95% CI 0.12~0.66) and a significantly 33% greater risk of MDD than those in the lowest AIP quartile (OR=1.33, 95% CI 1.02~1.73). Spline smoothing plot analysis further confirmed the positive and non-linear association between AIP and PHQ-9 and MDD. ROC analysis (AUC=0.771) and the Hosmer-Lemeshow test (c2 = 14.239, P=0.076) suggested an excellent performance and goodness-of-fit of the relatively optimal model. DCA and CIC analysis also revealed a favorable overall net benefit and clinical impact of the model. Subgroup analyses and interaction tests revealed that the association between AIP and PHQ-9 score and MDD remained consistent across different subgroups and was not modified by other covariates, and this positive correlation was more pronounced in those with diabetes or hypertension. [ABSTRACT FROM AUTHOR]

Purpose: The Cardiometabolic Index (CMI) is a novel marker of visceral obesity and dyslipidemia. Our study aimed to explore the association between CMI and kidney stones among US adults. Methods: This cross-sectional study was conducted among adults with complete records of CMI and kidney stones information from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Inverse probability treatment weighting (IPTW) was used to balance the baseline characteristics of the study population. The independent relationship between CMI and kidney stones was evaluated using IPTW-adjusted multivariate logistic regression, restricted cubic splines (RCS), and subgroup analysis. Results: A total of 9,177 participants, with an average CMI of 0.72 (0.99), were included in this study. The IPTW-adjusted logistic regression revealed that CMI was an independent risk factor for kidney stones. The adjusted odds ratio (OR) for kidney stones were 1.39 (95% CI: 1.24 - 1.56, P < 0.001) for the second CMI tertile and 1.31 (95% CI: 1.17 - 1.47, P < 0.001) for the third CMI tertile, compared with the first CMI tertile. A linear relationship between CMI levels and kidney stone risk was observed in the RCS analysis. Subgroup analysis showed that the association between CMI levels and kidney stone risk remained stable across groups. Conclusions: A positive association between CMI level and the risk of kidney stones was observed among US adults in our study. Further large-scale prospective studies are needed to validate our findings. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis (OP) and sarcopenia are prevalent musculoskeletal conditions among the elderly. Nevertheless, the causal relationship between sarcopenia and OP remains a subject of controversy and uncertainty. In this study, we employed cross-sectional analysis and Mendelian randomization (MR) to investigate the intricate relationship between sarcopenia and OP. Methods: The cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2020, which involved in 116,876 participants. It assessed the correlation between sarcopenia, osteoporosis (OP), and bone mineral density (BMD) using Chi-square tests, Ttests, and a multiple logistic regression model. Additionally, we conducted Mendelian randomization (MR) analysis to investigate the causal effects of sarcopenia-related characteristics (ALM) on OP. We employed IVW, sensitivity analysis, heterogeneity testing, and other methods for MR. The ALM data was sourced from the UK Biobank (n=450,243), while the aggregated data on OP was obtained from GWAS statistics (n=53,236). Results: In this cross-sectional analysis, we observed that in the multivariate logistic regression model, without adjusting for any variables, OP emerged as a risk factor for sarcopenia [OR 95% CI = 1.90 (1.13-3.18), P = 0.02]. Following adjustments for gender, age, BMI, and biochemical variables, OP retained its status as a risk factor for sarcopenia [OR 95% CI = 3.54 (1.91-6.54), P < 0.001]. Moreover, after accounting for all variables, OP emerged as an independent risk factor for sarcopenia [OR 95% CI = 4.57 (1.47-14.22), P = 0.01].In the MR analysis, we uncovered that femoral neck BMD (FN BMD), lumbar spine BMD (LS BMD), and forearm bone mineral density (FA BMD) exerted a direct causal influence on ALM [FA BMD: OR 95% CI = 1.028 (1.008, 1.049), p = 0.006; FN BMD: OR (95% CI) = 1.131 (1.092, 1.170), p = 3.18E-12; LS BMD: OR (95% CI) = 1.080 (1.062, 1.098), p = 2.86E-19]. Conclusion: Our study has revealed a positive correlation between OP and the prevalence of sarcopenia. It suggests a potentially robust causal relationship between OP and sarcopenia. Notably, OP appears to be associated with a higher likelihood of losing ALM, and a significant loss of ALM may contribute to a decline in LS BMD. [ABSTRACT FROM AUTHOR]

Background and purpose: Previous studies have shown that human herpes simplex virus (HSV) infection may be associated with the onset of headache or migraine. We aimed to investigate the association between HSV infection and severe headache or migraine. Materials and methods: The cross-sectional data on 5,730 participants aged 20-49 years were obtained from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). We used weighted logistic regression analysis to assess the association between HSV infection (HSV-1 gG-1 and HSV-2 gG-2) and severe headache or migraine, and performed subgroup analyses. Results: Our study found that women, higher education, higher body mass index, better family conditions, smoking and alcohol consumption were all associated with severe headaches or migraines. After adjusting for confounding factors such as sex, age, race, and education, HSV-2 (+) was still significantly associated with severe headache or migraine (OR = 1.22, 95%CI:1.03-1.46, p = 0.0443). In subgroup analyses, we found that participants with HSV-1 (-) and HSV-2 (+) were also significantly associated with severe headache or migraine (OR = 1.41, 95%CI:1.04-1.91, p = 0.0281). Conclusion: HSV-2 gG-2(+) was significantly associated with severe headache or migraine. [ABSTRACT FROM AUTHOR]

Background: The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) is a novel lipid measure for assessing the risk of cardiovascular disease. Lipid metabolism disorders are reportedly associated with hearing impairment. This study aimed to investigate the potential association between NHHR and hearing. Methods: The data used in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) cycles of 2005–2010 and 2017–2018, including 4,296 participants aged 6–19 years. The NHHR was calculated from lipid profiles, and hearing was assessed using pure-tone audiometry. Weighted multivariate logistic regression analyses were used to investigate the association between the NHHR and hearing loss. Subgroup and sensitivity analyses were performed to verify the robustness of the results. Results: Univariate analysis revealed significant associations between the NHHR and hearing threshold at all categorized frequency (low, speech, or high-frequency) (P < 0.001). Three models were used: an unadjusted model, a model adjusted for age, sex, and race, and a model further adjusted for PIR, BMI, and diabetes. Multiple regression analysis confirmed these associations consistently across all models. When considered as a continuous variable, NHHR had a significant association with enhanced hearing thresholds at all categorized frequencies: low-frequency (β:0.56, 95% CI: 0.36–0.75), speech-frequency (β:0.55, 95% CI: 0.36–0.7), and high-frequency (β:0.55, 95% CI: 0.36–0.74). The adjusted models showed persistent positive correlations after controlling for covariates. The NHHR was consistently positively associated with hearing loss. The NHHR and auditory thresholds showed a general dose-response association across all frequencies. Conclusions: NHHR is a promising biomarker for predicting adolescent hearing threshold shifts and hearing loss. The study highlights the importance of early lipid monitoring and management as strategies to prevent or reduce hearing impairment. [ABSTRACT FROM AUTHOR]

