Pattern of prefrontal cortical activation and network revealed by task-based and resting-state fNIRS in Parkinson's disease's patients with overactive bladder symptoms.

Background: Overactive bladder (OAB) symptoms are common in Parkinson's disease (PD), and negatively contribute to the quality of life (QoL) of patients. To explore the underlying pathophysiological mechanism, we investigated the correlation between the prefrontal cortex (PFC) function and OAB symptoms in PD patients. Methods: One hundred fifty-five idiopathic PD patients were recruited and classified either as PD-OAB or PD-NOAB candidates based on their corresponding OAB symptom scores (OABSS). A linear regression analysis identified a correlative connection of cognitive domains. Then cortical activation during the performance of the verbal fluency test (VFT) and brain connectivity during resting state were conducted by functional near-infrared spectroscopy (fNIRS) for 10 patients in each group to investigate their frontal cortical activation and network pattern. Results: In cognitive function analysis, a higher OABS score was significantly correlated with a lower FAB score, MoCA total score, and sub-scores of visuospatial/executive, attention, and orientation as well. In the fNIRS study, the PD-OAB group exhibited significant activations in 5 channels over the left hemisphere, 4 over the right hemisphere, and 1 in the median during the VFT process. In contrast, only 1 channel over the right hemisphere showed significant activation in the PD-NOAB group. The PD-OAB group revealed hyperactivation, particularly in certain channel in the left dorsolateral prefrontal cortex (DLPFC), compared with PD-NOAB (FDR P < 0.05). In the resting state, there was a significant increase of the resting state functional connectivity (RSFC) strength between the bilateral Broca area, left frontopolar area (FPA-L) and right Broca's area (Broca-R), between the FPA and Broca's area if merging the bilateral regions of interest (ROI), and also between the two hemispheres in the PD-OAB group. The Spearman's correlation confirmed that the OABS scores were positively correlated with RSFC strength between the bilateral Broca area, FPA-L and Broca-R, between the FPA and Broca area if merging the bilateral ROI. Conclusion: In this PD cohort, OAB was related to decreased PFC functions, with particularly hyperactivated left DLPFC during VTF and an enhanced neural connectivity between the two hemispheres in the resting state as observed by fNIRS imaging.

Is vitamin D deficiency influenced by obesity during the first 5 years of life? A cross-sectional multicenter study.

Evidence on the association of 25-hydroxyvitamin D (25[OH]D) and obesity during the first 5 years of life is limited in China. The objective of this study was to examine the associations between weight, weight for age z score (ZWAZ), weight for length/height z score (ZWHZ), and body mass index for age z score (ZBMI) and 25(OH)D. This was a large population-based cross-sectional multicenter study in which the children aged 0-5 years were recruited from 12 children's healthcare centers by a stratified cluster random-sampling method in 10 cities of the Jiangsu province, China. The 25(OH)D concentration was determined by ELISA. A total of 5289 children were investigated. For 0-71 months children with obesity and nonobesity, the prevalence of vitamin D deficiency was 36.0% and 29.8%, and the 25(OH)D level was 59.8 and 64.0 nmol/L, respectively, and there were all significant difference. Compared with children with nonobesity, children with obesity had higher risk of vitamin D deficiency (OR [95% CI]: 1.33 [1.02, 1.72], p < .05), and had lower 25(OH)D level (ß = -3.84, 95% CI = -7.58, -0.09, p < .05). The results for children aged 24-71 months were similar to those for children aged 0-71 months. However, no significant difference was observed in children aged 0-23 months. Vitamin D deficiency was observed in children with greater adiposity during the first 5 years of life. However, the results mainly came from those in the age group of 2 to 5 years instead of the first 2 years in their lives.

Detection of a novel antigen for Crohn's disease.

