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Objective: Previous studies have suggested diet was associated with depressive symptoms. We aimed to develop and validate Dietary Depression Index (DDI) based on dietary prediction of depression in a large Chinese cancer screening cohort. Methods: In the training set (n = 2729), we developed DDI by using intake of 20 food groups derived from a food frequency questionnaire to predict depression as assessed by Patient Health Questionnaire-9 based on the reduced rank regression method. Sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the performance of DDI in evaluating depression in the validation dataset (n = 1176). Results: Receiver operating characteristic analysis was constructed to determine the best cut-off value of DDI in predicting depression. In the study population, the DDI ranged from −3.126 to 1.810. The discriminative ability of DDI in predicting depression was good with the AUC of 0.799 overall, 0.794 in males and 0.808 in females. The best cut-off values of DDI for depression prediction were 0.204 overall, 0.330 in males and 0.034 in females. DDI was a validated method to assess the effects of diet on depression. Conclusion: Among individual food components in DDI, fermented vegetables, fresh vegetables, whole grains and onions were inversely associated, whereas legumes, pickled vegetables and rice were positively associated with depressive symptoms. [ABSTRACT FROM AUTHOR]

Psychological problems (e.g., depression and anxiety) have been widely studied as an important public health issue in the background of the pandemic, whereas the positive aspects (e.g., well-being) have been paid little attention. The present study aimed to investigate the effects of the COVID-19 pandemic and generations on well-being by adopting 5 groups (Post-00s, Post-90s, Post-80s, Post-70s, and Post-60s) × 2 time points (before and during the COVID-19 pandemic) mixed factorial design. A total of 1579 Chinese adults completed the self-report survey, and a valid sample of 1529 adults from five generational cohorts was included in the data analysis. Results of the mixed factorial ANOVAs and simple effects analyses showed significant interaction effects on some dimensions of well-being. Specifically, the Post-80s exhibited a significant increase in both Engagement and Accomplishment of well-being during the pandemic, and the Post-60s generation demonstrated a significant improvement in Engagement of well-being. However, the other generations did not show significant changes. It could be concluded that the effects of the pandemic on well-being are complicated across generations. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the relationship between the atherogenic index of plasma (AIP) and diabetes risk in Chinese non-obese adults. This is important because the incidence of diabetes is significant in non-obese populations, and evidence regarding this association is limited. Methods: We conducted a retrospective cohort study with 82,977 Chinese non-obese adults. We used Cox proportional hazards regression to assess the relationship between baseline AIP levels and diabetes incidence. We also employed cubic spline functions and smooth curve fitting to investigate potential nonlinear relationships. Sensitivity and subgroup analyses were conducted to validate our findings. Results: The median follow-up duration for these participants was 3.10 years, during which 1,041 subjects (1.25%) were diagnosed with diabetes. Adjusted analyses demonstrated a strong positive association between AIP and the risk of diabetes onset (HR 2.07; 95% CI: 1.63-2.63; p < 0.001). The risk of diabetes increased with higher AIP quartiles, especially between the highest (Q4) and lowest (Q1) quartiles (adjusted HR 1.55; 95% CI: 1.27-1.89). We also identified a nonlinear relationship between AIP and diabetes risk. Sensitivity and subgroup analyses confirmed these findings. Furthermore, E-value analysis indicated that the results were robust against unmeasured confounding variables. Conclusion: Our findings highlight a positive, nonlinear association between AIP and diabetes risk in Chinese non-obese adults. Lowering triglycerides (TG) or increasing high-density lipoprotein cholesterol (HDL-C) levels may help reduce this risk. [ABSTRACT FROM AUTHOR]

Few epidemiological studies have investigated associations between anthropogenic heat emissions (AE) and serum lipids. We recruited 15,477 adults from 33 communities in northeastern China in 2009. We estimated AE flux by using data on energy consumption and socio-economic statistics covering building, transportation, industry, and human metabolism. We assessed the associations between AE and blood lipids and dyslipidemia prevalence using the restricted cubic spline models. The regression coefficients (β) and the 95% CI of total cholesterol for the 75th and 95th percentiles of the exposure were 0.23 mmol/L (95% CI: 0.15, 0.30) and 0.25 mmol/L (95% CI: 0.18, 0.32). We also found AE was positively associated with dyslipidemia. Participants who were female or who had low incomes exhibited more pronounced associations. Our research showed that exposure to AE was significantly associated with serum lipids. These novel, valuable findings are useful to inform policymakers to estimate the risks to human health from anthropogenic heat. [ABSTRACT FROM AUTHOR]

Background: This study explores how personality traits and mindfulness facets interact to influence perceived stress, focusing on a Chinese adult sample. It aims to address gaps in understanding the combined effects of dispositional and mindfulness factors on stress. Methods: A sequential explanatory mixed-methods design was employed. In the quantitative phase, 637 Chinese adults completed surveys measuring personality traits, mindfulness (attention, acceptance), and perceived stress. Hierarchical multiple regression, moderation, and mediation analyses were conducted. In the qualitative phase, semi-structured interviews with selected participants provided deeper insights into the quantitative findings. Results: Neuroticism (β = 0.29, p < 0.001) and conscientiousness (β = 0.15, p < 0.01) were positively associated with perceived stress, while mindfulness-acceptance (β = −0.25, p < 0.001) was a significant negative predictor. Neuroticism and mindfulness-acceptance uniquely explained 8 and 6% of the variance in stress, respectively. Mindfulness-attention moderated the relationship between agreeableness and stress, amplifying agreeableness' stress-buffering effect in individuals with low mindfulness-attention. Mediation analysis revealed mindfulness-acceptance partially mediated the agreeableness-stress link. Qualitative interviews underscored the role of personality and mindfulness in shaping stress responses and coping mechanisms. Conclusion: The findings highlight mindfulness-acceptance as a critical factor in reducing stress, particularly in individuals with agreeable personalities. These results support the development of mindfulness-based interventions targeting acceptance to enhance stress resilience across diverse personality profiles. [ABSTRACT FROM AUTHOR]

Choline and betaine are important in the body, from cell membrane components to methyl donors. We aimed to investigate trends in dietary intake and food sources of total choline, individual choline forms and betaine in Chinese adults using data from the China Health and Nutrition Survey (CHNS) 1991–2011, a prospective cohort with a multistage, random cluster design. Dietary intake was estimated using three consecutive 24-h dietary recalls in combination with a household food inventory. Linear mixed-effect models were constructed using R software. A total of 11 188 men and 12 279 women aged 18 years or older were included. Between 1991 and 2011, total choline intake increased from 219·3 (95 % CI 215·1, 223·4) mg/d to 269·0 (95 % CI 265·6, 272·5) mg/d in men and from 195·6 (95 % CI 191·8, 199·4) mg/d to 240·4 (95 % CI 237·4, 243·5) mg/d in women (both P -trends < 0·001). Phosphatidylcholine was the major form of dietary choline, and its contribution to total choline increased from 46·9 % in 1991 to 58·8 % in 2011. Cereals were the primary food source of total choline before 2000, while eggs had ranked at the top since 2004. Dietary betaine intake was relatively steady over time with a range of 134·0–151·5 mg/d in men (P -trend < 0·001) and 111·7–125·3 mg/d in women (P -trend > 0·05). Chinese adults experienced a significant increase in dietary intake of choline, particularly phosphatidylcholine during 1991–2011 and animal-derived foods have replaced plant-based foods as the main food sources of choline. Betaine intake remained relatively stable over time. Future efforts should address the health effects of these changes. [ABSTRACT FROM AUTHOR]

