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The objective of this research was to explore the potential association between lipid accumulation product (LAP) and chronic kidney disease (CKD) among adult population of United States (US). Using cross-sectional data from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES), we explored the association of LAP with CKD, low estimated glomerular filtration rate (eGFR), and albuminuria. This analysis encompassed multivariate logistic regression analyses, smoothed curve fitting, subgroup analyses, and interaction tests. We found a significant positive association between higher ln-transformed LAP (LAP was transformed using a natural logarithm) and the prevalence of CKD, low-eGFR and albuminuria. Notably, this association of ln-transformed LAP with CKD and albuminuria was significantly influenced by diabetes status and sex (P for interaction < 0.05), while no significant interaction was observed regarding the association with low-eGFR (P for interaction > 0.05). Additionally, in model 3 (adjusted for all included covariates except eGFR and urinary albumin-creatinine ratio (UACR)), a nonlinear relationship was identified between ln-transformed LAP and the presence of both CKD and albuminuria, with inflection points of 4.57 and 4.49, respectively. This indicates that this correlation is more pronounced on the right of the inflection point. In conclusion, the findings indicate a significant association between LAP and the prevalence of CKD in US adults.

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Background: Cardiometabolic index (CMI) is a well-promising indicator for predicting obesity-related diseases. Testosterone decline and deficiency importantly affect men's health, and may be associated with obesity and excessive deposition of visceral adipose tissue. We aimed to explore the association between CMI and serum testosterone in US adult males. Methods: The present cross-sectional study was conducted among adult males with complete data about CMI and testosterone in 2013-2016 National Health and Nutrition Examination Survey (NHANES). CMI was calculated as follows: triglyceride (TG) (mmol/L)/high-density lipid-cholesterol (HDL-C) (mmol/L) × waist-to-height ratio (WHtR). Multivariable regression and subgroup analyses were conducted to explore the association between CMI and testosterone. Results: We included 2,209 male participants for the final analysis. After adjusting for confounders, CMI was found to show a negative correlation between testosterone [minimally adjusted model: ß=-10.56, 95% confidence interval (CI): -12.76, -8.36, P<0.001, fully adjusted model: ß=-0.04 (-4.88, 4.81), P=0.99]. Multivariate-adjusted beta also showed testosterone levels were significantly lower in the two highest CMI groups (Q3, Q4) compared to the lowest group (Q1). In the subgroup populations, the relationship between CMI and testosterone was affected by age, race, education level, hypertension, and smoking status (P-interaction <0.05). Furthermore, receiver operating characteristic (ROC) curve analysis indicated that triglyceride-glucose-body mass index (TyG-BMI) (0.67, 95% CI: 0.65, 0.70) was the best predictor of low testosterone (results), although CMI was comparable in its predictive value (0.68, 95% CI: 0.65, 0.71). Conclusions: Higher CMI scores were associated with lower testosterone levels in adult males in the United States, with this correlation being influenced by factors such as age, race, education level, hypertension, and smoking status. CMI was comparable to other metabolic indexes for predicting testosterone deficiency, although TyG-BMI was the best overall predictor.

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Background: While deficiencies in vitamin B6, folate, and vitamin B12 are linked to various human diseases, including anemia, depression, peripheral neuropathy, and cardiovascular disease (CVD), literature regarding the association between vitamin B6, folate, and vitamin B12 and erectile dysfunction (ED) is scarce. We aimed to determine the dietary intake of vitamin B6, folate, and vitamin B12 and ED in the United States population. Methods: We extracted data from the 2001-2004 cycles of the National Health and Nutrition Examination Survey (NHANES). Dietary intakes of B vitamins were collected based on one 24-hour dietary recall. The association between dietary intake of vitamin B6, folate, vitamin B12 and ED was examined using multivariate logistic regression models. Results: A total of 3,875 participants were included for analysis, with 1,201 reporting ED and 2,894 not experiencing ED. The multivariable odds ratios (ORs) for the highest vs. lowest quartiles of vitamin B6 was 0.77 [95% confidence interval (CI): 0.60-0.99; P for trend =0.03] for the prevalence of ED. Subgroup analyses demonstrated a significant inverse association between dietary intake of vitamin B6, folate, vitamin B12 and the prevalence of ED among men aged ≤60 years, individuals of Mexican American and non-Hispanic White ethnicity, and those without a history of CVD, diabetes, hypertension, and high cholesterol. Conclusions: The consumption of dietary vitamin B6, folate, and vitamin B12 was significantly linked to decreased risks of ED among younger healthier men, suggesting a potential protective role of these nutrients against ED in United States adults.

