Modulating Metal-Nitrogen Coupling in Anti-Perovskite Nitride via Cation Doping for Efficient Reduction of Nitrate to Ammonia.

The complexes of metal center and nitrogen ligands are the most representative systems for catalyzing hydrogenation reactions in small molecule conversion. Developing heterogeneous catalysts with similar active metal-nitrogen functional centers, nevertheless, still remains challenging. In this work, we demonstrate that the metal-nitrogen coupling in anti-perovskite Co4 N can be effective modulated by Cu doping to form Co3 CuN, leading to strongly promoted hydrogenation process during electrochemical reduction of nitrate (NO3 - RR) to ammonia. The combination of advanced spectroscopic techniques and density functional theory calculations reveal that Cu dopants strengthen the Co-N bond and upshifted the metal d-band towards the Fermi level, promoting the adsorption of NO3 - and *H and facilitating the transition from *NO2 /*NO to *NO2 H/*NOH. Consequently, the Co3 CuN delivers noticeably better NO3 - RR activity than the pristine Co4 N, with optimal Faradaic efficiency of 97 % and ammonia yield of 455.3 mmol h-1 cm-2 at -0.3 V vs. RHE. This work provides an effective strategy for developing high-performance heterogeneous catalyst for electrochemical synthesis.

Dietary intakes of total, nonheme, and heme iron and hypertension risk: a longitudinal study from the China Health and Nutrition Survey.

AIMS: Evidence is limited regarding the long-term impact of dietary iron intake on the development of hypertension. We investigated the association between dietary intakes of total, nonheme, and heme iron and hypertension risk in a large prospective cohort of Chinese populations over 26 years. METHODS: A total of 16,122 adults (7810 men and 8312 women) who participated in the China Health and Nutrition Survey (1989-2015) were included. Dietary intake was repeatedly assessed by combining three consecutive 24­h individual dietary recalls with household food inventory weighing at each survey round. Incident hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, diagnosis by physicians, or current use of anti-hypertensive drugs. RESULTS: During a median follow­up of 11.1 years, 2863 men and 2532 women developed hypertension. After adjustment for non-dietary and dietary factors, a lower risk of hypertension was found in men and women with higher intakes of total, nonheme, or heme iron. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the highest vs. lowest quartiles were 0.76 (0.67, 0.87) in men and 0.85 (0.74, 0.97) in women for total iron intake, 0.77 (0.67, 0.87) in men and 0.85 (0.74, 0.98) in women for nonheme iron intake, and 0.73 (0.62, 0.87) in men and 0.69 (0.58, 0.82) in women for heme iron intake. Dose-response analyses further revealed a U-shaped association of total and nonheme iron intake and an L-shaped association of heme iron intake with hypertension risk in both men and women (all P for non-linearity < 0.001). CONCLUSIONS: Our findings emphasize the importance of maintaining moderate iron intake in the prevention of hypertension. Both insufficient and excess intake of iron might increase the risk of hypertension.

Long-term dietary iron intake and risk of non-fatal cardiovascular diseases in the China Health and Nutrition Survey.

AIMS: We aimed to investigate the association of long-term dietary iron intake with the risk of non-fatal cardiovascular diseases (CVDs), myocardial infarction (MI), and stroke in Chinese populations with predominantly plant-based diets by sex. METHODS AND RESULTS: A total of 17 107 participants (8569 men and 8538 women) aged 18-80 years in the China Health and Nutrition Survey (CHNS) 1989-2015 were included. Dietary intake was assessed repeatedly by three consecutive 24-h dietary recalls. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 11.1 years, the adjusted HRs (95% CIs) for non-fatal CVDs risk across quintiles of total iron intake in men were 1.00, 0.65 (0.46-0.93), 0.54 (0.37-0.78), 0.66 (0.46-0.94), 0.69 (0.47-1.03), but no significant association in women. Similar associations were found for stroke risk, but not for MI risk. The dose-response curves for the association of total iron and non-heme iron intake with the risk of non-fatal CVDs and stroke followed a reverse J-shape only in men and similar reverse J-shaped association of heme iron intake with non-fatal CVDs and stroke risk in both men and women (P-non-linearity <0.05). CONCLUSION: Moderate dietary iron intake may protect against non-fatal CVDs and stroke, especially in Chinese men consuming plant-based diets. Both quantity and quality of dietary iron intake should be considered in the prevention of non-fatal CVDs due to differences in dietary patterns among diverse populations.