Background: Although right atrial (RA) myocardial deformation has important implications for patient diagnosis, prognosis, and risk stratification, its implementation in clinical practice has been hampered by limited normal reference values, especially in Asian populations. Purpose: To establish age‐ and sex‐specific reference values for RA strain, strain rate (SR), and displacement based on a large sample of healthy Chinese adults using MR‐feature tracking (MR‐FT). Study Type: Retrospective. Population: 524 healthy Chinese adults (287 male; mean age 43.7 ± 11.9 years). Field Strength/Sequence: 1.5T/balanced steady‐state free precession. Assessment: RA deformation parameters, including reservoir, conduit, and booster strain (εs, εe, and εa), peak positive, early negative, and late negative SR (SRs, SRe, and SRa), and total, passive, and active displacement (Ds, De, and Da), were assessed using MR‐FT. Statistical Tests: Student's t‐test, one‐way ANOVA, coefficients of determination (r2), intraclass correlation coefficients (ICC), and Bland–Altman plots. A P value <0.05 was considered significant. Results: Women demonstrated significantly greater magnitudes of RA deformation parameters than men: εs (57.4% ± 15.1% vs. 44.3% ± 12.6%), εe (37.5% ± 13.4% vs. 27.4% ± 10.9%), εa (19.9% ± 5.7% vs. 16.9% ± 5.0%), SRs (2.62 ± 0.88 sec−1 vs. 2.00 ± 0.63 sec−1), SRe (−2.98 ± 1.26 sec−1 vs. −2.16 ± 0.92 sec−1), SRa (−2.28 ± 0.75 sec−1 vs. −1.84 ± 0.62 sec−1), Ds (−7.80 ± 1.90 mm vs. −7.46 ± 1.70 mm), and De (−4.84 ± 1.31 mm vs. −4.49 ± 1.21 mm). For both sexes, aging was significantly associated with decreased RA reservoir and conduit function (εs, SRs, Ds, εe, SRe, and De), and with increased εa and Da. RA deformation measurements had good to excellent intraobserver and interobserver reproducibility, with ICCs ranging from to 0.790 to 0.972. Data Conclusion: This study provides age‐ and sex‐specific reference values of RA strain, SR, and displacement based on a large cohort of healthy Chinese adults using MR‐FT. Level of Evidence: 3 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Ao Liu,1 Xin Li,2 Xueyi Zhang,1 Keke Chen,3 Zhi Zou,4 Yongbing Sun,1 Jing Zhou,5 Zhonglin Li,4 Xiaoling Wu,6 Xue Lv,5 Hao Li,7 Zhiping Guo,8 Yongli Li5 1Department of Medical Imaging, People’s Hospital of Zhengzhou University, Zhengzhou, 450003, People’s Republic of China; 2Department of Medical Imaging, People’s Hospital of Henan University, Zhengzhou, 450003, People’s Republic of China; 3Department of Medical Imaging, Henan Provincial People’s Hospital, Xinxiang Medical College, Zhengzhou, 450003, People’s Republic of China; 4Department of Medical Imaging, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China; 5Department of Health Management, Henan Provincial Key Laboratory of Chronic Disease Health Management, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China; 6Department of Nuclear Medicine, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China; 7Department of Health Management, Fuwai Central China Cardiovascular Hospital, Zhengzhou, 451464, People’s Republic of China; 8Henan Provincial Key Laboratory of Chronic Disease Health Management, Fuwai Huazhong Cardiovascular Hospital, Zhengzhou, 450003, People’s Republic of ChinaCorrespondence: Yongli Li, Department of Health Management, Henan Provincial Key Laboratory of Chronic Disease Health Management, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China, Email shyliyongli@126.comPurpose: The impact of hepatic lipid accumulation on hyperuricemia presents an intriguing research avenue, particularly in light of existing studies linking obesity with hyperuricemia. Nevertheless, there remains a scarcity of quantitative investigations into the correlation between liver fat content (LFC) and hyperuricemia among prediabetic cohorts, notably within the Chinese demographic.Patients and Methods: This cross-sectional study was conducted at the Health Management Center of Henan Provincial People’s Hospital between January 2019 and December 2023, involving 2,950 pre-diabetic participants. Participants were categorized into groups based on diagnostic criteria for hyperuricemia. LFC was assessed using computed tomography. Statistical analyses included multivariate logistic regression, limited cubic spline regression models, and subgroup analyses to explore the association between LFC and hyperuricemia among individuals with pre-diabetes.Results: The prevalence of hyperuricemia among the 2,950 prediabetic individuals was observed to be 22.20%. Prediabetic individuals with hyperuricemia exhibited higher levels of LFC compared to those without hyperuricemia. This association persisted even after adjusting for other variables, indicating a heightened risk of hyperuricemia among prediabetic individuals with elevated LFC [Q4 vs Q1: odds ratio (OR 2.70), 95% confidence interval (CI) 1.93– 3.79, P < 0.001; P for trend < 0.001]. Importantly, a nonlinear relationship between LFC and hyperuricemia risk was identified in the prediabetic individuals, showing a significant increase in hyperuricemia risk when LFC exceeded 8.4% (OR per standard deviation = 1.05, 95% CI: 1.02– 1.08, P < 0.001).Conclusion: In individuals with prediabetes, a higher LFC is associated with an elevated risk of hyperuricemia, especially when LFC exceeds 8.4%.Keywords: hyperuricemia, LFC, prediabetes, Chinese adults

Abstract Given the increasing global concerns about aggressive behaviors and the pressing need for effective psychological interventions, this study delves into the potential of a concept deeply rooted in positive and Buddhist psychology but largely researched in Western contexts, as a mitigating factor against aggression in Chinese adults. Through three core studies involving 652 participants (age: 30.52±8.16), our research illuminated the intricate relationship between self-compassion, perceived stress, and aggression. Study 1 identified a negative correlation among these variables, setting the empirical foundation. In Study 2, participants exposed to a self-compassion exercise reported enhanced self-compassion and reduced aggression. Study 3 further consolidated these findings, with participants in the self-compassion writing group, showing notable increases in self-compassion and decreases in aggression compared to a control group. Critically, perceived stress emerged as a significant mediator between self-compassion and aggression, elucidating its central role in this dynamic. Together, our findings underscore the promise of self-compassion as a strategy to curb aggression tendencies, especially in light of its influential relationship with perceived stress, suggesting vital implications for future mental health interventions.

Remnant cholesterol (RC), a key indicator of dyslipidemia, has been validated as a contributing factor to metabolic and cardiovascular diseases, both of which are closely associated with kidney stones (KS). This study aimed to investigate the association between RC and the risk of KS in Chinese adults. A total of 8,576 KS cases (mean age 55.87, 69.37% male) and 137,523 controls (mean age 54.57, 51.62% male) were included in this case-control study. RC was calculated using the formula: RC = TC-HDL-LDL. KS was ascertained with ultrasound by well-trained physicians. Multivariable logistic and restricted cubic spline (RCS) were applied to investigate the relationship between RC and KS. A total of 146,099 subjects (weighted mean age 54.64 years and 52.66% male) were included with mean RC = 0.8 for controls and RC = 0.72 for KS cases (P < 0.001). The multivariable-adjusted OR for KS occurrence across consecutive quartiles was 1.00 (reference), 1.05 (0.98–1.12), 1.15 (1.07–1.22), and 1.44 (1.35–1.53), respectively. Moreover, each standard deviation increment of RC was associated with a 15% (OR:1.15, 95% CI: 1.12–1.19) higher risk of KS occurrence. RCS showed significant and linear dose-response relationships between RC and KS occurrence (P-overall < 0.001, P-nonlinear = 0.270). The positive associations between RC and KS risk persisted in sensitivity analyses, suggesting the robustness of the results. In this case-control study of Chinese adults, elevated RC was associated with the occurrence of KS. [ABSTRACT FROM AUTHOR]

Given the increasing global concerns about aggressive behaviors and the pressing need for effective psychological interventions, this study delves into the potential of a concept deeply rooted in positive and Buddhist psychology but largely researched in Western contexts, as a mitigating factor against aggression in Chinese adults. Through three core studies involving 652 participants (age: 30.52±8.16), our research illuminated the intricate relationship between self-compassion, perceived stress, and aggression. Study 1 identified a negative correlation among these variables, setting the empirical foundation. In Study 2, participants exposed to a self-compassion exercise reported enhanced self-compassion and reduced aggression. Study 3 further consolidated these findings, with participants in the self-compassion writing group, showing notable increases in self-compassion and decreases in aggression compared to a control group. Critically, perceived stress emerged as a significant mediator between self-compassion and aggression, elucidating its central role in this dynamic. Together, our findings underscore the promise of self-compassion as a strategy to curb aggression tendencies, especially in light of its influential relationship with perceived stress, suggesting vital implications for future mental health interventions. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion This study examined cross‐sectional and longitudinal associations of intermittent fasting (IF) engagement with body mass index (BMI), both thinness‐oriented and muscularity‐oriented eating disorder (ED) psychopathology, eating‐related psychosocial impairment, and intuitive eating.Using a longitudinal design, 491 Chinese adults (Mage = 30.33 years, SD = 7.89) provided data regarding BMI, IF status, and eating variables at baseline (T1) and 8‐month (T2) follow‐up. One‐way ANOVA was used to explore cross‐sectional associations between IF engagement at T1 and study variables (i.e., BMI and eating variables) at T1. Cross‐lagged regression analyses were used to examine the longitudinal associations between IF engagement at T1 and study variables at T2, after adjusting for covariates and study variables at T1.Cross‐sectionally, compared with participants who never engaged in IF at T1, those with current or past engagement in IF at T1 exhibited significantly higher BMI, ED psychopathology, eating‐related psychosocial impairment, and lower intuitive eating at T1. Longitudinally, relative to never engagement in IF at T1, both current and past engagement in IF at T1 were associated with higher ED psychopathology and greater eating‐related psychosocial impairment at T2. Also, relative to never engagement in IF at T1, past engagement in IF at T1 was associated with higher BMI at T2 and lower unconditional permission to eat as a facet of intuitive eating at T2.The findings challenge the perception of IF as an effective approach for weight loss and also suggest IF might have enduring adverse impacts on eating behaviors, similar to traditional forms of dieting. [ABSTRACT FROM AUTHOR]