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Purpose: This study investigates the association between heavy metal exposure and the prevalence of depression, with the mediating role of sleep duration. Method: Our study investigated the association between heavy metal concentration and depression risk in the NHANES from 2005 to 2020. We used logistic regression analysis, WQS regression model and BKMR model to assess the association. Mediation analysis was performed to explore the role of sleep duration in heavy metal exposure-induced depression. Result: Of the 10,825 individuals included in this study, 705 (6.85%) were diagnosed with depression. We found a positive association between the cadmium (Cd), cobalt (Co), lead (Pb), antimony (Sb), wolfram (W) concentration and the prevalence of depression. Moreover, heavy metals mixtures were positively correlated with the prevalence of depression, with Cd identified as the main contributor in the WQS regression model (0.4654). Furthermore, sleep duration mediated the association between Cd, molybdenum (Mo), Pb, Sb, W exposure and prevalence of depression, explaining 3.12%, 15.84%, 18.24%, 9.56%, 3.68% of the effect. Conclusion: The findings affirm that heavy metal exposure is linked to higher depression incidence and that this relationship is partly mediated by sleep duration alterations. The study underscores the importance of environmental health monitoring and interventions aimed at reducing heavy metal exposure to mitigate its psychological impacts.

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OBJECTIVE: To investigate relationships between prognostic nutritional index (PNI) during pregnancy and risk of all-cause mortality (ACM) and cardiovascular disease (CVD) mortality in persons with gestational diabetes mellitus (GDM). METHODS: A cross-sectional study was conducted using NHANES data from 2007 to 2018, and weighted Cox regression models were established. Restricted cubic spline analysis was used to unveil associations of PNI with risk of ACM and CVD mortalities in individuals with GDM. Receiver operating characteristic curve was employed for determination of threshold value for association of PNI with mortality. Sensitivity analysis was performed to verify the stability of the results. RESULTS: 734 GDM individuals and 7987 non-GDM individuals were included in this study. In GDM population, after adjusting for different categorical variables, PNI was significantly negatively correlated with ACM risk. Subgroup analysis showed that among GDM populations with no physical activity, moderate physical activity, parity of 1 or 2, negative correlation between PNI and risk of ACM was stronger than other subgroups. Sensitivity analysis results showed stable negative correlations between PNI and ACM and CVD mortality of total population, and between PNI and ACM of GDM. CONCLUSION: In individuals with GDM, PNI was negatively correlated with ACM risk, especially in populations with no physical activity, moderate physical activity, and parity of 1 or 2. PNI = 50.75 may be an effective threshold affecting ACM risk in GDM, which may help in risk assessment and timely intervention for individuals with GDM.

