The effect of diabetes mellitus on tuberculosis in eastern China: A decision-tree analysis based on a real-world study.

OBJECTIVES: The public health system faces major challenges due to the double burden of diabetes mellitus (DM) and tuberculosis (TB) in China. We aimed to investigate the prevalence and impact of diabetes on patients with TB. METHODS: Stratified cluster sampling was used to select 13 counties as study sites in the Zhejiang province. Patients who visited designated TB hospitals in these areas participated in this study between 1 January 2017 and 28 February 2019. Multiple logistic regression models were performed to investigate the association between DM and bacteriological and imaging results. A decision tree was used to predict the bacteriology and imaging results under the influence of DM. RESULTS: Of 5920 patients with newly diagnosed pulmonary tuberculosis, 643 (12.16%) had DM. Patients with pulmonary TB and DM were more likely to have pulmonary cavities (adjusted odds ratio [aOR], 2.81; 95% confidence intervals [95% CI]: 2.35-3.37) and higher rates of positive bacteriological tests (aOR, 2.32; 95% CI:1.87-2.87). Decision-tree analysis showed similar results. CONCLUSIONS: Concurrence of DM and pulmonary TB makes patients more likely to have positive bacteriological results and pulmonary cavities. Therefore, appropriate measures are necessary to promptly identify and manage patients with TB and DM.

Sleep behaviors and Parkinson's disease: A bidirectional Mendelian randomization analysis.

OBJECTIVE: Whether the quantity and quality of sleep are the risk factors for the development of Parkinson's disease remains unclear though it has now been confirmed that the quality of sleep among patients with Parkinson's disease is affected at the prodromal and clinical stages. Accordingly, this study aimed to examine the bidirectional causal relationships of multiple sleep-related phenotypes with Parkinson's disease using a two-sample Mendelian randomization (MR) method. METHODS: The summary-level data collected from the published genome-wide association studies was used for analysis. Besides, the genetic relationships between different sleep-related phenotypes, including self-reported and accelerometer measured traits, were estimated for the risk and age at the onset of Parkinson's disease. To conduct MR analysis, inverse variance weighted, weight median, MR-Egger, and MR-PRESSO method were mainly used. Moreover, sensitivity analyses were carried out to examine the pleiotropic effect. RESULTS: In general, there was insufficient evidence to support the causal effect of sleep-related phenotypes on risk (N cases/controls = 33,674/449,056) and age at the onset (N cases = 28,568) of Parkinson's disease. However, the results of this study indicated that the later onset age of Parkinson's disease was related to the frequent occurrence of insomnia (OR [95% CI] 1.007 [1.003, 1.011], P < 0.001) after the adjustment for multiple testing. CONCLUSIONS: The results of this study suggest that insomnia-associated single nucleotide polymorphisms are more frequent in later onset Parkinson's disease patients compared to earlier onset patients. However, given the limitations of statistical power and potential bias, further validation should be still conducted through larger population research.

Osteoarthritis, coronary artery disease, and myocardial infarction: A mendelian randomization study.

Background: Observational studies indicate that osteoarthritis (OA) and coronary artery disease (CAD), as well as myocardial infarction (MI), are often diagnosed as comorbid diseases. We performed a bidirectional Mendelian randomization (MR) study to demonstrate whether there is a causal relationship between OA, CAD, and MI. Methods: We extracted single nucleotide polymorphisms (SNPs) related to OA in the Genetics of Osteoarthritis (GO) Consortium as instrumental variables to assess whether OA is associated with CAD and MI in the CARDIoGRAMplusC4D 1,000 Genomes genome-wide association study (GWAS). In the reverse MR, we used CAD-associated and MI-associated SNPs to the GWAS of OA to analyze their causality. These GWASs included 766,690 individuals of OA, 184,305 individuals of CAD, and 166,065 individuals of MI. MR was conducted using several methods, including the inverse variance weighted (IVW) method, the weighted median method, the MR-Egger method, and the MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO) method. Results: The forward causal effect of OA on CAD and MI was not observed. In reverse analysis, no causal effect was discovered for CAD on the risk of OA. Notably, we observed a causal association between MI and total OA [IVW odds ratio (OR) = 0.95, 95% CI = 0.93, 0.98, P = 4E-04] and spine OA (IVW OR = 0.92, 95% CI = 0.88, 0.97, P = 0.001) but a null association between MI and knee OA, hip OA, hand OA, and thumb OA. Conclusion: This MR study identifies a potentially protective effect of genetically predicted MI on total and spine OA risks.