This prospective cohort study, using data from 8569 men and 8538 women who participated in the China Health and Nutrition Survey (CHNS) 1989­2015, suggests that moderate intake of dietary iron may protect against non-fatal cardiovascular diseases (CVDs) and stroke, especially in men consuming predominantly plant-based diets. Key findings In men, the association of dietary intake of total iron, heme iron, and non-heme iron with the risk of non-fatal CVDs and stroke followed a reverse J-shape, with the lowest risk at ∼26 mg/d of total iron intake, ∼2 mg/d of heme iron intake, and ∼24 mg/d of non-heme iron intake. In women, a J-shaped association between dietary heme iron intake and the risk of non-fatal CVDs and stroke were observed, with the lowest risk at ∼1.8 mg/d of heme iron intake; while higher dietary intakes of total iron and non-heme iron tended to be associated with a lower risk of non-fatal stroke.

Replacing CC Unit with B←N Unit in Isoelectronic Conjugated Polymers for Enhanced Photocatalytic Hydrogen Evolution.

Three linear isoelectronic conjugated polymers PCC, PBC, and PBN are synthesized by Suzuki-Miyaura polycondensation for photocatalytic hydrogen (H2 ) production from water. PBN presented an excellent photocatalytic hydrogen evolution rate (HER) of 223.5 µmol h-1 (AQY420  = 23.3%) under visible light irradiation, which is 7 times that of PBC and 31 times that of PCC. The enhanced photocatalytic activity of PBN is due to the improved charge separation and transport of photo-induced electrons/holes originating from the lower exciton binding energy (Eb ), longer fluorescence lifetime, and stronger built-in electric field, caused by the introduction of the polar B←N unit into the polymer backbone. Moreover, the extension of the visible light absorption region and the enhancement of surface catalytic ability further increase the activity of PBN. This work reveals the potential of B←N fused structures as building blocks as well as proposes a rational design strategy for achieving high photocatalytic performance.

Rational Design of PDI-Based Linear Conjugated Polymers for Highly Effective and Long-Term Photocatalytic Oxygen Evolution.

Constructed through relatively weak noncovalent forces, the stability of organic supramolecular materials has shown to be a challenge. Herein, the designing of a linear conjugated polymer is proposed through creating a chain polymer connected via bridging covalent bonds in one direction and retaining π-stacked aromatic columns in its orthogonal direction. Specifically, three analogs of linear conjugated polymers through tuning the aromatic core and its covalently linked moiety (bridging group) within the building block monomer are prepared. Cooperatively supported by strong π-π stacking interactions from the extended aromatic core of perylene and favorable dipole-dipole interactions from the bridging group, the as-expected high crystallinity, wide light absorption, and increased stability are successfully achieved for Oxamide-PDI (perylene diimide) through ordered molecular arrangement, and present a remarkable full-spectrum oxygen evolution rate of 5110.25 µmol g-1  h-1 without any cocatalyst. Notably, experimental and theoretical studies reveal that large internal dipole moments within Oxamide-PDI together with its ordered crystalline structure enable a robust built-in electric field for efficient charge carrier migration and separation. Moreover, density functional theory (DFT) calculations also reveal oxidative sites located at carbon atoms next to imide bonds and inner bay positions based on proven spatially separated photogenerated electrons and holes, thus resulting in highly efficient water photolysis into oxygen.

Dietary Folate, Vitamin B6, and Vitamin B12 and Risk of Cardiovascular Diseases among Individuals with Type 2 Diabetes: A Case-Control Study.