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The USDA Thrifty Food Plan (TFP) is a federal estimate of a healthy diet at lowest cost for US population groups defined by gender and age. The present goal was to develop a version of the TFP that was more tailored to the observed dietary patterns of self-identified Hispanic participants in NHANES 2013-16. Analyses used the same national food prices and nutrient composition data as the TFP 2021. Diet quality was measured using the Healthy Eating Index 2015. The new Hispanic TFP (H-TFP) was cost-neutral with respect to TFP 2021 and fixed at $186/week for a family of four. Two H-TFP models were created using a quadratic programming (QP) algorithm. Fresh pork was modeled separately from other red meats. Hispanic NHANES participants were younger, had lower education and incomes, but had similar or higher HEI 2015 scores than non-Hispanics. Their diet included more pulses, beans, fruit, 100% juice, grain-based dishes, and soups, but less pizza, coffee, candy, and desserts. The H-TFP market basket featured more pork, whole grains, 100% fruit juice, and cheese. The second TFP model showed that pork could replace both poultry and red meat, while satisfying all nutrient needs. A vegetarian H-TFP proved infeasible for most age-gender groups. Healthy, affordable, and culturally relevant food plans can be developed for US population subgroups.

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BACKGROUND: Numerous studies have demonstrated shared risk factors and pathophysiologic mechanisms between osteoporosis and cardiovascular disease. High-density lipoprotein cholesterol (HDL-C) and platelets have long been recognized as crucial factors for cardiovascular health. The platelet to HDL-C ratio (PHR) combines platelet count and high-density lipoprotein cholesterol (HDL-C) level, It is a novel biomarker for metabolic syndrome and cardiovascular disease. The platelet to HDL-C ratio (PHR) possibly reflects the balance between proinflammatory and anti-inflammatory states in the body. Therefore, we hypothesized that changes in PHR ratios may predict a predisposition to pro-inflammatory and increased bone resorption. However, the relationship between the platelet to HDL-C ratio (PHR) and bone mineral density (BMD) remains insufficiently understood. This study aimed to elucidate the relationship between the platelet to HDL-C ratio (PHR) index and bone mineral density (BMD). METHODS: Data from the NHANES 2005-2018 were analyzed, excluding adults with missing key variables and specific conditions. Nonlinear relationships were explored by fitting smoothed curves and generalized additive models, with threshold effects employed to calculate inflection points. Additionally, subgroup analyses and interaction tests were conducted. RESULTS: The study included 13,936 individuals with a mean age of 51.19 ± 16.65 years. Fitted smoothed curves and generalized additive models revealed a nonlinear, inverted U-shaped relationship between the two variables. Threshold effect analysis showed a significant negative association between PHR and total femur bone mineral density (BMD) beyond the inflection point of platelet to HDL-C ratio (PHR) 33.301. Subgroup analyses showed that a significant interaction between these two variables was observed only in the age and sex subgroups (P-interaction < 0.05). CONCLUSIONS: Our study identified a complex, nonlinear, inverted U-shaped relationship between platelet to HDL-C ratio (PHR) and total femur bone mineral density (BMD). These findings underscore the importance of maintaining optimal PHR levels to support bone health, especially in high-risk populations.

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Anthropometric parameters are widely used in the clinical assessment of hypertension, type 2 diabetes, and cardiovascular disease. However, few studies have compared the association between different anthropometric parameters and insulin resistance (IR). This study was aimed at investigating the relationship between 6 indicators, including body mass index (BMI), calf circumference (CC), arm circumference (AC), thigh circumference (TC), waist circumference (WC), waist-height ratio (WHtR), and IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to measure IR. Weighted linear regression was used to assess the relationship between different parameters and IR. The receiver operating characteristic curve (ROC) was employed to compare the strength of the relationship between different anthropometric parameters and IR. A total of 8069 participants were enrolled in our study, including 4873 without IR and 3196 with IR. The weighted linear regression results showed that BMI, CC, AC, TC and WC were significantly correlated with IR, except WHtR. After adjusting for multiple confounding factors, we found that BMI, AC and WC were significantly positively correlated with IR, while TC was significantly negatively correlated with IR. Logistic regression results showed that a larger TC was associated with a decreased risk of IR. In addition, BMI and WC had similar areas under the curve (AUC: 0.780, 95% CI 0.770-0.790; AUC: 0.774, 95% CI 0.763-0.784, respectively), which were higher than TC and AC (AUC: 0.698, 95% CI 0.687-0.710, AUC: 0.746, 95% CI 0.735-0.757, respectively). To our knowledge, this is the first study to report a negative correlation between TC and IR among patients without diabetes mellitus. Therefore, TC may be a new tool to guide public health and a clinical predictor of IR in non-diabetic patients.

