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1.
Hypertension ; 79(9): 1971-1980, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2009244

ABSTRACT

BACKGROUND: The National Health and Nutrition Examination Survey data indicate that the proportion of US adults with hypertension that had controlled blood pressure (BP) declined from 2013 to 2014 through 2017 to 2018. We analyzed data from National Health and Nutrition Examination Survey 2009 to 2012, 2013 to 2016, and 2017 to 2020 to confirm this finding. METHODS: Hypertension was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg or antihypertensive medication use. BP control among those with hypertension was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg. RESULTS: The age-adjusted prevalence of hypertension was 31.5% (95% CI, 30.3%-32.8%), 32.0% (95% CI, 30.6%-33.3%), and 32.9% (95% CI, 31.0%-34.7%) in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively (P trend=0.218). The age-adjusted prevalence of hypertension increased among non-Hispanic Asian adults from 27.0% in 2011 to 2012 to 33.5% in 2017 to 2020 (P trend=0.003). Among Hispanic adults, the age-adjusted prevalence of hypertension increased from 29.4% in 2009 to 2012 to 33.2% in 2017 to 2020 (P trend=0.029). In 2009 to 2012, 2013 to 2016, and 2017 to 2020, 52.8% (95% CI, 50.0%-55.7%), 51.3% (95% CI, 47.9%-54.6%), and 48.2% (95% CI, 45.7%-50.8%) of US adults with hypertension had controlled BP (P trend=0.034). Among US adults taking antihypertensive medication, 69.9% (95% CI, 67.8%-72.0%), 69.3% (95% CI, 66.6%-71.9%), and 67.7% (95% CI, 65.2%-70.3%) had controlled BP in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively (P trend=0.189). Among all US adults with hypertension and those taking antihypertensive medication, a decline in BP control between 2009 to 2012 and 2017 to 2020 occurred among those ≥75 years, women, and non-Hispanic black adults. CONCLUSIONS: These data confirm that the proportion of US adults with hypertension who have controlled BP has declined.


Subject(s)
Antihypertensive Agents , Hypertension , Adult , Antihypertensive Agents/pharmacology , Antihypertensive Agents/therapeutic use , Blood Pressure , Female , Humans , Hypertension/drug therapy , Hypertension/epidemiology , Nutrition Surveys , Prevalence
2.
Nutrients ; 14(14)2022 Jul 10.
Article in English | MEDLINE | ID: covidwho-1979321

ABSTRACT

We investigated whether dining with companions is correlated with the alleviation of depression and differs by sex among Korean adults. We used 4-year data from the 2014, 2016, 2018, and 2020 Korea National Health and Nutrition Examination Survey. We surveyed 11,055 participants (4699 men, 6356 women) using the Patient Health Questionnaire-9 to measure their depression scores. We evaluated participants' meal companionship status by asking whether they had usually dined with companions for breakfast, lunch, or dinner during the past year. Statistical analysis was performed using chi-square tests and multivariate/multinomial logistic regression. We found depression to be less prevalent among participants who dined with companions at least once a day (adjusted OR: 0.26, 95% CI: 0.15-0.45, men; adjusted OR: 0.50, 95% CI: 0.34-0.74, women). In the moderate depression subgroup, participants who dined with companions at least once a day showed lower OR (adjusted OR: 0.28, 95% CI: 0.16-0.50, men; adjusted OR: 0.50, 95% CI: 0.32-0.76, women). Among participants who dined together, men's severe depression dramatically decreased (adjusted OR: 0.05, 95% CI: 0.01-0.31). Thus, we found an association between dining with companions and the prevalence of depression among Korean adults. Dining with companions compared with dining alone signified a lower depression rate, especially among men. This study can provide an initiative to further analyze psychological and physiological effects of dining together and be applied to practical fields as education and societal campaigns.


