To investigate the association between frailty and heart failure onset, and to identify the metabolomic features mediating the relationship between frailty and heart failure.

Based on the UK Biobank (UKB), 255 160 participants who underwent baseline testing for 168 metabolites were included. The Fried frailty phenotype assessment data were obtained and divided into three groups: non-frailty (0), pre-frailty (1-2), and frailty (≥3). The Cox proportional hazards model was used to analyze the relationship between frailty and the risk of heart failure. Additionally, a mediation analysis was conducted on metabolites to assess the mediating role of metabolic markers in the relationship between frailty and heart failure.

Compared with non-frail participants, participants in the pre-frailty and frailty states had an increased risk of heart failure, with hazard ratios ( HR) of 1.441 (95% CI: 1.374–1.55) and 2.544 (95% CI: 2.323–2.785), respectively. Mediation analysis revealed that small high-density lipoprotein-related metabolites and low-density lipoprotein components played an important mediating role in the relationship between frailty and heart failure, with corresponding mediation proportions of 3.8%–5.5%.

Frailty is associated with an increased risk of heart failure, and plasma metabolites characterised by small high-density lipoproteins and low-density lipoproteins may be key biomarkers mediating the association between frailty and heart failure.

This study aims to explore the effects of total physical activity (PA) and its structural composition on phenotypic age acceleration (PhenoAgeAccel) in older adults, providing a scientific basis for intervening in aging through optimizing PA structure.

A cross-sectional study was conducted involving 7 016 older adults aged 60 years and above from the West China Health and Aging Cohort Study. Weekly PA levels and their domain-specific proportions (work, transportation, recreation) were assessed using the Global Physical Activity Questionnaire-2 (GPAQ-2). PhenoAgeAccel was calculated as the residual of chronological age regressed on PhenoAge. Multiple linear regression models were employed to analyze the effects of total PA on PhenoAgeAccel, controlling for demographic characteristics, anthropometric indices, lifestyle factors, and chronic diseases, followed by subgroup analyses. Isometric log-ratio transformation (ILR) in compositional data analysis (CoDA) and isotemporal substitution model were applied to analyze the effects of the proportion of different PA types.

Total PA was negatively correlated with PhenoAgeAccel. Each 1-standard deviation increase in total PA was associated with a 0.32-year reduction in PhenoAgeAccel (β=-0.32, 95% CI: -0.46 - -0.18). Subgroup analyses showed that increasing PA could more effectively delay aging in elderly individuals aged 60 - 70 years, those with obesity, non-smokers, and those with baseline hypertension, diabetes mellitus, or dyslipidemia. There were differential contributions among PA types. When 1% of leisure activity replaced work activity, PhenoAgeAccel decreased by 0.031 years (β=-0.031, 95% CI: -0.057 - -0.006). When 1% of leisure activity replaced transport activity, PhenoAgeAccel decreased by 0.034 years (β=-0.034, 95% CI: -0.059 - -0.010). The substitution effect between the proportion of work activity and that of transport activity was not statistically significant.

Increasing total PA and optimizing PA types can slow down PhenoAgeAccel, and recreation activities replacing work or transport activities have prominent effects in delaying aging. Promoting a physical activity pattern centered on recreational activities is recommended to reduce the risk of aging-related diseases.

To analyze the trend of pancreatic cancer disease burden attributable to hyperglycemia in China from 1990 to 2021 and project it to 2030, and to compare the differences in disease burden characteristics and trends between China and the world and different SDI regions, in order to provide a basis for optimizing pancreatic cancer prevention and control strategies.

Based on the Global Burden of Disease Database 2021, the disease burden of pancreatic cancer attributable to hyperglycemia in China was described by the number of deaths, mortality rate, DALY, and DALY rate from 1990 to 2021, the PAF was used to rank the risk factors, and the AAPC was calculated using the Joinpoint model to analyze the difference in disease burden trends in China, globally, and in different SDI regions, and the ARIMA model was used to project to 2022-2030.

The number of pancreatic cancer deaths attributable to hyperglycemia, mortality rate, DALY and DALY rate in China showed an increasing trend from 1990 to 2021. Men had higher mortality, standardized mortality, DALY rate and standardized DALY rate than women. The peaks of PAF for mortality and DALY rate were in the 75-79 and 70-74 age groups, respectively. The standardized mortality rate and standardized DALY rate were positively correlated with the SDI, and China was lower than the global average. The ARIMA model predicted that the standardized mortality rate and the standardized DALY rate would decrease to 1.13/100 000 and 25.33/100 000 in 2030, respectively.