DEHP can pose a threat to human health. However, there is no available study on the exposure levels and risk assessment of DEHP in adults nationwide. This study collected data on the concentrations of DEHP metabolites in the urine of Chinese adults through a literature review to evaluate the exposure levels and health risks of DEHP. Thirty-four articles including 15955 subjects from 2000 to 2018 were included in the study. The results showed a substantial decrease in the exposure levels of DEHP among Chinese adults from 2000 to 2018, dropping from 81.66 μg/gCr to 43.34 μg/gCr. Compared to other provinces, Shanghai (81.40 μg/gCr) and Tianjin (80.97 μg/gCr) had higher levels of DEHP. The DEHP levels for males and females were 50.27 μg/gCr and 57.64 μg/gCr, respectively. The exposure levels in the 18 ∼ 40-year-old group and above 40-year-old group were 50.84 μg/gCr and 58.23 μg/gCr, respectively. HQs were less than 1. CR values exceeded 10−6, indicating that exposure to DEHP could increase the risk of developing cancer. This study revealed that the exposure levels of DEHP for Chinese adults have shown a remarkable downward trend over time, and exposure to DEHP may pose potential health risks to Chinese adults. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to explore the association between tea-drinking habits and health-related quality of life (HRQoL) in Chinese adults and the mediating effect of sleep quality in this association. Methods Data were derived from the 2020 Survey of Social Factors for Chronic Disease Prevention and Control among adults in Lishui District, Nanjing, Jiangsu Province, China. Tea-drinking habits were measured by participants' self-report. The HRQoL was measured using the 12-item Short Form Health Survey. Multiple linear regression modelling and mediating effects modelling were used for analyses. Results Habitual tea drinking, frequent tea drinking (drinking tea 6–7 days per week), tea concentration and <10 g of tea per day were strongly associated with an increase in HRQoL among Chinese adults (all p<0.05). The association between tea-drinking habits and HRQoL among Chinese adults was more pronounced in the male population and in those ≥45 y of age (all p<0.05). Tea drinking habits may improve HRQoL in Chinese adults by enhancing sleep quality (all p<0.05). Conclusions Maintaining the habit of habitual tea drinking (6–7 days per week), in small amounts (<10 g tea per day) was conducive to improving HRQoL of Chinese adults by improving sleep quality. [ABSTRACT FROM AUTHOR]

Background: Both serum uric acid (SUA) levels and body mass index (BMI) are recognized as important risk factors for hypertension. The current study aimed to investigate the interaction effects between SUA levels and overweight (defined as BMI ≥ 24 kg/m2 in Chinese) on the incidence of hypertension among Chinese adults. Methods: 1124 hypertensive participants and 7283 non-hypertensive participants, extracted from the China Health and Nutrition Survey (CHNS), were analyzed. Participants were categorized based on their SUA levels and BMI, to investigate the interaction effects between SUA levels and overweight on hypertension. Results: In comparison with the reference group (BMI < 24 kg/m2 and in the 1st quintile of SUA), multivariable adjusted analysis demonstrated that the odds ratio (OR) (95% confidence interval, 95% CI) of hypertension for participants with overweight alone was 2.18 (1.41–3.37); for elevated SUA levels alone, the ORs (95% CIs) were 1.57 (1.08–2.30), 1.84 (1.24–2.74), 2.21 (1.47–3.32), and 2.48 (1.55–3.96) across SUA quintiles; and for the combined effect of higher SUA levels and overweight, the ORs (95% CIs) were 3.25 (2.19–4.82), 3.73 (2.51–5.55), 5.17 (3.42–7.80), and 6.21 (4.01–9.60). The relative excess risk due to interaction (RERI) was 3.26 (1.43–5.09) at the 5th quintile of SUA, indicating the presence of additive interaction between overweight and SUA levels on hypertension. Conclusion: Interaction between SUA levels and overweight on hypertension exists specifically at the highest quintile (Q5, > 6.39 mg/dL) of SUA among Chinese adults. Therefore, strategies to lower SUA levels could be considered as a potential approach to mitigate hypertension risk in overweight individuals within this specific subgroup. [ABSTRACT FROM AUTHOR]

Background: This study aimed to establish reference intervals for two biomarkers actively utilized in routine annual medical check-ups in China: squamous cell carcinoma antigen (SCCA) and cytokeratin 19 fragment (CYRFA 21-1), and to understand the influence of age, gender, and benign nodule(s) on their levels. Methods: This prospective multicenter cross-sectional study continuously enrolled apparently healthy adults attending annual medical check-ups at three sites in 2019. Serum SCCA and CYFRA 21-1 levels were measured using electrochemiluminescence immunoassays. Age- and gender-specific reference intervals for the two biomarkers were established by using the 0 - 95th percentiles with 90% confidence intervals (CIs). The 97.5th percentiles were also provided. Results: A total of 1,017 subjects were enrolled in this study. Both biomarkers were significantly lower in females, and age was negatively associated with SCCA while positively associated with CYFRA 21-1 (all p < 0.0001). No statistically significant differences were determined between subgroups without/with benign nodule(s) despite nodule(s) status (all p > 0.05). The overall reference interval for SCCA is 0 - 2.64 ng/mL and 0 - 4.39 ng/mL for CYFRA 21-1. The age-specific reference intervals for SCCA are 0 - 2.76 ng/mL (18 - 49 years) and 0 - 2.22 ng/mL (≥ 50 years), and for CYFRA 21-1, they are 0 - 3.86 ng/mL (18 - 49 years) and 0 - 4.89 ng/mL (≥ 50 years). The gender-specific reference intervals for SCCA are 0 - 2.83 ng/mL (male) and 0 - 2.49 ng/mL (female), and for CYFRA 21-1, they are 0 - 4.34 ng/mL (male) and 0 - 4.45 ng/mL (female). Conclusions: The reference intervals for SCCA and CYFRA 21-1 established in this study could be utilized in annual medical check-ups and contribute to the screening of lung cancer in China. [ABSTRACT FROM AUTHOR]

Little evidence exists about whether a combination of healthy lifestyle factors is associated with a lower risk of depressive symptoms among Chinese population. We aimed to investigate the association between combined healthy lifestyle factors and risk of depressive symptoms. We conducted a baseline survey from July 2021 to December 2023, including 53,642 Chinese adults from general population. A healthy lifestyle score was constructed based on six lifestyle factors (physical activity, smoking status, alcohol consumption, diet, sleep duration, and body mass index). Logistic regression models were used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) adjusted for confounding variables. Each additional healthy lifestyle score was associated with a 20 % lower risk of having depressive symptoms (OR (95 % CI): 0.80 (0.78–0.81)). Compared with individuals with ≤2 healthy lifestyle factors, individuals with all the six healthy lifestyle factors had a 58 % reduced risk of having depressive symptoms (0.42 (0.37–0.47)). After stratification by gender, education and urbanization, the significant inverse association with healthy lifestyle score was stronger in women, individuals with high education, and urban residents. Besides, the significant negative association between healthy lifestyle score and depressive symptoms remained for different severity of depressive symptoms. Given the cross-sectional nature of data, we cannot make causal inferences. Our study indicated that adherence to healthy lifestyle factors was associated with a reduced risk of having depressive symptoms among Chinese adults. The observed associations were modified by gender, education and urbanization. These findings warrant further verification in interventional studies. • Those with the healthiest lifestyle had 58 % reduced risk of depressive symptoms. • Risk of depressive symptoms reduced 20 % with each healthy lifestyle increased. • The protective effect was stronger among women, individuals with high education, and urban residents. • The protective effect was observed for different severity of depressive symptoms. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aims to investigate the relationship between the atherogenic index of plasma (AIP) and diabetes risk in Chinese non-obese adults. This is important because the incidence of diabetes is significant in non-obese populations, and evidence regarding this association is limited.MethodsWe conducted a retrospective cohort study with 82,977 Chinese non-obese adults. We used Cox proportional hazards regression to assess the relationship between baseline AIP levels and diabetes incidence. We also employed cubic spline functions and smooth curve fitting to investigate potential nonlinear relationships. Sensitivity and subgroup analyses were conducted to validate our findings.ResultsThe median follow-up duration for these participants was 3.10 years, during which 1,041 subjects (1.25%) were diagnosed with diabetes. Adjusted analyses demonstrated a strong positive association between AIP and the risk of diabetes onset (HR 2.07; 95% CI: 1.63-2.63; p < 0.001). The risk of diabetes increased with higher AIP quartiles, especially between the highest (Q4) and lowest (Q1) quartiles (adjusted HR 1.55; 95% CI: 1.27-1.89). We also identified a nonlinear relationship between AIP and diabetes risk. Sensitivity and subgroup analyses confirmed these findings. Furthermore, E-value analysis indicated that the results were robust against unmeasured confounding variables.ConclusionOur findings highlight a positive, nonlinear association between AIP and diabetes risk in Chinese non-obese adults. Lowering triglycerides (TG) or increasing high-density lipoprotein cholesterol (HDL-C) levels may help reduce this risk.

