Burden of disease scenarios by state in the USA, 2022-50: a forecasting analysis for the Global Burden of Disease Study 2021

Biomarkers of aging: from molecules and surrogates to physiology and function

Many countries face an unprecedented challenge in aging demographics. This has led to an exponential growth in research on aging, which, coupled to a massive financial influx of funding in the private and public sectors, has resulted in seminal insights into the underpinnings of this biological process. However, critical validation in humans has been hampered by the limited translatability of results obtained in model organisms, additionally confined by the need for extremely time-consuming clinical studies in the ostensible absence of robust biomarkers that would allow monitoring in shorter time frames. In the future, molecular parameters might hold great promise in this regard. In contrast, biomarkers centered on function, resilience, and frailty are available at the present time, with proven predictive value for morbidity and mortality. In this review, the current knowledge of molecular and physiological aspects of human aging, potential antiaging strategies, and the basis, evidence, and potential application of physiological biomarkers in human aging are discussed.

A cross-sectional study examining the relationship between the advanced lung cancer inflammation index and prostate cancer

BACKGROUND

Prostate cancer (PCa), a significant health concern among middle-aged and elderly men globally, has increasingly been associated with metabolic and inflammatory processes. The advanced lung cancer inflammation index (ALI), a novel marker reflecting nutritional and inflammatory status, has not yet been thoroughly investigated in the context of PCa. This study investigated the potential link between ALI and PCa.

METHODS

We first conducted a cross-sectional study utilizing data from the National Health and Nutrition Examination Survey (NHANES). The relationship between ALI and PCa was examined by NHANES-provided survey weights. Smoothed curve fitting and threshold effect analyses were conducted to evaluate possible nonlinear associations. Then we analyzed the correlation between the prognosis of PCa patients and ALI.

RESULTS

Out of 15,042 adult participants, 683 (4.54%) were diagnosed with PCa. The risk of PCa decreased across increasing quartiles of ALI. Multivariate logistic regression analysis revealed that compared to participants in the lowest ALI quartile (Q1: 2.89-41.94), those in higher quartiles (Q2: 41.94-59.08, Q3: 59.08-80.88, and Q4: ≥80.88) had progressively lower odds of developing PCa in both unadjusted and adjusted models. Smoothed curve fitting indicated a U-shaped relationship between ALI and PCa. Longitudinal follow-up data indicated that lower ALI values were positively correlated with a poor survival in cancer patients.

CONCLUSION

Our study revealed a non-linear relationship between ALI and the risk of PCa development. Specifically, there was a negative correlation between ALI and PCa risk when the ALI value was < 100. Furthermore, we found that lower ALI levels are strongly associated with a poor survival in cancer patients. Additional large-scale prospective studies are needed to confirm these findings and investigate the underlying mechanisms.

Klotho protein: a multifaceted regulator in aging and cancer dynamics

Klotho, named after the youngest of the three Fates in Greek mythology daughters of Zeus and Nyx, who together spin the thread of life, allot destiny, and determine the time of passing for both mortals and immortals, is an important regulatory factor in aging and cancer dynamics. Initially described as an aging-suppressing protein, Klotho is now recognized for its more diverse role in modulating key signaling pathways like Wnt/β-catenin, IGF-1, PI3K/AKT, and TGF-β. Essentially, its various pro-cellular health functions, such as antioxidant, anti-inflammatory, and tumor-suppressive activities, are, in fact, considered that ensures the maintenance of cellular health and reduce complications related to aging. Klotho deficiency is associated with accelerated aging, chronic kidney disease, cardiovascular disorders, neurodegeneration, and various cancers. This review thus covers the twin roles of Klotho as an antiaging and tumor-suppressor protein, on their therapeutic potential, as well as advances in delivery systems and development of biomarkers and challenges for clinical translation.. Moreover, natural strategies like exercise and dietary interventions are explored that could help overcome Klotho deficiency. Further research with Klotho may offer a paradigm shift in the treatment of aging and cancer and add yet another avenue to increase survival of the patients.

Disease burden of aortic aneurysm from 1990 to 2021 with a forecast to 2045: insights from the global burden of disease 2021

INTRODUCTION

Aortic aneurysm is one of the causes of cardiovascular disease-related death, posing a significant challenge to global healthcare. Understanding the burden of aortic aneurysm is crucial for formulating effective public health intervention policies and allocating resources. The study aims to assess the global, regional, and national burden, trend, and inequalities of aortic aneurysm.

METHODS

Aortic aneurysm-associated mortality, disability-adjusted life-years (DALYs), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life-years (ASDR), and their average annual percentage change (AAPC) were estimated based on a population-based study, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The global, regional, and national burden of aortic aneurysm was analyzed across 204 countries and territories from 1990 to 2021, stratified by sex, sociodemographic index (SDI), and further predicted to 2045.