Subject(s)
Depression , Friends , Adult , Depression/epidemiology , Female , Humans , Male , Meals , Nutrition Surveys , Republic of Korea/epidemiology
3.
Hepatol Commun ; 6(8): 2070-2078, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1958743

ABSTRACT

Recently, an expert panel proposed diagnostic criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) in the pediatric population. The aim of this study was to evaluate the prevalence of MAFLD among US adolescents and to investigate whether the new MAFLD definition is able to identify individuals with more advanced liver disease. We analyzed data from participants 12-18 years old included in the 2017-2020 cycles of the National Health and Nutrition Examination Survey, a large survey aimed at including individuals representative of the non-institutionalized general US population. Participants with a complete vibration-controlled transient elastography exam were included. Steatosis was evaluated through the median controlled attenuation parameter (CAP) and fibrosis through median liver stiffness measurement (LSM). Recently proposed criteria for the diagnosis of MAFLD were applied. Multivariable logistic regression analysis was performed to evaluate the impact of the new MAFLD definition on the odds of significant liver fibrosis. We included a total of 1446 adolescents (mean age: 14.9 years; 52.0% male; 47.3% overweight or obese). No participant reported a previous history of viral hepatitis. Steatosis (CAP ≥ 248 dB/m) was present in 25.9% (95% confidence interval [CI] 23.3-28.9) of individuals, and among these, 87.7% met the MAFLD criteria. Only 22.9% of patients with steatosis had elevated alanine aminotransferase levels. Among participants with steatosis, prevalence of significant liver fibrosis (LSM ≥ 7.4 kPa) did not differ significantly according to whether they met MAFLD criteria (9.7% vs. 15.2%, p = 0.276). In the multivariable model, odds of significant fibrosis did not differ significantly between these two groups. MAFLD criteria are met by most US adolescents with elastographic evidence of steatosis. Nonetheless, these criteria do not appear to improve detection of subjects with more advanced liver disease. Further longitudinal studies are needed to evaluate whether metabolic dysfunction is associated with faster progression toward inflammation, fibrosis, and liver-related events.


Subject(s)
Elasticity Imaging Techniques , Fatty Liver , Adolescent , Child , Fatty Liver/complications , Female , Humans , Liver Cirrhosis/diagnosis , Male , Nutrition Surveys
4.
Nutrients ; 14(13)2022 Jun 29.
Article in English | MEDLINE | ID: covidwho-1917646

ABSTRACT

The COVID-19 pandemic introduced risks and challenges to global food and nutrition security. In this paper, we examine the impact of the COVID-19 pandemic on the nutritional intake of China's rural residents using panel data and a fixed effects model. The data were collected in 2019 and 2020 and covered nine provinces and 2631 households in rural China. The results reveal that an increase of 100 confirmed cases in a county resulted in a 1.30% (p < 0.01), 1.42% (p < 0.01), 1.65% (p < 0.01), and 1.15% (p < 0.01) decrease in per capita intake of dietary energy, carbohydrates, fats, and proteins, respectively. Moreover, the COVID-19 pandemic had a significant and negative effect on dietary macronutrient intake in the low-income group at the 5% level of significance. Our study indicates that the potential insufficient nutrition situation, nutritional imbalance, and dietary imbalance of low-income rural residents should be addressed appropriately.


Subject(s)
COVID-19 , COVID-19/epidemiology , China/epidemiology , Eating , Humans , Nutrition Surveys , Pandemics , Rural Population
5.
Int J Environ Res Public Health ; 19(13)2022 Jun 22.
Article in English | MEDLINE | ID: covidwho-1911326

