Effects of vitamin D supplementation on the regulation of blood lipid levels in prediabetic subjects: A meta-analysis.

This meta-analysis aimed to systematically investigate whether vitamin D supplementation reduces blood lipid-total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and triglyceride (TG)-levels in prediabetic individuals. Pubmed, Web of Science, Cochrane Library, Embase, CNKI, and WANFANG databases were searched for studies published before 13 February 2022 (including 13 February 2022). Five articles were included. The results showed that vitamin D intervention led to a significant reduction in TG compared with control or placebo treatment (-0.42 [-0.59, -0.25], P < 0.001). Subgroup analyses showed that this effect was particularly significant among the studies that included obese subjects (-0.46 [-0.65, -0.28], P < 0.001), the studies that also included men (not only women) (-0.56 [-0.78, -0.34], P < 0.001), and the studies with intervention durations longer than 1 year (-0.46 [-0.65, -0.28], P < 0.001). Both relatively low doses of 2,857 IU/day (-0.65 [-0.92, -0.38], P < 0.001) and relatively high doses of 8,571 IU/day (-0.28 [-0.54, -0.02] P = 0.04) of vitamin D supplementation reduced TG levels, and the effect was observed both in Northern Europe (-0.65 [-0.92, -0.38], P < 0.001) and Asian (-0.25 [-0.48, -0.03], P = 0.03) country subgroups. No significant effects on TC, HDL-C, and LDL-C were shown. In conclusion, vitamin D supplementation might beneficially affect TG levels in individuals with prediabetes. Particularly longer durations of treatment, more than 1 year, with doses that correct vitamin deficiency/insufficiency, can have a beneficial effect. This meta-analysis was registered at www.crd.york.ac.uk/prospero (CRD42020160780).

Cognitive Impairment Mediates the Association between Dietary Inflammation and Depressive Symptoms in the Elderly.

The underlying mechanism in both cognitive impairment and depression was chronic inflammation, which could be reflected by the dietary inflammatory index (DII). However, the effect of cognitive impairment on the association between DII and depression was not clear. Therefore, in this study, we hypothesized that cognitive impairment could mediate the association between dietary inflammation and depressive symptoms. A total of 2550 participants aged ≥60 from the National Health and Nutrition Examination Survey (NHANES) in 2011-2014 were involved in the serial, cross-sectional study. Proinflammatory and anti-inflammatory diets were measured by DII. Cognitive impairment was measured by four dimensions, CERAD-immediate, CERAN-delayed, animal fluency test, and DSST. Depressive symptoms were measured by PHQ-9 scores. We found that a proinflammatory diet and cognitive impairment were both risk factors for depressive symptoms. An interaction between an inflammatory diet and cognitive impairment was detected (P-interaction = 0.060). In addition, all four dimensions of cognition mediated the association between DII and depressive symptom scores. Part of the association between DII and depressive symptoms scores could be explained by different dimensions of cognitive function, and the proportion of mediation ranged from 10.0% to 36.7%. In conclusion, cognitive impairment levels partly mediated the association between DII and depressive symptoms.

Association between dietary inflammatory index and metabolic syndrome: Analysis of the NHANES 2005-2016.

Objective: Metabolic syndrome (MetS) is a global problem that increasingly violates human health and quality of life. We explored the relationship between dietary inflammatory potential represented by dietary inflammatory index (DII) and the occurrence of MetS to provid data support for the prevention of it through dietary structure intervention. Methods: The data was come from National Health and Nutrition Examination Survey 2007-2018, including demographic, dietary, questionnaire variables and laboratory indicators. MetS was defined according to the criteria proposed by the American Endocrine Association (ACE) and the American Society of Clinical Endocrinology (ACCE). DII was calculated using the scoring method established by Shivappa. We divided DII scores into 4 quartiles, the chi-square test was used to compare the variable difference between DII quartiles groups. A logistic regression model was used to analyze the association between DII and MetS. We also performed subgroup analysis. A generalized linear regression model was used to explore the association of DII level and the levels of seven MetS related biochemical indicators. Results: The final sample size was 8,180, and the DII scores of the subjects were -5.50 to 5.22. The proportions of men, young people, non-Hispanic blacks, poor people, smokers, and MetS patients in the Q1-Q4 DII quantiles groups were gradually increased. The risk of MetS in the Q4 group which had highest dietary inflammatory degree was 1.592 (1.248, 2.030) times higher than that in the Q1 group, respectively (P < 0.001). After subgroup analysis, women, youth, non-smokers and alcohol drinkers were found to be more sensitive to the dietary inflammation. Then we found that the level of DII was significantly positively correlated with waist circumference (WC), body mass index (BMI), triglyceride (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP), but negatively correlated with high density lipoprotein cholesterol (HDL-C). Conclusions: In the research subjects, the degree of dietary inflammation was associated with the occurrence of MetS and significantly affected WC, BMI, blood pressure, and blood lipid levels. It is necessary to conduct investigations and early dietary interventions for women and young people to prevent the occurrence of chronic metabolic diseases.