The neutrophil-to-lymphocyte ratio (NLR), a simple marker of systemic inflammation, is crucial in the progression of cardiovascular diseases (CVD). Its predictive value for all-cause and cardiovascular mortality in CVD patients with diabetes or pre-diabetes remains unclear. We analyzed 3,780 CVD patients with diabetes or pre-diabetes from the National Health and Nutrition Examination Survey (2001–2018). Kaplan-Meier survival curves, weighted Cox proportional hazards models, and restricted cubic spline (RCS) analyses were used to assess the relationship between NLR and mortality risk. RCS revealed a U-shaped association between NLR and all-cause mortality, with an inflection point at 1.776. For NLR < 1.776, the risk of all-cause mortality decreased by 13% per unit increase in NLR (HR: 0.87, 95% CI: 0.76–0.98). For NLR ≥ 1.776, the risk increased by 15% per unit increase (HR: 1.15, 95% CI: 1.10–1.26). A positive linear association was found between NLR and cardiovascular mortality, with a 17% increase in risk per unit increase in NLR (HR: 1.17, 95% CI: 1.10–1.25). No significant interactions were observed in stratified analyses. Our study revealed the U-shaped relationship between NLR and all-cause mortality, and a positive linear relationship with cardiovascular mortality in CVD patients with diabetes or pre-diabetes. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The Composite Dietary Antioxidant Index (CDAI) measures the antioxidant capacity of the diet, which is believed to provide protection against various diseases, including depression, osteoporosis, and papillomavirus infection, by neutralizing harmful oxidative stress. However, the relationship between CDAI and infertility is not well understood. This research aims to explore the potential correlations between CDAI and the risk of infertility.This research harnessed data from the National Health and Nutrition Examination Survey (NHANES) to execute a cross‐sectional analysis involving 8263 US women aged 20–45. Each participant was subjected to two distinct 24‐h dietary recall interviews. We calculated the CDAI using average daily antioxidant intake. Infertility was assessed using a standardized questionnaire. The association between CDAI and infertility was examined using weighted multiple logistic regression models, while nonlinear correlations were explored through restricted cubic splines. To affirm the robustness of our findings, sensitivity and subgroup analyses were performed using unweighted logistic regression. Additionally, to ascertain the causal influence of circulating antioxidant levels on infertility, a two‐sample univariable Mendelian randomization (MR) analysis was conducted, using the inverse variance weighted (IVW) method as the primary analytic approach.Participants who were infertile exhibited lower CDAI levels compared to their fertile counterparts. When confounding variables were accounted for in the multivariate weighted logistic regression model, an inverse relationship was observed between CDAI and infertility, with the odds ratio for the highest versus lowest quartile being 0.55 (0.33–0.90, P = 0.02). However, the IVW method indicated that genetically predicted elevated levels of CDAI did not significantly correlate with infertility.Cross‐sectional observational studies indicate that antioxidants from diets might diminish infertility risks. However, findings from MR studies do not confirm a causal connection. Additional prospective research is required to elucidate this association further. [ABSTRACT FROM AUTHOR]

Objective: Although abnormal lipid metabolism is one of the major risk factors for diabetes, the correlation between lipids and glucose is rarely discussed in the general population. The differences in lipid-glucose correlations across gender and ethnicity have been even more rarely studied. We examined the association between fasting blood glucose (FBG) and lipids, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein B (ApoB), using 6,093 participants aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES). Methods: Analyses were performed using multiple logistic regression and generalised additive models. Results: When other confounders were considered, we found that fasting glucose was positively correlated with triglycerides and negatively correlated with HDL-C, whereas total cholesterol, LDL-C cholesterol, and fasting glucose were related to each other in a U-curve fashion, with inflection points of 5.17 mmol/L and 2.3 mmol/L, respectively.This relationship persisted in subgroups of different sexes and races. A positive correlation was found between fasting glucose and ApoB, but subgroup analyses revealed that this relationship was not correlated across gender and race. Conclusion: In the general population, fasting blood glucose levels were positively correlated with TG, negatively correlated with HDL-C, and U-shaped with total cholesterol and LDL-C. The likelihood of developing diabetes was 40% higher when LDL-C was greater than 2.3 mmol/L than in patients with LDL-C less than 2.3 mmol/L. [ABSTRACT FROM AUTHOR]

ABSTRACT The weight‐adjusted‐waist index (WWI) is an innovative measure of obesity that appears to surpass body mass index (BMI) in assessing lean body mass and fat mass. This study aimed to evaluate the relationship between WWI and AS in hypertensive adults in the United States. The study included 9753 adults diagnosed with hypertension from the National Health and Nutrition Examination Survey (NHANES), which spanned the years 2007–2016. WWI was calculated by dividing waist circumference (in cm) by the square root of body weight (in kg), and arterial stiffness (represented by estimated pulse wave velocity [ePWV]) was analyzed as the outcome. Weighted multiple linear regression and smooth curve fitting were used to test for linear and nonlinear associations. Threshold effects were determined using a two‐part linear regression model. Additionally, subgroup analyses and interaction tests were conducted to gain a more in‐depth understanding of the observed associations. The mean WWI of the participants was 11.32 ± 0.76. After multivariable adjustment, WWI showed a significant nonlinear association with ePWV, with a U‐shaped association observed between the two. Specifically, WWI below the threshold of 10.23 was negatively associated with arterial stiffness (β = −0.39, 95% CI: −0.54 to −0.25), while WWI above the threshold of 10.23 was positively associated with arterial stiffness (β = 0.04, 95% CI: 0.01–0.07). To conclude, the present findings imply that maintaining WWI within an optimal range could reduce AS in hypertensive individuals and potentially decrease cardiovascular risk. However, this observation needs to be confirmed in large clinical trials. [ABSTRACT FROM AUTHOR]

The aim of our study was to assess the association between muscle mass and strength and depression through a cross-sectional study of the National Health and Nutrition Examination Survey from 2011 to 2014. Muscle mass was calculated by summing the lean body mass of the limbs and muscle strength was assessed by grip strength. Depression was determined by The 9-item Patient Health Questionnaire. We used weighted multivariate logistic regression models to explore the relationship between muscle mass and strength and depression. Generalized additive models were used to test for the presence of nonlinear associations. We then constructed a two-piece-wise linear regression model and performed a recursive algorithm to calculate inflection points. In addition, subgroup analyses and interaction tests were performed. The study recruited 4871 adults from the United States. In regression models adjusted for all confounding variables, the OR (95 % CI) for the association between grip strength and appendicular lean mass (ALM) and depression were 0.943 (0.903, 0.985), 0.945 (0.908, 0.983), respectively. There was a non-linear association between grip strength and depression with a turning point of 46.3. The OR (95 % CI) before the turning point was 0.920 (0.872, 0.972). The interaction was statistically significant only in the age analysis. There was also a nonlinear association between ALM and depression, but no significant turning point was found. The interaction was statistically significant in the gender and BMI analyses. Grip strength and ALM are negatively associated with an increased likelihood of depression in US adults. Exercises for muscle mass and strength may help prevent depression. • There is a negative correlation between ALM and depression. • There is a negative correlation between grip strength and depression. • There was a nonlinear association between grip strength and depression. [ABSTRACT FROM AUTHOR]