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[This corrects the article DOI: 10.3389/fendo.2024.1266761.].

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Objective: The relationship between dietary niacin intake (DNI) and mortality rates among patients afflicted with chronic kidney disease (CKD) is a subject of debate. Utilizing data derived from the National Health and Nutrition Examination Survey (NHANES), this study adopts a retrospective cohort design with an aim to investigate the association in the American adult patients with CKD. Methods: A cohort study was conducted in the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2018 that enrolled 6,191 CKD patients aged 20 years and above. We collected data on mortality through 31 December 2018. DNI was measured using a 24-h recall method. The relationship between DNI levels and mortality from all causes and cardiovascular causes was analyzed using weighted Cox proportional hazards models. The Kaplan-Meier (K-M) survival curve was plotted to illustrate these associations. Results: Following a median monitoring period of 85 months, it was observed that 2,419 individuals (33.08%) succumbed to all causes, whereas cardiovascular-related deaths were recorded for 746 participants (10.45%). When controlling for confounders, an inverse relationship was established between DNI and mortality rates. Specifically, a marginal increase of 1 mg/day in DNI corresponded to a reduced Hazard Ratios (HRs) of 0.993 (0.987, 0.999; p = 0.027) for all-cause mortality and 0.980 (0.969, 0.991; p < 0.001) for cardiovascular mortality. A further stratified analysis by quartiles of DNI, with the lowest quartile serving as the reference, revealed that the highest quartile was associated with HRs of 0.820 (0.697, 0.966) for all-cause mortality and 0.663 (0.465, 0.944) for cardiovascular mortality, both displaying a significant trend (p < 0.001). However, a subdivision of CKD patients by age showed that the protective effects of higher DNI were only confined to individuals aged 60 years and above but not to those under 60 years of age. Conclusion: A negative correlation between DNI and mortality due to all causes and cardiovascular issues among CKD patients aged 60 and above was revealed based on the datasets; however, this association was not observed in younger individuals under 60. Consequently, enhancing DNI might serve as a beneficial therapeutic strategy specifically for the older CKD demographic.

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Objective: Hypertension (HTN) is a prevalent global health concern. From the standpoint of preventive and personalized medicine (PPPM/3PM), early detection of HTN offers a crucial opportunity for targeted prevention and personalized treatment. This study aimed to evaluate the association between the weight-adjusted waist index (WWI) and HTN risk. Methods: A case-control study using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 was conducted. Logistic regression models assessed the association between WWI and HTN. Subgroup analyses explored differences in age, sex, ethnicity, and diabetes status. Restricted cubic spline (RCS) analyses examined potential nonlinear relationships. Results: A total of 32,116 participants, with an average age of 49.28 ± 17.56 years, were included in the study. A significant positive association between WWI and the risk of HTN was identified (odds ratio [OR], 2.49; 95% CI, 2.39-2.59; P < 0.001). When WWI was categorized into quartiles (Q1-Q4), the highest quartile (Q4) exhibited a stronger association compared to Q1 (OR, 2.94; 95% CI, 2.65-3.27; P < 0.001). Subgroup analyses indicated that WWI was a risk factor for HTN across different populations, although variations in the magnitude of effect were observed. Furthermore, the findings from the RCS elucidated a nonlinear positive correlation between WWI and HTN. Conclusion: WWI is independently associated with HTN risk, highlighting its potential as a risk assessment tool in clinical practice. Incorporating WWI into early detection strategies enhances targeted prevention and personalized management of HTN. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00375-3.