BACKGROUND: Emerging evidence suggests that dietary one-carbon metabolism-related B-vitamins are associated with the reduced risk of cardiovascular disease (CVD) in the general population. However, only a few studies have assessed their associations in patients with type 2 diabetes (T2D). OBJECTIVE: This study aimed to assess the associations between the intake of three one-carbon metabolism-related B-vitamins (folate, vitamin B6, and vitamin B12) and CVD risk in Chinese patients with T2D. METHODS: A hospital-based case-control study of 419 patients with T2D and newly diagnosed CVD and 419 age- (±5 years) and sex-matched T2D-only controls was carried out in China. A validated 79-item semi-quantitative food-frequency questionnaire administered in face-to-face interviews was used to measure dietary B-vitamin intake. Conditional logistic regression was used to assess associations, which were tested by estimating odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Compared with the lowest quartile, the multivariable-adjusted ORs and 95% CIs for highest quartile were 0.32 (95% CI: 0.20, 0.52; p trend <0.001) for folate, 0.47 (95% CI: 0.30, 0.76; p trend = 0.002) for vitamin B6, and 1.02 (95% CI: 0.67, 1.55; p trend = 0.841) for vitamin B12. Consistent inverse associations were found for folate intake from eggs, vegetables, fruits, soy, and other foods but not for folate intake from grains. CONCLUSIONS: Findings suggest that the high consumption of folate and vitamin B6, but not that of vitamin B12, might be associated with the low risk of CVD in patients with T2D. This study suggests that dietary folate and vitamin B6 protect against CVD in patients with T2D.

Examining the Effects of Visibility and Time Headway on the Takeover Risk during Conditionally Automated Driving.

The objective of this study is to examine the effects of visibility and time headway on the takeover performance in L3 automated driving. Both non-critical and critical driving scenarios were considered by changing the acceleration value of the leading vehicle. A driving simulator experiment with 18 driving scenarios was conducted and 30 participants complete the experiment. Based on the data obtained from the experiment, the takeover reaction time, takeover control time, and takeover responses were analyzed. The minimum Time-To-Collision (Min TTC) was used to measure the takeover risk level and a binary logit model for takeover risk levels was estimated. The results indicate that the visibility distance (VD) has no significant effects on the takeover control time, while the time headway (THW) and the acceleration of the leading vehicle (ALV) could affect the takeover control time significantly; most of the participants would push the gas pedal to accelerate the ego vehicle as the takeover response under non-critical scenarios, while braking was the dominant takeover response for participants in critical driving scenarios; decreasing the TCT and taking the appropriate takeover response would reduce the takeover risk significantly, so it is suggested that the automation system should provide the driver with the urgency of the situation ahead and the tips for takeover responses by audio prompts or the head-up display. This study is expected to facilitate the overall understanding of the effects of visibility and time headway on the takeover performance in conditionally automated driving.

Enhanced Built-in Electric Field Promotes Photocatalytic Hydrogen Performance of Polymers Derived from the Introduction of B←N Coordination Bond.

High concentrations of active carriers on the surface of a semiconductor through energy/electron transfer are the core process in the photocatalytic hydrogen production from water. However, it remains a challenge to significantly improve photocatalytic performance by modifying simple molecular modulation. Herein, a new strategy is proposed to enhance the photocatalytic hydrogen evolution performance using boron and nitrogen elements to construct B←N coordination bonds. Experimental results show that polynaphthopyridine borane (PNBN) possessing B←N coordination bonds shows a hydrogen evolution rate of 217.4 µmol h-1 , which is significantly higher than that of the comparison materials 0 µmol h-1 for polyphenylnaphthalene (PNCC) and 0.66 µmol h-1 for polypyridylnaphthalene (PNNC), mainly attributed to the formation of a strong built-in electric field that promotes the separation of photo-generated electrons/holes. This work opens up new prospects for the design of highly efficient polymeric photocatalysts at the molecular level.

Adherence to the Chinese dietary guidelines and metabolic syndrome among children aged 6-14 years.

The role of diet in the development of childhood metabolic syndrome (MetS) has not been clearly elucidated. This study aims to investigate the association between the adherence to the Chinese Dietary Guidelines (CDG) 2016 and the presence of MetS and its components in Chinese children aged 6-14 years. This study is a cross-sectional study using data from the 2017 and 2019 Nutrition and Health Surveillance in Primary and Secondary school students of Beijing (NHSPSB). MetS was diagnosed using the recommended criteria for Chinese children. Diet was assessed using 3 consecutive days of 24-hour dietary recalls in addition to weighing household cooking oils and condiments. The Chinese Healthy Eating Index (CHEI) score was calculated based on the CDG 2016. Generalized estimating equations (GEEs) were used to estimate the correlation between the CHEI score and the likelihood of MetS and its components. A total of 2092 records (1048 in 2017 and 1044 in 2019), derived from 1835 children, were included. A higher CHEI score, which reflects better adherence to the CDG 2016, was correlated with a lower presence of MetS (per 5-point increment: OR = 0.85, 95% CI: 0.75-0.97) and low HDL-C (per 5-point increment: OR = 0.89, 95% CI: 0.80-0.99). Regarding the CHEI components, higher scores in dark vegetables and cooking oils were also associated with reduced likelihood of MetS (per 1-point increment: OR = 0.79, 95% CI: 0.67-0.93 for dark vegetables; OR = 0.91, 95% CI: 0.86-0.96 for cooking oils). This study suggests that better adherence to the CDG 2016 may reduce the risk of MetS in Chinese children aged 6-14 years.