Depression is a significant public health issue, closely associated with epilepsy and oxidative stress (OS). This study aims to explore the level of OS in patients with epilepsy and its relationship with moderate to severe depression (MSD). This cross-sectional study includes 10,819 participants aged 20–80 from the National Health and Nutrition Examination Survey (NHANES) database (2013–2020 pre-pandemic). Depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and epilepsy was diagnosed based on antiepileptic drug use in the past 30 days. The oxidative balance score (OBS) was calculated from dietary recall and lifestyle habits over the previous 24 h. Compared to non-epileptic subjects, epileptic patients have a significantly higher prevalence of depression. Epileptic patients exhibit lower OBS and Dietary Oxidative Balance Scores (DOBS), while there is no significant difference in Lifestyle Oxidative Balance Scores (LOBS). Depressed patients show lower OBS, DOBS, and LOBS. The mediation model indicates that DOBS mediates 3.44 % of epilepsy-related MSD. Epileptic patients exhibit significantly higher levels of OS and consume more pro-oxidant foods compared to the general population. However, their lifestyle habits do not differ significantly from those of the control group. Additionally, epileptic patients are at a higher risk of developing MSD. Although a pro-oxidant diet may be associated with epilepsy-mediated MSD, its mediating effect is relatively weak. • Epileptic patients consume more pro-oxidant foods than non-epileptic patients, despite similar lifestyle habits. • The Dietary Oxidative Balance Score (DOBS) influences the relationship between epilepsy and depression. • DOBS mediates 3.44% of epilepsy-related moderate to severe depression (MSD). [ABSTRACT FROM AUTHOR]

The study aimed to comprehensively assess the separate and combined effects of physical activity (PA) and tea consumption on all-cause mortality and cancer-specific mortality among 21,350 participants from The National Health and Nutrition Examination Survey (NHANES) between 2009 and 2018. PA and tea consumption were evaluated through self-reported questionnaires and dietary recall interviews at baseline, with mortality data from the National Death Index. Cox regression analyses yielded hazard ratios (HR) and 95% confidence intervals (CI). Results indicated that both tea consumption and PA independently reduced all-cause mortality. In the physically active group, tea consumption further decreased mortality risk, while this effect was not significant in the inactive group. Jointly, the highest tea consumers who exercised the most exhibited the lowest mortality risk compared to non-tea drinkers who exercised the least. Tea consumption alone does not significantly impact cancer-specific mortality; it is only in physically active group that tea consumption significantly lowers the risk of cancer-specific mortality. These findings underscore the potential benefits of regular tea consumption and PA in promoting longevity and reducing premature death risks. [ABSTRACT FROM AUTHOR]

Background: Higher thyroid-stimulating hormone (TSH) amidst normal thyroid hormone (TH) levels may contribute to a negative impact on cardiovascular health (CVH). We sought to probe the associations between Life's Essential 8 (LE8), a newly revised CVH evaluation, and low thyroid function among US adults. Methods: The datasets from the 2007-2012 National Health and Nutrition Examination Survey (NHANES) were applied to the study. Low-normal thyroid function and subclinical hypothyroidism (SCH) were both regarded to be low thyroid function. Multivariable logistic regressions were utilized to inquire about the relationship between LE8 and low thyroid function. Results: Among the 6,315 participants (age =20 years), 1,375 (21.77%) were ascertained to be low thyroid function. After adjusting possible confounders, a higher LE8 score was linked to a lower probability of experiencing low thyroid function (Odds ratio [OR] for each 10-point increase: 0.923 [95% CI, 0.884-0.964]). A similar correlation was found between the health factors score and low thyroid function (OR for each 10-point increase: 0.905 [95% CI, 0.876-0.935]). Also, scoring better on physical activity (PA), body mass index (BMI), blood lipid, blood glucose (BG), and blood pressure (BP) may be conducive to reducing the rates of low thyroid function. Furthermore, subgroup and sensitivity analyses indicated that the negative correlations were generally robust. Conclusions: The LE8 score and health factors score were nonlinearly and negatively related to the prevalence concerning low thyroid function. Promoting the regulation of optimum CVH levels could work on mitigating the load of low thyroid function and cardiovascular diseases (CVDs). [ABSTRACT FROM AUTHOR]

Background: Depression is a common mental illness with a high prevalence in overweight or obese individuals. Recent studies suggest that the Metabolic Score for Visceral Fat (METS-VF) is a novel metric for assessing visceral fat levels, potentially linking metabolic disturbances to depression. This study explores the association between METS-VF and depression severity in overweight or obese U.S. adults. Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 dataset, including 9,415 overweight or obese participants. Depression severity was measured using the Patient Health Questionnaire-9 (PHQ-9). To assess the association between METS-VF and depression, the study methodology included multivariate logistic regression, subgroup analyses, generalized additive model (GAM), and smoothed curve fitting. This study also calculated BMI for the Non-Hispanic Asian population from 2011-2018 and incorporated this data as part of a sensitivity analysis. Results: Elevated levels of METS-VF in overweight or obese participants were significantly associated with increased PHQ-9 scores and an increased likelihood of depression. Notably, this association remained significant after adjustment for multiple covariates. Smoothed curve-fitting plots showed no nonlinear association between METS-VF and PHQ-9 scores. Subgroup analyses confirmed the robustness of these results across populations, particularly among people under the age of fifty. The sensitivity analyses confirmed the robustness of the results in this study. Conclusion: METS-VF levels were positively associated with depression severity and the likelihood of depression in overweight or obese individuals, with the association being particularly pronounced in people under 50 years of age. [ABSTRACT FROM AUTHOR]

Background: The relationship between sex steroid hormones and highsensitivity C-reactive protein(hs-CRP) levels in American children and adolescents is understudied. This research will examine this association. Methods: The study conducted a data analysis from the National Health and Nutrition Examination Survey (NHANES) 2015-2016, adjusting multiple linear regression models with R 4.2.2 and EmpowerStats. A total of 1,768 children and adolescents were surveyed. Data collection involved measurements of serum levels of testosterone, estradiol, sex hormone-binding globulin (SHBG) and hs-CRP. Results: With the increase in testosterone, a brief rise (b=0.082, P=0.047) followed by an overall decline (b=-0.028, P=0.023) in hs-CRP was observed in the Male Prepubertal population, while a continuous decline (b=-0.002, P<0.05) was seen in the Male Pubertal group. A positive correlation (b=0.047, P<0.05) was found between testosterone and hs-CRP in the Female Prepubertal population, whereas no significant association (b=0.002, P>0.05) was detected in the Female Pubertal group. A significant inverse correlation was observed between estradiol and hs-CRP solely in the Female Pubertal group (b=-0.002, P<0.05), while no association was found in other populations. An inverse relationship between SHBG and hs-CRP was consistently noted across all groups: Male Prepubertal, Male Pubertal, Female Prepubertal, and Female Pubertal. Conclusions: The association between sex steroid hormones and highsensitivity C-reactive protein (hs-CRP) levels among American children and adolescents is conditional and influenced by multiple factors. [ABSTRACT FROM AUTHOR]

