Association of waist circumference and BMI with premature death in young and middle-aged population.

Introduction: Premature death is a global health indicator, significantly impacted by obesity, especially in young and middle-aged population. Both body mass index (BMI) and waist circumference (WC) assess obesity, with WC specifically indicating central obesity and showing a stronger relationship with mortality. However, despite known associations between BMI and premature death, as well as the well-recognized correlation between WC and adverse health outcomes, the specific relationship between WC and premature death remains unclear. Therefore, focusing on young and middle-aged individuals, this study aimed to reliably estimate independent and combined associations between WC, BMI and premature death, thereby providing causal evidence to support strategies for obesity management. Methods: This study involved 49,217 subjects aged 18-50 years in the United States from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Independent and combined associations between WC and BMI with premature death across sex and age stratum were examined by Cox regression. Survey weighting and inverse probability weighting (IPW) were further considered to control selection and confounding bias. Robustness assessment has been conducted on both NHANES and China Health and Retirement Longitudinal Study (CHARLS) data. Results: A linear and positive relationship between WC and all-cause premature death was found in both males and females, with adjusted HRs of 1.019 (95%CI = 1.004-1.034) and 1.065 (95%CI = 1.039-1.091), respectively. Nonlinear relationships were found with respect to BMI and all-cause premature death. For females aged 36-50 with a BMI below 28.6 kg/m2, the risk of premature death decreased as BMI increased, indicated by adjusted HRs of 0.856 (95%CI = 0.790-0.927). Joint analysis showed among people living with obesity, a larger WC increased premature death risk (HR = 1.924, 95%CI = 1.444-2.564). Discussion: WC and BMI exhibited prominent associations with premature death in young and middle-aged population. Maintaining an appropriate WC and BMI bears significant implications for preventing premature death.

Association of the triglyceride-glucose index with early-onset atherosclerotic cardiovascular disease events and all-cause mortality: a prospective cohort study.

BACKGROUND: The association between the triglyceride glucose (TyG) index and the risk of early-onset atherosclerotic cardiovascular disease (ASCVD) events or all-cause mortality in young and middle-aged people is not fully elucidated. METHODS: The present study included 64,489 young and middle-aged people who participated in the 2006 Kailuan Study physical examination. Multivariate Cox proportional hazards models and restricted cubic spline curves were used to assess the association of TyG index with early-onset ASCVD events and all-cause mortality. RESULTS: During a median of 11-year follow-up, 1984 (3.08%) participants experienced at least one ASCVD event and 1,392 (2.16%) participants experienced all-cause death. A higher TyG index was significantly associated with a higher risk of early-onset ASCVD events (HR: 1.61, 95% CI 1.38-1.89) and all-cause mortality (HR: 1.39, 95% CI 1.17-1.65), respectively. For each unit increase in TyG index, the risk of early-onset ASCVD events increased by 20%. In addition, there was a non-linear association between the TyG index and early-onset ASCVD events (P for non-linear < 0.01), and a linear association between TyG index and all-cause mortality (P for non-linear = 0.476). CONCLUSIONS: A higher TyG index is significantly associated with an increased incidence of early-onset ASCVD events and all-cause mortality in a young and middle-aged population from North China.

Retrospective cohort study on the factors influencing poor prognosis in young and middle-aged patients with pulmonary tuberculosis / 公共卫生与预防医学