The burden of pancreatic cancer disease attributable to hyperglycemia in China from 1990 to 2021 showed significant gender differences and age distribution patterns, and the burden of disease in China, although consistently lower than the global average, showed a trend of synchronous growth with that of the world and all SDI regions. Therefore, China should improve its hyperglycemia screening and management system and adopt targeted interventions for men and young and middle-aged groups to reduce the disease burden of pancreatic cancer due to hyperglycemia.

To assess the disease burden and trends of age-related and other hearing loss in China from 1990 to 2021, and to project future developments through 2030, thereby informing the optimisation of healthcare resource allocation and the formulation of targeted prevention and control strategies.

Data sourced from the 2021 Global Burden of Disease (GBD) study. Indicators including the number of prevalence cases, Years Lived with Disability (YLDs), and age-standardized rates for age-related and other hearing loss in China were extracted. Joinpoint regression models were used to analyse temporal trends, calculating annual percentage change (APC) and average annual percentage change (AAPC) with 95% confidence intervals. Bayesian age-period-cohort (BAPC) models projected disease burden for 2022-2030.

Between 1990 and 2021, the number of prevalence cases and YLDs for age-related and other hearing loss in China increased by 125.06% (AAPC=2.65%, P<0.001) and 135.13% (AAPC=2.79%, P<0.001), respectively. Crude rates of prevalence and YLDs increased by 86.10% and 94.43%, respectively, whereas age-standardized rates of prevalence YLDs showed smaller increases with AAPCs of 0.19% and 0.28%. Absolute disease burden values were higher among males than females, though females exhibited faster growth rates. The most pronounced increase in disease burden occurred among the working-age population aged 20-54 years. Moderate and profound hearing loss showed significant growth, whereas the prevalence of complete hearing loss declined. Projections indicate that age-standardized rates of prevalence YLDs will continue to rise through 2030, albeit at a slower pace.

The disease burden of age-related hearing loss in China continues to rise, with population ageing as the primary driver. Sex, age, and severity differences exist within this burden, necessitating the development of lifecycle-spanning and differentiated hearing health prevention and control strategies. These should prioritize working-age populations and female cohorts, while strengthening early intervention and noise control measures.

To investigate the association between systemic inflammation markers (SII, NHR, MHR, LHR) and metabolic dysfunction-associated steatotic liver disease (MASLD) among employees of coal electricity corporation, providing a basis for early screening of MASLD in occupational populations.

A cross-sectional study was conducted, and 16 912 medical examination employees of a coal electricity corporation in Shanxi Province were included in 2023. Logistic regression was used to analyze correlations, restricted cubic spline (RCS) was performed to explore dose-response relationships, and subgroup analyses was conducted based on demographics, occupation and disease history.

The prevalence of MASLD among coal-electricity workers was 28.03%, and the prevalence was higher in men than in women. Logistic regression analysis found that the highest quartile (Q4) of SII, MHR, and LHR were all significantly associated with the risk of MASLD, with OR (95% CI) of 1.259 (1.066-1.485), 2.166 (1.817-2.582) and 1.272 (1.085-1.491), respectively. The RCS showed that a nonlinear correlation of the four systemic inflammation markers and MASLD (P_total <0.05, P_nonlinear <0.05). Subgroup analysis showed that LHR was positively associated with MASLD risk in all subgroups of gender, age groups, metabolic-related diseases and occupational exposure, SII was positively associated in subgroups of males, ≥ 50 years old, no metabolic-related diseases and no occupational exposures, and MHR was also positively associated in subgroups of males, ≥ 40 years old, and no metabolic-related diseases and occupational exposures. NHR was only associated with MASLD in women subgroups.

SII, MHR, NHR and LHR were nonlinearly correlated with the risk of MASLD among coal-electricity workers, and were influenced by gender, age, metabolism-related diseases, and occupational exposures.

To investigate the impact of occupational noise exposure, personality traits, and their interactions on the risk of depression among working populations, to identify potential high-risk groups for depression, and to provide scientific evidence for the early prevention and personalized intervention of depression among occupational populations.

In this study, individual occupational noise exposure levels were assessed using cumulative noise exposure (CNE) for employees in a transport rail enterprise and automobile manufacturing unit in Guangzhou City in 2024. Depression, personality traits, and other relevant information were collected through questionnaires and occupational health examinations. Associations of occupational noise exposure, personality traits, and depression symptoms were statistically analyzed using logistic regression models and restricted cubic spline analysis. Interactions between occupational noise exposure and personality traits were analyzed using additive models to identify subgroups that may be at different risk or benefit as a result of the interaction.