Abstract Background During the first nine months of the COVID-19 emergency, patients were encouraged to use virtual versus clinic visits if in-person care was not deemed necessary by clinical staff. This study examined the association of spoken language preference and ethnicity with use of video versus phone virtual visits by US Latino and Chinese adult patients who got care in the same healthcare system. Methods We analyzed electronic health record data for four groups of adults aged 26-85y who had ≥ 1 primary or specialty care outpatient clinician visits during April-December 2020: 80,869 Latino adults preferring Spanish (LEP Latino); 214,765 Latino adults preferring English (non-LEP Latino); 23,430 Chinese adults preferring a Chinese dialect (LEP Chinese); and 49,710 Chinese adults preferring English (non-LEP Chinese). Prevalence of the following utilization outcomes were compared by language preference (LEP/non-LEP) within ethnicity and by ethnicity within language preference for four age subgroups (26-39y, 40-64y, 65-75y, and 76-85y): ≥ 1 virtual (video or phone) visit, ≥ 1 video visit, ≥ 1 phone visit, ≥ 1 clinic visit, video visits only, and phone visits only. We also compared ethnicity x language group differences within age subgroups using absolute difference and adjusted prevalence ratios derived from modified log-Poisson regression models that controlled for age and sex. Results Among virtual users, LEP Latino and Chinese adults were significantly less likely to use video visits and more likely to use phone visits than non-LEP Latino and Chinese adults in the same age strata. The LEP/non-LEP difference in video visit use was significantly larger among Latino than Chinese patients, with no similar ethnic group difference observed for phone visits. Within the LEP and non-LEP language groups, Chinese adults were significantly more likely than Latino adults to use video visits and less likely to use phone visits. Conclusions During the first nine months of the COVID-19 pandemic, uptake of video and phone virtual visits by Latino and Chinese adults significantly differed by LEP/non-LEP status within ethnicity and by ethnicity within LEP/non-LEP language group. These findings underscore the importance of disaggregating data by ethnicity and language preference when attempting to understand and study patient use of different virtual visit modalities.

The present study explored retrospective childhood parenting styles and retrospective childhood parent-child relationship quality as correlates of Chinese adults' current psychological distress. An online community sample of 501 Chinese adults (aged 19-46 years, M = 28.55, SD = 5.38; 252 men) was recruited. Retrospective parenting styles and parent-child relationship quality were measured by asking participants to recall their childhood experiences (≤12 years old). With bivariate correlations, both retrospective parenting styles and parent-child relationship quality were significantly associated with adults' current psychological distress. With multiple linear regressions, retrospective parental rejection was the only significant, positive correlate of current psychological distress (β = 0.36, p < 0.001). Gender significantly moderated the relation between retrospective parental warmth and current psychological distress (β = −0.12, p = 0.049) and the relation between retrospective parent-child relationship quality and current psychological distress (β = 0.18, p = 0.032). These findings suggest that Chinese adults' retrospective parenting styles and relationship quality with their parents during childhood may relate to current mental health status as represented by psychological distress, highlighting the potential influence of family-of-origin. Highlights: With bivariate correlations, both retrospective parenting styles and parent-child relationship quality were significantly associated with adults' current psychological distress. With multiple linear regressions, retrospective parental rejection was the only significant, positive correlate of current psychological distress. Higher retrospective parental warmth interacted with female gender in relation to lower current psychological distress. Higher retrospective parent-child relationship quality interacted with male gender in relation to lower current psychological distress. [ABSTRACT FROM AUTHOR]

Objective: Given the limited evidence on the relationship between the triglyceride-glucose (TyG) index and the risk of prediabetes among young adults, our study aimed to investigate the potential impact of the TyG index on the future development of prediabetes in young individuals. Methods: This retrospective cohort study included 125,327 healthy adults aged 20 to 45 years. We utilized Cox proportional hazards regression models, combined with cubic spline functions and smooth curve fitting, to assess the relationship between baseline TyG index and the risk of prediabetes among young adults, exploring its non-linear association. A series of sensitivity analyses and subgroup analyses were conducted to ensure the robustness of our findings. Results: After adjusting for covariates, the study found a positive correlation between the TyG index and the risk of prediabetes (HR=1.81, 95%CI: 1.54–2.13, p<0.0001). The risk of prediabetes increased progressively across quartiles of the TyG index (Q1 to Q4), with Q4 showing a significantly higher risk compared to Q1 (adjusted HR=2.33, 95% CI=1.72–3.16). Moreover, a non-linear relationship was identified between the TyG index and the risk of prediabetes, with an inflection point at 9.39. To the left of the inflection point, the HR was 2.04 (95% CI: 1.69 to 2.46), while to the right, the HR was 0.89 (95% CI: 0.48 to 1.65). Conclusion: Our study reveals a non-linear relationship and a saturation effect between the TyG index and the development of prediabetes among young individuals in China, with an inflection point at 9.39. Understanding this non)linear relationship can assist clinicians in identifying young individuals at high risk and implementing targeted interventions to reduce their risk of progressing to diabetes. [ABSTRACT FROM AUTHOR]

Background: During the first nine months of the COVID-19 emergency, patients were encouraged to use virtual versus clinic visits if in-person care was not deemed necessary by clinical staff. This study examined the association of spoken language preference and ethnicity with use of video versus phone virtual visits by US Latino and Chinese adult patients who got care in the same healthcare system. Methods: We analyzed electronic health record data for four groups of adults aged 26-85y who had ≥ 1 primary or specialty care outpatient clinician visits during April-December 2020: 80,869 Latino adults preferring Spanish (LEP Latino); 214,765 Latino adults preferring English (non-LEP Latino); 23,430 Chinese adults preferring a Chinese dialect (LEP Chinese); and 49,710 Chinese adults preferring English (non-LEP Chinese). Prevalence of the following utilization outcomes were compared by language preference (LEP/non-LEP) within ethnicity and by ethnicity within language preference for four age subgroups (26-39y, 40-64y, 65-75y, and 76-85y): ≥ 1 virtual (video or phone) visit, ≥ 1 video visit, ≥ 1 phone visit, ≥ 1 clinic visit, video visits only, and phone visits only. We also compared ethnicity x language group differences within age subgroups using absolute difference and adjusted prevalence ratios derived from modified log-Poisson regression models that controlled for age and sex. Results: Among virtual users, LEP Latino and Chinese adults were significantly less likely to use video visits and more likely to use phone visits than non-LEP Latino and Chinese adults in the same age strata. The LEP/non-LEP difference in video visit use was significantly larger among Latino than Chinese patients, with no similar ethnic group difference observed for phone visits. Within the LEP and non-LEP language groups, Chinese adults were significantly more likely than Latino adults to use video visits and less likely to use phone visits. Conclusions: During the first nine months of the COVID-19 pandemic, uptake of video and phone virtual visits by Latino and Chinese adults significantly differed by LEP/non-LEP status within ethnicity and by ethnicity within LEP/non-LEP language group. These findings underscore the importance of disaggregating data by ethnicity and language preference when attempting to understand and study patient use of different virtual visit modalities. [ABSTRACT FROM AUTHOR]

Background: The rising prevalence of depressive symptoms presents a pressing global public health concern, exacerbated by prevailing social inequality. Aim: This study seeks to identify latent profiles of social inequality perception and explore their associations with depressive symptoms. Methods: Data were obtained from the China Family Panel Studies (CFPS) involving 10,529 residents aged 18 years and above. Latent profile analysis (LPA) was used to identify different patterns of social inequality perception. Multiple linear regression analysis examined the links between these patterns and depressive symptoms. Results: Three distinct patterns of social inequality perception were identified: the disappointed pattern (TDP), the neutral pattern (TNP), and the positive pattern (TPP). Perceived social inequality was significantly associated with short-term and long-term depressive symptoms (β =.51, 95% CI [0.29, 0.72] vs. β =.51, 95% CI [0.27, 0.74]). Increases in social inequality perception patterns were also related to more severe depressive symptoms (β =.55, 95% CI [0.36, 0.74]). Conclusions: Increasing perceived social inequality is closely linked to elevated depressive symptoms in Chinese adults. This underscores the need for tailored strategies aimed at addressing heightened perceptions of social inequality to reduce the risk of depressive symptoms. [ABSTRACT FROM AUTHOR]

