To analyze the changing trend of disease burden of senile dementia attributed to high BMI in China from 1990 to 2019, and to provide references for the formulation of prevention and control strategies for senile dementia in China.

The data of death number, mortality rate, disability adjusted life years (DALY) number and DALY rate of senile dementia attributed to high BMI in China from 1990 to 2019 were extracted from the global disease burden database, and the estimated annual percentage of change (EAPC) was used to analyze the change trend in terms of sex, age and exposure rate.

From 1990 to 2019, the disease burden of senile dementia attributed to high BMI in China showed an upward trend. The burden of women was higher than that of men, and the latter had the fatest increase. The mortality rate and DALY rate increased with the increase of age, with the fastest increase in males aged 60 to 70 years and females aged 60 to 75 years, respectively.Males had larger EAPC than females in the same age group. From 1990 to 2019, the DALY loss of senile dementia caused by high BMI had the fatest increase, and the standardized (summary exposure value) SEV rate of high BMI increased rapidly (EAPC=3.67%, P < 0.001).

From 1990 to 2019, the burden of senile dementia attributed to high BMI in China became heavier. With the increase of aging and obesity rate, the burden of senile dementia attributed to high BMI is expected to continue to increase rapidly without no sustained and effective intervention.

The 25(OH)D deficiency is a prevalent issue among patients with chronic kidney disease (CKD). The aim of our study is to investigate whether low levels of 25(OH)D are associated with increased all-cause and cardiovascular mortality in patients with CKD.

This retrospective cohort study utilized the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) 2007—2018 database to investigate the association between 25(OH)D levels and all-cause mortality as well as cardiovascular mortality. A total of 2 668 eligible subjects were included in this study, with follow-up conducted until December 31, 2019. Cox proportional hazards regression, restricted cubic spline, Kaplan-Meier survival curves, and competing risk survival analysis were performed to evaluate the associations. Furthermore, subgroup and sensitivity analyses were performed.

During a median follow-up of 6 years in a weighted population of 11 715 452 eligible participants, there were 665 deaths from any cause, including 196 cardiovascular-related deaths. After adjusting for covariates, lower levels of 25(OH)D were significantly associated with increased risks for both all-cause (HR=0.85, 95%CI: 0.77-0.94) and cardiovascular mortality (SHR=0.80, 95%CI: 0.67-0.94). Consistent results were also observed when analyzing 25(OH)D as a categorical variable (quartile) (both P<0.05). Weighted restricted cubic splines revealed an inverse J-shaped association between levels of 25 (OH) D and all-cause mortality (P_nonliner> 0.05). Subgroup analysis (P_interaction>0.05) and sensitivity analysis (HR=0.85, 95%CI: 0.77-0.93) yielded similar findings.

Lower 25(OH)D levels, both as a continuous and categorical variable, are significantly associated with an increased risk of all-cause mortality and cardiovascular disease-related mortality.The 25(OH)D has a negative j-shaped association with all-cause and cardiovascular mortality.

To explore the causal relationship between lipoprotein (a) [Lp (a)] and cerebral small vascular disease (CSVD) by Mendelian randomization (MR) analysis.

Using genome-wide association study (GWAS) public database, the single nucleotide polymorphisms independently associated with Lp (a) (P < 5 × 10^-8) were selected as instrumental variables (IVs). The main outcomes of this study were white matter hyperintensity (WMH), cerebral microhemorrhage, and lacunar infarction. Inverse variance weighted (IVW) mothod was used to evaluate the causal relationship between Lp (a) and CSVD. Sensitivity analysis was carried out by MR-Egger and MR-PRESSO to evaluate the pleiotropy of IVs. Furthermore, weighted median method, simple median method, and maximum likelihood ratio method were used to test the reliability of the results.

IVW results showed that there was a positive risk relationship between Lp (a) and WMH (OR=1.083, 95%CI: 1.035-1.134, P <0.001), but Lp (a) was not correlated with cerebral microhemorrhage (P=0.568) and lacunar infarction (P=0.651). MR-Egger analysis showed that the MR analysis of Lp (a) and WMH was not affected by horizontal pleiotropy (P=0.721).

MR analysis shows that Lp (a) is related to the increased risk of WMH.

To understand the risk factors of two common chronic diseases in order to provide evidence for the prevention of common chronic diseases and government investment in disease management.

Four waves follow-up data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 were used. In total 2 992 and 1 952 patients with hypertension and rheumatism or arthritis, stomach diseases and rheumatism or arthritis were included. Cox proportional hazard model and shared vulnerability model were used to analyze the influencing factors of multimorbidity.