Circulating vitamin C and the risk of cardiovascular diseases: A Mendelian randomization study.

BACKGROUND AND AIMS: The impact of vitamin C supplementation on the risk of cardiovascular diseases (CVDs) remains uncertain with inconsistent evidence obtained from observational studies and randomized clinical trials (RCTs). We aimed to assess possible causal associations of vitamin C with major CVD events as well as their risk factors using Mendelian randomization (MR) design. METHODS AND RESULTS: Nine genetic variants associated with vitamin C at genome-wide significance (p < 5 × 10-8) were used as instrumental variables to predict plasma vitamin C levels. The primary outcomes were coronary artery disease (Ncase = 122,733 and Ncontrol = 424,528), atrial fibrillation (Ncase = 60,620 and Ncontrol = 970,216), heart failure (Ncase = 47,309 and Ncontrol = 930,014), and ischemic stroke (Ncase = 40,585 and Ncontrol = 406,111). Several CVD risk factors were also evaluated in secondary analyses. Two-sample MR analyses were performed using the inverse variance weighted method, with several sensitivity analyses. Genetically determined higher levels of plasma vitamin C were not significantly associated with any of the four examined CVD events. Likewise, there is no convincing evidence for the associations between genetically determined vitamin C and CVD risk factors, including higher blood lipids, higher blood pressure, and abnormal body composition. Sensitivity analyses using different analytical approaches yielded consistent results. Additionally, MR assumptions did not seem to be violated. CONCLUSION: This MR study does not support a causal protective role to circulate vitamin C levels on various types of CVD events. In combination with previous RCT results, our findings suggest that vitamin C supplementation to increase circulating vitamin C levels may not help in CVD prevention.

A Correlative Study Between Personality Traits and the Preference of Site Selection in Cosmetic Treatment.

Background: Cosmetic treatment was closely associated with beauty seekers' psychological well-being. Patients who seek cosmetic surgery often show anxiety. Nevertheless, not much is known regarding how personality traits relate to the selection of body parts that receive cosmetic treatment. Aims: This study aims to investigate the correlation between personality traits and various selection sites for cosmetic treatment via Eysenck Personality Questionnaire (EPQ). Methods: A cross-sectional approach was adopted to randomly recruited patients from a general hospital planning to undergo cosmetic treatments. All respondents completed the EPQ and provided their demographic information. The EPQ involves four scales: the extraversion (E), neuroticism (N), psychoticism (P), and lying scales (L). Psychological scales were evaluated to verify that people who selected different body sites for cosmetic intervention possessed different personality portraits. Results: A total of 426 patients with an average age of 32.14 ± 8.06 were enrolled. Among them, 384 were females, accounting for more than 90% of patients. Five treatment sites were analyzed, including the body, eye, face contour, nose, and skin. Comparatively, patients with neuroticism were more likely to undergo and demand rhinoplasty (OR 1.15, 95% CI 1.07-1.24, P < 0.001). Face contour treatment was commonly associated with extraversion (OR 1.05, 95% CI 1.00-1.11, P = 0.044), psychoticism (OR 1.13, CI 1.03-1.25, P = 0.013), and neuroticism (OR 1.05, CI 1.01-1.10, P = 0.019). Conclusions: This novel study attempted to determine the personality profiles of beauty seekers. The corresponding assessments may provide references for clinical treatment options and enhance postoperative satisfaction for both practitioners and patients.

Physical activity and the risk of rheumatoid arthritis: evidence from meta-analysis and Mendelian randomization.

BACKGROUND: There is very little information about the association between physical activity (PA) and the risk of rheumatoid arthritis (RA). The purpose of this study is to understand the effect of PA on subsequent risk of developing RA. METHODS: A literature search was performed in PubMed and Web of Science up to 19 September 2020. Observational studies examining associations between PA and the RA development were identified. Categorical and dose-response meta-analyses were both performed. Then two-sample Mendelian randomization (MR) analysis was conducted to interrogate the causal relationship by utilizing genetic instruments identified from a genome-wide association study of self-reported and accelerometer-based PA traits. RESULTS: Four eligible studies were included in the meta-analyses, involving 4213 RA cases among 255 365 participants. The summary relative risk (RR) of RA risk was 0.79 [95% confidence interval (CI): 0.72, 0.87] for the highest vs the lowest PA, and 0.85 (95% CI: 0.79, 0.92) for PA vs inactivity/occasional PA. However, we found no convincing evidence supporting a causal role of genetically predicted accelerometer-measured PA [odds ratio (OR): 0.97; 95% CI: 0.88, 1.08 per 1-SD unit increment], genetically predicted moderate-to-vigorous PA (OR: 1.08; 95% CI: 0.49, 2.39 per 1-SD unit increment) or genetically predicted vigorous PA ≥3 days/week (OR: 2.63; 95% CI: 0.05, 130.96) with RA risk. CONCLUSIONS: The meta-analyses of the observational studies indicated that higher PA levels correlate with reduced risk of RA. In contrast to meta-analyses, the MR analyses reported here suggested PA may not help to prevent RA.