ABSTRACT

The COVID-19 pandemic has profoundly affected people's daily lives, including their dietary behaviors. Using a panel data set of 31 provinces from 2015 to 2020, this study employed two-way fixed effects (FE) models to examine the impacts of the COVID-19 pandemic on dietary consumption among Chinese residents. The results showed that the COVID-19 pandemic positively affected residents' consumption of grain, eggs, dairy, and white meat (poultry and aquatic products), while it had a negative effect on individuals' red meat consumption in both urban and rural areas. These results were robust to different measures of the COVID-19 pandemic, including the number of confirmed cases, suspect cases, and dead cases. Comparatively, the changes in food consumption induced by the COVID-19 pandemic were more prominent for Chinese residents who lived in rural areas than urban areas. In addition, compared to their counterparts, the dietary consequences of the pandemic were more pronounced for residents living in the eastern region and regions with a high old-age dependency ratio and low illiteracy rate. Furthermore, the estimation results of the quantile regression model for panel data suggested that the COVID-19 pandemic had relatively larger impacts on the dietary consumption of Chinese residents at lower quantiles of food consumption compared with those at higher quantiles. Overall, the results of this study suggested that Chinese residents had a healthier diet after the outbreak of the COVID-19 pandemic. We discussed possible mechanisms, including health awareness, income, food supply and prices, and other behavioral changes during COVID-19 (e.g., physical activity and cooking). To further improve residents' dietary behaviors and health, our study proposed relevant measures, such as increasing residents' dietary knowledge, ensuring employment and income, and strengthening the food supply chain resilience during the pandemic.


Subject(s)
COVID-19 , COVID-19/epidemiology , China/epidemiology , Diet , Humans , Nutrition Surveys , Pandemics
7.
Cad Saude Publica ; 37(8): e00300020, 2021.
Article in English | MEDLINE | ID: covidwho-1896511

ABSTRACT

This article aims to present general methodological aspects of the Brazilian National Survey on Child Nutrition (ENANI-2019), from the conception of the study design to details of the data collection. This is a household-based population survey with a sample calculated at 15,000 households to identify children under five years of age, conducted in 123 municipalities in Brazil's 26 states and the Federal District. ENANI-2019 includes data on breastfeeding and dietary intake; anthropometric nutritional status of all children and their biological mothers; and nutritional status concerning the following micronutrients: iron (hemoglobin and ferritin), zinc, selenium, and vitamins A, B1, B6, B12, D, E, and folic acid of children from 6 to 59 months of age. A total of 193,212 households were visited, of which 19,951 were eligible, and 12,524 were included in the study. A total of 14,558 children were studied, of whom 13,990 (96.1%) and 13,921 (95.6%) had their body mass and length/stature measured, respectively, and 14,541 (99.9%) underwent 24-hour dietary recalls (24HR). Of the 12,598 children eligible for blood sample collection, 8,739 (69.3%) had at least one laboratory parameter measured. Data were collected from February 2019 to March 2020, when the survey was interrupted due to the COVID-19 pandemic. The evidence produced by the ENANI-2019 survey can back the formulation, follow-up, and/or reorientation of food and nutrition policies such as the promotion of breastfeeding and healthy eating and the prevention and control of different forms of malnutrition.


Subject(s)
Nutrition Surveys , Brazil , Child, Preschool , Data Collection , Diet , Humans , Infant , Nutritional Status
8.
Ann Med ; 54(1): 1520-1529, 2022 12.
Article in English | MEDLINE | ID: covidwho-1882888

