Association of Waist Circumference and Body Mass Index Deciles Ratio with All-Cause Mortality: Findings from the National Health and Nutrition Examination Survey.

Given the importance and continued interest in finding a simple, accessible, and universal measure which reflects both general and abdominal adiposity, this study tested for an association of the ratio of WC decile to BMI decile (WC-d/BMI-d) with all-cause mortality. Individuals aged 18-79 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during the years 2007 to 2018 were included in the analysis. WC and BMI deciles were defined separately for males and females, while WC-d/BMI-d was calculated for each individual. The association of WC-d/BMI-d with mortality was assessed using logistic models for the total study population, and then again after stratification by sex, ethnicity, morbidity level, and BMI categories. Positive associations between WC-d/BMI-d and mortality were demonstrated for the total study population (adjusted OR = 1.545, 95%CI: 1.369-1.722) and within different sub-groups, including the population with a normal BMI level (adjusted OR = 1.32, 95%CI: 1.13-1.50). WC-d/BMI-d increased with age, with ~40 years representing a critical time point when WC-d surpasses BMI-d, with a sharper incline for males as compared to females. WC-d/BMI-d was significantly associated with all-cause mortality amongst NHANES American adults; thus, measurements of WC and its integration with BMI in this metric should be considered in clinical practice.

Time-varying association of acute and post-acute COVID-19 with new-onset diabetes mellitus among hospitalized and non-hospitalized patients.

INTRODUCTION: Previous studies have shown disruption of glycometabolic control and new diabetes mellitus (DM) diagnosis among patients with COVID-19. It is still unclear how the association of COVID-19 and new-onset DM may be modified by disease severity or vary over time, during acute and post-acute phases. RESEARCH DESIGN AND METHODS: In this retrospective matched cohort study, 157 936 patients with COVID-19 (aged ≥25 years, diagnosis date between March 01, 2020 and August 31, 2021) were compared with individuals without COVID-19, separately for non-hospitalized, hospitalized, and severe hospitalized patients. Stratified Cox proportional hazards models, with changing baseline time (starting at the date of COVID-19 diagnosis, and at 1, 2, 3, and 4 months afterwards), were used to evaluate the occurrence of new DM in relation to COVID-19 infection in different time frames-from each landmark date until end of study. RESULTS: During mean follow-up time of 10.9 months, there were 1145 (0.72%) new diagnoses of DM compared with 1013 (0.64%) in the individuals without COVID-19 (p=0.004). Non-hospitalized patients with COVID-19 were not at higher risk of new DM neither during the acute phase nor afterward. Hospitalized patients with COVID-19 had a higher risk of developing DM, with the highest risk among severe hospitalized patients. This risk among hospitalized patients was highest in the acute phase (HR 2.47 (95% CI 1.86 to 3.29)), attenuated over time, but remained significant at 4-month landmark analysis (HR 1.60 (95% CI 1.12 to 2.29)). CONCLUSIONS: Acute and post-acute COVID-19 were associated with new DM only among hospitalized patients, with the highest risk among those hospitalized with severe disease. Those patients should be followed and monitored post-discharge for new DM. Patients who were not hospitalized did not have higher risk of new-onset DM.

The influence of hearing impairment on sleep quality among workers exposed to harmful noise.

OBJECTIVE: To assess connections between sleeping quality and hearing impairment due to prolonged exposure to industrial noise. DESIGN: Observational cross-sectional study. SETTING: Occupational clinic of the Clalit Health Services in Israel. PARTICIPANTS: 298 male volunteers occupationally exposed to harmful noise, who had an audiometric examination performed by an occupational nurse as a part of the national workers health supervision programs. MEASUREMENTS AND RESULTS: The participants underwent an audiometric testing, and their sleep quality was measured by a validated Mini Sleep Questionnaire (MSQ). Participants with hearing loss greater than 25 dBA in the range of 1000-4000 Hz were defined as the research group (n = 99) and were compared to those with no hearing impairment (n = 199). Sleeping disorders were age related (30% higher MSQ score among workers above 50 years, P = 0.003). Tinnitus was the highest sleep disturbing factor, with 75% higher score among those affected, P = 0.001. In multiple linear regression analysis, tinnitus was the leading sleep-disturbing factor (regression coefficient B = 8.66, P < 0.001) followed by hearing impairment (regression coefficient B = 2.42, P = 0.084), adjusted for age (or years of exposure) and coffee drinking. A part of the MSQ, related to insomnia, was further evaluated using logistic regression models. Tinnitus was again the leading sleep disturbing factor [OR = 11.91; CI95% (1.56-91.2)], followed by hearing impairment [OR = 3.051; CI95% (1.18-7.86)]. CONCLUSION: Although tinnitus was the main sleep disrupting factor, hearing impairment among workers occupationally exposed to harmful noise, independently contributed to sleep impairment, especially to insomnia, regardless of age and years of exposure.