Massive Cerebral Infarction Following Facial Injection of Autologous Fat: A Case Report and Review of the Literature.

Facial fat grafting techniques often offer impressive surgical results. However, fatal complications, such as irreversible cerebral ischemia, blindness, and hemiplegia are associated with them. We have presented a case report of a patient who presented with a massive cerebral infarction, a serious complication of facial autologous fat injection. The patient was a 28-year-old female who experienced motor dysfunction of the left extremities, which was accompanied with loss of consciousness immediately following fat grafting for facial augmentation. Imaging studies suggested that the patient had a large cerebral infarction on the right frontal, temporal, and parietal lobes due to complete occlusion of her right external carotid artery. Emergency decompressive craniectomy was completed in addition to multiple follow-up medical treatments. The patient recovered after 4 months with reduced motor function in her left upper extremity. This report further summarizes published cases of massive cerebral ischemia after facial injection of autologous fat, as well as lists high-risk facial areas and critical warnings.

Circulating chemerin level and risk of cancer: a systematic review and meta-analysis.

Aim: Circulating chemerin level has been reported to be higher in patients with various types of cancer. However, the conclusions obtained are not unified. The aim of present study is to draw an evidence-based conclusion on the relationship between circulating chemerin and risk of cancer. Materials & methods: A systematic search was carried out in PubMed and Web of Science up to 30 June 2019. The random-effects model was applied to calculate summary standardized mean differences with 95% CIs. Results: The meta-analysis included a total of 12 separate studies, 876 cases and 739 healthy controls. The results showed that the expression level of circulating chemerin was significantly higher in cancer patients than that in control group (pooled standardized mean difference = 1.47, 95% CI = 1.03-1.90). Conclusion: This meta-analysis concludes that a high level of circulating chemerin is strongly associated with cancer risk.

Relationship between urinary bisphenol a levels and cardiovascular diseases in the U.S. adult population, 2003-2014.

BACKGROUND: Emerging evidence has identified cardiovascular system as a potential target of Bisphenol A (BPA). Although a few studies have revealed the relationship between BPA and the risk of several cardiovascular diseases (CVD) outcomes and CVD risk factors, no published studies have investigated the link between urinary BPA and the risk of stroke. METHODS: Data were derived from the United States National Health and Nutrition Examination Surveys (NHANES), with a representative sample aged ≥20 years (n = 9139) from 2003 to 2014. We performed multivariable logistic regression model to estimate associations between quartiles and natural logarithm transformed urinary BPA concentrations and five specific CVD outcomes and total CVD. RESULTS: In quartile analysis, highest level of urinary BPA was associated with increased prevalence of myocardial infarction (MI) (OR = 1.73, 95% CI = 1.11-2.69) and stroke (OR = 1.61, 95% CI = 1.09-2.36), when compared with those at the lowest quartile. Per unit (µg/g creatinine) increment in ln-transformed BPA concentration was shown to be significantly associated with 19%, 19%, 25%, 29%, 20%, and 16% increased odds ratios of prevalence of congestive heart failure, coronary heart disease (CHD), angina pectoris, MI, stroke and total CVD among total participants, respectively. Similar associations were found in males rather than in females. CONCLUSION: We provided the premier evidence of positive relationship between urinary BPA concentration and stroke in U.S. POPULATION: Urinary BPA levels were also positively correlated with congestive heart failure, CHD, angina pectoris, MI, as well as total CVD. These associations were more evident in males. Well-coordinated and prospective studies are warranted to gain the human effects of BPA on CVD.

Association between dietary inflammatory index and upper aerodigestive tract cancer risk: A systematic review and dose-response meta-analysis.

