Biomedical and environmental sciences : BES最新文献

Objective: We examined the associations between obesity-related indices and the risk of diabetes progression from prediabetes in older adults, comparing the differences in using the American Diabetes Association (ADA) and World Health Organization (WHO) criteria.

Methods: Data were obtained from the Healthy Aging Evaluation Longitudinal Study conducted in China. At baseline, prediabetes (in participants without diabetes) was classified based on fasting plasma glucose (FPG) levels using both criteria. Body mass index (BMI) and waist circumference (WC) were categorized according to data distribution and diagnostic cut-off values, respectively. Cox proportional hazards regression models were used to estimate the adjusted hazard ratios ( aHRs) with 95% confidence intervals ( CIs) for obesity-related indices and diabetes progression from prediabetes.

Results: Among the 1,127 participants classified as prediabetic according to the ADA criteria, 474 met the WHO criteria. Under ADA-defined prediabetes, the highest WC quartile (≥ 93 cm) was significantly associated with an increased diabetes risk ( aHR 1.93 [1.06, 3.53, P < 0.05]), whereas BMI-related and cut-off-based abdominal obesity demonstrated no significant associations ( P > 0.05). Under WHO-defined prediabetes, both the high tertile of WC (≥ 90 cm) and general obesity (BMI ≥ 28.0 kg/m ²) were significantly associated with progression to diabetes ( P < 0.05), with aHR 2.13 (1.06, 4.27) and 2.44 (1.19, 5.01), respectively. However, cut-off-based abdominal obesity and the high BMI tertile (≥ 25.75 kg/m ²) were not significantly associated with diabetes progression ( P > 0.05).

Conclusion: Elevated WC, rather than BMI-based indices or cut-off-based abdominal obesity, was significantly associated with diabetes progression according to the ADA-defined prediabetes criteria. However, both the evaluated WC and general obesity predicted progression to diabetes according to the WHO criteria.

Objective: To identify whether metabolic status mediates the associations between frailty and mortality and incident cardiovascular disease (CVD), and to assess of interactive or joint relationships between frailty and metabolic status on these outcomes.

Methods: In this prospective cohort study of 456,445 UK Biobank participants, frailty was assessed using five phenotype criteria. Metabolic status was scored (0-4) based on central obesity, hypertension, hyperglycemia, and dyslipidemia. Multivariable-adjusted Cox regression models were used to assess the associations between frailty and mortality and incident CVD.

Results: During a median follow-up of 13.8 years for mortality and 13.6 years for CVD, 30,907 deaths (7,467 CVD-related) and 37,115 incident CVD cases occurred. Frailty was associated with higher risks of all-cause mortality (hazard ratio [ HR], 2.41; 95% confidence interval [ CI], 2.31-2.51), CVD mortality ( HR, 2.64; 95% CI, 2.43-2.87), and incident CVD ( HR, 1.83; 95% CI, 1.75-1.91), compared with non-frail individuals. Metabolic status mediated 8.7%, 16.1%, and 16.4% of these associations, respectively. Frailty and metabolic status interacted multiplicatively for all-cause mortality ( P-value for interaction < 0.001) and additively for CVD mortality [relative excess risk due to interaction (RERI), 1.78; 95% CI, 0.88-2.68] and incident CVD (RERI, 0.60; 95% CI, 0.33-0.86). Joint exposure to frailty and three to four metabolic disorders conferred 3.34-, 6.32-, and 3.30-fold risks of all-cause mortality, CVD mortality, and incident CVD, respectively, compared with metabolically healthy non-frail individuals.

Conclusion: This study highlights the need for integrated management strategies targeting both frailty and metabolic conditions to mitigate cardiovascular and mortality risks.

Objective: To examine the effect of excess body weight on adherence and lesion detection in colorectal cancer (CRC) screening.

Methods: A cross-sectional analysis was conducted within an opportunistic CRC screening program in Chongqing, which enrolled 43,797 adults aged 35-74 years between 2021 and 2022. A total of 42,279 participants were included in the final analysis, of whom 19,462 (46.0%) had excess body weight (BMI > 24.0 kg/m ²). Colonoscopy adherence and detection were compared between normal and excess body weight group, and associated factors were examined.

Results: Of the 7,002 participants recommended for colonoscopy, 3,808 (54.4%) had excess body weight. Adherence was significantly lower in the excess weight group (6.6%) than in the normal weight group (10.7%, P < 0.001), and this trend was consistent across sex and age groups. The detection rates of advanced neoplasms (3.6% vs. 1.8%) and non-advanced adenomas (10.7% vs. 6.7%) were higher in the excess weight cohort, with a significant difference for any neoplasm (14.2% vs. 8.9%, P < 0.05). Differences in adherence- and detection-related factors were also observed between the groups.

Conclusion: Excess body weight was associated with lower colonoscopy adherence but higher neoplasm detection. These findings support the integration of weight management with targeted screening promotion to improve CRC prevention in this high-risk population.

Objectives: This study aimed to quantify the impact of major chronic diseases on changes in healthy life expectancy (HLE) from 2011 to 2020 in China using an age-specific disability weights (DW) estimation method.