Dietary Total Vitamin A, ß-carotene, and Retinol Intake and the Risk of Diabetes in Chinese Adults with Plant-based Diets.

PURPOSE: Epidemiologic evidence regarding the role of dietary vitamin A in the development of diabetes is limited and inconsistent. This study was to explore the association between vitamin A intake and diabetes risk in Chinese adults. METHODS: A prospective cohort study was conducted among 17 111 adults (8537 men and 8577 women) who participated in the China Health and Nutrition Survey between 1989 and 2015. Dietary intakes were assessed by 3 consecutive 24-hour dietary recalls combined with a household food inventory. Diabetes was determined by self-reported diagnosis, diabetes medication use, or additional criterion in 2009 of fasting blood glucose or hemoglobin A1c. We analyzed the association of vitamin A intake (total, ß-carotene, retinol) with diabetes risk using Cox proportional hazards models. RESULTS: A total of 519 men and 531 women developed diabetes during a median of 11 years of follow-up. Higher dietary total vitamin A intakes were associated with a lower risk of diabetes in both men (quintile 5 [Q5] vs Q1: hazard ratio [HR] = 0.69, 95% CI, 0.49-0.97, P-trend = 0.079) and women (Q5 vs Q1: HR = 0.63; 95% CI, 0.45-0.89; P-trend = 0.039). An inverse relation with diabetes risk was observed for dietary intakes of ß-carotene (Q5 vs Q1: HR = 0.71; 95% CI, 0.52-0.97) and retinol (Q5 vs Q1: HR = 0.58; 95% CI, 0.39-0.85) among men, but not women. Dose-response analyses showed the association of dietary intakes of total vitamin A, ß-carotene, and retinol with diabetes risk in men was L-shaped (P-nonlinearity = 0.043), reverse J-shaped (P-nonlinearity = 0.001), and linear, respectively. CONCLUSION: Our findings suggest that adequate intake of vitamin A may help protecting against diabetes, especially for men.

Greater Adherence to Dietary Guidelines Associated with Reduced Risk of Cardiovascular Diseases in Chinese Patients with Type 2 Diabetes.

The evidence regarding the impact of the scores on healthy eating indices on the risk of cardiovascular events among patients with type 2 diabetes (T2D) is limited. As such, in this study, we examined the associations of adherence to the Chinese and American dietary guidelines and the risk of cardiovascular disease (CVD) among Chinese individuals with T2D. We conducted a 1:1 age- and sex-matched case−control study based on a Chinese population. We used a structured questionnaire and a validated 79-item food-frequency questionnaire to collect general information and dietary intake information, and calculated the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index-2015 (HEI-2015). As participants, we enrolled a total of 419 pairs of hospital-based CVD cases and controls, all of whom had T2D. We found a significant inverse association between diet quality scores on the CHEI and HEI-2015 and the risk of CVD. The adjusted odds ratios (95% confidence interval) per five-score increment were 0.68 (0.61, 0.76) in the CHEI and 0.60 (0.52, 0.70) in the HEI-2015. In stratified analyses, the protective associations remained significant in the subgroups of sex, BMI, smoking status, tea-drinking, hypertension state, dyslipidemia state, T2D duration, and medical nutrition therapy knowledge (all p < 0.05). These findings suggest that a higher CHEI or HEI-2015 score, representing a higher-quality diet relative to the most recent Chinese or American dietary guidelines, was associated with a decreased risk of CVD among Chinese patients with T2D.