OBJECTIVES: The relationship between dietary inflammatory index (DII) and upper aerodigestive tract (UADT) cancer risk have been investigated in a growing number of epidemiological studies. However, their findings were inconsistent, and no systematic review or meta-analysis has been conducted up to now. This meta-analysis was carried out to examine potential dose-response relationship between DII score and UADT cancer risk. MATERIAL AND METHODS: A systematic search was conducted for relevant studies in PubMed and Web of Science up to March 28, 2019. Categorical meta-analysis as well as linear and non-linear dose-response meta-analysis were performed to evaluate association between DII and UADT cancer risk. RESULTS: Nine case-control studies with a total of 4138 cases and 15,326 healthy controls were eligible in the present meta-analysis. The pooled odds ratios (ORs) of UADT cancer risk were 2.07 [95% confidence interval (CI): 1.82, 2.35] for the highest DII score compared with the lowest and 1.53 (95% CI: 1.39, 1.69) for higher DII score compared with lower score, respectively. Furthermore, a one-unit increment in DII score was associated with an increased risk of 18% for UADT cancers (OR: 1.18; 95% CI: 1.15, 1.21). An upward trend towards a positive association between elevated DII score and UADT cancer risk was also observed in non-linear dose-response meta-analysis. CONCLUSIONS: The present meta-analysis provides evidence of highly pro-inflammatory diets that might increase risk of UADT cancers. Therefore, reducing pro-inflammatory components in diets should be considered to prevent and control UADT cancers.

Relationship between polycyclic aromatic hydrocarbons and rheumatoid arthritis in US general population, NHANES 2003-2012.

The purpose of this study was to explore the association between urinary concentrations of polycyclic aromatic hydrocarbon (PAH) metabolites and the prevalence of rheumatoid arthritis (RA). Cross-sectional data were analyzed from the National Health and Nutrition Examination Survey (NHANES) 2003-2012 using levels of nine monohydroxylated urinary PAH metabolites as exposure. Multivariable logistic regression was used to examine the association between urinary biomarkers of PAHs and RA. All of the models were adjusted for age, sex, race, education level, marital status, smoking, BMI, physical activity, energy, diabetes, and survey cycle. Ultimately, 6,072 adults (3,108 men and 2,964 women) 20 years of age or older were analyzed. In the quartile analyses, compared with the lowest quartile, increased RA prevalence was observed in the participants with the highest quartile of 2-hydroxynapthalene (OR = 1.89, 95% CI = 1.28-2.78), 3-hydroxyfluorene (OR = 1.55, 95% CI = 1.07-2.25), 2-hydroxyfluorene (OR = 1.51, 95% CI = 1.02-2.24), 3-hydroxyphenanthrene (OR = 1.50, 95% CI = 1.09-2.07), and 9-hydroxyfluorene (OR = 1.60, 95% CI = 1.10-2.33) in a fully adjusted model, respectively. In the subgroup analysis of current smokers, compared with the participants with lower urinary PAH scores, those with higher scores had a dramatically increased prevalence of RA (OR = 15.46, 95% CI = 3.11-76.75) in the adjusted model. There was a significant interaction between all of the urinary PAH metabolite levels and smoking status in the relationship with RA (P < 0.05). High levels of urinary PAH metabolites are positively associated with RA prevalence in the US general population. PAH exposure and smoking may potentially interact to increase the prevalence of RA. Further prospective studies are needed to clarify the possible effect of PAHs on RA.

Association between total sleep time and all cancer mortality: non-linear dose-response meta-analysis of cohort studies.

OBJECTIVE: Appropriate total sleep time is reported to be associated with several important health outcomes. However, the relationship between total sleep time and all cancer mortality is not well defined because of inconsistent results from published studies, and no dose-response meta-analysis was performed to evaluate the exact dose-response relationship. METHODS: We conducted a literature search of PubMed and Web of Science to identify all relevant epidemiological studies published before August 9, 2018. We performed categorical and non-linear dose-response meta-analyses to quantify the association between total sleep time and all cancer mortality. RESULTS: Finally, we included 14 cohort studies in the present meta-analyses enrolling 866,877 participants with 43,021 cancer deaths. We found that total sleep time less than seven hours was not significantly associated with increased risk of all cancer mortality [relative risk (RR) = 1.02; 95% confidence interval (CI) = 0.99-1.05]. However, four to five hours total sleep time was related to an 8% increased risk of all cancer mortality (RR = 1.08; 95% CI = 1.02-1.13) in dose-response meta-analysis. Furthermore, long total sleep time (≥8 hours) was weakly associated with all cancer mortality (RR = 1.05; 95% CI = 1.02-1.08). However, the increment in total sleep time longer than nine hours was notably associated with an increased risk of cancer mortality. CONCLUSION: The current meta-analysis provides evidence of a positive association between total sleep time of four to five hours and total sleep time longer than eight hours with the risk of all cancer mortality among the general population. Additional studies are needed to establish causality.