This study aims to investigate the association between an inflammatory score constructed from white blood cell (WBC) count and high-sensitivity C-reactive protein (hs-CRP) and the risk of type 2 diabetes mellitus (T2DM).

Using data from the China Health and Retirement Longitudinal Study (CHARLS) and the U.S. National Health and Nutrition Examination Survey (NHANES), this study performed logistic regression analyses, restricted cubic spline (RCS) analyses, and subgroup analyses to investigate the association between the WBC-hsCRP inflammatory score and T2DM.

Logistic regression analyses indicated that higher WBC-hsCRP inflammatory scores were associated with increased odds of T2DM.After extensive adjustment for potential confounders, each interquartile-range (IQR) increase in the WBC-hsCRP inflammatory score was associated with a 12% and 45% higher odds of T2DM in CHARLS and NHANES, respectively (CHARLS: OR=1.12,95% CI: 1.05-1.19; NHANES: OR=1.45, 95% CI: 1.22-1.72). RCS analyses suggested a nonlinear association in CHARLS but an approximately linear association in NHANES. The robustness of these findings was further confirmed by subgroup analyses.

Our results indicate a positive association between the WBC-hsCRP inflammatory score and T2DM, suggesting its potential utility for identifying individuals at elevated risk of T2DM.

To explore the independent and combined effects of diabetes onset age and disease duration on all-cause and cause-specific mortality.

A total of 5 555 adult patients with diabetes from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2018 were included. The associations of age at onset and disease duration of diabetes with all-cause and cause-specific mortality were analyzed using weighted Cox proportional hazards models and restricted cubic spline analysis.

Multivariable analysis showed that diabetic patients with onset age of 60 years or older had lower all-cause mortality, cardiovascular disease mortality, and diabetes-related mortality than those with onset age under 45 years [hazard ratio (HR) and 95% confidence interval (CI): 0.55 (0.46-0.65), 0.65 (0.49-0.88), 0.34 (0.19-0.64),respectively]. Patients with a disease duration of ≥17 years had higher all-cause mortality, cardiovascular disease mortality, and diabetes-related mortality than those with a disease duration of <4 years [HR (95% CI): 1.85 (1.51-2.27), 1.66 (1.22-2.26),4.82 (2.11-8.69), respectively]. Compared with patients with onset age <45 years and disease duration ≥17 years, the subgroups with onset age of 45-<60 years and onset age ≥60 years (both with disease duration of 0-17 years) had a lower mortality risk[HR (95% CI): 0.37 (0.19-0.70), 0.59 (0.40-0.87), 0.72 (0.56-0.93), 0.55 (0.43-0.71), 0.59 (0.46-0.74), 0.72 (0.57-0.90),respectively].

Age at onset and disease duration have non-linear associations with mortality in diabetic patients,and the coexistence of the two factors further increases the risk of mortality.

To analyze the dynamic trajectory of the CD4/CD8 ratio and its influencing factors in human immunodeficiency virus (HIV)-infected patients after initiating antiretroviral therapy (ART), and to explore its association with risk of mortality.

Data were obtained from HIV-infected patients who initiated ART between 2005 and 2023 in Wuxi.A latent class trajectory model was adopted to identify distinct trajectories of CD4/CD8 ratio. A multivariable logistic regression model was applied to analyze the factors influencing the trajectories of CD4/CD8 ratio, while a generalized linear mixed model tree (GLMMT) was employed to explore population characteristics associated with trajectory group membership. Furthermore,the Cox proportional hazards regression model was used to assess the association between trajectories and mortality.