Background: Testosterone deficiency (TD) is an urgent health issue that requires attention, associated with various adverse health outcomes including cardiovascular diseases (CVD) and metabolic syndrome. Remnant cholesterol (RC) has emerged as a potential biomarker for cardiovascular risk, but its relationship with testosterone levels and TD has not been thoroughly investigated. This study aims to explore the association between RC and TD in adult American males using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized data from three NHANES cycles (2011-2016), including 2,848 adult male participants. RC was calculated as total cholesterol minus high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). TD was defined as total testosterone levels below 300 ng/dL. Multivariable linear and logistic regression analyses, as well as smooth curve fitting and generalized additive models, were performed to assess the associations between RC and total testosterone levels and TD, adjusting for potential confounders. Subgroup analyses were conducted based on age, BMI, smoking status, diabetes, hypertension, CVD, and chronic kidney disease (CKD). Results: Higher RC levels were significantly associated with lower total testosterone levels (b = -53.87, 95% CI: -77.69 to -30.06, p<0.001) and an increased risk of TD (OR = 1.85, 95% CI: 1.29 to 2.66, p=0.002) in fully adjusted models. When RC was analyzed as quartiles, participants in the highest quartile (Q4) had significantly lower total testosterone levels (b = -62.19, 95% CI: -93.62 to -30.76, p<0.001) and higher odds of TD (OR = 2.15, 95% CI: 1.21 to 3.84, p=0.01) compared to those in the lowest quartile (Q1). Subgroup analyses revealed consistent associations across different age groups, particularly strong in participants over 60 years, and in never smokers. The associations remained significant in both hypertensive and non-hypertensive groups, as well as in those with and without CKD. No significant interactions were found across subgroups. Conclusion: This study demonstrates a significant inverse association between RC levels and total testosterone levels, along with a positive association with the risk of TD. These findings suggest that RC could serve as a valuable biomarker for early identification of individuals at risk for TD. Future longitudinal studies are needed to confirm these findings and explore the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: The impact of polycyclic aromatic hydrocarbons (PAHs) on lung function has garnered attention, but studies mostly focus on individual effect. This study investigates urinary PAH metabolites as biomarkers of exposure and assesses the relationships between single and combined exposures to nine urinary PAH metabolites and lung function in adults. Methods: Data from 4040 adults in the 2007–2012 National Health and Nutrition Examination Survey (NHANES) were analyzed. Weighted generalized linear models estimated the effects of individual PAH metabolites on lung function. Additionally, weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) were employed to evaluate the combined impacts of multiple PAH metabolites. Results: Analyses of individual PAH metabolites revealed negative associations with lung function, excluding forced vital capacity (FVC). The WQS, qgcomp, and BKMR models consistently showed that exposure to multiple PAH metabolites was associated with lung function decrease. WQS indicated that 2-hydroxynaphthalene (2-NAP) was the largest contributor to the reductions in forced expiratory volume in 1 s (FEV1), FVC, peak expiratory flow (PEF), and forced expiratory flow from 25 to 75% of FVC (PEF25-75%). Additionally, 1-hydroxypyrene (1-PYR) was the primary PAH metabolite contributing to the decreases in FEV1/FVC and fractional exhaled nitric oxide (FeNO). The combined effect of urinary PAH metabolites did not affect FVC in the current smokers or FeNO in nonsmokers, but decreased FEV1/FVC in current smokers. Conclusion: This study strengthens the negative relationships between multiple PAH metabolites exposure and lung function in adults. Given the limitations of this study, including the lack of knowledge of other exposure pathways and the uncertainty of urinary metabolites, further research is necessary to explore the mechanisms underlying these associations and to address the limitations in exposure assessment. [ABSTRACT FROM AUTHOR]

Inflammation plays a crucial role in cancer development. The neutrophil-to-lymphocyte ratio (NLR), a measure of inflammation, is obtained from a complete blood count. However, little is known about the association between NLR and cancer in the general adult population in the United States. This study aimed to evaluate whether NLR is associated with cancer in American adults. This retrospective cross-sectional study included 28,016 adult participants from the National Health and Nutrition Examination Survey (NHANES) dataset spanning 2005 to 2018. Data on demographics (age, sex, race, marital status, Poverty-Income Ratio, education level), lifestyle factors (smoking, alcohol consumption, body mass index), medical conditions (hypertension, diabetes, cardiovascular disease), and laboratory parameters (hemoglobin, platelet count, alanine aminotransferase, creatinine, albumin, and lactate dehydrogenase), were collected. Logistic regression analysis was used to investigate the research objectives. Of the total 28,016 participants, 2639 had cancer. The mean age was 49.6 ± 17.6 years, and 50% were male. A positive association between NLR and cancer risk was observed after multivariate adjustment (OR = 1.20, 95% confidence interval (CI) = 1.05–1.36, p = 0.006). Similar patterns were observed in subgroup analyses (all p-values for interaction > 0.05). A higher NLR was directly correlated with an increased risk of developing cancer in adults. [ABSTRACT FROM AUTHOR]

Purpose: Muscle Quality Index (MQI), defined as the muscle strength per unit of muscle mass, is considered an emerging indicator of health and physical function. This study aims to explore the relationship between MQI and the risk of depression among non-elderly US adults. Methods: This cross-sectional study collected data from participants aged between 20 and 59 years old, utilizing the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The MQI was calculated by dividing the handgrip strength (HGS, kg) by the arm and appendicular skeletal muscle mass (ASM, kg). Depression assessments were conducted using the Patient Health Questionnaire (PHQ-9). The relationship between MQI and the risk of depression was explored by weighted logistic regression, smooth curve fitting, and subgroup analyses. Results: A total of 4773 participants were included in this study. After adjusting for confounding factors, low MQI levels were identified as an independent risk factor for depression (OR = 0.800, 95%CI:0.668–0.957, P = 0.015). Smooth curve fitting analysis indicated a nonlinear relationship. Subgroup analysis did not identify any specific populations. Conclusions: Higher MQI levels were closely associated with a lower risk of depression among non-elderly US adults. MQI could enhance our understanding of the link between muscle and depression and might serve as a simple functional measure for evaluating and predicting depression. [ABSTRACT FROM AUTHOR]

Background: Depression and chronic constipation often co-occur, but the reciprocal influence between the two remains unclear. The purpose of this study is to explore the potential association between depression and chronic constipation. Methods: This study initially utilized data from National Health and Nutrition Examination Survey (NHANES) 2005–2010 to explore the correlation between depression scores and chronic constipation, assessing the non-linear relationship between the two. Subsequently, we conducted a two-sample Mendelian randomization (MR) analysis to evaluate the causal relationship between depression and major depression with chronic constipation. The Inverse Variance Weighting (IVW) method served as the primary reference, supplemented by sensitivity tests. Finally, a reverse MR analysis was performed to assess the presence of any reverse causation. The STROBE-MR checklist for the reporting of MR studies was used in this study. Results: In the NHANES analysis, survey-weighted logistic regression revealed a significantly positive correlation between depression scores and chronic constipation (OR = 1.04, 95% CI = 1.02–1.07, p = 0.002), even after adjusting for the included covariates. The nonlinear analysis using Restricted Cubic Splines (RCS) enhanced the robustness of the association (P-non-liner = 0.01). The MR analysis also confirmed the causal relationship between depression (OR = 11.43, 95% CI = 1.85–70.67, p = 0.008) and major depression (OR = 1.12, 95% CI = 1.03–1.22, p = 0.007) with chronic constipation, passing rigorous sensitivity tests. No evidence of reverse causation was observed in the reverse MR analysis (P > 0.05). Conclusions: Depression is positively correlated with the risk of chronic constipation. Therefore, enhancing attention to chronic constipation in patients with depression may be effective in clinical practice. [ABSTRACT FROM AUTHOR]