1 046 employees from two units in Guangzhou City were included in the final study. The median age of the study subjects was 29.0 (8.0) years, with a median CNE exposure level of 90.9 dB-years. A total of 390 individuals were identified as having depressive symptoms. The results of the logistic regression model indicate that CNE (OR=1.013, 95% CI: 1.008 to 1.018) and neuroticism (OR=1.106, 95% CI: 1.087 to 1.126) are risk factors for positive depressive symptoms. Agreeableness (OR=0.906, 95% CI: 0.884 to 0.927), Conscientiousness (OR=0.929, 95% CI: 0.909 to 0.948), openness (OR=0.947, 95% CI: 0.927 to 0.966), and extraversion (OR=0.877, 95% CI: 0.855 to 0.898) were protective factors against positive depressive symptoms. Simultaneously, RCS results indicated that agreeableness and extraversion exhibited linear dose-response relationships with depressive symptoms (P for overall <0.05, P for nonlinear >0.05), while cumulative noise exposure, neuroticism, conscientiousness, and openness demonstrated non-linear dose-response relationships (P for overall <0.05, P for nonlinear <0.05). Moreover, high neuroticism, low agreeableness, and low extraversion each exhibited additive interactions with occupational noise exposure. The relative excess risk due to interaction (RERI) values were 3.332, 2.653, and 4.579; the synergy index (SI) values were 2.315, 1.852, and 2.979；and the attributable proportions of interaction (AP) were 0.485, 0.392, and 0.580, respectively.

Occupational noise exposure and personality traits are influencing factors in the development of depressive symptoms among employees, with occupational noise exposure exhibiting an additive interaction with high neuroticism, low agreeableness, and low extraversion. Consequently, organizations should strengthen noise control measures in the workplace and implement targeted psychological interventions for employees exhibiting specific personality characteristics within this environment.

To explore the association between long-term exposure to PM_2.5 and the risk of gastric intestinal metaplasia (IM), and to analyze the heterogeneity of the associations across age, sex, and the form of medical consultation.

A case-control study was conducted, including patients first diagnosed with IM (case group, n=8 822) and chronic gastritis (CG) controls (n=191 840) at the Second Affiliated Hospital of Army Medical University between January 2012 and September 2024. Population-weighted average concentrations of air pollutants (PM_2.5, SO₂, CO, NO₂, O₃) over the 3-year period prior to diagnosis were calculated as exposure metrics. Single- and dual-pollutant logistic regression models were used to estimate PM_2.5 effects, with subgroup analyses stratified by sex, age, and the form of medical consultation. Restricted cubic spline (RCS) models were used to explore the nonlinear associations. The 1-year and 5-year exposure windows were used as sensitivity analyses.

IM patients (mean age 57.521 years) were older than CG controls (49.254 years), with higher proportions of males (58.3% vs. 42.7%) and inpatients (15.6% vs. 4.7%). After adjusting for calendar year and province, single-pollutant models revealed that each 10μg/m³ increase in PM_2.5 exposure was associated with 35% (OR=1.35, 95% CI: 1.27–1.43), 39% (OR=1.39, 95% CI: 1.32–1.47), and 38% (OR=1.38, 95% CI: 1.31–1.46) elevated IM risks for 1-, 3-, and 5-year exposure windows, respectively. Effects remained stable after adjusting for SO₂, O₃, or CO, but attenuated (while still significant) when adjusting for NO₂. Subgroup analyses showed no significant heterogeneity across age, sex, and the form of medical consultation. RCS indicated a nonlinear dose-response relationship between PM_2.5 and log-transformed IM risk (P<0.001).

Long-term PM_2.5 exposure is significantly associated with an increased IM risk, with consistent effects across sex, age, and the form of medical consultation subgroups.

To develop a comprehensive index for evaluating the beverage intake quality of Chinese children and assess its reliability and validity.

Using data on commercially available children’s beverages in China collected through both online and offline channels, beverage scores were calculated for different beverage categories. Based on these scores and relevant domestic and international recommendations, CCHBI was established. Leveraging publicly available data from the China Health and Nutrition Survey and referencing the validity and reliability evaluation methods of the Healthy Beverage Index for American Children, the validity and reliability of CHNS were assessed in terms of construct validity, discriminant validity, and internal consistency.