BACKGROUND AND AIMS: Accurate serological assays are desirable for the diagnosis of inflammatory bowel disease (IBD). We identify an antigen-like substance called Crohn's disease (CD) antibody binding polypeptide (CABP). As a serological marker, anti-CABP may contribute to the diagnosis of IBD. The present study aims to evaluate the clinical role of anti-CABP as a serological antibody for IBD. METHODS: Using enzyme-linked immunosorbent assay (ELISA), serum anti-CABP, anti-Saccharomyces cerevisiae antibody (ASCA) and perinuclear anti-neutrophil cytoplasmic antibody (pANCA), titers were tested in 168 CD patients, 123 ulcerative colitis (UC) patients and 170 controls. The correlation between serum antibody and clinical characteristics was investigated. The diagnostic potential of the anti-CABP was evaluated by receiver operating characteristic (ROC) analysis. RESULTS: The titers of anti-CABP (IgA or IgG) and ASCA IgG of CD patients were significantly higher than non-CD group (all p < .01). In the differential diagnosis of CD and non-CD, anti-CABP IgA revealed an area under the curve (AUC) of 0.706 and anti-CABP IgG demonstrated an AUC of 0.788. As an individual antibody, anti-CABP could effectively distinguish CD from non-CD (AUC 0.816), and the diagnostic efficacy was better than that of ASCA (AUC 0.680). The combined use of anti-CABP, ASCA and pANCA significantly improved the diagnostic value (AUC 0.857). Anti-CABP positive rates were associated with perianal lesions and disease location in CD patients (both p < .05). CONCLUSIONS: Our results suggested that anti-CABP could be used as a serological marker to assist the diagnosis of CD. CLINICAL TRIAL REGISTRATION: This trial is registered with clinical trial registration unique identifier ChiCTR2000037094.

Vitamin D status and its dietary and lifestyle factors in children during the first 5 years of life: A cross-sectional multicentre Jiangsu bone study.

BACKGROUND: To explore the vitamin D status with its demographic and lifestyle factors including dietary, supplementation, and physical activity in 0-5 years old children. METHODS: This was a large population-based cross-sectional multicentre study in which the children were recruited from 12 Children's Health Care Centers by a stratified cluster random-sampling method in 10 cities in Jiangsu Province, China. RESULTS: A total number of 5289 children were investigated. The prevalence of vitamin D deficiency was 30.1%. The concentration of 25 hydroxyvitamin D was 64.0 (46.3-83.0) nmol mL-1 after adjustment for covariates. Children with higher risk of vitamin D deficiency were more likely to be at older age, girls, survey conducted in spring, location in southern Jiangsu province, residence in urban, outdoor activity < 2 h day-1 (all p < 0.05). Moreover, those with lower risk were more likely to be the number of parity ≥ 2 times, vitamin D supplementation from birth to 6 months, the initial time of vitamin D supplementation after birth ≤ 1 months, vitamin D and calcium supplementation in the last 3 months, and dose of vitamin D supplementation > 400 IU day-1 (all p < 0.05). Children with preferences for sweets, meat consumption > 150.0 g day-1 , milk consumption < 250 mL day-1 , time of sleeping < 10 h day-1 had higher risks of vitamin D deficiency. However, these relationships were affected by demographics. CONCLUSIONS: Vitamin D status during the first five years of life was suboptimal and was associated with demographic and lifestyle determinants including milk, meat, sweets, vitamin D and calcium supplementation, sleeping and outdoor activity.

Association of serum IL-21 and vitamin D concentrations in Chinese children with autoimmune thyroid disease.

BACKGROUND: The etiology of Autoimmune thyroid disease (AITD) in pediatric age is multifactorial and mainly implicated with immune disorder. Previous studies have reported that interleukin-21 (IL-21) and vitamin D play crucial roles in autoimmune diseases. We investigated the correlation between IL and 21 and 25(OH)D and their potential role in the pathogenesis of AITD. METHODS: Total of 54 primary Graves disease (GD) patients, 36 Hashimato's thyroditis (HT) cases and 30 healthy subjects from The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from September through November 2017 to 2019. The serum concentrations of IL-21, 25(OH)D, thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), antibodies against receptor for TSH (TRAb) and thyroglobulin antibody (TGAb) were determined. RESULTS: The serum concentration of 25(OH)D was lower while IL-21 was higher in the GD patients and HT patients than in the control patients. Serum 25(OH)D concentration was negatively correlated with TPOAb and TGAb while serum IL-21 concentration was positively correlated with TPOAb, TGAb and TRAb in the HT group. Moreover, the serum concentration of 25(OH)D had a significant negative correlation with serum IL-21 concentration in the HT and GD children before or after treatment. Therefore, we studied the correlation between IL and 21 and 25(OH)D, and infer that they play a role in AITD. Moreover, adding Vitamin D could inhibit the expression concentrations of TPOAb, TGAb and IL-21. CONCLUSION: IL-21 and Vitamin D may be involved in the occurrence and development of AITD. Targeting IL-21 and Vitamin D may be a promising therapeutic approach for AITD in the future.