A total of 3 808 HIV-infected patients were included. Two distinct trajectories of CD4/CD8 ratio were identified: a gradual recovery group(28.02%, 1 067/3 808) and a sustained inversion group(71.98%, 2 741/3 808). Multivariable logistic regression analysis revealed that patients who were male(OR=1.29, 95% CI: 1.01-1.64), infected through homosexual contact (OR=1.25,95% CI: 1.04-1.49), initiated ART more than 30 days after diagnosis (OR=1.70, 95% CI: 1.47-1.97), had baseline CD4 count <200 cells/μl (OR=1.21, 95% CI: 1.03-1.43), and had baseline CD4/CD8 ratio <1 (OR=2.24, 95% CI: 1.59-3.17) were more likely to belong to the sustained inversion group. GLMMT analysis showed that the prevalence of sustained CD4/CD8 ratio inversion was 77.72% (1 427/1 836) among HIV-infected individuals with ART initiation >30 days and a baseline CD4/CD8 ratio <1, and 73.85% (401/543) among those with ART initiation ≤30 days who were male and had a baseline CD4 count <200 cells/μl. Furthermore, individuals in the sustained inversion group had a significantly increased risk of acquired immunodeficiency syndrome (AIDS)-related death (HR=4.90, 95% CI: 1.52-15.83), but no significant association was found with non-AIDS-related death.

The persistent inversion of the CD4/CD8 ratio is common among people living with HIV. A comprehensive assessment of immune status and disease progression should, therefore, include not only the CD4 count but also the CD4/CD8 ratio, while fully considering the influence of demographic and behavioral factors.

To investigate the relationship between different uric acid-to-high-density lipoprotein cholesterol ratios (UHR) and new-onset diabetes in middle-aged and older individuals, providing a reference basis for diabetes prevention and treatment in this population.

Using data from the China Health and Retirement Longitudinal Study (CHARLS), we selected middle-aged and older adults who participated in five waves of the survey from 2011 to 2020. Restricted cubic spline (RCS) analysis was employed to examine the potential nonlinear associations of baseline UHR and cumulative UHR with diabetes risk. The UHR trajectory was categorized into three classes using the k-means clustering algorithm: low-level increasing class (Class 1), moderate-level increasing class (Class 2), and high-level decreasing class (Class 3). Cox proportional hazards regression models were then used to analyze the association between different UHR parameters and new-onset diabetes. Further subgroup analyses were conducted by sex, age, and household registration type, with interaction terms included to test for interactions. Logistic regression sensitivity analyses were performed to validate the robustness of the findings.

This study included 4 638 participants, with 342 new cases of diabetes (7.37%)occurring during the 5-year follow-up period. RCS analysis revealed that higher baseline UHR and cumulative UHR levels were associated with increased diabetes risk in middle-aged and older adults. After adjusting for confounders, diabetes risk significantly increased in Class 2 and Class 3 groups compared to Class 1, with HRs of 1.42 (95% CI: 1.10-1.83) and 1.79 (95% CI: 1.27-2.53),respectively. Furthermore, compared with the lowest tertile group (T1) of baseline UHR and cumulative UHR, the adjusted HRs for the highest tertile group (T3) were 1.64 (95% CI: 1.21-2.23) and 1.60 (95% CI: 1.18-2.18), respectively.

Elevated UHR levels increase the risk of developing diabetes. Continuous monitoring of UHR and early intervention can help reduce the incidence of diabetes in middle-aged and older adults.

To explore the influence of regional light climate levels (light levels) on myopia in children and adolescents and the differences among different populations.

Two kindergartens, two primary schools and two junior high schools were randomly selected from each of the 187 districts (counties) in Sichuan Province. In each school, students (at least 80 students) were selected from the entire class of each grade for vision examination, and questionnaires were conducted among primary school students in grades 4 to 6. The χ² test was used for the differential comparison of myopia rates. The logistic regression model was used to study the influence of regional light climate levels on myopia.

A total of 330 132 students were included. Among them, 5.9% were from Category II areas (45>Eq≥40klx）, 9.8% from Category III areas (40>Eq≥35klx）,15.1% from Category IV areas (35>Eq≥30klx), and 69.2% from Category V areas (Eq<30klx). The myopia rates of children and adolescents in Class II, Class III, Class IV and Class V areas were 30.4%, 29.0%, 33.9% and 43.1%, and increased with the decrease of light climate levels (the increase of type codes). After controlling for covariates, with the type II area (high light level) as the reference, the risk effect of myopia was observed in the type III, type IV, and type V areas (OR=1.433, 95% CI:1.331-1.543; OR=1.543, 95% CI: 1.437-1.656; OR=1.325, 95% CI: 1.238-1.418, all P<0.001). Stratified analysis showed that the same effect was observed in both male and female students, as well as in regions with good and poor economic levels (P<0.001).