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Background: Benign prostate hyperplasia (BPH) occurs in elder men globally with high prevalence. Human diet and lifestyle aroused great attention in the prevalence of BPH. Prostate enlargement (PE) is a major symptom of BPH. Objectives: To elaborate the effect of total diet quality for adults from the United States, we investigated the association between Health Eating Index (HEI)-2015 and the risk of PE in adults from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study was conducted based on NHANES 2001-2008. Participants who reported a PE history were included. We conducted a logistic regression analysis to investigate the association between HEI-2015 and PE. Results: A total of 4,866 male participants aged 40 and above were enrolled. Compared with Q1 of HEI-2015, no significant differences were found in adjusted models. Higher vegetables intake (Odds ratio [OR] = 1.073; 95% confidence interval [95%CI] 1.015 to 1.134, P = 0.02) and higher total dairy intake (OR = 1.034; 95%CI 1.009 to 1.061, P = 0.01) were significantly related with higher risk of PE. Conclusions: There was no significant difference between HEI-2015 and PE after full adjustment. Total vegetables and dairy product might be associated with higher risk of PE and needed further validation.

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Background: Obesity represents a significant risk factor for the development of metabolic abnormalities. However, it is not inevitable that all individuals with obesity will develop these disorders. Selenium has been demonstrated to play a role in maintaining metabolic homeostasis in vivo, with the ability to regulate relevant signaling pathways involved in glucose and lipid metabolism processes. Previous studies have indicated that selenium concentrations in obese individuals are higher than those reported in the general population. These findings the question of whether altered selenium concentrations may act as important triggers for accelerating metabolic imbalances in the obese population. The aim of this study was to examine the potential correlation between serum selenium concentrations and the risk of developing metabolic abnormalities in individuals with obesity. Methods: The present study included 6,125 participants from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) who were aged between 20 and 80 years, with a body mass index (BMI) of 30 kg/m2 or greater, and met the inclusion and exclusion criteria. Weighted generalized linear regression analyses were conducted to evaluate the associations between serum selenium concentrations and the conversion of metabolically healthy obesity (MHO) to metabolically unhealthy obesity (MUO). A generalized additive model (GAM) and a two-piecewise linear regression model were employed to investigate the saturation threshold effect between selenium and MUO. The correlation between different selenium concentration intervals and metabolic diseases was evaluated by categorizing selenium concentrations according to the saturation threshold. Furthermore, this study investigated the correlation between serum selenium and lipid concentrations in obese females and between serum selenium and blood pressure in obese males. Results: The weighted prevalence of MUO in the study population was 48.35%. After rigorous adjustment for sociodemographic, physical, and laboratory test covariates, the weighted odds ratio (OR) of MUO increased by 44% for every 1 µM increase (approximately 78.74 µg) in the serum selenium concentration (weighted OR=1.44; 95% CI=1.09 - 1.91; P=0.018). Second, GAM analysis and saturation threshold analyses revealed an inverted U-shaped relationship between serum selenium and metabolic abnormalities in males, with a corresponding inflection point (K) of 2.82 µM. When the serum selenium concentration was below the K-value, the effects of serum selenium were mainly on blood pressure, especially diastolic blood pressure (DBP) (weighted ß: 3.34; 95% CI= 0.25 - 6.44; P=0.038). Conversely, the correlation between the serum selenium concentrations and metabolic homeostasis imbalance in females was linear. When the selenium concentration exceeded 2.12 µM, the increase in selenium content was accompanied by increases in total cholesterol (TC, weighted ß=0.54, 95% CI=0.32 - 0.76; P=0.000) and triglyceride (TG, weighted ß=0.51, 95% CI=0.27 - 0.75; P=0.000) concentrations. Conclusions: The findings of our study indicate that selenium supplementation strategies for individuals with obesity should be tailored to the sex of the individual. In females, serum selenium concentration above the saturation threshold primarily facilitates the transition from MHO to MUO by influencing alterations in serum lipid metabolism. Maintaining selenium concentrations below the threshold levels is highly important for preventing the conversion of MHO to MUO. In males, serum selenium concentrations above the threshold were found to be effective in preventing an elevation in blood pressure, particularly in improving systolic blood pressure (SBP). Nevertheless, serum selenium concentrations below the threshold are linked to an increased risk of hypertension in obese individuals, particularly those with elevated diastolic blood pressure (DBP). Further research is needed to elucidate the optimal serum selenium concentration that exerts deleterious effects on blood pressure.

