Association of ticagrelor with risk of infection：a two-sample Mendelian randomization study based on the GWAS database / 中国药房

OBJECTIVE To investigate the causal association between ticagrelor and risk of infection METHODS Two-sample Mendelian randomization was adopted. Genetic instrumental variables were selected based on the results of the largest genome-wide association analysis to in vivo exposure of ticagrelor and its major active metabolite AR-C124910XX. The causal associations of ticagrelor and its major active metabolite AR-C124910XX with drug indications （coronary artery disease， unstable angina pectoris， myocardial infarction， stroke and ischemic stroke）were analyzed by inverse variance weighted Mendelian randomization model as a positive control for genetic instrumental variables. The causal relationship between ticagrelor and bacterial infection， acute lower respiratory infection， bacterial pneumoniae， pneumoniae，acute upper respiratory infection and sepsis were furtheranalyzed by using this method， and the robustness of the results was assessed by using heterogeneity tests and horizontal 202002030415） pleiotropy tests. RESULTS The increase of area under the curve at steady state （AUCss） of the genetic surrogated ticagrelor significantly reduced the risk of coronary artery disease， myocardial infarction and unstable angina pectoris （P＜0.001）. AUCss genetic instrument variables of its main active metabolite AR-C124910XX failed to pass positive control. Further analysis showed that the increase of the genetic surrogated ticagrelor exposure suggestively reduced the risk of bacterial infection [OR（95%CI）＝0.80（0.65，0.99），P＝0.040] and sepsis [OR （95%CI）＝0.84（0.73， 0.98）， P＝0.023]. The results of the heterogeneity tests showed that there was no heterogeneity in the causal association of the genetic surrogated ticagrelor AUCss with bacterial infection and sepsis （P＞0.05）. The results of horizontal pleiotropy tests showed that the causal association of genetic surrogated ticagrelor AUCss with bacterial infection and sepsis had no effects on horizontal pleiotropy （P＞0.05）. CONCLUSIONS Ticagrelor has a potential role in reducing the risk of sepsis and bacterial infections.

Association of Bisphenol A and Its Substitutes, Bisphenol F and Bisphenol S, with Obesity in United States Children and Adolescents

BACKGROUND: Bisphenol F (BPF) and bisphenol S (BPS) are increasingly used as substitutes for bisphenol A (BPA), an environmental obesogen. However, health effects of BPF and BPS remain unclear. In this study, we evaluated the associations of BPA, BPF, and BPS with obesity in children and adolescents. METHODS: We used data from the U.S. National Health and Nutrition Examination Survey 2013 to 2014, a nationally representative study. We included 745 participants aged 6 to 17 years old. General obesity was defined based on the 2000 Centers for Disease Control and Prevention body mass index-for-age growth charts for the United States. Abdominal obesity was defined as waist-to-height ratio ≥0.5. RESULTS: After adjustment for demographic, socioeconomic and lifestyle factors, and urinary creatinine levels, the odds ratio of general obesity comparing the highest with lowest quartile of urinary bisphenol levels was 1.74 (95% confidence interval [CI], 0.92 to 3.31) for BPA, 1.54 (95% CI, 1.02 to 2.32) for BPF, and 1.36 (95% CI, 0.53 to 3.51) for BPS. Moreover, the associations were stronger in boys than in girls for BPA and BPF. Similar results were observed for abdominal obesity. CONCLUSION: This study for the first time showed that exposure to BPF, a commonly used substitute for BPA, was positively associated with higher risk of obesity in children and adolescents. The association of BPA and BPF with general and abdominal obesity was primarily observed in boys, suggesting a possible sex difference. Further investigations on the underlying mechanisms are needed.

Secular trends of overweight and obesity prevalence between 2007 and 2011 in children and adolescents in Guangzhou / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aimed to explore the secular trends of overweight and obesity prevalence between 2007 and 2011 in children and adolescents in Guangzhou.</p><p><b>METHODS</b>The data of physical examination was collected from the routine measurements carried out by the Health Care Facilities of Primary and Secondary schools between 2007 and 2011. Random stratified cluster sampling was conducted, all the students aged 5-18 years old form 19 primary and secondary schools from 4 districts (Tianhe district, Yuexiu district, Baiyun district and Haizhu district) were included in this survey, including 27 944 students in 2007 and 38 284 students in 2011. Body mass index reference norm established by Working Group on Obesity in China (WGOC) and the WHO cut-off criteria were employed for overweight and obesity screening, and the trend was analyzed.</p><p><b>RESULTS</b>Prevalence of obesity in children and adolescents (7-18 years old) significantly increased from 5.96% (1 553/26 055) in 2007 to 6.56% (2 339/35 664) in 2011, and the difference showed statistical significance (χ(2) = 9.195, P < 0.05). Overweight and obesity was more common in boys (overweight: 13.25% (1 766/13 329) in 2007 and 13.87% (2 559/18 451) in 2011; obesity: 7.82% (1 042/13 329) in 2007 and 8.63% (1 592/18 451) in 2011) than in girls (overweight: 7.43% (946/12 726) in 2007 and 8.17% (1 406/17 213) in 2011; obesity: 4.11% (523/12 726) in 2007 and 4.48% (771/17 213) in 2011), and the difference showed statistical significance (overweight:χ(2) = 236.123 in 2007 and χ(2) = 292.892 in 2011; obesity:χ(2) = 158.533 in 2007 and χ(2) = 247.794 in 2011. All P values < 0.05). Further analysis found that significant increases occurred in boys aged 16 and 17 years old and in girls aged 12 years old (boy: 16 years old,χ(2) = 6.820, P < 0.05. 17 years old, χ(2) = 4.893, P < 0.05. girl: 12 years old,χ(2) = 5.921, P < 0.05).</p><p><b>RESULTS</b>of Join-point regression showed that for boys less than 10 years old the prevalence increased with age increasing (in 2007, APC = 3.75; in 2011, APC = 1.76), while over 10 years old the prevalence decreased with age increasing (in 2007, 10-18 years old's APC = -18.58; in 2011, 10-18 years old's APC = -15.95). While for girls the prevalence of obesity increased with age increasing between 7-9 years old (APC = 12.16), decreased with age increasing through 9 to 18 years old (APC = -17.23) in 2007. The prevalence decreased with age increasing for girls in 2011 (APC = -4.66).</p><p><b>CONCLUSION</b>The prevalence of obesity is high and still increasing in children and adolescents in Guangzhou, and it is higher in boys than in girls. It is more likely to become obesity at 10 years for boys, and for girls the prevalence decrease with age increasing.</p>

Sleep problems in children with developmental behavioral disorder / 国际儿科学杂志

It has been showed that sleep problems are prevalent in children,affecting children's cognitive and neurobehavioral development.This paper reviews currently available evidence on sleep characteristics in children with attention deficit hyperactivity disorder,Tourette's Syndrome,emotional disorders and autism spectrum disorders,in order to understand the relationship between these developmental behavioral disorders and sleep problems,and the present therapies for these children.