A diet rich in fruit and whole grains is associated with a low risk of type 2 diabetes mellitus: findings from a case-control study in South China.

OBJECTIVE: Various foods are associated with or protect against type 2 diabetes mellitus (T2DM). This study was to examine the associations of foods and food patterns with the risk of T2DM in South China. DESIGN: Case-control study. SETTING: The dietary patterns were identified by a principal components factor analysis. Univariable and multivariable conditional logistic regression analyses were used to analyse the associations between food groups and dietary patterns and the risk of T2DM. PARTICIPANTS: A total of 384 patients with T2DM and 768 controls. RESULTS: After adjustment for total energy intake, the standard intake of grains (228·3 ± 71·9 v. 238·8 ± 73·1 g/d, P = 0·025) and fruits (109 ± 90 v. 145 ± 108 g/d, P < 0·001) were lower in T2DM than in controls. Four dietary patterns were identified: (1) high light-coloured vegetables and low grains, (2) high fruits, (3) high red meat and low grains and (4) high dark-coloured vegetable. After adjustment for covariables, multivariable conditional logistic regression analyses showed significant dose-dependent inverse associations between total fruit intake, whole grains intake and the score of the high-fruit dietary pattern (all Pfor trend < 0·001) and the risk of T2DM. The adjusted OR (95 % CI) for T2DM comparing the extreme quartiles were 0·46 (0·29, 0·76) for total fruits, 0·48(0·31, 0·77) for whole grains and 0·42 (0·26, 0·68) for the high-fruit dietary pattern, respectively. Similar associations were observed for all subgroups of fruits (dark-colour and light-colour). CONCLUSION: In South China, a diet rich in fruit and whole grains is associated with lower risk of T2DM.

Thermal Cloak: Theory, Experiment and Application.

In the past two decades, owing to the development of metamaterials and the theoretical tools of transformation optics and the scattering cancellation method, a plethora of unprecedented functional devices, especially invisibility cloaks, have been experimentally demonstrated in various fields, e.g., electromagnetics, acoustics, and thermodynamics. Since the first thermal cloak was theoretically reported in 2008 and experimentally demonstrated in 2012, great progress has been made in both theory and experiment. In this review, we report the recent advances in thermal cloaks, including the theoretical designs, experimental realizations, and potential applications. The three areas are classified according to the different mechanisms of heat transfer, namely, thermal conduction, thermal convection, and thermal radiation. We also provide an outlook toward the challenges and future directions in this fascinating area.

Daily Supplementation With Whey, Soy, or Whey-Soy Blended Protein for 6 Months Maintained Lean Muscle Mass and Physical Performance in Older Adults With Low Lean Mass.

BACKGROUND: Few studies have investigated the effect of long-term protein supplementation alone on muscle health in older adults with low lean mass. OBJECTIVE: To determine the effect of whey, soy or whey-soy blended protein supplementation on lean muscle mass and physical performance in older adults with low lean mass. DESIGN: A 4-arm randomized controlled trial. PARTICIPANTS/SETTING: Chinese older adults (n = 123, 65-79 years) with low lean mass (appendicular skeletal muscle index < 7.0 kg/m2 in men and < 5.4 kg/m2 in women) living in the urban area of Guangzhou participated between October 2015 and June 2016. INTERVENTION: Participants were randomly assigned to receive approximately 16 g/d of whey, soy, or whey-soy blend protein or maintained habitual diets in control group for 6 months. MAIN OUTCOME MEASURES: Lean mass, handgrip strength, and physical performance (gait speed, chair stand test, and Short Physical Performance Battery) were assessed at baseline and 6 months. STATISTICAL ANALYSES: Two-way analysis of variance with the main effects of treatment and time and treatment × time interaction and analysis of covariance was used to determine differences in outcomes. RESULTS: Appendicular skeletal muscle index, lean mass, percent lean mass in legs and appendicular areas, gait speed, and Short Physical Performance Battery score were maintained in the treatment groups and decreased in the control group, resulting in significant reduction in these variables from baseline in the control compared with treatment groups (all P < .01; percent differences between treatment and control groups ranged from 80% to 156%). The chair stand test time at month 6 decreased from baseline in the treatment groups and increased in the control group, resulting in a significant increase in the control compared with treatment groups (all P < .01; percent differences between treatment and control groups ranged from 132% to 155%). Handgrip strength remained unchanged. There were no significant differences in outcomes among treatment groups. CONCLUSIONS: Supplementation with whey, soy, or whey-soy blended protein for 6 months equally maintained lean muscle mass and physical performance in older adults with low lean mass.