Background: This study explores the intricate relationship between Chronic Kidney Disease (CKD), the Triglyceride-Glucose (TyG) index, and Cardiovascular Disease (CVD) in a U.S. adult population. It focuses on understanding how the TyG index, as a marker of insulin resistance, relates to cardiovascular risk in the presence of CKD. Methods: A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. The study involved classifying stages of CKD, calculating the TyG index, and applying statistical analyses including logistic regression. Results: The investigation revealed that individuals with CKD, who comprised 49% males with an average age of 47 years, exhibited a higher incidence of CVD. The study demonstrated that before adjusting for the TyG index, the odds ratio (OR) for the association between CKD and CVD was 1.77. Importantly, the TyG index was found to mediate 10% of the association between CKD and CVD. Moreover, a significant synergistic interaction was observed between a high TyG index and CKD, with the combined presence of these conditions increasing the risk ratio for CVD to 3.01. Conclusion: The findings highlight the crucial role of insulin resistance in the link between CKD and CVD. The paper discusses the implications of chronic inflammation and endothelial dysfunction in CKD patients and the importance of the TyG index in assessing cardiovascular risk. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence is frequent in the general population and affects men and women of all ages. UI carries an unsuspected load on the healthcare system. To investigate whether urinary incontinence is associated with all-cause, cardiovascular disease (CVD) and cancer mortality among US adults. Methods: The analyzed data was collected from the 2007–2016 National Health and Nutrition Examination Survey (NHANES) data. A total of 25,182 US participants with complete information about follow-up information and urinary incontinence (UI) were included in this cohort study. Univariate Cox regression analyses, the UpSet plot, multivariate Cox regression analysis, subgroup analysis of all-cause mortality, and Kaplan-Meier survival curve were employed to support the research objectives. Results: A total of 25,182 participants had a mean age of 49.8 ± 17.8 years, with 49.3% of them being male and 50.7% of them being female. In the unadjusted model, we found that the risk of all-cause mortality increased by 12% (95% CI 1.03–1.22, P = 0.008), the risk of CVD mortality increased by 21% (95% CI 1.07–1.36, P = 0.002), and the risk of Cancer mortality increased by 8% (95% CI 0.95–1.22, P = 0.243) among individuals with urinary incontinence. After adjusting for multiple variables, we found that the risk of all-cause mortality in patients with urinary incontinence decreased by 1% (95% CI 0.9–1.09), but this decrease was statistically insignificant (P = 0.868), and the risk of Cancer mortality decreased by 3% (95% CI 0.84–1.12, P = 0.686). The association between urinary incontinence and mortality risk were stable in stratified analyses. Conclusions: In our study, we found that urinary incontinence itself is an independent risk factor for death. The association between urinary incontinence and mortality became less significant after adjusting for covariates, this is a common occurrence in statistical analysis. Future research, with larger sample sizes and more robust study designs, is needed to further elucidate the complex relationship between urinary incontinence and mortality risk. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore the relationship between niacin intake and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) within a large, multi-ethnic cohort. Methods: A total of 2946 participants from the National Health and Nutrition Examination Survey (NHANES) were carefully selected based on strict inclusion and exclusion criteria. Participants meeting the eligibility criteria underwent two dietary recall interviews, and niacin intake was calculated using the USDA's Food and Nutrient Database for Dietary Studies (FNDDS). Liver steatosis was diagnosed using a Controlled Attenuation Parameter (CAP) of 248 dB/m, and MASLD diagnosis was based on metabolic indicators. Weighted multivariate logistic regression was utilized to analyze the correlation between niacin intake and MASLD prevalence, with potential nonlinear relationships explored through restricted cubic spline (RCS) regression. Results: Analysis of baseline data revealed that MASLD patients had lower niacin intake levels and poorer metabolic biomarker profiles. Both RCS analysis and multivariate logistic regression indicated a U-shaped association between niacin intake and MASLD prevalence. Specifically, there was a non-linear dose-response relationship, with the odds of MASLD gradually decreasing with increasing niacin intake until reaching a threshold of 23.6 mg, beyond which the odds of MASLD began to increase. Conclusion: This study confirms a U-shaped nonlinear relationship between niacin intake and MASLD prevalence within the diverse American population. [ABSTRACT FROM AUTHOR]

Epidemiological evidence on the relationship between lead exposure and mortality in specific chronic kidney disease (CKD) populations is limited. We aimed to examine the relationship between urinary lead and blood lead concentrations and all-cause mortality in US patients with CKD. This cohort study included 2320 participants with CKD from the National Health and Nutrition Examination Survey (2005–2018), with follow-up until December 31, 2019. All-cause mortality was ascertained by matching US National Death Index records. Hazard ratios (HRs) and 95% confidence intervals (CI) for urinary lead and blood lead concentrations in relation to all-cause mortality were estimated using a weighted Cox regression model. During a median follow-up period of 79 months, a total of 625 participants with CKD succumbed to mortality. Compared to the lowest quartile, the highest quartile of urine and blood lead concentrations was associated with an increased risk of all-cause mortality, with HRs and corresponding 95% CIs of 1.77 (1.05–2.99) and 2.65 (1.38–5.10), respectively. Furthermore, each additional unit increase in urinary and blood lead concentrations was associated with HRs for all-cause mortality of 1.21 (95% CI 1.06–1.38) and 1.09 (95% CI 1.01–1.19), respectively. Kaplan–Meier survival curve analysis and restricted cubic regression spline curve analysis demonstrated significant positive associations between elevated blood lead levels, elevated urinary lead levels, and all-cause mortality risk (P < 0.05). A nonlinear concentration–response relationship was observed between blood lead level and all-cause mortality risk (PNonlinear < 0.05), with an inflection point at a concentration of 1.613 µg/dL. Subgroup analysis as well as sensitivity analysis yielded consistent findings. Our findings demonstrate that elevated levels of lead in urine and blood are associated with a significantly increased mortality risk among patients with CKD, underscoring the importance of reducing lead exposure to mitigate mortality risk in individuals at high risk for CKD. [ABSTRACT FROM AUTHOR]