Objective To conduct a retrospective cohort study on the influencing factors of poor prognosis of young and middle-aged patients with pulmonary tuberculosis. Methods Selecting 426 young and middle-aged patients who were diagnosed with pulmonary tuberculosis in our hospital from January to December 2018 as the research subjects. Collecting the social demography information of all patients and the information of potential factors affecting the prognosis (allergy history, smoking history, drinking history, BMI level, disease information, treatment information, etc.) and discussing the factors affecting the prognosis of young and middle-aged pulmonary tuberculosis patients and their effects. Results The average age of 426 patients was (41.93±5.17) years old, the average BMI of them was (21.97±3.15) kg/m2, and an average course of disease of them was (2.76±0.99) years. There was no significant difference in the basic sexual information between men and women. In this study, a total of 128 patients with poor prognosis were retrospectively followed up, including 90 males and 38 females. The detection rate of males was significantly higher than that of females (χ2=16.976, P2=18.850, P2=38.924, P2=127.207, P2=32.566, P2=16.715, P2=17.315, P2=16.976，P1 and P1 and P<0.05; Regular treatment still showed potential protective factors, with an HR of 0.408, P<0.05. Conclusion: Male, emaciated body type, disease course ≥ 5 years, smoking history, number of lung field lesions ≥ 3, presence of pulmonary cavities and comorbidities are potential risk factors, while regular treatment suggests potential protective factors. Conclusion More targeted disease control and management should be implemented for middle-aged and young patients with pulmonary tuberculosis based on the aforementioned influencing factors to improve their prognosis.

Study on the risk of coronary heart disease in middle-aged and young people based on machine learning methods: a retrospective cohort study.

Objective: To identify coronary heart disease risk factors in young and middle-aged persons and develop a tailored risk prediction model. Methods: A retrospective cohort study was used in this research. From January 2017 to January 2020, 553 patients in the Department of Cardiology at a tertiary hospital in Anhui Province were chosen as research subjects. The research subjects were separated into two groups based on the results of coronary angiography performed during hospitalization (n = 201) and non-coronary heart disease (n = 352). R software (R 3.6.1) was used to analyze the clinical data of the two groups. A logistic regression prediction model and three machine learning models, including BP neural network, Extreme gradient boosting (XGBoost), and random forest, were built, and the best prediction model was chosen based on the relevant parameters of the different machine learning models. Results: Univariate analysis identified a total of 24 indexes with statistically significant differences between coronary heart disease and non-coronary heart disease groups, which were incorporated in the logistic regression model and three machine learning models. The AUCs of the test set in the logistic regression prediction model, BP neural network model, random forest model, and XGBoost model were 0.829, 0.795, 0.928, and 0.940, respectively, and the F1 scores were 0.634, 0.606, 0.846, and 0.887, indicating that the XGBoost model's prediction value was the best. Conclusion: The XGBoost model, which is based on coronary heart disease risk factors in young and middle-aged people, has a high risk prediction efficiency for coronary heart disease in young and middle-aged people and can help clinical medical staff screen young and middle-aged people at high risk of coronary heart disease in clinical practice.

Inverse association between low-density lipoprotein cholesterol and bone mineral density in young- and middle-aged people: The NHANES 2011-2018.

Objectives: Low-density lipoprotein cholesterol (LDL-C) plays an essential part in bone metabolism. However, the correlation between LDL-C levels and bone mineral density (BMD) is still controversial. This study aimed to explore the relationship between LDL-C levels and lumbar BMD in young- and middle-aged people. Methods: We conducted a cross-sectional study comprising 4,441 participants aged 20-59 from the National Health and Nutrition Examination Survey (NHANES). LDL-C levels and lumbar BMD were used as independent and dependent variables, respectively. We evaluated the correlation between LDL-C levels and lumbar BMD through a weighted multivariate linear regression model. We performed a subgroup analysis of the relationship between LDL-C levels and lumbar BMD based on age, gender, and body mass index (BMI). Results: After adjusting for confounding factors, LDL-C levels were negatively correlated with lumbar BMD. In subgroup analyses stratified by gender, this negative association was statistically significant in men and women. In the subgroup analysis stratified by age, a negative connection existed in people aged 30-49 years. In the subgroup analysis divided by BMI, there was an inverse correlation in overweight people (25 ≤ BMI < 30). Conclusions: Our research observed an inverse association between LDL-C levels and lumbar BMD in young- and middle-aged people, especially in people aged 30-49 years and who are overweight. Close monitoring of BMD and early intervention may be required for these people.

The association between obesity indices and hypertension: Which index is the most notable indicator of hypertension in different age groups stratified by sex?