For people with hypertension and rheumatism or arthritis, living in rural areas (HR=1.367, 95%CI: 1.096-1.705), advanced age group (HR=1.342, 95%CI: 1.013-1.778), obesity (HR=2.424, 95%CI: 1.790-3.283), rheumatism or arthritis as first onset disease (HR=3.797, 95%CI: 3.059-4.713) and other chronic diseases more than 1 (HR=2.694, 95%CI: 2.042-3.555) were associated with a higher possibility of multimorbidity, while people with high education level (HR=0.766, 95%CI: 0.594-0.988) had a lower possibility of multimorbidity, and the shared vulnerability model outperformed Cox model. For people with stomach disease and rheumatism or hypertension: advanced age (HR=0.392, 95%CI: 0.240-0.640), highly educated (HR=0.667, 95%CI: 0.461-0.964),and overweight (HR=0.720, 95%CI: 0.540-0.96)) were associated with lower possibility to have multimorbidity, negative health self-assessment (HR=1.409, 95%CI: 1.038-1.912), being lean (HR=1.935, 95%CI: 1.198-3.126), and having more than 1 chronic diseases (HR=2.339, 95%CI: 1.644-3.328) were associated with higher possibility to have multimorbidity, and there was no significant difference between the two models in this population.

In the hierarchical survival data, the fitting effect of the shared fragile model is better than that of the traditional model. In the group of patients with hypertension and rheumatism or arthritis, there is an increased risk of rheumatism or arthritis in the older age group, obesity and the first onset of rheumatism or arthritis, and the incidence of stomach disease and rheumatism or arthritis is lower in the higher age group and overweight group. Therefore, the prevention measures of chronic multimorbidity should be taken based on different combinations of common diseases to identify high-risk groups respectively, carry out different intervention behaviors, accurately invest medical resources, and reduce the disease burden of the government.

To investigate the relationship between hearing loss and the risk of muscular dystrophy in the middle-aged and elderly, so as to provide scientific basis for the prevention and intervention of myogenic in this population.

In this study, people aged 45 and above in the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 were selected as research subjects. Self-reported hearing loss was used to evaluate hearing loss. Based on the consensus of Asian muscular dystrophy working group in 2019, muscular dystrophy was determined. Cox proportional hazard model was used to investigate the relationship between hearing loss and the risk of myasthenia.

Among 11 528 middle-aged and elderly people, the incidence of baseline hearing loss was 12.8%. During the 4-year follow-up, there were 558 new cases of muscular dystrophy, with an incidence of 6.4%. The results of the Cox proportional hazard model showed that subjects with hearing loss had an increased risk of muscular dystrophy by 31.1% (HR=1.311, 95%CI: 1.059-1.625) compared with those without hearing loss. The results of stratified analysis showed that the relationship between hearing loss and muscular dystrophy was more obvious in women, the elderly, rural household registration, married people, those with education level of junior high school or above, and those with high annual family income.

Hearing loss is related to the increased risk of muscular dystrophy in middle-aged and elderly people in China. Early screening and intervention for hearing loss may help reduce the incidence of future muscular dystrophy.

To investigate the status and distribution characteristics of microbial pollution on the surface of indoor air and public facilities at a metro station of a city in the central south China.

The total number of bacteria and fungi in the air and those of bacteria, fungi, coliform, and Staphylococcus aureus on the surface of key public facilities were sampled and detected. Multiple linear regression and Logistic regression were used to analyze the influencing factors.

The median of the total number of bacteria and fungi in the indoor air of metro station was 194.35 and 346.29 CFU/m³, respectively, the median of the total number of bacteria and fungi on the surface was 15.00CFU/25cm² and 0.00CFU/50cm², and the positive rates of coliform group and Staphylococcus aureus were 2.22% and 11.11%, respectively. There were differences in the temporal and spatial distribution of microorganisms in the indoor air of the metro: the total number of bacteria in the station hall was the highest and the total number of fungi in the platform was the highest; the total number of bacteria was the highest in the early peak period and the highest in the evening peak period. The total number of bacteria and fungi on the surface of the ticket inspection machine was higher than that of other public facilities, the total number of fungi on the surface of public facilities at noon was lower than that in the evening peak period, and the positive rate of coliform group was lower than that in the morning peak period. The total number of bacteria in the indoor air of subway station was negatively correlated with temperature (β=-0.06,95%CI: -0.11 to -0.01) and wind speed (β=-0.28, 95%CI: -0.55 to -0.01). The total number of air fungi was positively correlated with relative humidity (β=0.01, 95%CI: 0.00 to 0.02) and negatively correlated with PM_2.5 (β=-0.01, 95%CI: -0.02 to-0.01). There was a negative correlation between the total number of bacteria on the surface and PM_2.5 (β=-0.04, 95%CI: -0.07 to -0.02).

The level of microorganisms in indoor environment of three metro stations in a city in the central south China is low, and the surface of public facilities is contaminated by pathogenic bacteria. The distribution of bacterial and fungal concentrations in metro stations vary among regions and time periods, which is related to temperature, humidity, wind speed, and PM_2.5.

To investigate the effect of built environment on cardiovascular disease in middle-aged and elderly people.

In this study, 17 256 subjects were selected from China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, and the built environment and meteorological data of their cities were collected. Multivariate logistics regression model and weighted quantile regression model were used to analyze the relationship between built environment and cardiovascular disease in the middle-aged and elderly.