Background: The association between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score and serum prostate-specific antigen (PSA) and allcause mortality remains underexplored. We aimed to investigate the relationship between HALP score and these outcomes among middle-aged and elderly individuals without prostate cancer (PCa). Methods: This cross-sectional study included participants aged 40 years and older from National Health and Nutrition Examination Survey (NHANES) 2001-- 2010. HALP score was calculated using the formula: HALP score = (Hemoglobin x Albumin x Lymphocytes)/Platelets. High PSA level was defined as a percentage free PSA (%fPSA) less than or equal to 25% and a total PSA (tPSA) level equal to or higher than 4.0 ng/mL. Mortality data were obtained through December 30, 2019 by linking to the National Death Index. Results: Among 7,334 participants, 6,826 were classified as having low PSA level, while 508 were categorized as having high PSA level. Logistic regression revealed lower odds of high PSA level with higher HALP quartiles (Ptrend<0.001). Among 508 participants with high PSA level, over a median follow-up period of 10.13 years (IQR: 5.42-13.17 years), a total of 268 all-cause deaths were recorded. Cox regression analysis showed that participants in the highest HALP quartile had the lowest risk of all-cause mortality (HR = 0.527, 95% CI: 0.368-0.754) in participants with high PSA level. Restricted cubic spline analysis indicated a non-linear and negative correlation between HALP score and all-cause mortality, with an inflection point at 43.98 (P for non-linearity = 0.009). Random survival forest analysis ranked HALP score as the most significant predictor for all-cause mortality. Conclusion: Our study highlights that the HALP score the HALP score is associated with high PSA level and all-cause mortality among middle-aged and elderly individuals without PCa. Further research is warranted to validate these findings and elucidate underlying mechanisms. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Is parity associated with all-cause and cause-specific mortality among women in a nationally representative cohort of the US population, and does depression mediate this association? SUMMARY ANSWER Nulliparous women have a higher risk of all-cause and cause-specific mortality, with depression partially mediating the relationship between parity and women's all-cause and cause-specific mortality. WHAT IS KNOWN ALREADY Parity, a significant state in reproductive life, has enduring implications for women's health. There is also a complex relationship between depression, a prevalent mental and emotional disorder, and female fertility. Previous studies have elucidated the relationships between parity and depression, both of which are associated with mortality. However, findings from studies examining parity and women's mortality have been inconsistent. Moreover, few studies have investigated whether the effect of parity on mortality is mediated by depression. STUDY DESIGN, SIZE, DURATION We conducted a cross-sectional study using data from seven cycles of the National Health and Nutrition Examination Survey (NHANES) spanning 2005–2018. PARTICIPANTS/MATERIALS, SETTING, METHODS The study cohort comprised adult women with available parity and survival follow-up data. Parity data were self-reported and sourced from the Reproductive Health Questionnaire. Depression scores were derived from the Patient Health Questionnaire 9, and cause-specific deaths were identified using the International Statistical Classification of Diseases, 10th Revision (ICD-10). Weighted multivariable Cox regression was applied to analyze the association between parity, depression, and mortality. Weighted linear regression was performed to examine the relationship between parity and depression. Mediation analyses were employed to determine whether and to what extent depression mediated the effect of parity on mortality. MAIN RESULTS AND THE ROLE OF CHANCE Our study ultimately encompassed 16 962 American women. Following multivariable adjustment, compared to nulliparous women, those with one to three live births exhibited a 17% and 33% reduction in all-cause and cancer mortality, respectively (all-cause mortality: HR = 0.83, 95% CI = 0.69–0.99, P  =   0.040; cancer mortality: HR = 0.67, 95% CI = 0.45–0.99, P  =   0.045). Women with more than four live births demonstrated lower all-cause mortality and mortality from other (not cancer or cardiovascular disease) diseases (all-cause mortality: HR = 0.73, 95% CI = 0.58–0.93, P  =   0.011; other diseases mortality: HR = 0.66, 95% CI = 0.47–0.91, P  =   0.013). No correlation was detected between parity and the risk of cardiovascular disease mortality among women. Furthermore, depression was found to partially mediate the impact of parity on all-cause mortality and mortality from other diseases in women. LIMITATIONS, REASONS FOR CAUTION Firstly, a single index of parity was used as an exposure factor, and other reproductive factors such as birth spacing, age at first birth, and mode of delivery were not taken into account. Secondly, despite accounting for important potentially confounders in our analysis, such as BMI, smoking status, and educational level, the influence of unmeasured confounders (e.g. social class, latent reproductive system diseases) on reproductive behavior or mortality cannot be dismissed. Thirdly, women's vulnerability to depression fluctuates across reproductive stages, and the effect of depression on female fertility varies over time. Due to data constraints, we were unable to obtain information on women's mental health status at different reproductive stages. Fourthly, due to the data accessibility limitations of NHANES, we were unable to specifically explore the relationship between parity and different specific types of cancer, a limitation that may obscure potential correlations. Additionally, despite our efforts to control for various confounding factors in subgroup analyses, the smaller sample sizes in some subgroups may limit the statistical power, affecting the ability to detect effects. Finally, studies exploring the association between parity and depression are cross-sectional designs, making it difficult to infer causality. These results should be interpreted with caution, and further research is warranted to corroborate our findings. WIDER IMPLICATIONS OF THE FINDINGS Our study underscores the elevated risk of all-cause and cause-specific mortality in nulliparous women and reveals that depression partially mediates the negative correlation between parity and women's all-cause mortality and mortality from other diseases. These results should be interpreted with caution, and further investigation is needed to support our findings. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Key Research and Development Program of China (2023YFC2705700), the Key Research & Developmental Program of Hubei Province (2022BCA042), and the Interdisciplinary Innovative Talents Foundation from Renmin Hospital of Wuhan University (JCRCWL-2022-001). The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Background: Endometriosis is intricately linked to metabolic health. The Cardiometabolic Index (CMI), a novel and readily accessible indicator, is utilized to evaluate metabolic status. This study seeks to investigate the potential correlation between CMI and endometriosis. Methods: Data from four consecutive survey cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2006 were utilized. This included adult females with self-reported diagnoses of endometriosis and complete information required for calculating the CMI. The calculation formula for CMI is Triglycerides(TG) / High-density lipoprotein cholesterol (HDL-C) × WHtR (WHtR = waist circumference / height). A multivariable logistic regression model was employed to investigate the linear association between CMI and endometriosis. Subgroup analyses were performed to explore potential influencing factors. Additionally, the linear relationship was validated using restricted cubic spline (RCS) curve plotting and threshold effect analysis. Results: This study, based on the National Health and Nutrition Examination Survey (NHANES), included a cohort of 2,224 adult women. The multivariable logistic regression analysis demonstrated that in the fully adjusted model, individuals with the highest CMI exhibited a 78% elevated likelihood of endometriosis compared to those with the lowest CMI (OR = 1.78; 95% CI, 1.02–3.11, P < 0.05). The subgroup analysis indicated that there were no significant interactions between CMI and specific subgroups (all interaction P > 0.05), except for the subgroup stratified by stroke status (P < 0.05). Additionally, the association between CMI and endometriosis was linear, with a 20% increase in the association for each unit increase in CMI when CMI > 0.67 (OR = 1.20; 95% CI, 1.05–1.37, P < 0.01). Conclusion: The study found that CMI levels are closely correlated with endometriosis, with this correlation increasing when the CMI exceeds 0.67. This finding implies that by regularly monitoring CMI levels, physicians may be able to screen women at risk for endometriosis at an earlier stage, thereby enabling the implementation of early interventions to slow the progression of the disease. To further validate these findings, larger-scale cohort studies are required to support the results of this research. [ABSTRACT FROM AUTHOR]