A panel regression analysis for the COVID-19 epidemic in the United States.

This study explored the roles of epidemic-spread-related behaviors, vaccination status and weather factors during the COVID-19 epidemic in 50 U.S. states since March 2020. Data from March 1, 2020 to February 5, 2022 were incorporated into panel model. The states were clustered by the k-means method. In addition to discussing the whole time period, we also took multiple events nodes into account and analyzed the data in different time periods respectively by panel linear regression method. In addition, influence of cluster grouping and different incubation periods were been discussed. Non-segmented analysis showed the rate of people staying at home and the vaccination dose per capita were significantly negatively correlated with the daily incidence rate, while the number of long-distance trips was positively correlated. Weather indicators also had a negative effect to a certain extent. Most segmental results support the above view. The vaccination dose per capita was unsurprisingly proved to be the most significant factor especially for epidemic dominated by Omicron strains. 7-day was a more robust incubation period with the best model fit while weather had different effects on the epidemic spread in different time period. The implementation of prevention behaviors and the promotion of vaccination may have a successful control effect on COVID-19, including variants' epidemic such as Omicron. The spread of COVID-19 also might be associated with weather, albeit to a lesser extent.

The Association Among Inflammatory Diet, Glycohemoglobin, and Cognitive Function Impairment in the Elderly: Based on the NHANES 2011-2014.

BACKGROUND: Dietary inflammatory index (DII) was associated with Type 2 diabetes mellitus and cognitive function impairment (CFI). OBJECTIVE: The aim of this study was to explore whether the associations among DII, glycohemoglobin (HbA1c), and CFI were similar in the participants with or without diabetes. METHODS: A total of 1,198 participants aged 60 and over from the National Health and Nutrition Examination Survey (NHANES) in 2011-2014 were involved in this study, dividing into subgroups as diabetes and non-diabetes for further analysis. RESULTS: We found that participants with pro-inflammatory diet had higher proportion of CFI patients (p < 0.05). Pro-inflammatory diet and HbA1c were positively associated with the risk of CFI; participants with pro-inflammatory diet was 1.479 times on occurrence of CFI compared with anti-inflammatory diet group. The interaction between inflammatory diet and HbA1c was positive on the risk of CFI and was negative on the CERAD-immediate and CERAD-delayed, respectively. Among the participants without diabetes, the associations of Energy-adjusted DII (E-DII) with Animal Fluency test and Digit Symbol Substitution Test (DSST) were partially mediated by HbA1c, and the mediated proportion was 5.8% and 6.6%, respectively. However, there was no such mediation effect in the diabetes patients. CONCLUSION: In elderly participants without diabetes, there was an interaction between inflammatory diet and HbA1c on the association with CFI, especially for the dimension of CERAD-immediate and CERAD-delayed. Besides, the associations of E-DII with Animal Fluency test and DSST were partially mediated by HbA1c. For diabetic patients, HbA1c, rather than the inflammatory diet has a positive effect on the CFI risk.

The Role of Dietary Inflammatory Index on the Association Between Sleep Quality and Long-Term Cardiovascular Risk: A Mediation Analysis Based on NHANES (2005-2008).