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Background: While several studies have noted a higher SII correlates with multiple diseases, research on the association between SII and atopic dermatitis remains limited. Our cross-sectional study seeks to examine the association between SII and atopic dermatitis among outpatient US adults. Methods: This compensatory cross-sectional study utilized NHANES data from 2001-2006 cycles, conducting sample-weighted multivariate logistic regression and stratified analysis of sub-groups. Results: Higher levels of SII were positively associated with an increased risk of atopic dermatitis in adults with BMI <30 (OR, 1.44; 95% CI, 1.10-1.90) (p = 0.010). Conclusion: Our findings suggested SII higher than 330 × 109/L was positively associated with a high risk of atopic dermatitis in US adults with BMI <30. To our knowledge, this is the first study focused on the risk of higher SII on atopic dermatitis in the outpatient US population. Currently, there are differences in the standards used to diagnose atopic dermatitis across countries, and our study may have implications.

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Purpose: To explore the combined effects of sleep disorders and depression on chronic low back pain (CLBP) in American adults. Material and methods: In this cross-sectional study, the data of all participants were obtained from the National Health and Nutrition Examination Survey (NAHNES) between 2009 and 2010. CLBP was defined as persistent LBP for a consecutive three-month period. Sleep disorders were self-reported and were diagnosed by a doctor before. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms by trained personnel. Potential covariates were selected using weighted univariate logistic regression models. Weighted univariate and multivariate logistic regression models were used to evaluate the separate and combined effects of sleep disorders and depression on CLBP, respectively. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Associations were further explored in the subgroups of age, chronic kidney disease (CKD), diabetes, and having pain outside the low back. Results: A total of 5275 participants were included. Among them, 542 (10.28%) had CLBP. The mean age of all participants was 47.19 (0.53), and 50.65% (n=2668) were female. Sleep disorder (OR=1.52, 95% CI: 1.17-1.98) or depressive symptoms (OR=3.06, 95% CI: 2.41-3.88) were associated with higher odds of CLBP. Compared to participants without sleep disorders and depression symptoms, participants in both conditions had an increased risk of CLBP (OR=3.95, 95% CI: 2.58-6.05, P for trend <0.001). The combined effects of sleep disorders and depressive symptoms were also found in the population aged <45 years, ≥45 years, with and without CKD, with and without diabetes, and no pain outside the low back. Conclusion: Sleep disorders and depressive symptoms may increase the odds of reporting CLBP. Further research is necessary to explore the effectiveness of multidisciplinary interventions targeting sleep disorders, depressive symptoms, and CLBP.

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OBJECTIVE: To examine the relationship between C-reactive protein (CRP) and knee pain, and further explore whether this association is mediated by obesity. METHODS: The population was derived from 1999 to 2004 National Health and Nutrition Examination Survey. Logistic regression was used to analyze the relationship between CRP and knee pain in three different models, and the linear trend was analyzed. A restricted cubic spline model to assess the nonlinear dose-response relationship between CRP and knee pain. Mediation analyses were used to assess the potential mediating role of obesity. Subgroup analyses and sensitivity analyses were performed to ensure robustness. RESULTS: Compared with adults with lower CRP (first quartile), those with higher CRP had higher risks of knee pain (odds ratio 1.39, 95% confidence interval 1.12-1.72 in third quartile; 1.56, 1.25-1.95 in fourth quartile) after adjusting for covariates (except body mass index [BMI]), and the proportion mediated by BMI was 76.10% (p < .001). BMI and CRP were linear dose-response correlated with knee pain. The odds ratio for those with obesity compared with normal to knee pain was 2.27 (1.42-3.65) in the first quartile of CRP, 1.99 (1.38-2.86) in the second, 2.15 (1.38-3.33) in the third, and 2.92 (1.72-4.97) in the fourth. CONCLUSION: Obesity mediated the systemic inflammation results in knee pain in US adults. Moreover, higher BMI was associated with higher knee pain risk in different degree CRP subgroups, supporting an important role of weight loss in reducing knee pain caused by systemic inflammation.