ABSTRACT

BACKGROUND & AIMS: Soluble α-Klotho (s-Klotho) is a circulating protein with pleiotropic effects that mainly induce protective effects. Our study investigates the associations between s-Klotho and several established inflammatory biomarkers, with the aim of examining whether s-Klotho levels are representative of inflammatory states. METHODS: A total of 11,128 eligible participants from NHANES 2007-2016 were included in our study. Levels of four inflammatory biomarkers, uric acid (UA), C-reactive protein (CRP), white blood cell (WBC) count, and mean platelet volume (MPV), were examined for their relationship with s-Klotho levels. Sub-analyses sorted the total population by gender and into four quartiles. Linear regression models were used to evaluate the strengths of associations. RESULTS: All four inflammatory biomarkers were significantly associated with s-Klotho levels. UA, CRP, and WBC count showed an inverse association, while MPV showed a direct one. Of the four markers, UA was most strongly correlated with s-Klotho levels (ß coefficient: -28.89 in unadjusted model, p<.001), and this relationship was stronger in women than in men (ß coefficient of UA in men: -22.01, p<.001; in women: -31.54, p<.001). In addition, all four biomarkers manifested stronger associations with s-Klotho in higher quartiles, and the highest absolute values of ß coefficients appeared in Q4 vs. Q1. CONCLUSION: s-Klotho is significantly associated with well-recognized inflammatory biomarkers. A decrease in s-Klotho levels implies a general inflammatory status; therefore, s-Klotho serves as a potential biomarker that is inversely correlated with inflammatory conditions. Further applications in clinical practice will provide us with a better understanding of its role.Key messagesSoluble α-Klotho (s-Klotho) levels are significantly associated with the inflammatory markers uric acid, C-reactive protein, white blood cell count, and mean platelet volume.S-Klotho is involved in inflammatory processes and plays a protective role.S-Klotho may serve as an inverse indicator of inflammation.


Subject(s)
C-Reactive Protein , Uric Acid , Biomarkers , C-Reactive Protein/metabolism , Female , Humans , Klotho Proteins , Male , Nutrition Surveys
9.
Int J Environ Res Public Health ; 19(10)2022 05 23.
Article in English | MEDLINE | ID: covidwho-1875636

ABSTRACT

Indoor air pollution is injurious to human health, even worse than outdoor air pollution. However, there is a lack of empirical evidence using large samples in developing countries regarding whether indoor air purification can improve human health by reducing indoor air pollutants. Using the data from the China Health and Nutrition Survey in 2015, this study analyzes the relationship between indoor air purification and residents' self-rated health. We apply the generalized ordered logit model and find that indoor air purification has a significantly positive effect on residents' self-rated health. This positive effect is limited to improving the probability of residents' health level being rated "good", and there is no significant movement between the two levels of "bad" and "fair". The results also show that, as an important source of indoor air pollutants, solid fuels used in cooking significantly reduced residents' self-rated health level. Additional results show the heterogeneity of the relationship between indoor air purification and resident health among groups with different characteristics. This study provides empirical evidence for further optimizing the indoor air environment.


Subject(s)
Air Pollutants , Air Pollution, Indoor , Air Pollution , Air Pollutants/analysis , Air Pollution, Indoor/analysis , China , Humans , Nutrition Surveys
10.
Front Public Health ; 10: 894266, 2022.
Article in English | MEDLINE | ID: covidwho-1847249

ABSTRACT

The Korea National Health and Nutrition Examination Survey (2020) reported that the prevalence of obesity (≥19 years old) was 31.4% in 2011, but it increased to 33.8% in 2019 and 38.3% in 2020, which confirmed that it increased rapidly after the outbreak of COVID-19. Obesity increases not only the risk of infection with COVID-19 but also severity and fatality rate after being infected with COVID-19 compared to people with normal weight or underweight. Therefore, identifying the difference in potential factors for obesity before and after the pandemic is an important issue in health science. This study identified the keywords and topics that were formed before and after the COVID-19 pandemic in the South Korean society and how they had been changing by conducting a web crawling of South Korea's news big data using "obesity" as a keyword. This study also developed models for predicting timing before and after the COVID-19 pandemic using keywords. Topic modeling results was found that the trend of keywords was different between before the COVID-19 pandemic and after the COVID-19 pandemic: topics such as "degenerative arthritis", "diet," and "side effects of diet treatment" were derived before the COVID-19 pandemic, while topics such as "COVID blues" and "relationship between dietary behavior and disease" were confirmed after the COVID-19 pandemic. This study also showed that both RNN and LSTM had high accuracy (over 97%), but the accuracy of the RNN model (98.22%) had higher than that of the LSTM model (97.12%) by 0.24%. Based on the results of this study, it will be necessary to continuously pay attention to the newly added obesity-related factors after the COVID-19 pandemic and to prepare countermeasures at the social level based on the results of this study.


