Association of C-reactive protein level with adverse outcomes in patients with atrial fibrillation: A meta-analysis.

BACKGROUND: Studies on the association between C-reactive protein (CRP) level and poor outcomes have been yielded controversial results in patients with atrial fibrillation (AF). This meta-analysis sought to investigate the utility of elevated CRP level in predicting adverse outcomes in AF patients. METHODS: Two authors systematically searched PubMed and Embase databases (until December 10, 2022) for studies evaluating the value of elevated CRP level in predicting all-cause mortality, cardiovascular death, stroke, or major adverse cardiovascular events (MACEs) in AF patients. The predictive value of CRP was expressed by pooling adjusted hazard ratio (HR) with 95% confidence intervals (CI) for the highest versus the lowest level or per unit of log-transformed increase. RESULTS: Ten studies including 30,345 AF patients satisfied our inclusion criteria. For the highest versus the lowest CRP level, the pooled adjusted HR was 1.57 (95% CI 1.34-1.85) for all-cause mortality, 1.18 (95% CI 0.92-1.50) for cardiovascular death, and 1.57 (95% CI 1.10-2.24) for stroke, respectively. When analyzed the CRP level as continuous data, per unit of log-transformed increase was associated with a 27% higher risk of all-cause mortality (HR 1.27; 95% CI 1.23-1.32) and 16% higher risk of MACEs (HR 1.16; 95% CI 1.05-1.28). CONCLUSIONS: Elevated CRP level may be an independent predictor of all-cause mortality, stroke, and MACEs in patients with AF. CRP level at baseline can provide important prognostic information in risk classification of AF patients.

Submicronic particulate matter (PM1), a "neglected killer" for HIV/AIDS patients in Hubei, China: Results from a cohort study from 2001 to 2020.

BACKGROUND: Although with the progress of antiretroviral therapy, the life expectancy of HIV/AIDS patients was still not equal to that of normal people. Submicronic particulate matter (PM1) might play a role in mortality among people living with HIV/AIDS, However, cohort evidence is extensively scarce. METHODS: This twenty-year open cohort study involved all individuals officially diagnosed with HIV/AIDS in Hubei Province from 2001 to 2020. Time-varying Cox proportional hazard models were applied to investigate the associations between long-term exposure to PM1 and mortality in HIV/AIDS patients. The concentration-response curves between PM1 and AIDS-related deaths/all-cause deaths were characterized by fitting restricted cubic spline models. These curves were then utilized to estimate the number of deaths attributed to PM1. RESULTS: Long-term exposure to PM1 was significantly associated with AIDS-related deaths and all-cause death among HIV/AIDS patients, with excess risks of 2.33 % [95 % confidence interval (CIs): 1.62, 3.15] and 0.69 % (0.22, 1.17) for each 1 µg/m3 increase in annual PM1. HIV-positive people with lower initial CD4+ cell count levels or aged over 65 years old were more susceptible to PM1 exposure. We estimated about 844 AIDS-related deaths and 1175 all-cause deaths can be attributable to ambient PM1 exposure, accounting for 41.7 % and 23.8 % of the total deaths from corresponding causes, respectively. CONCLUSIONS: Long-term exposure PM1 was a novel factor hindering the life spans of people living with HIV/AIDS. Early establishment of PM1 concentration standards and efforts to achieve them will bring substantial health benefits to people living with HIV/AIDS, especially in low- and middle-income countries facing the dual challenges of high air pollution and high AIDS prevalence.

Prevalence and risk factors of osteoporosis and osteopenia among residents in Hubei province, China.

It is the first time to estimate the prevalence and characterize of osteoporosis in Hubei province, China. The prevalence of osteoporosis was 12.19%, 3.69% for males, and 18.94% for females; 56.6% were diagnosed with osteopenia, 44.96% for males, and 65.84% for females. INTRODUCTION: The disease burden of osteoporosis is increasing, but there are few studies on the prevalence and risk factors in Hubei, China. This study aims to analyze the prevalence of osteoporosis using dual-energy X-ray absorptiometry (DXA) measurement and the risk factors of osteoporosis using epidemiological survey methods. OBJECTIVE: To explore the prevalence of osteoporosis and osteopenia in Hubei province, and provide the epidemiological basis for policymakers, to reduce the prevalence of osteoporosis METHODS: Based on data derived from the epidemiological survey of osteoporosis in Hubei province in 2018, 1592 residents aged 40 and above from 32 neighborhood committees/villages in 4 districts/counties of Hubei province were selected by multistage stratified random sampling. The lumbar spine AP (L1-L4 and L2-L4), femoral neck, and total hip BMD were measured using DXA of the internationally recognized gold standard and assessed according to WHO diagnostic criteria, utilizing unconditional logistic regression to explore the risk factors of osteoporosis and osteopenia. RESULTS: The overall crude prevalence of osteoporosis was 12.19%, 3.69% for males, and 18.94% for females. Osteopenia was diagnosed in 56.6% of all participants, 44.96% in males, and 65.84% in females. Increasing age, females, and underweight were related to the high prevalence of osteoporosis and osteopenia, while people with higher levels of education, overweight, and obese had a low prevalence of osteoporosis and osteopenia. In women, the absence of chronic disease and moderate intake of dairy products probably be associated with the low prevalence of osteopenia. CONCLUSIONS: The prevalence of osteoporosis and osteopenia is high in Hubei, China. The risk of prevalence of osteoporosis and osteopenia was higher in females and people with higher age and low BMI. While high BMI, high education, the absence of chronic disease, and intaking dairy moderately were negatively correlated with the prevalence of osteopenia or osteoporosis. The government should support the prevention and treatment of osteoporosis.