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BACKGROUND: Health-related quality of life (HRQoL) reflects an individual's perception of their physical and mental health over time. Despite numerous studies linking physical activity to improved HRQoL, most rely on self-reported data, limiting the accuracy and generalizability of findings. This study leverages objective accelerometer data to explore the association between physical activity and HRQoL in Korean adults. OBJECTIVE: The objective of this study is to analyze the relationship between objectively measured physical activity using accelerometers and HRQoL among Korean adults, aiming to inform targeted interventions for enhancing HRQoL through physical activity. METHODS: This observational study included 1298 participants aged 19-64 years from the Korea National Health and Nutrition Examination Survey (KNHANES) VI, who wore an accelerometer for 7 consecutive days. HRQoL was assessed using the EQ-5D questionnaire, and physical activity was quantified as moderate-to-vigorous physical activity accelerometer-total (MVPA-AT) and accelerometer-bout (MVPA-AB). Data were analyzed using logistic regression to determine the odds ratio (ORs) for low HRQoL, adjusting for socioeconomic variables and mental health factors. RESULTS: Participants with higher HRQoL were younger, more likely to be male, single, highly educated, employed in white-collar jobs, and had higher household incomes. They also reported less stress and better subjective health status. The high HRQoL group had significantly more participants meeting MVPA-AB ≥600 metabolic equivalents (P<.01). Logistic regression showed that participants meeting MVPA-AB ≥600 metabolic equivalents had higher odds of high HRQoL (OR 1.55, 95% CI 1.11-2.17). Adjusted models showed consistent results, although the association weakened when adjusting for mental health factors (OR 1.45, 95% CI 1.01-2.09). CONCLUSIONS: The study demonstrates a significant association between HRQoL and moderate to vigorous physical activity sustained for at least 10 minutes, as measured by accelerometer. These findings support promoting physical activity, particularly sustained moderate to vigorous activity, to enhance HRQoL. Further interventional studies focusing on specific physical activity domains such as occupational, leisure-time, and commuting activities are warranted.

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PURPOSE: This study aimed to explore the correlation between hemoglobin levels and albuminuria in US adults. METHODS: This cross-sectional investigation analyzed the National Health and Nutrition Examination Survey (NHANES) information from 2011 to 2020. Data on hemoglobin, albuminuria, and other variables were collected from all participants. The logistic-regression analyses and smoothed curves were used to substantiate the research objectives. RESULTS: The average age of the 8,868 participants was 49.5 ± 17.3 years, and 49.3% were men. The prevalence of albuminuria was 12.1%. After adjusting for potential variables in the logistic-regression analysis models, hemoglobin (per 1 g/dL increase) was inversely associated with the presence of albuminuria (odds ratio [OR], 0.92; 95% confidence interval [95%CI], 0.87-0.97). Compared with participants in quartile 3 (Q3, 14.1-15.0 g/dL) for hemoglobin levels, those in the lowest quartile 1 (Q1, 6.1-13.0 g/dL) and highest quartile 4 (Q4, 15.1-19.6 g/dL) had adjusted ORs for albuminuria of 1.48 (95% CI, 1.19-1.85) and 1.11 (95% CI, 0.9-1.38), respectively. Our observations indicated a U-shaped association between hemoglobin levels and albuminuria, with a point of inflection at approximately 15.5 g/dL. The effect sizes and CIs below and above this point were 0.853 (95% CI, 0.798-0.912) and 1.377 (95% CI, 1.055-1.797), respectively. CONCLUSION: This study indicates that the presence of albuminuria is linked to both low and high hemoglobin levels in US adults. The management of hemoglobin may benefit kidney health.