OBJECTIVE: This study aimed to investigate the most notable obesity index and its optimal cut-off point of hypertension in different age groups stratified by sexes among community residents in southern China. METHODS: In this cross-sectional study, 620 men and 631 women aged 18-59 years were enrolled. The independent-samples t-test and chi-square test were conducted to analyze continuous and categorical variables, respectively. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis assessed the association between the obesity indices and hypertension risk. RESULTS: Waist-stature ratio (WSR) and waist-hip ratio (WHR) were the most notable risk factors for hypertension in young men and women, respectively. The odds ratios (ORs) of hypertension risk increased with per standard deviation (SD) in WSR and WHR (WSR: OR = 2.877, 95% confidence interval [CI] = 1.602 to 5.167; WHR: OR = 10.683, 95%CI = 2.179 to 52.376). In the middle-aged group of both sexes, body mass index (BMI) was the most distinctive risk factor for hypertension, the ORs of hypertension risk increased with per SD in BMI (men: OR = 2.297, 95%CI = 1.683 to 3.136; women: OR = 1.810, 95%CI = 1.338 to 2.450). ROC curve analysis demonstrated WSR and PI were better indicators than other indices among young men, and WSR was the best marker among young women. However, BMI and WC were the most sensitive markers in middle-aged men and women, respectively. CONCLUSIONS: In this Chinese population, the association of obesity indices and hypertension is inconsistent in different age groups and sexes. It is important to choose appropriate indicators for specific groups of people.

Comparison of blood lipid levels and influencing factors among normotensive young and middle-aged people with different brachial ankle pulse wave velocity / 中国综合临床

Objective To compare the blood lipid levels of different brachial-ankle pulse wave velocity (baPWV) in young and middle-aged people with normal blood pressure and to explore the related factors affecting baPWV.Methods From January 2014 to December 2017,the clinical data of one thousand two hundred and sixty-eight middle-aged and young people with normal blood pressure who underwent physical examination in Dongying People's Hospital were retrospectively analyzed.Using baPWV＜ 1 400 cm/s as the standard of normal arterial stiffness,the patients were divided into normal arterial stiffness group (normal group,1 128 cases),abnormal arterial stiffness group (abnormal group,baPWV ≥ 1 400 cm/s,140 cases).The blood lipid indexes of the two groups were analyzed and compared.Logistic regression analysis was used for multivariate analysis and linear correlation analysis was used for linear correlation analysis.Pearson correlation analysis was used.Results Compared with the normal group,TC ((4.99 ± 1.10) mmol/L vs.(4.48 ± 1.03) mmoL/L,t =5.830),TG ((1.62 ± 0.27) mmol/L vs.(1.49 ± 0.23) mmol/L,t=5.102),LDL-C[(3.25±0.23) mmol/L vs.(3.11±0.16) mmol/L,t =4.712),Apo B((0.96 ±0.07) g/L vs.(0.87±0.08) g/L,t =4.297)in abnormal group all increased,and HDL-C((1.15±0.09) mmol/L vs.(1.27±0.07) mmol/L,t =4.712) decreased,and the differences were statistically significant (P＜0.05).Smoking,high FPG,high LDL-C,high Apo B,low HDL-C were the independent factors affecting baPWV abnormality (P＜ 0.05).TC,TG,LDL-C,Apo B and baPWV in abnormal group were positively correlated(P＜0.05),and HDL-C and baPWV were negatively correlated(P＜0.05).There was a linear regression relationship between LDL-C,Apo B and baPWV (P＜0.05).Conclusion The increase of LDL-C and Apo B are closely related to early arterial disease in the low-risk populations of normotensive young and middle-aged people,even the risk of blood lipid may already exist within the normal range.

Left Ventricular Strain and Dyssynchrony in Young and Middle-Aged Peritoneal Dialysis Patients and Healthy Controls: A Case-Matched Study.

