Physical activity and liver health among urban and rural Chinese adults: results from two independent surveys

Altered central pain processing in patients with degenerative lumbar diseases and its association with low physical activity levels after lumbar spinal surgeries: a retrospective cohort analysis

PURPOSE

To investigate the occurrence of altered central pain modulation in patients with degenerative lumbar diseases (DLDs) and to analyze its association with physical activity (PA) 3 years after lumbar decompression and fusion.

METHODS

Preoperative assessments of pressure pain thresholds (PPTs), temporal summation (TS), conditioned pain modulation (CPM) and pain were, respectively, recorded in 304 patients. These patients further underwent International Physical Activity Questionnaire (IPAQ) and both pain-related and psychological assessments 3 years post-operation.

RESULTS

Preoperatively, the patients had lower PPTs in both local pain and pain-free areas and lower CPM and higher TS in pain-free areas than healthy subjects (P < 0.05). Postoperatively, 53.9% (164/304) patients showed PA below healthy-related thresholds (< 600 MET min/w). Low PA group showed a greater postoperative weight gain and bone loss and a higher postoperative prevalence of both moderate anxiety and marginal depression than high PA group (P < 0.05). All covariates with differences between the high and low PA groups were subjected to multivariate logistic regression, and long preoperative disease duration, low preoperative PPT in pain-free area, high preoperative TS, revision surgery, severe postoperative low back pain and significant postoperative pain catastrophizing thought were independently associated with low postoperative PA (P < 0.05).

CONCLUSIONS

This study supports the existence of central sensitization (CS) caused by abnormal central pain modulation in DLDs. Pre-existing CS in these patients may be associated with low PA after lumbar surgeries, and this low-activity lifestyle may predispose patients to multiple adverse health outcomes. Preoperative dynamic quantitative sensory testing may provide information for the identification of at-risk patients.

Anti-hepatitis C antibody carriage and risk of liver impairment in rural-Cameroon: adapting the control of hepatocellular carcinoma for resource-limited settings

BACKGROUND

The Viral hepatitis elimination by 2030 is uncertain in resource-limited settings (RLS), due to high burdens and poor diagnostic coverage. This sounds more challenging for hepatitis C virus (HCV) given that antibody (HCVAb) sero-positivity still lacks wide access to HCV RNA molecular testing. This warrants context-specific strategies for appropriate management of liver impairment in RLS. We herein determine the association between anti-HCV positivity and liver impairment in an African RLS.

METHODS

A facility-based observational study was conducted from July-August 2021 among individuals attending the "St Monique" Health Center at Ottou, a rural community of Yaounde,Cameroon. Following a consecutive sampling, consenting individuals were tested for anti-HCV antibodies, hepatitis B surface antigen (HBsAg) and HIV antibodies (HIVAb) as per the national guidelines. After excluding positive cases for HBsAg and/or HIVAb, liver function tests (ALT/AST) were performed on eligible participants (HBsAg and HIVAb negative) and outcomes were compared according to HCVAb status; with p < 0.05 considered statistically significant.

RESULTS

Out of 306 eligible participants (negative for HBsAg and HIVAb) enrolled, the mean age was 34.35 ± 3.67 years. 252(82.35%) were female and 129 (42.17%) were single. The overall HCVAb sero-positivity was 15.68%(48/306), with 17.86% (45/252) among women vs. 5.55%(3/54) among men [OR (95%CI) = 3.69(2.11-9.29),p = 0.04]. HCVAb Carriage was greater among participants aged > 50 years compared to younger ones [38.46%(15/39) versus 12.36% (33/267) respectively, OR(95%CI) = 4.43(2.11-9.29), p < 0.000] and in multipartnership [26.67%(12/45)vs.13.79%(36/261) monopartnership, OR (95%CI) = 2.27(1.07-4.80),p = 0.03]. The liver impairment rate (abnormal ALT+AST levels) was 30.39%(93/306), with 40.19%(123/306) of abnormal ALT alone. Moreover, the burden of Liver impairment was significantly with aged> 50 versus younger ones [69.23% (27/39) versus 24.72%(66/267) respectively, p < 0.000). Interestingly, the burden of liver impairment (abnormal AST + ALAT) was significantly higher in HCVAb positive (62.5%, 30/48) versus HCVAb negative (24.42%, 63/258) participants, OR: 3.90 [1.96; 7.79], p = 0.0001.

CONCLUSIONS

In this rural health facility, HCVAb is highly endemic and the burden of liver impairment is concerning. Interestingly, HCVAb carriage is associated with abnormal liver levels of enzyme (ALT/AST), especially among the elderly populations. Hence, in the absence of nuclei acid testing, ALT/AST are relevant sentinel markers to screen HCVAb carriers who require monitoring/care for HCV-associated hepatocellular carcinoma in RLS.

Changes in Self-Esteem in Patients with Hirayama Disease and its Association with Prognosis After Anterior Cervical Fusion Procedures

OBJECTIVE

To quantify self-esteem in patients with Hirayama disease (HD) and investigate the impact of this psychosocial factor on surgical outcomes in HD.