Objective: People with poor sleep quality have higher risk of cardiovascular disease (CVD), and one potential mechanism of CVD is chronic inflammation. The aim of this study was to investigate the role of dietary inflammation in the relationship between sleep quality and CVD risk. Methods: This study involved 5594 participants from the National Health and Nutrition Examination Survey (NHANES) in 2005-2008. Sleep quality, dietary inflammation, and 10-year CVD risk were evaluated via the Pittsburgh Sleep Quality Index (PSQI), the Energy-adjusted Dietary Inflammatory Index (E-DII), and the Framingham Risk Score (FRS), respectively. We used generalized additive model (GAM) and mediation analysis to investigate the relationship among sleep quality, 10-year CVD risk, and E-DII. Results: PSQI had a non-linear relationship with 10-year CVD risk (P < 0.001). Meanwhile, among the participants with poor sleep quality, PSQI was positively associated with increased 10-year CVD risk (P < 0.001) and E-DII (P < 0.001). Furthermore, the association between sleep quality and CVD risk was partially mediated by E-DII, and the mediated proportion was 14.6%, and the mediating effect of E-DII varied in different gender and age groups. However, in the subjects with good sleep quality, the association among PSQI, E-DII, and 10-year CVD risk was not existed. Conclusion: Ten-year CVD risk could be reduced by controlling the intake of inflammatory food, especially for whom with sleep disorders. In general, the reduction of inflammatory diet could weaken the effect of sleep disorders on the CVD risk.

Efficacy and Safety of Four Different Endoscopic Treatments for Early Esophageal Cancer: a Network Meta-analysis.

PURPOSE: Cap-assisted endoscopic mucosal resection (EMRC), ligation-assisted endoscopic mucosal resection (EMRL), endoscopic submucosal dissection (ESD), and multiband mucosectomy (MBM) are used for treating early esophageal cancer patients. Our aim was to compare the efficacy and safety of four different endoscopic treatments. METHODS: Electronic databases (PubMed, Cochrane, Embase, and Web of Science) were systematically searched to include relevant studies published from database inception until February 15, 2021. There were no date or language restrictions. Data related to study such as characteristics, methods, outcomes, and risks of bias were extracted by two reviewers. RESULTS: A total of 11 articles with 1880 patients were included. The results of the network meta-analysis showed that ESD was a better choice considering the efficacy of en bloc resection rate (surface under the cumulative ranking curves (SUCRA) = ESD: 99.5%, EMRC: 26.5%, MBM: 24.1%) and local recurrence rate (SUCRA = EMRC: 95.6%, MBM: 42.9%, ESD: 11.6%). MBM had a lower rate of side effects compared to the other treatments: perforation rate (SUCRA = ESD: 100%, EMRC: 48.1%, MBM: 1.9%), stricture rate (SUCRA = ESD: 99.8%, MBM: 40.8%, EMRC: 9.4%), and bleeding rate (SUCRA = EMRC: 69.4%, ESD: 62.2%, EMRL: 61.6%, MBM: 6.8%). MBM also had the shortest operation time and smallest diameter of the specimens. CONCLUSION: The MBM endoscopic treatment was recommended for early esophageal cancer patients, but considering the increase in lesion size, ESD would be better.

Prevalence and correlates of psychological distress in the front-line anti-epidemic medical staff during the COVID-19 outbreak in Wuhan.