Current guidelines encourage large studies in a diverse population to establish normal reference ranges for three-dimensional (3D) echocardiography for different ethnic groups. This study was designed to establish the normal values of 3D-left ventricular (LV) and left atrial (LA) volume and function in a nationwide, population-based cohort of healthy Han Chinese adults. A total of 1117 healthy volunteers aged 18–89 years were enrolled from 28 collaborating laboratories in China. Two sets of 3D echocardiographic instruments were used, and full-volume echocardiographic images were recorded and transmitted to a core laboratory for image analysis with a vendor-independent off-line workstation. Finally, 866 volunteers (mean age of 48.4 years, 402 men) were qualified for final analysis. Most parameters exhibited substantial differences between different sex and age groups, even after indexation by body surface area. The normal ranges of 3D-LV and 3D-LA volume and function differed from those recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging guidelines, presented by the World Alliance Societies of Echocardiography (WASE) study, and from the 2D values in the EMINCA study. The normal reference values of 3D echocardiography-derived LV and LA volume and function were established for the first time in healthy Han Chinese adults. Normal ranges of 3D-LV and 3D-LA echocardiographic measurements stratified with sex, age, and race should be recommended for clinical applications. [ABSTRACT FROM AUTHOR]

AimsTo explore the effect of plasma homocysteine (Hcy) on cardiometabolic multimorbidity (CMM) among Chinses adults.MethodsThis study combined a community-based cross-sectional study with a 1:1 matched case–control study using propensity score method among adults aged over 30 years in six districts randomly selected from Hunan Province, China. We recruited 5,258 people, of whom 4,012 met the study criteria were enrolled. CMM was defined as the coexistence of two or more cardiometabolic diseases, including diabetes, hypertension, coronary heart disease and stroke. The plasma Hcy and other laboratory data was measured by chemical automatic detector. Lifestyles and personal characteristics were collected by a questionnaire. Multivariate models were used to explore the associations. We calculated the attributable risk proportion (ARP) for the association of Hcy with CMM. The dose–response relationship was evaluated using restricted cubic splines method.ResultsOf the 4,012 adults, 436 had CMM, with a population prevalence of 10.9%. In the propensity-score-matched case–control study, 828 (414 cases and 414 controls) were included, and those with high plasma Hcy level (>16.2 μmol/L) had a higher risk of CMM than those with lowest level (

IntroductionRapid growth has been found in the market of dietary supplements (DSs) in China. However, studies about the knowledge level, intentions, and behavior related to DS remained limited in the Chinese population. This study aimed to explore the knowledge level, perception, and practice toward DS among Chinese adults.MethodsThis is a cross-sectional design among 1,714 participants aged between 18 and 65 years. A total of 54.1% of participants reported purchasing supplements in the past 6 months. Knowledge levels were assessed with a score from 1 to 10 based on correct answers to 10 binary questions about supplements.ResultsOnly 29.1% of participants answered seven or more questions correctly, while 7.9% answered three or fewer questions correctly. Participants with high and middle knowledge levels were more likely to seek medical advice when experiencing discomfort symptoms and were less likely to choose DS, with corresponding odd ratios (ORs) of 1.58 (95% CI: 1.16, 2.13) and 0.69 (95% CI: 0.52, 0.91) in high knowledge group and ORs of 1.36 (95% CI: 1.03, 1.80) and 0.96 (95% CI: 0.72, 1.30) in middle knowledge group (Pfor trend = 0.003 and 0.028, respectively). No significant differences were found in the motivation of DS use between knowledge levels. Although higher knowledge levels were associated with less spending on DS (OR high = 0.69; 95% CI: 0.49, 0.99; OR middle = 0.88; 95% CI: 0.64, 1.20; Pfor trend = 0.038), it did not guarantee better and more accurate awareness toward DS use.DiscussionIn conclusion, there is a growing demand for supplements among Chinese adults, but a significant gap between knowledge and behavior exists, affecting decision-making behaviors regarding DS.

ObjectiveThis study aimed to determine the average intake of CoQ10 from dietary sources and explore the dose–response relationships between the dietary-derived CoQ10 intake and lipid profiles.MethodsWe performed a cross-sectional study based on the China Health and Nutrition Survey, which included 7,938 adults. The dietary intake assessment used three consecutive 24-h recalls combined with a household inventory. Serum was used for lipid profiling.ResultsThe average dietary-derived CoQ10 intake was 5.4 mg/day in Chinese adults. The dietary CoQ10 intake of the highest quartile (Q4 ≥ 6.96 mg/day) was negatively associated with total cholesterol (TC) [−0.12 (−0.19, −0.06) mmol/L], low-density lipoprotein cholesterol (LDL-C) [−0.17 (−0.23, −0.10) mmol/L], and non-high-density lipoprotein cholesterol (non-HDL-C) [−0.12 (−0.18, −0.05) mmol/L], while positively associated with apolipoprotein A-1 (ApoA1) [0.10 (0.08, 0.13) g/L] and triglycerides (TG) [0.14 (0.05, 0.23) mmol/L], compared to the lowest quartile (Q1

Wan-Sen Yan,1,2 Su-Jiao Liu,1 Meng-Meng Liu1 1Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, People’s Republic of China; 2Guizhou Research Institute for Health Development, Guizhou Medical University, Guiyang, People’s Republic of ChinaCorrespondence: Wan-Sen Yan, Department of Psychology, School of Medical Humanitarians, Guizhou Medical University and Guizhou Research Institute for Health Development, Guizhou Medical University, 9 Beijing Road, Yunyan District, Guiyang, 550004, People’s Republic of China, Tel +86-136-4850-4644, Email yanwansen@163.comBackground: Although structured clinical interviews are considered the gold standard for assessing binge eating disorder (BED), the self-administered Binge Eating Scale (BES) has been widely used as a screening tool for BED in clinical research. However, the psychometric properties of the BES among Chinese young adults remain unclear. This study aimed to examine the validity of a Chinese version of the BES with a large sample.Methods: A total of 2182 young adult college students were tested using the Simplified Chinese version of BES (SCBES), the 7-Item Binge-Eating Disorder Screener (BEDS-7), the Zung Self-Rating Depression Scale (SDS), the Generalized Anxiety Disorder Scale (GAD-7), and the Dual-Modes of Self-Control Scale (DMSC). The frequency of objective binge-eating episodes was used as a measure of severity. Validity and reliability of the SCBES were assessed through multiple analyses, along with the item analysis.Results: The data revealed that the SCBES demonstrated reasonable reliability and validity. The Cronbach’s α value was 0.813, with a one-month test–retest reliability of 0.835. The exploratory factor analysis (EFA) extracted three first-order factors, which explained a total of 53.82% of the variance. The confirmatory factor analysis (CFA) confirmed the three-factor model (ie, Binge-eating behaviors, Lack of control, Negative affects related to overeating), with a good model fit. The SCBES also demonstrated excellent concurrent and criterion validity, significantly correlating with the BEDS-7 and frequency of objective binge-eating episodes (r= 0.760– 0.782, p< 0.001). Gender, body mass index, depression, anxiety, impulsivity, and self-control were significantly associated with the total score of SCBES.Conclusion: The SCBES demonstrated sound psychometric properties and exhibited good cross-cultural adaptability in Chinese young adults, with a novel three-factor model fitting the data best. This scale could serve as a useful screening tool for identifying the severity of binge eating behaviors among Chinese youths.Keywords: Binge eating, psychometric properties, Chinese adults, college students

As one of the most severe public health issues, depressive symptoms have attracted wide attention around the world. This study aims to investigate the mediating role of marital life satisfaction in the relationship between gender inequality perception and depressive symptoms. Data were obtained from the China Family Panel Studies (CFPS) conducted in 2020. This study incorporated a total of 13,409 married residents aged 20 and above. The residents with middle (B = 0.19, 95 % CI = 0.01, 0.40) or high perception of gender inequality (B = 0.55, 95 % CI = 0.34, 0.75) were more likely to develop depressive symptoms. Marital life satisfaction plays a mediating effect in the relationship between patterns of gender inequality perception and depressive symptoms, and the mediating effect accounted for 4.89 % or 1.37 % of the total impact in the residents with middle or high patterns of gender inequality perception. Further studies need to understand the mechanisms of perceived patterns of gender inequality and depressive symptoms, because the cross-sectional design in this study cannot draw causal inferences. Patterns of gender inequality perception are significantly associated with depressive symptoms. Marital life satisfaction plays a mediating role in the relationship between patterns of gender inequality perception and depressive symptoms. It is plausible that nurturing healthy marital relationships could mitigate depressive symptoms in individuals who perceive high degrees of gender disparity. • Patterns of gender inequality perception are significantly associated with depressive symptoms. • Marital life satisfaction plays a mediating role in the above relationship. • Tailored strategies must be devised for those parts of the population that identify a pronounced degree of gender inequality. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the association of circulating levels of 25-hydroxyvitamin D (25[OH]D) with the risk of metabolic syndrome (MetS) and its components in adults. Methods: This nationwide cohort involved 23,810 Chinese adults attending annual health evaluations. Serum 25(OH)D levels, MetS status, and covariates were determined at each examination. Among them, 8146, 3310, and 1971 completed two, three, and more than three evaluations, respectively. A hybrid mixed-effects and Cox regression model was employed to determine the cross-sectional and longitudinal relationships. Results: The odds ratios (ORs) and 95% confidence intervals (CIs) of MetS were significantly lower in individuals within quartile 4 (vs. 1) of serum 25(OH)D for both between-individual (0.43 [0.35, 0.52]) and within-individual comparisons (0.60 [0.50, 0.73]), respectively (all p-trends < 0.001). Among the MetS components, the corresponding ORs (95% CI) in between- and within-individual comparisons were 0.40 (0.29, 0.54) and 0.26 (0.19, 0.36) for abdominal obesity, 0.49 (0.41, 0.58) and 0.78 (0.66, 0.93) for high triglycerides, 0.70 (0.59, 0.82) and 0.75 (0.64, 0.87) for hypertriglyceridemia, 0.48 (0.39, 0.59) and 0.87 (0.71, 1.07) for low HDL cholesterol, and 0.92 (0.76, 1.12) and 0.49 (0.41, 0.59) for hypertension, respectively. Decreased hazard ratios (95% CIs) in quartile 4 (vs. 1) of 25(OH)D were found for MetS (0.80 [0.65, 1.00]), high triglycerides (0.76 [0.62, 0.92]), abdominal obesity (0.77 [0.63, 0.96]), and low HDL cholesterol (0.64 [0.50, 0.81]). Conclusions: Decreased concentrations of serum 25(OH)D correlate significantly to a heightened MetS risk and specific components. Our findings underscore the potential preventive function of circulating vitamin D concerning metabolic disorders. [ABSTRACT FROM AUTHOR]