Subject(s)
COVID-19 , Adult , Big Data , COVID-19/epidemiology , Humans , Nutrition Surveys , Obesity/epidemiology , Pandemics , SARS-CoV-2 , Young Adult
11.
Epidemiol Health ; 44: e2022043, 2022.
Article in English | MEDLINE | ID: covidwho-1841572

ABSTRACT

OBJECTIVES: This study aimed to describe trends in health behaviours between 2011 and 2020 and compare the changes in these behaviours between the 2020 COVID-19 pandemic and previous periods according to socio-demographic variables. METHODS: This study used data from the 2011 to 2020 Korea National Health and Nutrition Examination Survey. Current cigarette smoking, high-risk drinking, and inadequate physical activity levels were used as health behaviour indicators. The age-standardized prevalence, differences in prevalence between the periods, and the annual percentage change (APC) were calculated. RESULTS: Current cigarette smoking showed a decreasing trend (APC, -2.6), high-risk drinking remained unchanged, and inadequate physical activity levels increased (APC, 3.5) during 2011-2020. There were significant differences in high-risk drinking (3.1%p; 95% confidence interval [CI], 0.3 to 5.9) and inadequate physical activity levels (4.3%p; 95% CI, 0.4 to 8.1) between 2019 and 2020 in men. Among men, increased high-risk drinking was found in those aged 40-49 years, non-single households, urban residents, and the middle and highest income groups between 2019 and 2020. The low educational group and manual workers among men aged 30-59 years also showed an increased proportion of high-risk drinking. Inadequate physical activity levels also increased among men between 2019 and 2020 in those aged 30-39 years, non-single households, urban residents, and the upper-middle-income group. CONCLUSIONS: In the first year of the COVID-19 pandemic, Korean men's high-risk drinking and inadequate physical activity levels increased. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Exercise , Humans , Male , Nutrition Surveys , Pandemics , Prevalence , Republic of Korea/epidemiology , Smoking/epidemiology
12.
Epidemiol Health ; 44: e2022042, 2022.
Article in English | MEDLINE | ID: covidwho-1841571

ABSTRACT

OBJECTIVES: Coronavirus disease 2019 (COVID-19) and the associated social distancing, limited freedom, and fear of an uncertain future are expected to have substantial mental health effects. We investigated mental health responses in the community during the first year of the COVID-19 pandemic in Korea. METHODS: We used 2016-2019 and 2020 data from the Korea National Health and Nutrition Examination Survey (KNHANES) to assess pre-pandemic and pandemic mental health status, respectively, in terms of perceived severe stress, depression, and suicidal plans. All analyses were gender-stratified. Pre-specified subgroup analyses were performed according to age, employment status, and household income. RESULTS: The percentage of Korean adults with suicidal plans increased significantly from 1.3%p (95% confidence interval [CI], 1.1 to 1.5) in 2016-2019 to 1.8%p (95% CI, 1.4 to 2.1) in 2020. Individuals in their 20s and 40s showed a marked increase in suicidal plans (1.2%p; 95% CI, 0.0 to 2.3 and 0.9%p; 95% CI, 0.0 to 1.8, respectively). In men, depression and perceived severe stress increased significantly from pre-COVID-19 to 2020. There was a 2.4%p (95% CI, 0.8 to 4.0) increase in depression among standard workers and a 2.9%p increase in depression in individuals in the second-highest quintile of household income from 2016 and 2018 to 2020. CONCLUSIONS: As COVID-19 continued, mental health issues such as suicidal plans, depression, and severe stress increased significantly in young men and people in the second-highest quintile of household income. Proactive community mental health efforts are needed to prevent increases in the suicide rate resulting from prolonged exposure to the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Adult , Depression , Humans , Male , Mental Health , Nutrition Surveys , Republic of Korea/epidemiology , Suicidal Ideation
13.
Epidemiol Health ; 44: e2022041, 2022.
Article in English | MEDLINE | ID: covidwho-1841570

ABSTRACT

OBJECTIVES: We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population. METHODS: Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment). RESULTS: Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively). CONCLUSIONS: An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.