Background: Ethylene oxide (EO) is a common organic compound associated with many adverse health outcomes. However, studies exploring the association between EO exposure and cognitive function are limited. Objective: This study aims to examine this relationship between EO exposure and cognition in older adults. Methods: This study enrolled 438 older adults from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle. EO exposure was quantified by the measurements of blood hemoglobin adducts of ethylene oxide (HbEO) concentrations. Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer's Disease battery (CREAD), the Animal Fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Linear regression model, generalized additive model, and smooth curve fitting were applied to examine the linear and nonlinear relationship between EO exposure and cognitive function. We used a two-piecewise linear regression model to detect the threshold effect of EO exposure on cognitive function. Results: Participants with higher HbEO levels had lower AFT and DSST scores than those with lower HbEO levels. After adjusting for all confounding factors, log2-transformed HbEO levels were negatively associated with AFT score. The smooth curve fitting demonstrated the nonlinear relationship between EO exposure and DSST scores. When log-2 transformed HbEO levels >4.34 pmol/g Hb, EO exposure was negatively associated with DSST score. Conclusions: This study indicated that high levels of HbEO were associated with cognitive decline in US older adults. Future cohort studies are needed to verify our findings. [ABSTRACT FROM AUTHOR]

Hearing loss is a prevalent issue resulting from loud noise exposure, aging, diseases, and genetic differences. As individuals age, the likelihood of experiencing hearing loss and depression escalates; yet, the link between hearing loss and the risk of depression remains ambiguous. This study explores the relationship between hearing and depression risk, taking into account sociodemographic and health-related factors. Using data from the National Health and Nutrition Examination Survey (NHANES) 2015–2018, a cross-sectional analysis was conducted, focusing on adult participants. It evaluated their hearing status and depression levels using the Patient Health Questionnaire-9 (PHQ-9). The study examined a range of variables, such as age, gender, socioeconomic status, lifestyle choices, and comorbidities, to understand their influence on the link between hearing loss and depression. Analysis indicated a significant association between moderate to severe hearing loss and an increased risk of depression, notably in older adults. This relationship remained significant even after adjusting for a variety of sociodemographic and health factors. This is a study using the NHANES database using self-reported surveys. The findings of this study emphasize the need to integrate hearing health in the holistic assessment and treatment of depression, particularly advocating for combined care strategies for the elderly. [ABSTRACT FROM AUTHOR]

Carotenoids are a group of tetraterpenoid lipophilic pigments linked to depression, but studies on individual carotenoid components are lacking. We aimed to assess the association between each serum carotenoids and depressive symptoms in adults. This cross-sectional study included 7264 adults from the National Health and Nutrition Examination Survey (NHANES). Serum carotenoid levels (α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein/zeaxanthin) were measured using high-performance liquid chromatography. Participants with a Patient Health Questionnaire score ≥ 10 were considered to have depressive symptoms. The association between each carotenoid and depressive symptoms was investigated using multivariable-adjusted logistic regression, restricted cubic spline, and weighted quantile sum regression models. The participants' average age was 46.0 (interquartile range: 34.0–60.0) years (50.9 % females), and 545 participants (7.5 %) were diagnosed with depressive symptoms. The logistic regression model demonstrated that high serum α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin levels were associated with a lower likelihood of depressive symptoms. The restricted cubic spline model revealed that the significantly inverse relationships between serum carotenoid levels and the risk of depressive symptoms were nonlinear for α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin and were linear for lycopene. The threshold effect analysis further identified the inflection points were 12.1, 35.7, 5.9, and 7.7 μg/dL for α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin, respectively. The weighted quantile sum regression model revealed that β-cryptoxanthin (35.2 %) and α-carotene (34.5 %) were the top-weighted carotenoids correlated with depressive symptoms. The present results suggested an association between higher levels of each serum carotenoids and a decreased risk of depressive symptoms in adults. • The concentrations of various components of carotenoids correlate with each other. • Five common serum carotenoids levels are negatively associated with the risk of depressive symptoms. • The protective effect of α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin has threshold values. • β-cryptoxanthin and α-carotene are major carotenoids in improving depressive symptoms. [ABSTRACT FROM AUTHOR]

To investigate the association between Kaposi's sarcoma‐associated herpesvirus (KSHV)/human herpesvirus 8 (HHV8) infection and both all‐cause and cardiovascular mortality in a representative cohort of US adults, data from the National Health and Nutrition Examination Survey III (NHANES III; 1988‒1994) were analyzed, including 13,993 participants aged 18‒90 years who underwent KSHV serology evaluations. Mortality outcomes were ascertained through December 2019 using the National Death Index. Cox proportional hazards models were employed to examine the association between KSHV seropositivity and mortality, adjusting for potential confounders such as age, sex, ethnicity, body mass index, and serum TG. Over a median follow‐up period of 26.5 years, 5503 deaths were recorded. KSHV seropositivity was associated with an increased hazard of all‐cause mortality (Hazard Ratio [HR]: 1.32, 95% Confidence Interval [CI]: 1.03‒1.69) and cardiovascular mortality (HR: 1.58, 95% CI: 1.00‒2.50) after adjusting for age, sex, ethnicity, and body mass index. Notably, the association between KSHV infection and all‐cause mortality persisted among women (HR: 1.32, 95% CI: 1.02‒1.72) after adjusting for all confounders, whereas the association with cardiovascular mortality was only statistically significant for men (HR: 1.90, 95% CI: 1.02, 3.53).KSHV infection may represent an independent risk factor for all‐cause and cardiovascular mortality among US adults. These findings highlight the need for further research to validate these associations in independent populations and to elucidate the biological mechanisms underlying the observed increased mortality associated with KSHV infection. [ABSTRACT FROM AUTHOR]

Background: We aimed to examine the relationship of 2 dietary scores [dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI)] with frailty in elderly adults with diabetes. Methods: Data were gathered from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The frailty index was calculated using 49 deficits across various systems to define frailty. To examine the relationship of 2 dietary scores (DII and CDAI) with frailty in elderly adults with diabetes, multiple logistic regression analyses were performed. In logistic regression model, DII and CDAI were calculated as both continuous and tertiles. Subgroup analyses were performed to demonstrate stability of results. Restricted cubic splines were utilized to examine the non-linear correlations. Results: A total of 2,795 elderly adults with diabetes were included in this study. In the multivariate logistic regression model, the odds ratio (OR) of DII for risk of frailty was 1.08 (95% CI 1.02–1.15) and the OR of CDAI for risk of frailty was 0.96 (95% CI 0.93–0.99). The ORs of DII for risk of frailty were 1.36 (95% CI 1.09–1.70) and 1.33 (95% CI 1.04–1.70) for tertiles 2 and 3, respectively (p for trend 0.027). The ORs of CDAI for risk of frailty were 0.94 (95% CI 0.75–1.17) and 0.75 (95% CI 0.58–0.98) for tertiles 2 and 3, respectively (p for trend 0.036). The subgroup analysis demonstrated reliable and enduring connections between 2 dietary scores and frailty (all p for interaction > 0.05). In the restricted cubic spline analyses, we discovered the non-linear relationship between DII and frailty (P for nonlinearity = 0.045) and linear relationship between CDAI and frailty (P for nonlinearity = 0.769). Conclusion: The research showed connections between 2 dietary scores (DII and CDAI) and frailty as measured by frailty index in elderly adults with diabetes. [ABSTRACT FROM AUTHOR]