BACKGROUND: Since the outbreak of the novel coronavirus disease 2019 (COVID-19), medical staff and affiliated healthcare staff are under both physical and psychological pressures. Due to this serious situation, it is extremely important to assess the prevalence and possible predictors of psychological distress in front-line, anti-epidemic medical staff. METHODS: A cross-sectional study was conducted through the use of the network crowdsourcing platform (which provides functions equivalent to Amazon Mechanical Turk) in Jilin, China. A total of 725 Jilin medical staff who had returned from Wuhan participated in the survey. The collected data included demographics and psychological responses to COVID-19, and the following tests were used to measure the data: (I) the Social Support Rate Scale (SSRS) was used to measure the types and levels of social support that were received by the medical staff; (II) the Stanford Acute Stress Reaction Questionnaire (SASRQ) was used to evaluate anxiety and dissociation symptoms in the aftermath of traumatic events; (III) the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality; and (IV) the Kessler Psychological Distress Scale (K10) was used to evaluate nonspecific psychological distress. The χ2 test, Kruskal-Wallis test, ANOVA test and binary logistic regression were used to identify the factors that were correlated with psychological distress. RESULTS: In our study, 475 (65.5%) participants reported low psychological distress, and 72 (10%) participants reported high psychological distress. The results of the binary logistic regression analysis identified that the performance of physical activity in Wuhan (ß=-0.585; P<0.001; OR =0.557) and years of work experience (in contrast to approximately 0-5 years, approximately 6-15 years: ß=-1.258; P=0.008; OR =0.284, >15 years: ß=-0.562; P=0.016; OR =0.570) were protective factors for the possibility of having a mental disorder, whereas a high PSQI score (ß=0.106; P=0.024; OR =1.112) and a high SASRQ score (ß=0.242; P<0.001; OR =1.274) were risk factors. CONCLUSIONS: The high psychological distress (10%) of Jilin medical staff who returned from the front-line areas of Wuhan was higher than that in other studies. Medical staff with less physical activity and work experience in Wuhan, as well as high PSQI and SASRQ scores, had higher psychological distress.

The association between carotenoids and subjects with overweight or obesity: a systematic review and meta-analysis.

BACKGROUND: Excess body weight, including overweight and obesity, is one of the major factors influencing human health, and plays an important role in the global burden of disease. Carotenoids serve as precursors of vitamin A-related retinoids, and are considered to have potential effects on many diseases. However, the influence of carotenoids on people with excess body weight is unclear. METHODS: This meta-analysis was conducted to assess the effects of carotenoids on overweight or obese subjects utilizing the available evidence. We searched PubMed, Medline, Cochrane Library, Web of Science and EMBASE databases up to September 2020. Random effects models were used to calculate the standard mean differences (SMDs) and odds ratios (ORs) with their 95% confidence intervals (95% CIs). RESULTS: A total of seven randomized controlled trials and eight observational studies met the inclusion criteria and contained 28 944 subjects and data on multiple carotenoid subgroups, including lycopene, astaxanthin, cryptoxanthin, α-carotene, and ß-carotene. In all included Randomized Controlled Trial (RCT), the intervention duration was 20 days at the shortest and 16 weeks at the longest, and the range of intervention doses was 1.2-60 mg d-1. Our study found that the insufficiency of serum carotenoids was a risk factor for overweight and obesity (OR = 1.73, 95% CI [1.57, 1.91], p < 0.001). Moreover, carotenoid supplementation was significantly associated with body weight reductions (SMD = -2.34 kg, 95% CI [-3.80, -0.87] kg, p < 0.001), body mass index decrease (BMI, SMD = -0.95 kg cm-2, 95% CI [-1.88, -0.01] kg cm-2, p < 0.001) and waist circumference losses (WC, SMD = -1.84 cm, 95% CI [-3.14, -0.54]cm, p < 0.001). CONCLUSION: In summary, the carotenoids show promising effects in overweight or obese subjects. Additional data from large clinical trials are needed.

The Effect of Residential Environment on Respiratory Diseases and Pulmonary Function in Children from a Community in Jilin Province of China.

PURPOSE: Respiratory disease is a major and increasingly global epidemic that has a great impact on humans, especially children. The purpose of this study was to identify environmental risk factors for respiratory diseases and pulmonary function in children. PATIENTS AND METHODS: A population-based, cross-sectional survey of respiratory diseases and environmental risk factors was conducted in Jilin Province, China. Complete questionnaire information was available for 2419 children, while adequate pulmonary function data were available for a subgroup of 627 children. RESULTS: Our study found that environmental risk factors for respiratory health in children were mainly concentrated indoors. After adjusting for demographic factors, insecticide exposure and passive smoking were risk factors for respiratory disease and industrial pollutant sources, insecticide exposure and the use of a fume exhauster may be independent risk factors for recurrent respiratory infections. The main fuel for cooking in the winter and passive smoking were the main influencing factors of pulmonary function indicators. CONCLUSION: The primary risk factors differ in different respiratory diseases. Passive smoking remains a critical adverse factor for respiratory illness and pulmonary function in children, and it is important to reduce children's exposure to passive smoking to increase pulmonary health. Insecticide exposure may be a neglected environmental risk factor, and further investigations are still needed to explore the relationship and mechanisms between insecticide exposure and children's respiratory health.