Status and influential factors of vitamin D among children aged 0 to 6 years in a Chinese population.

BACKGROUND: Vitamin D insufficiency and deficiency in childhood are common. However, the status and influential factors of vitamin D during different ages are not clear. This study aimed to survey vitamin D concentrations in children aged 0 to 6 years and explore its influential factors. METHODS: A total of 6953 children were recruited in Wuxi City of East China from January to December in 2016. Enzyme-linked immunosorbent assay was used to determine the serum concentrations of 25-hydroxyvitamin D [25(OH)D]. RESULTS: The median vitamin D concentrations in the infant group (0-1 years of age) was 69.40 nmol/L, which were higher than that in both the toddlerhood group (1-3 years of age; 62.30 nmol/L) and the preschool group (3-6 years of age; 50.85 nmol/L). In addition, the median vitamin D concentrations were 71.70 nmol/L in summer, which was higher than that in spring (64.25 nmol/L), autumn (62.95 nmol/L) and winter (64.10 nmol/L). However, no difference was observed between genders (P = 0.974). Furthermore, the prevalence of vitamin D deficiency (< 50 nmol/L) was 48.1% in the preschool group (3-6 years of age), which was higher than the 21.2% vitamin D deficiency in the toddlerhood group (1-3 years of age) and the 17.9% vitamin D deficiency in the infant group (0-1 years of age). Interestingly, a nonlinear association between 25(OH) D and air temperature was observed. CONCLUSIONS: A high prevalence of vitamin D deficiency was common in a Chinese population of children 0-6 years old, especially in the preschool-aged children. Therefore, we suggested that we should pay more attention to vitamin D supplementation in Chinese young children.

Adiposity is not beneficial to bone mineral density in 0-5 year old Chinese children: The Jiangsu bone health study.

OBJECTIVE: Data on obesity in relation to bone mineral density(BMD) in infants and preschool children were sparse in China. The objective of this study was to examine the associations between body mass index (BMI) and BMD. SUBJECTS AND METHODS: This was a large population-based multicenter study in which the representative children aged 0-5 years were recruited from 13 Children's Health Care Centers by a stratified cluster random-sampling method in Jiangsu Province, China. BMD was measured by using quantitative ultrasound. The association of BMD with BMI and obesity were evaluated using multiple linear regression and logistic regression analysis taking into account the effects of confounders. The relations between age, weight, height, BMI and BMD were analyzed by using Pearson's correlation and further tested using partial correlation in the additive model. RESULTS: A total of 5,289 children (2786 boys and 2503 girls) were recruited. The BMD was positively linear relation with age, length/height, and was inversely linear relation with BMI (r=0.711, P<0.001; r=0.727, P<0.001; r=-0.318, P<0.001, respectively). The BMD gradually increased when the weight was in the range within 21.2kg, but started to gain slowlyand even decreased when the weight was over 21.2kg. After adjusting for confounders, compared with control group, children with obesityhad higher odds of low BMD (OR 95%CI: 2.73 (1.57, 4.76), P<0.001), the speed of sound (SOS)value in children with obesity was lower 47.45 (ß=-47.45, 95%CI=-85.07, -9.83, P=0.013). CONCLUSIONS: Adiposity was not advantageous for bone mineral density in 0-5-year-old Chinese children.

Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss.

BACKGROUND: The association between vitamin D deficiency and early spontaneous pregnancy loss (SPL) is unclear. OBJECTIVES: To assess the association of serum 25-hydroxyvitamin D (25(OH)D) and SPL. SEARCH STRATEGY: Embase, PubMed, and Web of Science were searched for relevant papers published before February 20, 2016, using search terms including "vitamin D" and "pregnancy loss." SELECTION CRITERIA: Case-control and cohort studies investigating the relationship of maternal serum 25(OH)D and SPL were included. DATA COLLECTION AND ANALYSIS: Two authors independently extracted original data from the selected papers. The DerSimonian-Laird random-effects model was used to perform the meta-analysis. Heterogeneity was assessed by calculating I2 . MAIN RESULTS: Five studies, including 10 630 pregnant women, met the inclusion criteria. There was no significant association between a low 25(OH)D level and an increased risk of SPL. In a subgroup analysis, an extremely low 25(OH)D level (<20 ng/mL) was significantly associated with an increased risk of SPL in the first trimester (relative risk 2.24, 95% confidence interval 1.15-4.37); the heterogeneity across studies was not significant (I2 =0.0%, P=0.355). CONCLUSIONS: Severe Vitamin D deficiency could be detrimental to early embryonic development and increase the risk of early SPL.