The level of natural light in a region may affect the prevalence of myopia among children and adolescents.It is recommended to ensure adequate light intensity in reading and writing environments, provide supplementary artificial lighting when necessary, and further increase the duration of outdoor activities.

This study aims to investigate the impact of dietary quality on musculoskeletal age acceleration(MuscAgeAccel) in middle-aged and older adults, providing a scientific basis for dietary interventions to slow musculoskeletal aging.

A cross-sectional study was conducted involving 3 765 adults aged 45 years and above from the West China Health and Aging Cohort Study and the West China Bone Health Cohort. Diet quality was assessed by calculating the Chinese Healthy Eating Index (CHEI), using a simplified food frequency questionnaire (FFQ-25). MuscAgeAccel was calculated as the difference between musculoskeletal biological age predicted from clinical indicators and chronological age. Multiple linear regression models were used to examine the association between the CHEI and MuscAgeAccel, while adjusting for demographic characteristics, lifestyle factors, and chronic diseases. Subgroup analyses were then conducted.

The CHEI score was negatively associated with MuscAgeAccel (r_s=-0.09). Compared with participants in the lowest CHEI score group, those in the highest score group exhibited a 0.31-year reduction in MuscAgeAccel (β=-0.31, 95% CI:-0.51~-0.10). Subgroup analyses revealed that the beneficial effect of higher dietary quality on slowing musculoskeletal aging was more pronounced in males, those with body mass index (BMI) > 24 kg/m², and non-smokers (all P for interaction <0.05).

Adherence to the healthy dietary pattern recommended by the Chinese Dietary Guidelines may attenuate musculoskeletal age acceleration and reduce the risk of diseases related to musculoskeletal aging.

To investigate the pollution status of heavy metals (Cr, As, Pb, Cd, and Hg) in rice produced in Wuxi City and assess their potential health risks.

From 2021 to 2024, 157 rice samples were collected from rice planting areas A and B under the jurisdiction of Wuxi. Inductively coupled plasma mass spectrometry (ICP-MS) was used to detect target elements. Single factor pollution index (Pi) and Nemerow comprehensive pollution index method were used to evaluate the pollution level of rice produced in Wuxi City, and health risks were evaluated by environmental health risk assessment model.

The annual average concentrations of various heavy metals were within the standard limits, with the mean values ranging from high to low as Cr>As>inorganic As>Pb>Cd>Hg. The coefficient of variation for each element ranged from 33.12%to 352.94%. The single factor pollution index and comprehensive pollution index of Cr, As, Pb, Cd, and Hg in areas A and B were all less than 0.6, indicating a safe level. The total carcinogenic risk of heavy metals was 3.51×10^-4, with inorganic As having the highest carcinogenic risk of 2.68×10^-4. The individual non-carcinogenic risks of heavy metals and the combined health risk index of multiple heavy metals were all less than 1, with inorganic As having the highest non-carcinogenic risk of 5.95 × 10^-1.

The heavy metal pollution in rice produced in Wuxi was at a safe level, and the distribution of heavy metal pollution in the samples was uneven. The carcinogenic and non-carcinogenic risks of heavy metals from rice produced in Wuxi were at acceptable levels.

To analyze the dietary patterns and their influencing factors in Ali area, and to provide reference for the prevention and control of chronic diseases via dietary intervention in underdeveloped high altitude areas.

A stratified cluster sampling method was used to select 606 adult residents in Ali from June to August 2021 for investigation. The food frequency questionnaire was used to collect data on food consumption over the past year. Factor analysis was employed to construct dietary patterns, and stepwise multinomial logistic regression was applied to identify the factors affecting dietary patterns.

