Comparison of insulin resistance-associated parameters in US adults: a cross-sectional study.

BACKGROUND: Triglyceride-glucose (TyG) is correlated with cardiovascular events caused by insulin resistance (IR). The aim of this study was to analyze the relationship between TyG and its related indicators and IR among US adults from 2007 to 2018 in the National Health and Nutrition Examination Survey (NHANES) database so as to identify more accurate and reliable predictors of IR. METHODS: This is a cross-sectional study including 9884 participants (2255 with IR and 7629 without IR). TyG, TyG-body mass index (TyG-BMI), TyG waist circumference (TyG-WC), and TyG waist-to-height ratio (TyG-WtHR) were measured using standard formulas. RESULTS: TyG, TyG-BMI, TyG-WC, and TyG-WtHR were significantly correlated with IR in the general population, with TyG-WC being the most strongly correlated, with an odds ratio of 8.00 (95% confidence interval 5.05-12.67) for the fourth quartile of TyG-WC compared with the first quartile in the adjusted model. Receiver operating characteristic (ROC) analysis of the participants showed that the maximum area under the TyG-WC curve was 0.8491, which was significantly higher than that of the other three indicators. Moreover, this trend was stable both among people of both genders and among patients with coronary heart disease (CHD), hypertension, and diabetes. CONCLUSIONS: The present study confirms that the TyG-WC index is more successful than TyG alone in identifying IR. In addition, our findings demonstrate that TyG-WC is a simple and effective marker for screening the general US adult population and those with CHD, hypertension, and diabetes and can be effectively used in clinical practice.

Association between monocyte to high-density lipoprotein ratio and coronary heart disease in US adults in the National Health and Nutrition Examination Surveys 2009-2018.

BACKGROUND: Monocyte to high-density lipoprotein ratio (MHR) is associated with coronary heart disease (CHD) events. The purpose of this study was to analyze the correlation between MHR and CHD in American adults from 2009 to 2018 in the National Health and Nutrition Examination Surveys (NHANES) database. METHODS: A total of 25 862 persons in the NHANES from 2009 to 2018 were included in the cross-sectional analysis. The independent variable was MHR and the outcome variable was CHD. MHR was obtained by dividing the number of monocytes by the high-density lipoprotein concentration, and whether it is CHD is obtained through a questionnaire. Univariate analysis, stratified analysis, and a multivariate linear regression model were used to study the correlation between MHR and CHD. RESULTS: In each multivariate linear regression model, MHR was positively correlated with CHD, and this positive correlation was stable in both men and women [man odds ratio (OR): 1.54; 95% confidence interval (CI), 1.17-2.03; woman OR: 2.21; 95% CI, 1.40-3.50]. Our results show that the association between MHR and CHD was significant until MHR was less than 0.6 (OR: 7.2; 95% CI, 4.0-13.0); however, in cases where MHR was greater than 0.6, the results were negative but not significantly different (OR: 0.6; 95% CI, 0.3-1.2). CONCLUSION: MHR has a clear association with CHD. Our prediction model and validation model show that MHR is highly predictive and robust as a predictor of CHD, therefore it can play an important role in the prediction of CHD.

Association between hypertension and stroke in US adults in the National Health and Nutrition Examination Surveys (NHANES) 2007 to 2018.

BACKGROUND: Hypertension is associated with stroke events. The purpose of this study was to analyze the correlation between hypertension and stroke in American adults from 2007 to 2018 in National health and Nutrition Examination Survey (NHANES) database. METHODS: 28528 individuals in the NHANES from 2007 to 2018 were included in the cross-sectional analysis. The independent variable was blood pressure (BP) and the outcome variable was stroke. Multivariate linear regression model was used to study the correlation between BP and stroke. RESULTS: In each multivariate linear regression model, BP level was positively correlated with stroke, and this positive correlation was stable in both men and women (man OR: 1.36, 95% CI: 0.95 to 1.69; woman OR: 1.45, 95% CI: 1.12 to 1.78). CONCLUSION: Our results show that there is a significant positive correlation between BP and stroke. When the systolic blood pressure (SBP) is about 140 mmHg, the risk of stroke is the lowest; Male patients with diastolic blood pressure (DBP) of about 80 mmHg have a lower risk of stroke.

Development and validation using NHANES data of a predictive model for depression risk in myocardial infarction survivors.

BACKGROUND: Depression after myocardial infarction (MI) is associated with poor prognosis. This study aimed to develop and validate a nomogram to predict the risk of depression in patients with MI. METHODS: This retrospective study included 1615 survivors of MI aged >20 years who were selected from the 2005-2018 National Health and Nutrition Examination Survey database. The 899 subjects from the 2005-2012 survey comprised the development group, and the remaining 716 subjects comprised the validation group. Univariate and multivariate analyses identified variables significantly associated with depression. The least absolute shrinkage and selection operator (LASSO) binomial regression model was used to select the best predictive variables. RESULTS: A full predictive model and a simplified model were developed using multivariate analysis and LASSO binomial regression results, respectively, and validated using data from the validation group. The receiver operator characteristic curve and Hosmer-Lemeshow goodness of fit test were used to assess the nomogram's performance. The full nomogram model included 8 items: age, BMI, smoking, drinking, diabetes, exercise, insomnia, and PIR. The area under the curve for the development group was 0.799 and for the validation group was 0.731, indicating that our model has good stability and predictive accuracy. The goodness of fit test showed a good model calibration for both groups. The simplified model includes age, smoking, PIR, and insomnia. The AUC of the simplified model was 0.772 and 0.711 in the development and validation groups, respectively, indicating that the simplified model still possessed good predictive accuracy. CONCLUSION: Our nomogram helped assess the individual probability of depression after MI and can be used as a complement to existing depression screening scales to help physicians make better treatment decisions.

Ionic complexation of endblock-sulfonated thermoplastic elastomers and their physical gels for improved thermomechanical performance.

Thermoplastic elastomers (TPEs) composed of nonpolar triblock copolymers constitute a broadly important class of (re)processable network-forming macromolecules employed in ubiquitous commercial applications. Physical gelation of these materials in the presence of a low-volatility oil that is midblock-selective yields tunably soft TPE gels (TPEGs) that are suitable for emergent technologies ranging from electroactive, phase-change and shape-memory responsive media to patternable soft substrates for flexible electronics and microfluidics. Many of the high-volume TPEs used for these purposes possess styrenic endblocks that are inherently limited by a relatively low glass transition temperature. To mitigate this shortcoming, we sulfonate and subsequently complex (and physically crosslink) the endblocks with trivalent Al3+ ions. Doing so reduces the effective hydrophilicity of the sulfonated endblocks, as evidenced by water uptake measurements, while concurrently enhancing the thermomechanical stability of the corresponding TPEGs. Chemical modification results, as well as morphological and property development, are investigated as functions of the degree of sulfonation, complexation and TPEG composition.