Smoking is a major risk factor for mortality globally. Smoking cessation, rather than reduction, can reduce the risk of many chronic diseases. The aim of this study was to determine association of smokers' health literacy and smoking cessation using a structural equation model. In this cross sectional study and using the Hangzhou Annual Health Literacy Survey Database from 2018 to 2019, 1663 smokers were selected by multistage stratified cluster random sampling and were assessed for health literacy via the Chinese Residents' Health Literacy Questionnaire. Demographic characteristics, tobacco hazard scores, and willingness to quit smoking were obtained from the questionnaire. We established a model based on the research hypothesis and constructed a structural equation model to verify it. Willingness to quit smoking was correlated with age (r = -0.142, p < 0.05), gender (χ2 = 16.262, p < 0.05), education (r = 0.140, p < 0.05), family annual income (r = 0.075, p < 0.05), score of tobacco hazards questionnaire (r = 0.184, p < 0.05), doctors' suggestion that the patient quit smoking (χ2 = 34.946, p < 0.05), attempting to quit smoking within the last 12 months (χ2 = 221.274, p < 0.05) and health literacy. Regarding the impact on the willingness to quit smoking, doctors' suggestion that a patient quit smoking had the greatest effect (standardized total effect = 0.112, 95% CI 0.065–0.160), followed by health literacy (0.094, 95% CI 0.039–0.142) and demographic information (0.053, 95% CI 0.022–0.082). The final model showed an acceptable fit (χ2 = 464.797, df = 75, χ2/df = 6.197, P < 0.001, goodness of fit index = 0.960, adjusted goodness of fit index = 0.945, root mean square error of approximation = 0.056) and 15 of the 17 pathways were statistically significant. Health educators should first improve people's health literacy level, and help them to understand the hazards of tobacco use, so that they develop a willingness to quit smoking. [ABSTRACT FROM AUTHOR]

The Intuitive Eating Scale‐2 (IES‐2) is a measure of intuitive eating behaviors that has been extensively validated, with traditional latent variable modeling approaches, in youth and adults from many different populations, including college students in China. However, there is still a lack of research on the psychometric properties of the IES‐2 in adults from the Chinese general population. Moreover, psychometric network analysis, as a complement to traditional latent variable modeling approaches, has not been used for examining the psychometric properties of the IES‐2. Thus, the present study used a psychometric network approach to evaluate the psychometric properties of the IES‐2 in Chinese adults from the general population. A sample of 700 Chinese general adults (50% women; Mage = 31.13 years, SD = 9.19) recruited online were included in the present study. Psychometric network analysis was performed. Exploratory graph analysis (EGA) identified four dimensions, which were well separated in the estimated network. The network structure showed excellent stability and metric measurement invariance (i.e., network loadings) across men and women. Furthermore, several items on the IES‐2 were identified as key nodes in the network of the IES‐2 that may be important for the development and maintenance of intuitive eating. For example, two items (i.e., "I trust my body to tell me when to eat," and "I trust my body to tell me when to stop eating") related to reliance on body cues were the most impactful nodes in the complete network. The findings of our study provide a greater understanding of the IES‐2 from the perspective of network analysis and have implications for applications of intuitive eating interventions for general populations. [ABSTRACT FROM AUTHOR]

Objective: Sleep duration is an important factor influencing health outcomes. The association between sleep duration and kidney function remains elusive. This study aimed to explore the association between sleep duration and chronic kidney disease (CKD) amongst Chinese adults. Methods: We conducted a cross-sectional study based on the China Health and Nutrition Survey (CHNS) in the wave of 2009. Participants were divided into three groups: ≤ 6 h/day (short sleepers), 7–8 h/day (regular sleepers) and ≥ 9 h/day (long sleepers) according to self-reported sleep duration. CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2. Results: A total of 8096 Chinese adults (45.9% men) with a mean age of 50.6 years were included in the study. Compared with regular sleepers, both short and long regular sleepers had a higher prevalence of CKD. A U-shaped relationship between sleep duration and CKD was displayed by restricted cubic spline curve (P-overall < 0.001, P-nonlinear < 0.001). Multivariate logistic regression models revealed that both short and long sleep duration were clinically associated with higher odds of CKD, after adjustments for covariates [adjusted odds ratio (OR) 1.25 and 1.30; 95% confidence interval (CI) 1.00–1.56 and 1.08–1.54, for short and long sleep duration, respectively]. In subgroup analyses, we found the association was still observed in participants without hypertension or diabetes mellitus. Conclusion: Short or long sleep duration was associated with CKD in the general population. [ABSTRACT FROM AUTHOR]

Purpose: There has been limited evidence for the association between pulse pressure (PP) and proteinuria in prediabetes. The aim of our study was to explore the association between PP and albuminuria in community-dwelling Chinese adults with prediabetes. Materials and Methods: PP and urinary albumin-to-creatinine ratio (ACR) were measured in 2012 prediabetic patients and 3596 control subjects with normal glucose tolerance. Multivariate logistic regression models were used to evaluate the possible association of PP with the risk of presence of albuminuria. Results: PP was positively associated with the presence of albuminuria, and subjects in the higher PP quartiles had higher urinary ACR and presence of albuminuria as compared with those in the lowest quartile in both prediabetes and control groups (all P < 0.01). Multivariate logistic regression analysis demonstrated that the highest PP quartile was positively associated with increased risk of presence of albuminuria in all prediabetic subjects [odds ratio (OR): 2.289, 95% confidence interval (CI) 1.364–3.842, P < 0.01) and prediabetic subjects without anti-hypertensive drugs (OR: 1.932, 95% CI 1.116–3.343, P < 0.01), whereas higher PP quartile has nothing to do with the risk of presence of albuminuria in control subjects with and without anti-hypertensive drugs after adjustment for potential confounders (all P > 0.01). Consistently, stratified analysis showed that in the prediabetes group, the risks of presence of albuminuria progressively elevated with increasing PP quartiles in men, those aged 60 years or older, and with overweight/obesity, normal high-density lipoprotein cholesterol, and appropriate low-density lipoprotein cholesterol (all P for trend <0.05). Conclusion: Higher PP is independently related to increased risk of presence of albuminuria in community-dwelling Chinese adults with prediabetes. [ABSTRACT FROM AUTHOR]

Little is understood about the relationship between marriage matching patterns and mental health. This study aims to examine the relationship between patterns of marriage matching and depressive symptoms among married Chinese adults, and respectively validate the effects of age, period, and cohort with hierarchical APC models. A total of 20,430 couples from the 2012, 2016 and 2018 wave of China Family Panel Studies were included in this study. We investigate patterns of marriage matching from age, personal education, parental education and especially, parental hukou status, which reflects an individual's residential status through urban-rural divide and has vital implications for socioeconomic status in China. Age gap is significantly associated with depressive symptoms both for men and women, yet sorting of parents' hukou status and education presented significant relationship with depressive symptoms only among women. In addition, we found strong age effects that changing trajectories of depressive symptoms across the life course vary among different genders and marital patterns. We did not find significant cohort effects after considering other factors, indicating the stability of depressive symptoms across birth cohorts. The CES-D is a widely used tool for depressive symptoms screening, the self-report instrument may produce results with lesser accuracy. Marriage matching patterns are significantly associated with depressive symptoms among Chinese adults, and these effects vary significantly across the life course. Our study sheds lights on the public mental health promotion programs from a marital perspective, suggesting that women in less satisfying marriage should be prioritized. • Age gap was associated with depressive symptoms both for men and women. • Parents' SES is related to depressive symptoms among women. • None cohort effects indicates the stability of depressive symptoms somewhat. [ABSTRACT FROM AUTHOR]