The Effects of Metal Exposures on Charlson Comorbidity Index Using Zero-Inflated Negative Binomial Regression Model: NHANES 2011-2016.

BACKGROUND: With the rising incidence of chronic diseases, and the increase of aging population has led to multimorbidity a serious public health problem. The aim of this study was to explore the association between metal exposures and Charlson comorbidity index (CCI), which will provide valuable information for improving quality of life and reducing mortality. METHODS: The study sample consists of three continuous cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES), and 4901 eligible subjects were included in the study. Zero-inflated negative binomial (ZINB) model was utilized to investigate the effects in metal exposures on CCI, which includes spot urine (arsenic, mercury, and cadmium), whole blood (manganese, selenium, and lead), and serum (copper and zinc). RESULTS: In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in blood selenium is 0.997 (RR = 0.997, p = 0.017). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.659, 1.073, and 0.963 for every additional urinary cadmium (OR = 0.659, p = 0.007), blood lead (OR = 1.073, p = 0.023), blood manganese (OR = 0.963, p = 0.025), respectively. CONCLUSIONS: Our findings indicated that cadmium and manganese were likely to increase mortality. Inversely, selenium and lead might be positive on people's health. The findings may be extremely essential for preventing diseases and improving life quality.

A meta-analysis: Does vitamin D play a promising role in sleep disorders?

BACKGROUND: Sleep disorders, one of the most common problems in the general population, have been related to a series of harmful health consequences. Vitamin D appears to be associated with sleep disorders. However, the difference in vitamin D levels between sleep disorder subjects and people without a sleep disorder is unclear. Simultaneously, the influence of vitamin D replenishment on sleep disorders remains controversial. METHODS: PubMed, MEDLINE, Web of Science, and Cochrane Library were searched for literatures published until October 2019. Using a random effects model, a meta-analysis was conducted to calculate the standard mean difference to evaluate the difference in vitamin D concentrations between sleep disorder subjects and normal people and the efficacy of vitamin D supplementation on sleep disorders. RESULTS: Our study found that the serum vitamin D levels in the sleep disorder subjects were lower than that in the normal people (SMD = -0.75 ng/ml, 95% CI = -0.93, -0.57 ng/ml). Moreover, the Pittsburgh Sleep Quality Index (PSQI)in the subjects with vitamin D supplementation was lower than that in the controls (SMD = -0.45, 95% CI = -0.76, -0.13). CONCLUSIONS: Vitamin D could play a promising role in sleep disorders. More data are required to confirm the efficacy of vitamin D supplementation for improving sleep disorders.

Effects of fasting intervention regulating anthropometric and metabolic parameters in subjects with overweight or obesity: a systematic review and meta-analysis.

BACKGROUND: Previous studies have shown that fasting produces a potential effect in the prevention and treatment of many diseases. However, the role of fasting in people with overweight or obesity remains controversial. The aim of this study was to assess the intervention of fasting in the regulation of anthropometric and metabolic parameters of subjects with overweight or obesity. METHODS: The PubMed, Cochrane library, Web of science and EMBASE databases were searched from the inception dates to October 2019, identifying published literature evaluating the effect of fasting intervention on the people with overweight or obesity. RESULTS: Twenty-five studies with 1358 participants with overweight or obesity were included in the meta-analysis. Fasting was associated with the significant reduction of body weight, body mass index (BMI), fat free mass (FEM), fat mass (FM), waist circumference (WC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). However, there was no significant difference in the variations in the total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), blood glucose and insulin concentrations. CONCLUSION: Our meta-analysis found that fasting was associated with a significant effect on the regulation of anthropometric (body weight, BMI, FEM, FM and WC) and metabolic parameters (LDL-C, TG, SBP and DBP) in people with overweight or obesity. Considering some limitations found in this study, additional data from large clinical trials are needed.

Discrimination of Chronic Kidney Disease and Diabetic Nephropathy and Analysis of Their Related Influencing Factors.