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Background and aims: Rheumatoid arthritis (RA) is a prevalent chronic autoimmune disease characterized by chronic inflammation. The Inflammatory Burden Index (IBI) is a newly proposed comprehensive inflammation index used to assess systemic inflammation. The relationship between IBI and RA, as well as its all-cause mortality, remains unclear. The objective of this study was to examine the correlation between IBI and RA and to analyze the association between IBI and all-cause mortality in RA. Methods: The study comprehensively analyzes adult data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. The participants' IBI was calculated using the formula IBI = CRP * neutrophils/lymphocytes. Three models were constructed to investigate the relationship between IBI and the prevalence of RA. Nonlinear relationships were determined using restricted cubic spline curves. Stratified analyses and interaction tests were used to explore the relationship between RA and IBI in different subgroups. The same data analyses were applied to investigate the association between IBI and RA all-cause mortality. Results: The data analyses revealed a stable positive and nonlinear correlation between IBI and the risk of RA, as well as a positive, nonlinear, J-shaped association between IBI and RA all-cause mortality. The correlation and association were consistent across most subgroups, and multiple covariates had no effect on the results. No significant effect of multiple covariates on the association was found through interaction tests. Conclusion: Our study has demonstrated a positive correlation between the prevalence of RA and all-cause mortality with the IBI index. This suggests that lower levels of inflammation in the body are associated with a reduced risk of RA prevalence and all-cause mortality. Further prospective studies are required to explore the mechanisms involved.

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Background: To date, no studies have investigated the correlation between the neutrophil-to-lymphocyte ratio (NLR) and the long-term risk of mortality in individuals with both coronary heart disease (CHD) and hypertension. This study aims to evaluate the association between NLR and all-cause and cardiovascular mortality among this patient population. Methods: National Death Index (NDI) and National Health and Nutrition Examination Survey (NHANES 2001-2018) were the data sources. A nonlinear association between the NLR and mortality risk was shown by restricted cubic spline (RCS) analysis. Using a weighted Cox proportional hazards model, we quantitatively evaluated the effect of NLR on mortality risk.The capacity of NLR to forecast survival was assessed by evaluating time-dependent receiver operating characteristic (ROC) curves. A mediating influence analysis was conducted to assess the influence of NLR on mortality through eGFR as a mediator. Results: The study involved a total of 2136 individuals. During the median follow-up interval of 76.0 months, 801 deaths were recorded. The RCS analysis showed NLR and mortality risk to have a nonlinear relationship. Two groups were established based on the participants' NLR levels: a group with high NLR (NLR > 2.65) and a group with low NLR (NLR < 2.65). After adjusting for potential confounding factors, the Cox proportional hazards model revealed that participants with an increased NLR faced a significantly higher risk of cardiovascular mortality. (HR 1.58, 95% CI 1.33-1.82, p < 0.0001) and all-cause mortality (HR 1.46, 95% CI 1.30-1.62, p < 0.0001). An analysis of interactions and data stratification corroborated the validity of our findings. eGFR was identified as a partial mediator in the association between NLR and mortality rates, contributing 12.17% and 9.66% of the variance in all-cause and cardiovascular mortality, respectively. The predictive performance for cardiovascular mortality was quantified using ROC curves, with respective AUC values of 0.67, 0.65, and 0.64 for predictions over 3, 5, and 10 years. The AUC values for all-cause mortality were 0.66, 0.64, and 0.63 for the same time frames. Conclusion: For patients with CHD and hypertension, an elevated NLR serves as an independent prognostic indicator for both all-cause and cardiovascular mortality.

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