Five dietary patterns were extracted. Logistic regression analysis showed that the dried fruit beverage pattern was positively correlated with non-married (P=0.043), other occupations (P=0.027), smoking (P=0.023), weight gain >2.5 kg in the past year (P=0.019), non-clean fuel (P=0.006), and poor self-rated health (P=0.001). The Tibetan pattern was positively correlated with education level (P<0.001) but negatively correlated with non-cadre (P=0.002) and non-clean fuel (P<0.001).The highly processed unhealthy pattern was positively correlated with age (P<0.001) and poor self-rated health (P=0.027),while negatively correlated with non-married (P=0.019), non-cadre (P=0.039), family living standards (P=0.002), smoking (P=0.003), tea drinking (P=0.022), weight gain >2.5 kg in the past year (P=0.004), and non-clean fuel (P=0.004). The modern meat-dominant pattern was positively correlated with age (P=0.011), non-married (P=0.003), non-cadre (P=0.020) and tea drinking (P=0.005), but negatively correlated with drinking (P<0.001), amateur physical exercise (P=0.004) and non-clean fuel(P=0.042). The dietary fiber pattern was positively correlated with non-clean fuel (P=0.030), but negatively correlated with high family living standards (P=0.002) and tea drinking (P=0.018).

This study demonstrates that differences in the distribution of the five dietary patterns among residents of Ali are closely associated with demographic characteristics,socioeconomic status, and lifestyle factors, and some patterns are significantly associated with body weight changes and self-rated health status. Targeted dietary interventions should be implemented based on the local dietary culture and living habits to support the prevention and control of chronic diseases in underdeveloped high-altitude areas.

To assess the nitrite exposure level and associated risk from typical foods consumed by residents in Sichuan Province.

Based on the nitrite content data of 969 samples of typical foods and the food consumption survey data of 4 504 residents aged 2-96 years in Sichuan Province, a probabilistic assessment method was adopted to evaluate nitrite exposure using 0.07 mg/(kg BW·d) as the acceptable daily intake (ADI).

The over-standard rate of nitrite in typical foods was 1.96% (19/969). Among them, the over-standard rates of pickled vegetables and meat products were 2.78% (9/324)and 3.09% (10/324). A total of 78.31% of the surveyed population consumed the typical foods; the average daily intake of meat products was the highest (17.50 g/d). The intake of pickled vegetables was relatively higher among residents aged ≥60 years,while the intake of meat products was relatively higher among those aged 18-59 years. The average nitrite exposure of the total population was 0.002 5 mg/(kg BW·d), accounting for 3.57% of the ADI. Meat products were the main source of nitrite,contributing 65.52% to the total exposure, and 0.25% of the population had exposure exceeding the ADI.

The health risk of nitrite exposure from typical foods among residents in Sichuan Province is generally low, but there is a potential risk for a small number of extreme consumers of typical foods. Meat products are the primary contributor to nitrite exposure.

To investigate the longitudinal association of dynamic trajectories and cumulative changes of the geriatric nutritional risk index (GNRI) with all-cause mortality risk in the elderly.

Based on the cohort data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2012 and 2014, GNRI change indicators were constructed. With 2014 as the baseline, a 4-year prospective follow-up was conducted until 2018. K-means clustering was used to classify GNRI trajectory categories and calculate individual cumulative GNRI. Multivariable Cox proportional hazards models were used to examine the association with all-cause mortality. Restricted cubic spline (RCS) was used to explore the dose-response relationship, and time-dependent receiver operating characteristic curves were used to evaluate predictive performance.

A total of 1 102 participants were included, and 339 deaths occurred during follow-up (30.76%).Trajectory analysis showed that compared with the low-low group, the all-cause mortality risk was reduced by 47% (HR=0.53,95% CI: 0.37-0.77) in the high-high group and 39% (HR=0.61, 95% CI: 0.44-0.84) in the low-high group. In the cumulative GNRI quartile groups, the mortality risk of the Q3 and Q4 groups was reduced by 36% (HR=0.64, 95% CI: 0.45-0.91) and 54%(HR=0.46, 95% CI: 0.31-0.68) compared with the Q1 group. Cumulative GNRI was non-linearly and negatively associated with all-cause mortality risk, with AUC values of 0.692, 0.694, 0.720 and 0.712 at 12, 24, 36 and 48 months, respectively.

GNRI trajectories and cumulative GNRI were significantly associated with all-cause mortality risk among the elderly population. Cumulative GNRI has a good predictive value for all-cause mortality risk.