The CCHBI comprised four assessment dimensions—beverages, added sugars, water intake, and knowledge/attitudes—with 14 indicators, yielding a total score range of -77 to 19 points. Children with higher CCHBI scores exhibited water consumption more aligned with recommended standards and tended to choose healthier beverages such as 100% pure fruit juice. The index identified five distinct beverage consumption patterns, reflecting diversity in intake. The CCHBI demonstrated strong discriminant validity, differentiating beverage quality across sociodemographic factors such as residential location and maternal education level (Ps<0.05). Children with poor beverage intake quality exhibited an increased risk of overweight/obesity, confirming criterion validity. The standardized and non-standardized Cronbach α coefficients were 0.63 and 0.67, respectively, indicating acceptable internal consistency.

The CCHBI effectively reflects beverage intake quality and consumption habits among Chinese children, with satisfactory reliability and validity.

To investigate the dietary patterns among adults in Guizhou Province over the period from 1991 to 2023 and to offer a scientific foundation for developing strategies related to chronic disease prevention and nutritional enhancement.

The survey data originated from the China Health and Nutrition Survey project, selecting 10 892 subjects with complete data. Dietary data were collected using a 3-day 24-hour dietary recall method. Oblique principal component cluster analysis was employed to screen food groups, while K-means cluster analysis was used to extract distinct dietary patterns. Analysis of variance (ANOVA) was conducted to examine differences in the intake of major foods and nutrients across different dietary patterns. The Cochran-Armitage trend test analyzed changes in the proportion of individuals following different dietary patterns across years. A multivariable logistic regression model examined the interaction between survey year and geographic region. Chi-square tests assessed differences in the proportions of the three dietary patterns among adult residents in Guizhou Province with varying characteristics in 2023.

Dietary patterns among adult residents in Guizhou Province are primarily categorized into three types: high-quality protein, plant-based foods, and mixed. In 2023, the proportion of urban residents following the high-quality protein pattern exceeded that of rural residents, while the proportion adhering to the plant-based foods pattern was lower than in rural areas. As educational attainment increases, the proportion of individuals following the high-quality protein pattern rises, whereas the proportion following the plant-based foods pattern gradually decreases. From 1991 to 2023, plant-based dietary patterns predominated among Guizhou’s adult residents. After 1997, the proportion following plant-based patterns gradually declined while the proportion adopting high-quality protein patterns gradually increased. Starting in 2006, the proportion following high-quality protein patterns rose significantly, while the proportion following plant-based patterns decreased substantially. Multivariate logistic regression analysis revealed a significant interaction between survey year and geographic region for dietary patterns (P<0.000 1). The Northern/Western Guizhou Mixed Development Zone exhibited the fastest increase in the proportion of individuals following the high-quality protein pattern (OR=1.099) and the fastest decrease in the proportion following the plant-based food pattern (OR=0.943).

The proportion of people with more reasonable dietary patterns among adult residents of Guizhou Province increased from 1991 to 2023, but there is still a need to strengthen the publicity of nutritional and healthy diets and to promote the establishment of balanced dietary patterns.

To reveal the epidemiological patterns of unintentional injury among children and evaluate health inequality, providing a scientific basis for formulating appropriate prevention strategies.

Based on the Global Burden of Diseases, Injuries, and Risk Factors Study framework, we extracted disability-adjusted life years (DALYs) and DALYs rate for unintentional injury and its types among children 0～14 from 1990 to 2021. We employed the Joinpoint regression model to calculate the average annual percentage change (AAPC) for trend analysis. Das Gupta decomposition method was applied to quantify the contributions of age structure, population size and epidemiological factors changes to variations in DALYs. The Slope Index of Inequality and Concentration Index were used to analyze relative inequality and absolute inequality, respectively.

In 2021, the AAPC of DALYs for unintentional injury among children was -2.82%, and the AAPC of DALYs rate was -3.81% globally. In China, the AAPC of DALYs and DALYs rate were -6.41% and -5.76%, respectively. Males and children under 5 years old had higher DALYs and DALYs rate. Globally, the contributions of epidemiological factors changes, age structure, and population size to DALYs were -44.06 million, -1.77 million, and 6.46 million, respectively. In China, the corresponding values were -12.91 million, -0.66 million, and -1.84 million. The Slope Index of Inequality was decreased from -4 044.77 per 100 000 populations in 1990 to -1 473.73 per 100 000 populations in 2021. The Concentration Index was -0.30 in 2019, and -0.43 in 2021.

Although the burden of unintentional injury among children has shown downward trends, boys and children under 5 years old remain priority populations for targeted interventions. Relative health inequality has intensified, and countries or regions with lower Socio-Demographic Index (SDI) bear a heavier disease burden from unintentional injury.