Multivariate logistics regression analysis showed that for every increase of interquartile range (IQR) in land use mixture, residential land, and industrial land, the OR values were 1.13(95%CI: 1.07-1.19), 1.16 (95%CI: 1.10-1.23), and 1.11 (95%CI: 1.06-1.16), respectively. When the proportion of commercial land and green space area increased by 1 IQR, the OR values (95%CI) were 0.88 (95%CI: 0.85-0.92) and 0.94 (95%CI: 0.90-0.98), respectively. The mixed degree of land use, the proportion of residential land, and the proportion of industrial land all increased the risk of cardiovascular disease in men and women (P < 0.05), while the proportion of commercial land decreased the risk of cardiovascular disease in men and women. The green space area only decreased the risk of cardiovascular disease in women (P < 0.05). In the mixed exposure of 8 kinds of built environmental factors, the proportion of industrial land and residential land were 34.13% and 29.20%, respectively.

The built environment has a significant impact on the risk of cardiovascular disease in the middle-aged and elderly, and the area of green space has a more significant effect on the cardiovascular disease in the middle-aged and elderly women.

To investigate the potential relationship between dietary flavanone intake and asthma so as to provide reference for the prevention and control of asthma.

Adults over 20 years old in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2008 were selected as research subjects. Multivariate logistic regression model was used to analyze the relationship between flavanone intake and asthma. Finally, subgroup analysis was used to explore the relationship between flavanone intake and asthma in different sex and age groups.

A total of 5 415 subjects were included, of whom 710 (13.11%) had asthma. The median intake of flavanone was 0.27 mg/d. The intake of flavanone in patients with asthma was significantly lower than that in normal people, and the difference was statistically significant (Z=10.207, P < 0.001). After adjusting for age, sex, body mass index, race, education, drinking, smoking, monthly family poverty, hypertension, and diabetes, the incidence of asthma in the highest quantile was significantly lower than that in the lowest quantile (OR=0.781, 95%CI:0.615-0.991), and the risk of asthma decreased with the increase of flavanone intake (P _trend = 0.015).

There is a negative correlation between flavanone intake and asthma. Flavanone may be a protective factor for asthma, and the correlation may be more obvious in women and young and middle-aged people under 50 years old.

To investigate the causal relationship between tea intake and sex hormone levels by two-sample Mendelian randomization analysis.

Single nucleotide polymorphisms related to tea intake were screened from the genome-wide association study as genetic instrumental variables. Five Mendelian randomized methods including simple model, weighted model, inverse variance weighted (IVW) analysis, weighted median method, and MR-Egger method were used to study the causal association between tea intake and sex hormone levels, which was evaluated by the β value.

A total of 41 SNPs were included in this study. The results of inverse variance weighting method showed that tea intake could increase the level of bioavailable testosterone (β=0.073, P < 0.05) and decrease the level of estradiol (β=-0.023, P < 0.05). The estimated results of MR-Egger effect showed that tea intake could increase the level of bioavailable testosterone (β=0.179, P<0.05) and decrease the level of estradiol (β=-0.049, P<0.05), and the weighted median method also found that tea could increase the level of bioavailable testosterone (β=0.120，P<0.05) and decrease the level of extradiol (β=-0.047, P<0.05), consistent with the results of IVW method. MR-Egger regression method showed that there was no horizontal pleiotropy, leaving one method and Cochran’s Q statistics test showed no heterogeneity, and the direction of single SNP was correct.

Tea intake can up-regulate testosterone level and down-regulate estradiol level. Reasonable tea intake will contribute to the effective intervention of sex hormone-related diseases and provide important reference for the prevention and treatment of clinical diseases.

To systematically analyze the incidence of nutritional risk in patients with Alzheimer’s disease.

Chinese database (WIP, National Knowledge Infrastructure, Wan fang database, Sino Med) and English database (Cochrane library, PubMed, Embase, Web of Science) were searched, and the related studies on the influencing factors of malnutrition in patients with Alzheimer’s disease were collected. After screening and evaluating the literatures according to the criteria, Stata16.0 and Revman5.4 were used to analyze the prevalence of nutritional risk of Alzheimer’s disease and its influencing factors by meta-analysis.

A total of 25 articles were included, the number of patients with Alzheimer’s disease was 3 372, and the number of patients with nutritional risk was 2 038, involving 12 influencing factors. Meta-analysis showed that the prevalence rate of nutritional risk of AD was 62.5% (95%CI: 56.1%-68.9%). Marital status (OR=0.5, 95%CI: 0.34-0.73), course of disease (MD=0.36, 95%CI: 0.05-0.66) and swallowing function (OR=4.86, 95%CI: 1.74-13.61) were the influencing factors of nutritional risk of AD. Albumin (MD=-7.50, 95%CI: -9.25 to -5.75), cholesterol (MD=-0.87, 95%CI: -1.31 to -0.43), and hemoglobin (MD=-2.71, 95%CI: -3.96 to -1.46) were negatively correlated with nutritional risk in Chinese patients with Alzheimer’s disease.

The prevalence rate of nutritional risk in Chinese patients with Alzheimer’s disease is high and is related to marital status, course of disease, albumin, cholesterol, hemoglobin and swallowing function. Clinical attention should be paid to related factors and early identification and intervention to reduce the occurrence of nutritional risk and the impact of nutritional risk on the progression of Alzheimer’s disease.