Subject(s)
COVID-19 , Diabetes Mellitus , Hypercholesterolemia , Hypertension , Adult , Diabetes Mellitus/epidemiology , Female , Humans , Hypercholesterolemia/epidemiology , Hypertension/epidemiology , Male , Nutrition Surveys , Obesity/epidemiology , Pandemics , Prevalence , Republic of Korea/epidemiology , Risk Factors
14.
JAMA Netw Open ; 5(4): e2210276, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1825760
15.
Am J Clin Nutr ; 116(1): 197-205, 2022 Jul 06.
Article in English | MEDLINE | ID: covidwho-1815986

ABSTRACT

BACKGROUND: Ultra-processed foods contribute to risks of obesity and cardiometabolic disease, and higher intakes have been observed in low-income populations in the United States. Consumption of ultra-processed foods may be particularly higher among individuals experiencing food insecurity and participating in the Supplemental Nutrition Assistance Program (SNAP). OBJECTIVES: Using data from the 2007-2016 NHANES, we examined the associations between food insecurity, SNAP participation, and ultra-processed food consumption. METHODS: The study population comprised 9190 adults, aged 20-65 y, with incomes ≤300% of the federal poverty level (FPL). Food insecurity was assessed using the Household Food Security Survey Module and SNAP participation over the past 12 mo was self-reported. Dietary intake was measured from two 24-h dietary recalls. Ultra-processed food consumption (percentage of total energy intake) was defined using the NOVA food classification system. Linear regression models were used to examine the associations between food insecurity, SNAP participation, and ultra-processed food consumption, adjusting for sociodemographic and health characteristics. RESULTS: More severe food insecurity was associated with higher intakes of ultra-processed foods (P-trend = 0.003). The adjusted means of ultra-processed food intake ranged from 52.6% for adults with high food security to 55.7% for adults with very low food security. SNAP participation was also associated with higher intakes of ultra-processed foods (adjusted mean: 54.7%), compared with income-eligible participants (adjusted mean: 53.0%). Furthermore, the association between food insecurity and ultra-processed foods was modified by SNAP participation (P-interaction = 0.02). Among income-eligible nonparticipants and income-ineligible nonparticipants, more severe food insecurity was associated with higher consumption of ultra-processed foods. Among SNAP participants, the association between food insecurity and consumption of ultra-processed foods was nonsignificant. CONCLUSION: In a nationally representative sample of adults, food insecurity and SNAP participation were both associated with higher levels of ultra-processed food consumption.


Subject(s)
Food Assistance , Adult , Fast Foods , Food Insecurity , Food Supply , Humans , Nutrition Surveys , United States
16.
Vaccine ; 40(20): 2828-2832, 2022 05 03.
Article in English | MEDLINE | ID: covidwho-1805287

ABSTRACT

BACKGROUND: We assessed disparities in HPV vaccination coverage by sociodemographic characteristics in the United States. METHODS: Using 2017-March 2020 National Health and Nutrition Examination Survey data, we estimated vaccination coverage of ≥ 1 dose of HPV vaccine by race/ethnicity and poverty, insurance, and nativity status for females and males aged 9-14, 15-19, and 20-29 years. RESULTS: Among those aged 9-14 years, coverage among non-Hispanic Black (NHB), Hispanic, and non-Hispanic Asian (NHA) females (40.0%, 33.6%, 34.0%) and males (27.1%, 35.3%, 30.9%) was higher than non-Hispanic White (NHW) females (26.5%) and males (25.2%). Among those aged 15-19 and 20-29 years, coverage varied among NHB, Hispanic, and NHA compared to NHW females and was lower among NHB, Hispanic, and NHA than NHW males. Coverage was lower among uninsured than insured in most comparisons. CONCLUSIONS: HPV vaccination coverage varied by race/ethnicity and other characteristics. Efforts are needed to increase HPV vaccination coverage in all populations.