Methods: HLE at age 60 (HLE ₆₀) was used as the indicator of HLE in China. Cause-specific mortality rates were obtained from the cause-of-death database of the National Health Commission. Self-reported disease and disability status were derived from the China Health and Retirement Longitudinal Study. A total of 55,861 participants were included for DW estimation. Rates of disability, which was assessed using the Activities of Daily Living questionnaires, were estimated using data from 5,465 participants in 2011 and 9,910 participants in 2020. Age-specific DWs were calculated using a Bayesian logistic regression model. Changes in HLE ₆₀ were decomposed into mortality and disability effects by cause, based on the estimated DWs.

Results: HLE ₆₀ in China increased by 0.83 years from 2011 to 2020. Ischemic heart disease (IHD) contributed the most to the decline in HLE ₆₀, remaining the leading cause of reduction in terms of mortality effects. Diabetes showed the greatest impact on HLE ₆₀ due to disability, followed by stroke. The largest sex disparities in HLE ₆₀ were associated with disability from arthritis.

Conclusion: HLE ₆₀ in China improved from 2011 to 2020 and IHD remained the leading contributor to its decline, particularly through increased mortality. Disabilities related to diabetes, stroke, and arthritis had significant negative impacts. These findings highlight the need to strengthen integrated chronic disease prevention and rehabilitation services at community health centers.

Objective: Chronic obstructive pulmonary disease (COPD) is a major health concern in northwest China; however, the impact of particulate matter (PM) exposure during sand-dust storms (SDS) remains poorly understood. Therefore, this study aimed to investigate the association between PM exposure on SDS days and COPD hospitalization risk in arid regions.

Methods: Data on daily COPD hospitalizations were collected from 323 hospitals from 2018 to 2022, along with the corresponding air pollutant and meteorological data for each city in Gansu Province. Employing a space-time-stratified case-crossover design and conditional Poisson regression, we analyzed 265,379 COPD hospitalizations.

Results: PM exposure during SDS days significantly increased COPD hospitalization risk [relative risk ( RR) for PM _2.5, lag 3:1.028, 95% confidence interval ( CI): 1.021-1.034], particularly among men and the elderly, and during the cold season. The burden of PM exposure on COPD hospitalization was substantially high in Northwest China, especially in the arid and semi-arid regions.

Conclusion: Our findings revealed a positive correlation between PM exposure during SDS episodes and elevated hospitalization rates for COPD in arid and semi-arid zones in China. This highlights the urgency of developing region-specific public health strategies to address adverse respiratory outcomes associated with SDS-related air quality deterioration.

Objective: To investigate hypertension (HTN) trends, key risk factors, and gender disparities in rural China, and to propose targeted strategies for improving HTN control in resource-limited settings.

Methods: This longitudinal study used data from the Henan Rural Cohort Study, including baseline (2015-2017; n = 39,224) and follow-up (2018-2022; n = 28,621) participants. HTN was defined as systolic/diastolic blood pressure ≥ 140/90 mmHg, self-reported diagnosis, or use of antihypertensive medication. Severity was classified using a 7-tier blood pressure (BP) staging system (optimal, normal, high normal, and HTN stages 1-4). A generalized linear mixed-effects model (GLMM) identified associated risk factors.

Results: HTN prevalence increased modestly from 32.7% (95% CI: 32.2-33.2) to 33.9% (95% CI: 33.3%-34.4%). Awareness and treatment improved from 20.1% to 25.3%, and from 18.8% to 24.4%, respectively, but control rates remained low (6.2% to 12.3%). After adjustment, women had a 1.53-fold higher HTN risk than men ( OR = 1.53, 95% CI: 1.43-1.63), revealing gender-specific trends. Key risk factors included alcohol use ( OR = 1.37, 95% CI: 1.27-1.47) and overweight status ( OR = 1.76, 95% CI: 1.66-1.86). BP staging showed an increase in optimal BP (42.3% to 45.8%), but stagnant management of advanced HTN stages.

Conclusion: Hypertension in rural China is shaped by behavioral risk factors and healthcare access gaps. Gender-sensitive, community-based interventions, including task-shifting models, are necessary to mitigate the growing burden of hypertension.

Objective: The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.

Methods: A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted. Biological samples, including morning urine and venous blood, were collected to measure concentrations of 29 typical organic pollutants, including hydroxy polycyclic aromatic hydrocarbons (OH-PAHs), bisphenol A and its substitutes, phthalates and their metabolites, parabens, and five biomarkers of oxidative stress. Health assessments included blood pressure measurements and lung function indicators.

Results: Urinary concentrations of 2-hydroxyphenanthrene (2-OH-PHE) ( β = 4.35% [95% confidence interval ( CI): 0.85%, 7.97%]), 3-hydroxyphenanthrene ( β = 3.44% [95% CI: 0.19%, 6.79%]), and 4-hydroxyphenanthrene (4-OH-PHE) ( β = 5.78% [95% CI: 1.27%, 10.5%]) were significantly and positively associated with systolic blood pressure. Exposures to 1-hydroxypyrene (1-OH-PYR) ( β = 3.05% [95% CI: -4.66%, -1.41%]), 2-OH-PHE ( β = 2.68% [95% CI: -4%, -1.34%]), and 4-OH-PHE ( β = 3% [95% CI: -4.68%, -1.29%]) were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity. These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health. Biomarkers of oxidative stress, including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase, mediated the effects of multiple OH-PAHs on blood pressure and lung function.

Conclusion: Exposure to multiple organic pollutants can adversely affect cardiopulmonary health. Oxidative stress is a key mediator of the effects of OH-PAHs on blood pressure and lung function.