Association of serum 25-hydroxyvitamin D status with bone mineral density in 0-7 year old children.

OBJECTIVE: To describe the status of serum 25-hydoxyvitamin D [25(OH)D] concentrations and identify the relationship between 25(OH)D and bone mineral density (BMD). In an effort to explore the appropriate definition of vitamin D (VD) deficiency in 0-7 year old children. RESULTS: The median serum 25(OH)D concentrations was 62.9 nmol/L and 28.9% of the children had a low 25(OH)D (< 50 nmol/L). And a linear relation between 25(OH)D concentrations and BMD was surveyed (r = 0.144 , P < 0.001). After adjusting for the confounders, serum 25(OH)D was positively associated with BMD (ß = 172.0, 95%CI = 142.8-201.2, P < 0.001), and low 25(OH)D (< 75 nmol/L) had a high stake for low BMD (OR = 1.424, 95%CI = 1.145-1.769, P = 0.001). Additionally, there was a nonlinear relation between 25(OH)D and low BMD, and a critical value for 25(OH)D of 75 nmol/L appeared for low BMD. The prevalence of low BMD was 14.1% in children with 25(OH)D ≥ 75 nmol/L, much lower than that of the concentrations between 50-75 nmol/L and < 50 nmol/L. MATERIALS AND METHODS: A total of 4,846 children 0-7 years old were recruited in Jiangsu Province, China. BMD and serum 25(OH)D concentrations were determined by quantitative ultrasound and enzyme-linked immunosorbent assay, respectively. Linear regression and logistic regression analyses were used to assess the association of 25(OH)D concentrations with BMD. CONCLUSIONS: Serum 25(OH)D concentrations was related with BMD and 25(OH)D concentrations < 75 nmol/L might be a more appropriate definition of VD deficiency in 0-7 year old children.

The association between non-motor symptoms in Parkinson's disease and age at onset.

OBJECTIVE: Age at onset is likely to be related to a wide range of problems in Parkinson's disease (PD), including cardinal motor features, motor complications and non-motor symptoms (NMS). This study investigated the effect of the age at onset on NMS. METHODS: Two hundred and thirty patients were examined and classified into one of three groups based on age at onset: early onset PD (EOPD) group (<45 years), middle-age onset group (45-64 years) and old-age onset group (≥65 years). The trends relating to NMS were compared across the three groups. The EOPD and old-age onset groups were separately studied to determine their association to the appearance of non-motor features using logistic regression analysis. RESULTS: There were upward trends in the occurrence of dribbling (P=0.009; all P values are stated for trend), impaired taste/smelling (P=0.016), constipation (P=0.006), urinary urgency (P=0.002), nocturia (P=0.018), hallucinations (P=0.016) and acting out during dreams (P=0.011) with the increase of age at onset. Older age at onset is an independent risk factor for dementia (OR=8.42, CI 3.16-22.44), dribbling (OR=4.14, CI 1.93-8.87), impaired taste/smelling (OR=2.23, CI 1.20-4.13), constipation (OR=3.42, CI 1.88-6.24), incomplete bowel emptying (OR=2.23, CI 1.19-4.20), urinary urgency (OR=2.58 CI 1.46-4.57), nocturia (OR=2.65, CI 1.49-4.71), hallucinations (OR=5.32, CI 1.78-15.97), dizziness (OR=3.03, CI 1.59-5.79), falling (OR=3.60, CI 1.67-7.77), insomnia (OR=2.29, CI 1.28-4.11), intense vivid dreaming (OR=2.10, CI 1.21-3.66) and acting out during dreams (OR=2.23, CI 1.24-4.01). CONCLUSIONS: PD patients with different ages at onset present clinically different symptoms in terms of NMS. Old-age onset PD is characterized by more olfactory and sensory symptoms, autonomic symptoms, sleep disorders, dementia and psychosis compared to EOPD.