Abstract Background Studies regarding the validity of the food frequency questionnaire (FFQ) and the food composition table (FCT) are limited in Asian countries. We aimed to evaluate the validity of a 64-item FFQ and different methods of constructing the FFQ FCTs for assessing dietary intakes of foods and nutrients among adults in eastern China. Methods A total of 2325 participants (aged 56.2 ± 14.9 years, 51.6% female) from nine cities in Zhejiang province who completed a 64-item FFQ and 3-day 24-hour dietary recalls (24HRs) in 2015 were included. Eight FFQ FCTs were generated covering food items and specific weights estimated using professional knowledge, representative 24HRs data, or the Chinese FCT (CFCT). Energy-adjusted intakes of foods and nutrients were estimated by residual and energy density methods. Spearman correlation coefficients (SCCs) of intakes of 14 food groups and 17 nutrients between FFQ and 24HRs were calculated to evaluate the overall validity of FFQ. Results The average intakes of most food groups and nutrients assessed with FFQ were higher than those assessed using the 24HRs. For the food groups, the averaged energy-adjusted (residual method) SCC between FFQ and 24HRs was 0.27, ranging from 0.14 (starch-rich beans) to 0.49 (aquatic products). For nutrient assessment, the weighted FCT (WFCT) performs the best, and the averaged energy-adjusted (residual method) SCC was 0.26, ranging from 0.16 (iron) to 0.37 (potassium). Similar correlations with 24HRs were observed when using other FFQ FCT in the calculation of nutrient intakes. Conclusion The 64-item Chinese FFQ and the WFCT were reasonably valid to assess the dietary intakes of certain foods and nutrients among adults in eastern China.

Abstract Background Abnormal lipid metabolism poses a risk for prediabetes. However, research on lipid parameters used to predict the risk of prediabetes is scarce, and the significance of traditional and untraditional lipid parameters remains unexplored in prediabetes. This study aimed to comprehensively evaluate the association between 12 lipid parameters and prediabetes and their diagnostic value. Methods This cross-sectional study included data from 100,309 Chinese adults with normal baseline blood glucose levels. New onset of prediabetes was the outcome of concern. Untraditional lipid parameters were derived from traditional lipid parameters. Multivariate logistic regression and smooth curve fitting were used to examine the nonlinear relationship between lipid parameters and prediabetes. A two-piecewise linear regression model was used to identify the critical points of lipid parameters influencing the risk of prediabetes. The areas under the receiver operating characteristic curve estimated the predictive value of the lipid parameters. Results A total of 12,352 participants (12.31%) were newly diagnosed with prediabetes. Following adjustments for confounding covariables, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol were negatively correlated with prediabetes risk. Conversely, total cholesterol, triglyceride (TG), lipoprotein combine index (LCI), atherogenic index of plasma (AIP), non-HDL-C, atherogenic coefficient, Castelli’s index-I, remnant cholesterol (RC), and RC/HDL-C ratio displayed positive correlations. In younger adults, females, individuals with a family history of diabetes, and non-obese individuals, LCI, TG, and AIP exhibited higher predictive values for the onset of prediabetes compared to other lipid profiles. Conclusion Nonlinear associations were observed between untraditional lipid parameters and the risk of prediabetes. The predictive value of untraditional lipid parameters for prediabetes surpassed that of traditional lipid parameters, with LCI emerging as the most effective predictor for prediabetes.

Abstract Background Magnesium (Mg) is both an essential macro-element and a known catalyst, and it plays a vital role in various physiological activities and mechanisms in relation to chronic kidney disease (CKD). However, epidemiological evidence involving this is limited and not entirely consistent. This study aims to explore the association of serum Mg concentrations with the risk of CKD among general Chinese adults. Methods A total of 8,277 Chinese adults were included in the wave of 2009 from the China Health and Nutrition Survey (CHNS). The primary outcome was the risk of CKD, which was defined as the estimated glomerular filtration rate (eGFR)

Abstract The interplay among cigarette smoking status, oral microbiota, and cardiometabolic health is poorly understood. We aimed to examine the association of cigarette smoking status with oral microbiota and to assess the association of the identified microbial features with cardiometabolic risk factors in a Chinese population. This study included 587 participants within the Central China Cohort, including 111 smokers and 476 non-smokers, and their oral microbiota was profiled by 16S rRNA sequencing. Both oral microbial alpha- and beta-diversity were distinct between smokers and non-smokers (p

Abstract Background Although the tobacco epidemic is one of the greatest public health threats, the smoking cessation rate among Chinese adults is considerably lower. Personality information may indicate which treatments or interventions are more likely to be effective. China is the largest producer and consumer of tobacco worldwide. However, little is known about the association between smoking cessation and personality traits in China. Aim This study aimed to examine the association between successful smoking cessation and personality traits among Chinese adults. Methods This cross-sectional study used data from the 2018 China Family Panel Studies. Probit regression models were employed to analyze the association between successful smoking cessation and personality traits stratified by sex. Results Lower scores for neuroticism (Coef.=-0.055, p

Abstract Background The impact of total cholesterol (TC) on lumbar bone mineral density (BMD) is a topic of interest. However, empirical evidence on this association from demographic surveys conducted in China is lacking. Therefore, this study aimed to examine the relationship between serum TC and lumbar BMD in a sample of 20,544 Chinese adults between the ages of 20 and 80 years over a period of 5 years, from February 2018 to February 2023. Thus, we investigated the effect of serum TC level on lumbar BMD and its relationship with bone reduction in a Chinese adult population. Methods This cross-sectional study used data obtained from the Department of Health Management at Henan Provincial People’s Hospital between February 2018 and February 2023. The aim of this study was to examine the correlation between serum TC and lumbar BMD in individuals of different sexes. The research methodology encompassed population description, analysis of stratification, single-factor and multiple-equation regression analyses, smooth curve fitting, and analysis of threshold and saturation effects. The R and EmpowerStats software packages were used for statistical analysis. Results After adjusting for confounding variables, a multiple linear regression model revealed a significant correlation between TC and lumbar BMD in men. In subgroup analysis, serum TC was found to have a positive association with lumbar BMD in men, specifically those aged 45 years or older, with a body mass index (BMI) ranging from 24 to 28 kg/m2. A U-shaped correlation arose between serum TC and lumbar BMD was detected in women of different ages and BMI, the inflection point was 4.27 mmol/L for women aged ≥ 45 years and 4.35 mmol/L for women with a BMI of ≥ 28 kg/m2. Conclusion In this study, Chinese adults aged 20–80 years displayed different effects of serum TC on lumbar BMD in sex-specific populations. Therefore, monitoring BMI and serum TC levels in women of different ages could prevent osteoporosis and osteopenia. Trial registration The research protocol was approved by the Ethics Committee of Beijing Jishuitan Hospital, in accordance with the Declaration of Helsinki guidelines (No. 2015-12-02). These data are part of the China Health Quantitative CT Big Data Research team, which has been registered at clinicaltrials.gov (code: NCT03699228).

Introduction: The prevalence of hypertension increases with age and differs by race and ethnicity. Among U.S. Asian adults, prevalence is higher for Filipino adults than for other major Asian subgroups, but whether this disparity exists across the adult lifespan is unknown. This study examined hypertension prevalence by age decade, comparing Filipino adults with South Asian, Chinese, Black, Hispanic, and White adults. Methods: This cross-sectional study used 2015–2016 electronic health record data from a Northern California integrated healthcare delivery system for 1,839,603 adults aged 30–79 years, including 128,124 Filipino adults. Hypertension was defined by diagnosis codes. Sex-specific prevalence was calculated by race and ethnicity overall and by 10-year age decade from ages 30–39 years to 70–79 years. The prevalence of hypertension among 5 racial and ethnic groups was compared within each decade (with Filipino as the reference), adjusting for age, English language, diabetes, smoking, and weight category. Results: Decade-specific prevalence of hypertension among Filipino men and women, respectively, was 9.7% and 8.5% for ages 30–39 years, 26.0% and 23.9% for ages 40–49 years, 45.9% and 44.4% for ages 50–59 years, 65.4% and 63.9% for ages 60–69 years, and 82.1% and 82.9% for ages 70–79 years. Across all age decades, hypertension prevalence among Filipino adults largely tracked with Black adults and was much higher than among South Asian, Chinese, White, and Hispanic adults. This pattern remained after adjusting for covariates, with the largest differences observed for adults aged