Subject(s)
Alphapapillomavirus , Papillomavirus Infections , Papillomavirus Vaccines , Female , Humans , Male , Nutrition Surveys , Papillomavirus Infections/prevention & control , United States , Vaccination Coverage
17.
J Clin Lab Anal ; 36(4): e24334, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1782612

ABSTRACT

BACKGROUND: Among patients with diabetic retinopathy (DR), no proof was available to confirm the prognostic significance of the neutrophil percentage-to-albumin ratio (NPAR). We hypothesized that NPAR plays a role in the incidence of DR in diabetic patients. METHODS: We extracted all diabetes mellitus (DM) data from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2018, NPAR was expressed as neutrophil percentage/albumin. Multivariable logistic regression and generalized additive model were utilized for the purpose of examining the correction between NPAR levels and DR. Subgroup analysis of the associations between NPAR and DR was carried out to investigate if the impact of the NPAR varied among different subgroups. RESULTS: An aggregate of 5850 eligible participants were included in the present research. The relationship between NPAR levels and DR was positive linear. In the multivariate analysis, following the adjustment for confounders (gender, white blood cell, age, monocyte percent, red cell distribution width, eosinophils percent, bicarbonate, body mass index, iron, glucose, basophils percent, total bilirubin, creatinine, and chloride), higher NPAR was an independent risk factor for DR compared to lower NPAR (OR, 95% CI: 1.18, 1.00-1.39; 1.24, 1.04-1.48). For the purpose of sensitivity analysis, we found a trend of consistency (p for trend: 0.0190). The results of the subgroup analysis revealed that NPAR did not exert any statistically significant interactions with any of the other DR risk variables. CONCLUSIONS: Elevated NPAR is associated with an elevated risk of occurrence of DR in diabetic patients.


Subject(s)
Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Albumins/analysis , Diabetic Retinopathy/epidemiology , Humans , Leukocyte Count , Neutrophils/chemistry , Nutrition Surveys , Risk Factors
18.
Front Public Health ; 10: 847533, 2022.
Article in English | MEDLINE | ID: covidwho-1776061

ABSTRACT

Frailty is a commonly occurring geriatric condition that increases the risk of adverse health outcomes. The factors and predictors behind frailty are not yet well understood. A better understanding of these factors can enable prevention of frailty in elderly patients. The objective of this study was to determine the association between proteinuria and frailty in US individuals with metabolic syndrome (MetS). Data from the National Health and Nutrition Examination Survey III (NHANES III, 1988-1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a cross-sectional study, and proteinuria and frailty were measured only once at enrollment. The study included 2,272 participants with MetS aged 40-90 years from the NHANES III. The participants underwent assessments to evaluate frailty and frailty components (low body weight, weakness, exhaustion, low physical activity, and slow walking). Proteinuria was represented as albumin-to-creatinine ratio (ACR) (mg/g) and divided into tertiles: T1-normal range (ACR <30 mg/g), T2-microalbuminuria (ACR 30-299 mg/g), and T3-macroalbuminuria (ACR ≥ 300 mg/g). We applied multiple logistic regression to determine the odds ratios (ORs) of frailty for T2 vs. T1 and T3 vs. T1 in both sexes. In the adjusted analysis for male participants, the ORs of frailty for T2 and T3 vs. T1 were 3.106 (95% confidence interval [CI] = 1.078-8.948, P = 0.036) and 14.428 (95% CI = 4.231-49.193, P < 0.001), respectively. For female participants, the ORs of frailty for T2 and T3 vs. T1 were 1.811 (95% CI = 1.071-3.063, P = 0.027) and 2.926 (95% CI = 1.202-7.124, P = 0.018), respectively. The positive association between T2 and T3 vs. T1, and frailty were statistically significant. The trends of higher likelihood of every frailty component were also statistically significant across increasing tertiles of proteinuria after multiple levels of adjustment for covariates (P < 0.05). Increased proteinuria levels were positively associated with frailty and each frailty component. Proteinuria might be a useful maker for frailty in individuals with MetS.