Effects of probiotic supplementation on serum trimethylamine-N-oxide level and gut microbiota composition in young males: a double-blinded randomized controlled trial.

PURPOSE: To explore whether probiotic supplementation could attenuate serum trimethylamine-N-oxide (TMAO) level and impact the intestinal microbiome composition. DESIGN: Forty healthy males (20-25 years old) were randomized into the probiotic group (1.32 × 1011 CFU live bacteria including strains of Lactobacillus acidophilus, Lactobacillus rhamnosus GG, Bifidobacterium animalis, and Bifidobacterium longum daily) or the control group for 4 weeks. All participants underwent a phosphatidylcholine challenge test (PCCT) before and after the intervention. Serum TMAO and its precursors (TMA, choline and betaine) were measured by UPLC-MS/MS. The faecal microbiome was analyzed by 16S rRNA sequencing. RESULTS: Serum TMAO and its precursors were markedly increased after the PCCT. No statistical differences were observed in the probiotic and the control group in area under the curve (AUC) (14.79 ± 0.97 µmol/L 8 h vs. 19.17 ± 2.55 µmol/L 8 h, P = 0.106) and the pre- to post-intervention AUC alterations (∆AUC) (- 6.33 ± 2.00 µmol/L 8 h vs. - 0.73 ± 3.04 µmol/L 8 h, P = 0.131) of TMAO; however, higher proportion of participants in probiotic group showed their TMAO decrease after the intervention (78.9% vs. 45.0%, P = 0.029). The abundance of Faecalibacterium prausnitzii (P = 0.043) and Prevotella (P = 0.001) in the probiotic group was significantly increased after the intervention but without obvious differences in α- and ß-diversity. CONCLUSIONS: The current probiotic supplementation resulted in detectable change of intestinal microbiome composition but failed to attenuate the serum TMAO elevation after PCCT. CLINICALTRIALS. GOV IDENTIFIER: NCT03292978. CLINICALTRIALS.GOV WEBSITE: https://clinicaltrials.gov/ct2/show/NCT03292978 .

Serum folate concentrations at diagnosis are associated with hepatocellular carcinoma survival in the Guangdong Liver Cancer Cohort study.

Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.

Serum copper and zinc levels at diagnosis and hepatocellular carcinoma survival in the Guangdong Liver Cancer Cohort.

Copper and zinc are essential micronutrients, whose imbalance may be involved in the development and progression of cancer. However, the role of copper and/or zinc imbalance in the prognosis of hepatocellular carcinoma (HCC) is currently unclear. Our objective was to investigate the association between serum levels of copper, zinc and their ratio (copper/zinc) at diagnosis with HCC survival. We included 989 patients with incident HCC in this prospective cohort study, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study within 30 days of diagnosis between September 2013 and February 2017. Serum copper and zinc were measured using inductively coupled plasma mass spectrometry. Primary outcomes were liver cancer-specific survival (LCSS) and overall survival (OS). Cox proportional hazards models were used to calculate the multivariable hazard ratios (HRs) and 95% confidence interval (CI). Higher serum copper levels were strongly associated with worse LCSS (Q4 vs. Q1: HR = 1.87, 95% CI: 1.22-2.86; p < 0.01 for trend) and OS (Q4 vs. Q1: HR = 2.06, 95% CI: 1.36-3.11; p < 0.01 for trend). The calculated copper/zinc ratio was positively associated with LCSS (Q4 vs. Q1: HR = 1.31, 95% CI: 0.89-1.92; P = 0.04 for trend) and OS (Q4 vs. Q1: HR = 1.43, 95% CI: 0.99-2.08; P = 0.01 for trend). No overall associations were observed between serum zinc levels and LCSS or OS in the entire cohort. The results suggest that higher serum copper and copper in relation to zinc levels (i.e., higher copper/zinc ratio) may be associated with worse HCC survival, but serum zinc levels may be not associated with HCC survival.