METHODS

The Rosenberg Self-Esteem Scale (RSES) was measured in 58 patients with HD before anterior cervical fusion. These patients further underwent motor unit number estimation, handgrip strength, disabilities of the arm, shoulder and hand (DASH), Beck Anxiety Inventory (BAI) and Beck Depression Index (BDI) before and 18 months after operation. Furthermore, the International Physical Activity Questionnaire (IPAQ) was administered to all patients at postoperative 18-month assessments.

RESULTS

Compared with the general population, patients with HD showed a relatively lower RSES, and RSES was negatively associated with both postoperative DASH (r = -0.431, P < 0.05) and preoperative to postoperative changes (r = -0.295, P < 0.05) and positively associated with IPAQ (r = 0.472, P < 0.05). Similar to the difference in postoperative DASH scores, more patients with low self-esteem felt postoperative aggravated motor dysfunction than those with high/normal self-esteem (P < 0.05). Postoperative BDI exerted a partial mediating effect on the relationship between RSES and DASH scores (B = -0.30, P < 0.05), and postoperative BAI played a partial mediating effect on the relationship between RSES and IPAQ scores (B = 0.30, P < 0.05).

CONCLUSIONS

The self-esteem of HD patients may be below the population norms. Importantly, relatively low self-esteem in HD patients may cause/worsen postoperative depression and anxiety, thereby resulting in poor self-reported surgical prognosis and an inactive lifestyle after operation. Therefore, perioperative treatment and rehabilitation efforts in HD patients, especially those with low self-esteem, should account for both physiological and psychological symptoms.

Association between physical activity and serum liver aminotransferases in Southwestern Iran: A Cross-sectional study

BACKGROUND

The main aim of the present study is to investigate the independent association objectively measured level of physical activity (PA) and serum concentration of liver aminotransferases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) among seemingly healthy individuals.

MATERIALS AND METHODS

The current secondary study was conducted in the framework of Khuzestan Comprehensive Health Study, a large population-based multicentric cross-sectional study, conducted between 2016 and 2019 on 18,966 individuals living in Khuzestan province, southwestern Iran. International PA Questionnaire was used for evaluating PA levels, and participants were divided into three groups: low, moderate, and high PA, and ALT and AST were compared between these groups.

RESULTS

The mean ± standard deviation age of participants was 38.65 ± 11.40 years. The majority of participants were female (71%). The mean concentration of ALT in total sample was 18.22 ± 13.06 (male: 23.65 ± 16.26 and female: 15.57 ± 10.06), while the mean concentration of ALT in total sample was 19.61 ± 8.40 (male: 22.44 ± 10.03 and female: 18.23 ± 7.08). A statistically significant inverse correlation was found between AST (r = -0.08, P = 0.02) and ALT (r = -0.038, P < 0.001) with total PA score. The mean concentration of ALT was 19.96 ± 13.63 in people with low PA, 17.62 ± 12.31 with moderate PA, and 18.12 ± 13.47 with high PA (P < 0.001). The mean concentration of AST in total sample was 20.37 ± 8.85 in people with low PA, 19.21 ± 8.83 with moderate PA, and 19.75 ± 8.85 with high PA (P < 0.001). The difference between people in different levels of PA in terms of mean concentration of AST was remained significant (P = 0.003); however, the difference for ALT was not remained significant after adjusting potential confounders.

CONCLUSION

The current study based on large sample showed that PA had a statistically negative association with the concentration of liver aminotransferases in the seemingly healthy individuals; however, the observed associations were weak. People in the lowest levels of PA had the highest levels of ALT and AST.

Patterns of Lifestyle Behaviors and Relevant Metabolic Profiles in Chinese Adults: Latent Class Analysis from Two Independent Surveys in Urban and Rural Populations

BACKGROUND

This study was determined to describe the patterns of lifestyle behaviors and their associations with metabolic profiles among Chinese urban and rural adults.

METHODS

This was a cross-sectional study set in the Nanjing (5,824) and Hefei (20,269) Community Cardiovascular Risk Surveys from 2011-2013, using random cluster sampling. Questionnaires were completed via face-to-face interview, and data on lifestyle behaviors including daily night sleep duration, nap duration (if any) and sitting time, and weekly physical activity (measured using the International Physical Activity Questionnaire, in metabolic equivalents of task × minutes, and separated into walking and moderate-to-vigorous physical activity (MOVPA) according to intensity) was collected. The patterns of physical activity in Chinese urban and rural populations and the metabolic profile in each pattern were identified by the latent class analysis.

RESULTS

Six distinct clusters were determined, with the sizes ranging from 45% to 5% of the total population. For example, the most common cluster was associated with a sufficient night and nap sleep duration, a long sitting time, and above WHO recommended physical activities for both walking and MOVPA, and the smallest cluster was featured by its huge amount of MOVPA and limited amount of walking activity. Difference in proportion of each cluster was observed between the two survey sites. No obvious abnormal blood measures were seen in any cluster.

CONCLUSION

Common lifestyle behavior clusters were described, leading to a better understanding of people's routine activities.