BACKGROUND: This study aimed to evaluate the role of two-dimensional speckle-tracking imaging (2D-STI) and myocardial layer-specific analysis in evaluating early left ventricular (LV) myocardial function and systolic dyssynchrony in young and middle-aged uremic patients undergoing peritoneal dialysis (PD). METHODS: We enrolled 31 PD patients aged ≤65 years with preserved LV ejection fraction (LVEF, ≥54%) as the PD group and 49 age-matched healthy people as the control group. Echocardiography was used to assess the left atrial diameter index (LADI, LAD/BSA), LV mass index (LVMI), LVEF, peak early diastolic velocity/late diastolic velocity (E/A) (measured by pulsed Doppler), and peak early diastolic velocity (by pulsed Doppler)/peak velocity of the early diastolic wave (by pulsed-wave tissue Doppler) (E/e'). Next, we used 2D-STI and myocardial layer-specific analysis to obtain longitudinal strains (LS) of the endocardium (LSendo), the myocardium (LSmyo), the epicardium (LSepi), and the global myocardium (GLS). Then, we measured the postsystolic index (PSI) to evaluate LV myocardial function. Time to peak LS (TTP) and peak strain dispersion (PSD) from 17 consecutive segments were assessed to quantify LV dyssynchrony. RESULTS: Compared with the controls, PD patients had significantly increased LADI (p = 0.041), LVMI (p = 0.000), and E/e' (p = 0.009), but reduced LVEF (p = 0.000) and E/A (p = 0.000). The average values of GLS (GLS avg) (p = 0.01) and GLS of the apical 2-chamber view (p = 0.003), including the LSendo (p = 0.024), LSmyo (p = 0.024), and LSepi (p = 0.032), were significantly decreased in patients with PD compared with controls. In PSI, segments of LS were markedly delayed in the anterior septum (p = 0.047), anterior (p = 0.000) and septum wall (p = 0.024) from basal segments, anterior wall (p = 0.001) from middle segments, and anterior (p = 0.024) and inferior (p = 0.024) wall from apical segments. Moreover, PSD was significantly increased in PD patients (p = 0.015), while TTP was evidently delayed in the anterior septum (p = 0.004), anterior (p = 0.000) and posterior (p = 0.042) wall from basal segments, and inferior wall (p = 0.048) from apical segments. CONCLUSIONS: Despite preserved LVEF, young and middle-aged PD patients developed LV dysfunction and myocardial systolic dyssynchrony earlier compared with controls.

Blood pressure variability and circadian rhythms in young and middle-aged people with H-type primary hypertension / 重庆医学

Objective To investigate the blood pressure variability(BPV) and circadian rhythms in young and middle-aged people with H-type hypertension.Methods The ambulatory blood pressure monitoring data from 89 young and middle-aged patients with mild-to-moderate hypertension were retrospectively analyzed.All cases were divided into the H-type hypertension group (n=56) and non-H-type hypertension group(n=33) according to plasma homocysteine(Hcy) level.Blood pressure in different time periods(including 24hSBP/24hDBP,dSBP/dDBP,nSBP/nDBP,mSBP/mDBP,mnSBP/mnDBP),variability(including 24hSBPV/24hDBPV,dSBPV/dDBPV,nSBPV/nDBPV,mSBPV/mDBPV,mnSBPV/mnDBPV),day and night average heart rate,dipper ratio of SBP/DBP and morning blood pressure surge were compared between the two group.Results 24hSBP,dSBP,nSBP and mSBP in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group,while 24hDBP,dDBP,nDBP and mDBP were significantly lower than those in the non-H-type group,the differences were statistically significant(P＜0.01).24hSBPV,24hDBPV,dSBPV,nDBPV and mSBPV had statistically significantly difference between the H-type hypertension group and non-H-type hypertension group(P＜0.05).The dipper ratio of SBP and mean MBPS in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group(P＜0.01).Conclusion Blood pressure variability is increased within a certain range in young and middle-aged patients with H-type hypertension,which is correlated to circadian rhythm changes.