Trimethylamine N-oxide, a gut microbiota-dependent metabolite of choline, is positively associated with the risk of primary liver cancer: a case-control study.

BACKGROUND: Evidence has suggested a potential link exists between trimethylamine-N-oxide (TMAO), a choline-derived metabolite produced by gut microbiota, and some cancers, but little is known for primary liver cancer (PLC). METHODS: A case-control study was designed including 671 newly diagnosed PLC patients and 671 control subjects frequency-matched by age (±5 years) and sex, in Guangdong province, China. High-performance liquid chromatography with online electrospray ionization tandem mass spectrometry (HPLC-MS/MS) was used to measure serum TMAO and choline. The associations between these biomarkers and PLC risk were evaluated using logistic regression models. RESULTS: Serum TMAO concentrations were greater in the PLC group than the control group (P = 0.002). Logistic regression analysis showed that the sex- and age-adjusted odds ratio (OR) and (95% confidence interval [CI]) was 3.43 (2.42-4.86) when comparing the top and bottom quartiles (Q4 vs Q1). After further adjusting for more selected confounders, the OR (95% CI) remained significant but was attenuated to 2.85 (1.59-5.11) (Q4 vs Q1). The multivariable-adjusted ORs (95% CIs) across quartiles of choline were 0.35-0.15 (P -trend < 0.001). CONCLUSION: Higher serum levels of TMAO were associated with increased PLC risk. The association was stronger in those with lower serum levels of choline. Additional large prospective studies are required to confirm these findings. TRIAL REGISTRATION: This study was registered at clinicaltrials.gov as NCT 03297255.

High dietary inflammatory index scores are associated with an elevated risk of hepatocellular carcinoma in a case-control study.

Chronic inflammation and diet play crucial roles in the development of hepatocellular carcinoma (HCC); yet the association between dietary inflammatory potential and risk of HCC has rarely been investigated. This study aimed to examine whether a higher dietary inflammatory index (DII®) score (indicating a pro-inflammatory diet) is associated with an increased risk of HCC in a matched case-control study conducted between September 2013 and October 2017 in South China. A total of 659 cases with newly diagnosed, previously untreated HCC and 659 controls individually matched on age (±3 years) and sex were included in this study. DII scores were computed based on dietary intake information collected via a validated 79-item food frequency questionnaire (FFQ) during the one year prior to diagnosis (for the cases) or interview (for the controls). Logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) between the DII score and the risk of HCC, adjusted for age, energy intake, body mass index, physical activity, marital status, education, household income, smoking status, and hepatitis B virus (HBV) infection status. Compared with subjects in the lowest DII tertile, subjects in the highest tertile had an elevated risk of HCC (fully adjusted OR: 3.22, 95% CI: 1.30-7.98, P-trend = 0.009). In stratified analyses, a significantly positive association was observed only in men, individuals with lower education level, smokers and non-alcohol drinkers. In conclusion, a higher DII score, representing a more inflammatory diet, was associated with an increased risk of HCC, in men, individuals with lower education level, smokers and non-alcohol drinkers.

Adherence to the Chinese or American Dietary Guidelines is Associated with a Lower Risk of Primary Liver Cancer in China: A Case-Control Study.

Adherence to healthy dietary guidelines has been related to a lower risk of several cancers, but its role in primary liver cancer (PLC) has not been fully investigated, especially among Eastern populations. This study enrolled 720 PLC patients and 720 healthy controls who were frequency-matched by age and sex between September 2013 and October 2017 in South China. Dietary quality was assessed by the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index 2015 (HEI-2015), which manifests as scores of adhering to the 2016 Dietary Guidelines for Chinese and adhering to the 2015⁻2020 Dietary Guidelines for Americans, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models, adjusting for potential confounders. Higher scores in both the CHEI and HEI-2015 were associated with a lower risk of PLC (per 5-points increment of the total scores: OR: 0.43, 95% CI: 0.38⁻0.50 for CHEI; OR: 0.47, 95% CI: 0.40⁻0.55 for HEI-2015). The protective associations persisted significantly in the stratified analyses by sex, smoker status, alcohol consumption, HBV infection, and histological types of PLC, without statistical evidence for heterogeneity (p-interaction > 0.05). Closer adherence to the most recent dietary guidelines for Chinese or Americans may protect against PLC.