Background: Although a high C-reactive protein-to-albumin ratio (CAR) is believed to increase mortality risk, the association between the physical activity (PA), CAR, and mortality among cancer survivors has not been investigated. This study aimed to examine this association among cancer survivors in the United States. Methods: This cohort study used data from the National Health and Nutrition Examination Survey from 1999 to 2010. PA was self-reported using the Global Physical Activity Questionnaire, and C-reactive protein and albumin levels were obtained from laboratory data files. Mortality data were obtained by linkage of the cohort database to the National Death Index as of December 31, 2019. The analysis was conducted from November 1 to December 31, 2023. We used Cox proportional hazards multivariable regression to assess hazard ratios (HRs) and 95% confidence interval (CIs) for total and cancer-specific mortality risks attributable to PA and CAR. Results: Among 2,232 cancer survivors, 325 (14.6%) reported no PA with a high CAR. During a follow-up of up to 20.75 years (median, 12.3 years; 27,453 person-years), 1,174 deaths occurred (cancer, 335; other, 839). A high CAR was observed to be consistently associated with the highest risks of total (HR, 1.59; 95% CI, 1.37–1.85) and cancer-specific (HR, 2.06; 95% CI, 1.55–2.73) mortality compared with a low CAR in a series of adjusted models. Multivariable models showed that PA was associated with a lower risk of all-cause (HR, 0.60; 95% CI, 0.52–0.69) and cancer-specific (HR, 0.64; 95% CI, 0.49–0.84) mortality compared with no PA. In the joint analyses, survivors with PA ≥ 600 metabolic equivalent min/wk and a low CAR were more likely to reduce the risk of total (HR, 0.41; 95% CI, 0.32–0.51) and cancer-specific (HR, 0.32; 95% CI, 0.20–0.50) mortality by 59% and 68% compared with those with no PA and a high CAR. Conclusion: The pairing of adequate PA and a low CAR was significantly associated with reduced all-cause and cancer-related mortality risks. [ABSTRACT FROM AUTHOR]

Background: Many studies worldwide have reported the association between mental health and blood pressure, but the results are mixed, and even contradictory. We aim to investigate the relationship between systolic and diastolic blood pressure and depression in the entire US population. Methods: This study analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. All adults completed 3-4 blood pressure measurements after sitting quietly for 5 minutes. Depression was diagnosed based on the Patient Health Questionnaire (PHQ-9), with a score ≥10 defined as depression. Weighted logistic regression and restricted cubic splines (RCS) were used to assess the relationship between blood pressure and depression. Two-piecewise linear regression was used to determine the inflection point. Additionally, subgroup analyses and interaction tests were conducted to identify potential subgroups. Finally, two sensitivity analyses were conducted. Results: A total of 26,581 American adults were included, with a mean age of 47.2 years, of whom 13,354 (49.54%) were male; 2,261 individuals were defined as depressed, with a weighted prevalence of 7.41%. All participants' mean systolic blood pressure (SBP) was 121.7 mmHg, and the mean diastolic blood pressure (DBP) was 70.9 mmHg. RCS showed a nonlinear association between SBP and depression, while DBP showed a positive linear association with depression. Two-piecewise linear regression showed that the inflection point of the association between SBP and depression was 129.7 mmHg. Weighted logistic regression showed that after fully adjusting for depression-related risk factors, there was a significant positive correlation between per 10 mmHg increase in DBP and depression (OR: 1.06, 95% CI: 1.00-1.12, P=0.04); however, only on the left side of the inflection point, SBP tended to decrease the odds of depression (P =0.09). Furthermore, interaction analysis showed that the association between DBP and depression was significantly stronger in cancer patients (P for interaction=0.02); on the left side of the inflection point (<129.7 mmHg),current smokers also significantly interacted with SBP (P for interaction=0.018). Finally, two sensitivity analyses also supported our findings. Conclusion: In the adult population of the United States, there is a positive linear association between DBP and depression, while the association between SBP and depression exhibits a significant threshold effect, maintaining SBP at 129.7 mmHg is associated with the lowest prevalence of depression. [ABSTRACT FROM AUTHOR]

Background: It remains unknown whether composite-dietary-antioxidant-index (CDAI) is associated with the risk of sarcopenia. This study investigated the association of CDAI with sarcopenia risk among general US adults. Methods: A total of 10,093 participants were enrolled in the National Health and Nutrition Examination Surveys (NHANES) from 6 survey cycles (2003-2004, 2005-2006, 2011-2012, 2013-2014, 2015-2016 and 2017-2018). Multivariate logistic regression was carried out to examine the relationship between CDAI and the risk of sarcopenia. Restricted cubic spline (RCS) curves were employed to analyze nonlinear relationships. Results: In a multi-variable logistic regression model adjusting for demographics, lifestyle, economic status and other dietary factors, higher CDAI score was related to a lower risk of sarcopenia among US adults. Compared the highest quartile of CDAI score with the lowest, the OR and 95%CI were 0.49 (0.31-0.75). Furthermore, the RCS demonstrated a linear dose-response relationship between CDAI and sarcopenia (Pnon-linearity=0.92). These results remained consistent across subgroups stratified by age, sex, physical activity, drinking status, body mass index (BMI), smoking habits, energy intake, and Healthy Eating Index (HEI) score. In addition, the favorable associations of CDAI were primarily attributed to Vitamin E intake. Conclusion: A higher CDAI score was associated with a lower risk of sarcopenia. According to these results, a greater adherence to CDAI may benefit sarcopenia prevention in adults. [ABSTRACT FROM AUTHOR]

Objectives: The effects of nicotine metabolism on the kidneys of healthy individuals have not been determined. The nicotine metabolite ratio (NMR) indicates the rate of nicotine metabolism and is linked to smoking behaviors and responses to tobacco treatments. We conducted this study in order to investigated the relationship between nicotine metabolite ratio (NMR) and kidney function. Methods: An analysis of cross-sectional data of adults was conducted using a population survey dataset (National Health and Nutrition Examination Survey Data 2013/2018 of the United States). A weighted multivariate regression analysis was conducted to estimate the correlation between NMR and kidney function. Furthermore, we apply fitting smooth curves to make the relationship between NMR and estimated glomerular filtration rate (eGFR) more visualized. Results: The research included a total of 16153 participants. Weighted multivariate regression analyses adjusted for possible variables showed a negative relationship between NMR and estimated glomerular filtration rate (eGFR).The b (95%CI) of the regression equation between NMR and eGFR was -2.24 (-2.92, -1.55), the trend testing showed consistent results. NMR is positively correlated with urinary albumin creatinine ratio (uACR), but it is not statistically significant. A stratified analysis found a negative correlation between NMR and eGFR in all age, gender and diabetes subgroups, the results were not statistically significant among Mexican Americans and other races. Notably, each unit rise in NMR corresponded to a 4.54 ml/ min·1.73m² lower eGFR in diabetic participants and a 6.04 ml/min·1.73m² lower eGFR in those aged 60 and above. Conclusions: Our study shows that nicotine metabolite ratio is negatively associated with kidney function among most adults. It will be necessary to conduct more well-designed prospective clinical trials in order to determine the exact causal interactions between NMR and kidney function. Specific mechanisms also need to be further explored in basic experiments. [ABSTRACT FROM AUTHOR]