Prevalence characteristics of fatty liver and its risk factors analysis in young and middle-aged people / 中国综合临床

Objective To analyze the prevalence characteristics of fatty liver in young and middle-aged people,and to explore the risk factors of the disease,so as to provide clinical evidence for the prevention and treatment of fatty liver.Methods In 756 young and middle-aged healthy subjects with age≤50 years old,there were 197 fatty liver cases were diagnosed by ultrasonic test during 2015 year.The prevalence of different characteristics in young and middle-aged fatty liver was analyzed,the difference of blood biochemical index between fatty liver and non fatty liver group was compared,and risk factors of fatty liver was explored by binary logistic regression model.Results The total prevalence rate of fatty liver in young and middle-aged people was 26.1%(197/756),among which 33.1% (119/359) were male and 19.6%(78/397) were female,the prevalence rate of male was significantly higher than that of female(χ2=17.833,P<0.05).The prevalence rate of fatty liver increased with age(χ2=33.296,P<0.05),which in 40-50 years old was 37.1%(111/299) and significantly higher than that in 20 years-(15.0%)(24/160) and 30 years-(20.9%)(62/297).Logistic regression analysis on influencing factors of fatty liver prevalence showed that age,sex,body mass index(BMI),drinking,diabetes and fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC) were closely related to fatty liver(P<0.05),overweight,obesity,drinking,diabetes increased the risk of fatty liver disease.Biochemical indicators(FPG,TG,TC) in fatty liver group were higher than those in non fatty liver group((7.09±1.47) mmol/L vs.(5.14±1.71) mmol/L,(5.98±1.23) mmol/L vs.(4.95±1.42) mmol/L,(2.03±0.45) mmol/L vs.(1.23±0.67) mmol/L,t=271.905,98.866,278.255;P<0.05).Conclusion The prevalence rate of fatty liver in young and middle-aged people is high,and controlling body weight,give up drinking,active treating diabetes,reducing blood glucose and blood lipids can effectively decrease the prevalence of fatty liver in young and middle-aged people.

Association of physiological level of serum uric acid with reduced renal function in young and middle-aged healthy people / 中华内分泌代谢杂志

Objective To investigate the association of serum uric acid level with glomerular filtration rate and explore the predictive value of the physiological uric acid levels for reduced renal function.Methods A total of 6 532 subjects from Karemary community and 2 402 subjects from the First Affiliated Hospital of Xinjiang Medical University were enrolled.All subjects were surveyed with questionnaire and their serum biochemical indices and liver functions were measured.Meanwhile,a cohort study was conducted,752 subjects with normal renal function were selected from young and middle-aged healthy people in 2008.During the 3-year follow-up,the incidence of reduced renal function and the risk factors of estimated glomerular filtration rate (eGFR) were analyzed.Results Serum uric acid (SUA) was the independent risk factor of reduced GFR in cross-sectional analysis.The 2 groups were stratified by sex and age,except for female population over 45 years old in the first group,the level of physiological serum uric acid was the risk factor for decreased eGFR in the rest of groups.During 3-year follow-up,the incidence of reduced renal function was 15.40％ and SUA was the independent risk factor of decreased eGFR.Conclusions The concentration of physiological serum uric acid was closely related with renal function,and the increase in SUA whthin normal range had an important early predictive value for decreased GFR.

Investigation and analysis on the status and diet behavior of overweight and obesity in young and middle-aged people of Jinan / 中华行为医学与脑科学杂志

Objective To explore the status of obesity and diet behavior in young and middle-aged people of Jinan and supply reference for controlling overweight and obesity by diet intervention. Methods Stratified sampling method was conducted to investigate 18～59 inhabitants in Jinan. The information about their body height,body weight and diet behavior was collected to further analyze the relationship between the status of obesity and correlated behaviors by the SPSS 11.5 software. Results The prevalence rate of overweight and obesity had a significant difference between young group and middle-aged group(P＜0.01), which was separately 21.56% and 33.46%; the prevalence rate of overweight and obesity in young group had a significant difference between males and females(P＜0.05),but no significant difference in middle-aged group.Compared with the diet behavior problems of normal body weight people, the incidence rate of overweight and obesity was significantly higher(P＜0.01),but no significant difference for the habit of midnight snack.Females paid more attention to reasonable match and the speed of food intake than males.Conclusion Overweight and obesity in young and middle-aged people of Jinan is relatively serious,which is closely correlated with unscientific diet behavior.