PURPOSE: Clinically there are not many clinical indicators to differentiate diabetic kidney disease (DKD) and chronic kidney disease (CKD). Data from laboratory inspections on admission of clinical patients were used to complete the relationship and discrimination analysis of the two diseases. PATIENTS AND METHODS: All subjects were taken from the Department of Nephrology of the Second Hospital of Jilin University from January 2019 to September 2020 with clinical diagnosis of CKD or diabetic nephropathy and no other diseases. After querying the hospital's medical record system, the basic demographic information was obtained, and data on cardiovascular, metabolism, renal function, blood function, and other relevant indicators were extracted as well. IBM SPSS 24.0 software was used for data collation and analysis. RESULTS: A total of 1726 inpatients (986 males and 740 females) over 18 years old were included, 1407 were CKD patients, 319 were DKD patients. Female accounted for 55.4% in CKD patients, 64.6% in DKD patients. Compared to men, women may be more susceptible to DKD (OR=2.234). DKD patients were more likely to be have higher DP, GLU, eGFR, TCHO, and abnormal TVU (OR=1.746, 3.404, 1.107, 3.004, 14.03) while VB12 was the relative risk factor for CKD; thus, low VB12 level is more likely to happen in CKD patients (OR=0.054, OR95%CI: 0.005-0.552, P=0.014) compared with DKD patients. The stepwise discriminant analysis was completed, only 11 of the 34 variables had discriminative significance. The discriminant score (DS) was set to explore its test efficiency of DKD prediction by drawing ROC curve. Discriminant formula used for CKD and DN identification was given in the study. CONCLUSION: Female, higher DP, fasting blood GLU and TCHO level seemed to be more indicative for DKD, while lower eGFR level and VB12 deficiency were more likely to point to CKD. Doctors can refer to the discriminant formula to assist in the differential diagnosis of the two diseases after completing the detection of DP, fasting blood GLU, Cys-C, eGFR, TVU, TCHO, FA, VB12, CK, and CK-Mb.

Niacin, lutein and zeaxanthin and physical activity have an impact on Charlson comorbidity index using zero-inflated negative binomial regression model: National Health and Nutrition Examination Survey 2013-2014.

BACKGROUND: Combined with the increasing life expectancy, chronic medical conditions have gradually become the dominant cause of death and disability, and multimorbidity became an increasingly serious public health challenge. However, most existing studies have focused on the coexistence of specific diseases or relatively few diseases. Given one person may have multiple diseases at the same time, we applied Charlson Comorbidity Index (CCI) to systematically evaluate one's 10-year mortality. In this study, we explored the effects of nutrients and physical activity on CCI using National Health and Nutrition Examination Survey (NHANES) 2013-2014 data. METHODS: The study sample consists of one continuous cycle (2013-2014) of NHANES, and 4386 subjects were included in the study. Nutrients intake was measured by dietary recall, and physical activity was evaluated by the Global Physical Activity Questionnaire respectively. Besides, CCI was the sum of the scores assigned for each medical condition. We utilized zero-inflated negative binomial (ZINB) model to investigate the effects in nutrients intake and physical activity on CCI by adjusting for seven sociodemographic characteristics, smoking and drinking. RESULTS: Among the 4386 participants, 2018 (68.7%) are Non-Hispanic White, over half participants (78.6%) drink. In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in niacin is 1.621(RR = 1.621, p = 0.016), in lutein + zeaxanthin is 0.974 (RR = 0.974, p = 0.031), and in sedentary time is 1.035 (RR = 1.035, p = 0.005). Moreover, those who do not have vigorous work activity would be more likely to have higher CCI than those who have (RR = 1.275, P = 0.045). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.541 and 0.708 for every additional vigorous recreational activity (OR = 0.541, p = 0.004) and moderate recreational activity (OR = 0.708, p = 0.017) respectively. CONCLUSIONS: Lutein and zeaxanthin intake, vigorous work activity, vigorous recreational activity and moderate recreational activity may be good for one's health. Rather, increasing niacin intake and sedentary activity may be likely to raise 10-year mortality. Our findings may be significant for preventing diseases and improving health, furthermore, reducing people's financial burden on healthcare.