Background: Magnetic resonance imaging (MRI) reference ranges for ventricular morphology and function in the Chinese population are lacking. Purpose: To establish the MRI reference ranges of left and right ventricular (LV and RV) morphology and function based on a large multicenter cohort. Study Type: Prospective. Population: One thousand and twelve healthy Chinese Han adults. Field Strength/Sequence: Balanced steady‐state free procession cine sequence at 3.0 T. Assessment: Biventricular end‐diastolic, end‐systolic, stroke volume, and ejection fraction (EDV, ESV, SV, and EF), LV mass (LVM), end‐diastolic and end‐systolic dimension (LVEDD and LVESD), anteroseptal wall thickness (AS), and posterolateral wall thickness (PL) were measured. Body surface area (BSA) and height were used to index biventricular parameters. Parameters were compared between age groups and sex. Statistical Tests: Independent‐samples t‐tests or Mann–Whitney U test to compare mean values between sexes; ANOVA or Kruskal–Wallis test to compare mean values among age groups; linear regression to assess the relationships between cardiac parameters and age (correlation coefficient, r). A P value <0.05 was considered statistically significant. Results: The biventricular volumes, LVM, LVEDD, RVEDV/LVEDV ratio, LVESD, AS, and PL were significantly greater in males than in females, even after indexing to BSA or height, while LVEF and RVEF were significantly lower in males than in females. For both sexes, age was significantly negatively correlated with biventricular volumes (male and female: LVEDV [r = −0.491; r = −0.373], LVESV [r = −0.194; r = −0.184], RVEDV [r = −0.639; r = −0.506], RVESV [r = −0.270; r = −0.223]), with similar correlations after BSA normalization. LVEF (r = 0.043) and RVEF (r = 0.033) showed a significant correlation with age in females, but not in males (P = 0.889; P = 0.282). Data Conclusion: MRI reference ranges for biventricular morphology and function in Chinese adults are presented and show significant associations with age and sex. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Background: Studies regarding the validity of the food frequency questionnaire (FFQ) and the food composition table (FCT) are limited in Asian countries. We aimed to evaluate the validity of a 64-item FFQ and different methods of constructing the FFQ FCTs for assessing dietary intakes of foods and nutrients among adults in eastern China. Methods: A total of 2325 participants (aged 56.2 ± 14.9 years, 51.6% female) from nine cities in Zhejiang province who completed a 64-item FFQ and 3-day 24-hour dietary recalls (24HRs) in 2015 were included. Eight FFQ FCTs were generated covering food items and specific weights estimated using professional knowledge, representative 24HRs data, or the Chinese FCT (CFCT). Energy-adjusted intakes of foods and nutrients were estimated by residual and energy density methods. Spearman correlation coefficients (SCCs) of intakes of 14 food groups and 17 nutrients between FFQ and 24HRs were calculated to evaluate the overall validity of FFQ. Results: The average intakes of most food groups and nutrients assessed with FFQ were higher than those assessed using the 24HRs. For the food groups, the averaged energy-adjusted (residual method) SCC between FFQ and 24HRs was 0.27, ranging from 0.14 (starch-rich beans) to 0.49 (aquatic products). For nutrient assessment, the weighted FCT (WFCT) performs the best, and the averaged energy-adjusted (residual method) SCC was 0.26, ranging from 0.16 (iron) to 0.37 (potassium). Similar correlations with 24HRs were observed when using other FFQ FCT in the calculation of nutrient intakes. Conclusion: The 64-item Chinese FFQ and the WFCT were reasonably valid to assess the dietary intakes of certain foods and nutrients among adults in eastern China. [ABSTRACT FROM AUTHOR]

Background: This study explores the complex intersection of euthanasia, legal ambiguities, cultural attitudes, and the psychology of suicide among seriously ill patients in China. It addresses the lack of clear legislation on euthanasia and doctor-assisted killing, the impact of cultural and philosophical beliefs, and the evolution of legal and ethical perspectives on suicide. Additionally, it examines the psychological aspects of suicide ideation in acutely-ill patients, focusing on factors like familial burden and loss of dignity. Method: A survey was conducted with 356 Chinese adults, aged 23 to 64 years, using popular social media platforms in China. The study aimed to reflect a broad spectrum of the adult population in terms of age, education, and professional sectors. The research model involves suicide rumination as an independent variable, acutely-ill patients' suicide acceptance as a dependent variable, and three mediators: cognitive depression, ethical suicide acceptance, and suicide legitimization. Results: The findings reveal a significant total effect of Suicide Rumination on Acutely-ill Patients' Suicide Acceptance, underlining a robust direct relationship that supports Hypothesis 1. The analysis indicates that Suicide Rumination is a significant predictor of Cognitive depression, explaining approximately 8.05% of its variance, thereby fully supporting Hypothesis 2a. However, the effect of Suicide Rumination on Ethical Suicide Acceptance did not emerge as significant, failing to support Hypothesis 2b, while its impact on Suicide Legitimization was also non-significant, not supporting Hypothesis 2c. Cognitive depression was found to have a substantial effect in the models for both Ethical Suicide Acceptance and Suicide Legitimization, supporting Hypotheses 3a and 3b. In the comprehensive model assessing Acutely-ill Patients' Suicide Acceptance, incorporating all mediators, a significant variance (R-squared = 0.6625) was explained. Notably, Suicide Rumination, Ethical Suicide Acceptance, and Suicide Legitimization all emerged as significant predictors of this acceptance, with varying effects, thus supporting Hypotheses 4a and 4b. The role of Cognitive depression in this model was marginally significant, offering limited support for Hypothesis 4c. Crucially, the indirect effects of Suicide Rumination on Acutely-ill Patients' Suicide Acceptance through different mediational paths varied in significance and impact. The indirect effect via Cognitive depression alone, and through the sequential combination of Cognitive depression and Ethical Suicide Acceptance, were significant, highlighting the nuanced role of these mediators. These findings underscore the importance of considering multiple pathways in understanding the dynamics of Suicide Rumination and its influence on the acceptance of suicide among acutely-ill patients. Conclusion: This paper presents a comprehensive analysis of the legal, cultural, ethical, and psychological dimensions of euthanasia, doctor-assisted killing, and suicide in China. The findings highlight the significant direct and mediated effects of suicide rumination on the acceptance of suicide among acutely-ill patients. The study contributes valuable insights into the evolving bioethics and the interplay of various factors in the context of end-of-life decision-making in modern Chinese society. [ABSTRACT FROM AUTHOR]

This study aimed to prospectively explore the relationship between fruit and vegetable intake (FVI) and type 2 diabetes (T2D) risk amongst 13,175 Chinese adults. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of T2D events in relation to FVI. Results showed that the highest quintile of FVI was inversely associated with T2D risk in men (HR = 0.72, 95% CI: 0.50, 0.98) and women (HR = 0.74, 95% CI: 0.55, 0.97), whereas no such associations were observed between total vegetable intake and T2D in either men (HR = 0.92, 95% CI: 0.65, 1.26) or women (HR = 1.02, 95% CI: 0.77, 1.38). In addition, greater fruit intake was inversely associated with T2D risk in men (HR = 0.42, 95% CI: 0.28, 0.63) and women (HR = 0.64, 95% CI: 0.45, 0.90). Overall, FVI and total fruit intake were inversely associated with T2D risk amongst Chinese adults. [ABSTRACT FROM AUTHOR]

Many studies have established a correlation between air pollution and green space with age-related diseases, yet the relationship between air pollution, green space, and frailty among older adults is not fully understood. The primary objective of this investigation is to examine the longitudinal association among air pollution, green space, and frailty in older adults, as well as the potential interaction and mediating effect. Analyzed data were obtained from the multi-wave CLHLS investigation (2008–2018). The participants' environmental exposure was evaluated using six air pollutants (PM1, PM2.5, PM10, PM10-2.5, O3, and NO2), and normalized difference vegetation index (NDVI). Annual ambient air pollutants were estimated using satellite-based spatiotemporal models. Time-varying Cox proportional risk models were employed to investigate the longitudinal relationships between air pollutants, greenness, and the onset of frailty in the elderly population. We conducted a variety of subgroup analyses, sensitivity analyses, and assessed potential interaction and causal mediating effects. A total of 6953 eligible elderly individuals were enrolled in our study. In the fully adjusted model, per IQR uptick in levels of PM1, PM2.5, PM10, PM10-2.5, O3, and NO2 corresponded to a 17% (95% CI 1.10–1.24), 25% (95% CI 1.17–1.34), 29% (95% CI 1.20–1.39), 35% (95% CI 1.24–1.47), 12% (95% CI 1.04–1.20), and 11% (95% CI 1.05–1.18) increase in frailty risk, respectively. For NDVI, increased IQR was significantly negatively associated with the risk of frailty (aHR 0.82, 95% CI 0.77–0.87). Our results revealed a significant interaction effect among O3, NO2, and residential greenness. PM1, PM2.5, PM10, and PM10-2.5 play a mediating role in the estimated relationship between residential greenness and frailty. In summary, our study reveals that PM1, PM2.5, PM10, PM10-2.5, O3, and NO2 correspond to elevated risks of frailty in the elderly. Residential greenness is associated with a lower risk of frailty in the elderly. Residential greenness can exert a positive impact on frailty by reducing particulate matter concentrations. [ABSTRACT FROM AUTHOR]