Subject(s)
Frailty , Metabolic Syndrome , Proteinuria , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Frail Elderly , Frailty/epidemiology , Humans , Male , Metabolic Syndrome/epidemiology , Middle Aged , Nutrition Surveys , Proteinuria/epidemiology
19.
Front Public Health ; 10: 829466, 2022.
Article in English | MEDLINE | ID: covidwho-1776030

ABSTRACT

Aim: To examine the human exposure to perchlorate, nitrate, and thiocyanate, and their associations with oral pain (OP) in the general population from the U.S. Methods: A total of 13,554 participants were enrolled in the National Health and Nutrition Examination Survey. The urinary perchlorate, nitrate, and thiocyanate were measured using ion chromatography coupled with an electrospray tandem mass spectrometry. The multivariable linear and logistic regressions were performed to explore the associations of the urinary perchlorate, nitrate, and thiocyanate, with the prevalence of oral pain. Restricted cubic splines were used to explore the non-linearity. Results: There are 3,129 OP cases. There was a higher urinary level of perchlorate, nitrate, and thiocyanate in OP. We found that urinary thiocyanate was positively associated with OP (odds ratio [OR] = 1.06; [1, 1.13]; p = 0.049). Restricted cubic spines revealed that urinary thiocyanate was in a U-shape association with OP. Conclusions: Urinary thiocyanate was in a U-shape association with OP, suggesting that we should keep the exposure of thiocyanate under a reasonable range.


Subject(s)
Mouth , Nitrates , Pain , Perchlorates , Thiocyanates , Environmental Exposure/adverse effects , Humans , Mouth/physiopathology , Nitrates/urine , Nutrition Surveys , Pain/epidemiology , Perchlorates/urine , Thiocyanates/urine , United States/epidemiology
20.
Front Public Health ; 10: 820643, 2022.
Article in English | MEDLINE | ID: covidwho-1776015

ABSTRACT

Background: Cancer is one of the leading chronic diseases, which causes premature mortality in Korea. Early detection has been reported to be associated with reduced mortality and morbidity. Consistent evidence reports that lower screening rates are associated with socioeconomic-based disparities. This study aimed to examine income-related disparities in cancer screening services and to analyze the association between utilization of cancer screening and individual characteristics, including income levels. Methods: This study utilized the data from the Korea National Health and Nutrition Examination Survey (KNHANES), a population-based survey from 2013 to 2019. The study population included individuals aged 40 years or over. The variables were socioeconomic characteristics and perceived health status. Household income was categorized into quartiles from Q1 (the lowest income group) to Q4 (the highest income group). Multivariate logistic regression analysis was performed to analyze the association between cancer screening and individual characteristics and household income levels. Results: There were 20,347 individuals included in this study. Among these, 14,741 (72.4%) had undergone cancer screening. There existed a gap in the utilization of cancer screening between the lowest (Q1) and highest (Q4) income quintiles owing to evident income disparities; Q4 thus had a significantly higher likelihood of undergoing cancer screening than other quintiles. Female sex, university and over education, number of chronic diseases, and private insurance coverage were positively associated with cancer screening (p < 0.001). Conclusion: Our findings suggest that policymakers should develop and design strategies to increase awareness and efforts to improve the education and promotion of cancer screening among lower-income target groups.


Subject(s)
Early Detection of Cancer , Healthcare Disparities , Income , Neoplasms , Adult , Cross-Sectional Studies , Female , Humans , Neoplasms/diagnosis , Nutrition Surveys , Republic of Korea/epidemiology
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