RESULTS

The ASMR decreased from 2.54 per 100,000 population in 1990 to 1.86 per 100,000 population in 2021, with an AAPC of -0.99%. The ASDR declined from 48.79 per 100,000 population in 1990 to 36.54 per 100,000 population in 2021, with an AAPC of -0.90%. The most significant decline in ASDR was observed among males (-1.14% vs. -0.68% per year). ASMR increased considerably, especially in countries with a low-middle SDI (1.29% per year), while it dropped particularly in countries with a high SDI (-1.65% per year). Notably, though the number of mortality and DALYs was predicted to continue rising, the ASMR and ASDR for aortic aneurysm were projected to decrease annually from, with predicted values of 1.92 per 100,000 population and 40.38 per 100,000 population in 2045, respectively.

CONCLUSIONS

The global relative burden of individuals with aortic aneurysm decreased since 1990, along with a prominent decrease in related ASMR and ASDR. Aortic aneurysm-related mortality and DALYs were higher in males and those living in regions with a high SDI.

All-Cause Mortality and Life Expectancy by Birth Cohort Across US States

Importance

Although overall US mortality rates declined from 1969 to 2020, they vary considerably by state and generation, especially when evaluated by birth cohort. Trends in mortality and life expectancy by birth cohort for US states and Washington, DC, have yet to be characterized.

Objective

To estimate cohort mortality trends for each state and Washington, DC, and quantify life expectancy at birth and 40 years of age and the rate of increase after 35 years of age.

Design, Setting, and Participants

In this cohort study, all-cause mortality rates by single years of age (0-119) and birth cohort (1900-2000) were estimated for each state in January 2025. Mortality data and population estimates were obtained from the National Center for Health Statistics, the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research website, and the Surveillance, Epidemiology, and End Results database for each state and Washington, DC, by single years of ages 0 to 84 and calendar years 1969 to 2020. An age-period-cohort model with constrained cubic splines for temporal effect estimates was used to estimate mortality from 1900 to 2000.

Main Outcomes and Measures

Life expectancy for each cohort from birth or 40 years of age was estimated by sex and state, along with doubling time for the death rate after 35 years of age.

Results

Analyses included 179 million deaths (77 million female and 102 million male). In the West and Northeast, cohort life expectancy improved from 1900 to 2000, but in some Southern states, it changed less than 3 years since 1900 in females and less than 2 years since 1950 in males. Washington, DC, had the lowest life expectancy in the 1900 birth cohort but a greater increase than the other states (from 61.1 to 72.8 years of age). After 35 years of age, the highest rate-doubling time in a state was 9.39 years in New York for females and 11.47 years for males in Florida. The shortest rate-doubling times were 7.96 years for females in Oklahoma and 8.95 years for males in Iowa.

Conclusions and Relevance

Cohort-specific patterns across states reveal wide disparities in mortality. Some states have experienced little or no improvements in life expectancy from the 1900 to 2000 birth cohorts. Understanding how mortality patterns vary by birth cohort within each state can inform decision-making around resource allocation and public health interventions.

Trends in pulmonary arterial hypertension: insights from Global Burden of Disease 1990-2021

OBJECTIVE

This study aimed to assess the global, regional and national burden of pulmonary arterial hypertension (PAH) from 1990 to 2021 using data from the Global Burden of Disease Study 2021. The focus was on evaluating trends in incidence, prevalence, mortality and disability-adjusted life-years (DALYs) associated with PAH and examining these trends by age, gender and sociodemographic index (SDI).

DESIGN

This is a systematic analysis leveraging data from the Global Burden of Disease Study 2021. The analysis focused on both crude and age-standardised rates to track temporal trends in PAH burden, with data stratified by region and SDI.

SETTING

The study used global, regiona, and national data from 204 countries and regions, spanning from 1990 to 2021.

PARTICIPANTS

The participants in this study include individuals diagnosed with PAH, with data representing populations globally, categorised by age, gender and SDI.

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary outcome measures included global, regional and national incidence, prevalence, mortality and DALYs related to PAH. Secondary outcomes consisted of age-standardised rates (age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR)) and trends over the study period. A key strength of this study is the detailed stratification by SDI, revealing how PAH burden varies across different socio-economic settings. This extended temporal analysis offers new insights into long-term trends, highlighting the rising burden in lower-SDI regions and significant regional disparities in disease management and outcomes.

RESULTS

From 1990 to 2021, global PAH cases showed substantial increases in both incidence (85.62%) and prevalence (81.46%), while age-standardised rates remained stable. Across SDI levels, high-SDI regions maintained stable ASIRs (0.37 per 100 000) with a slight decline (estimated average percentage change (EAPC) -0.06%), while low-SDI regions demonstrated the most significant reduction (EAPC -0.30%). Deaths increased by 48.36% globally, though the ASMR decreased from 0.35 to 0.27 per 100 000. The disease burden measured by DALYs decreased by 6.59%, with high-SDI regions showing better improvements in age-standardised DALY rates (-1.39% EAPC) compared with other SDI levels. Gender analysis revealed persistent female predominance (female-to-male ratio 1.62:1), particularly pronounced in populations over 50 years across all SDI quintiles.

CONCLUSIONS

While global age-standardised rates have declined, PAH remains a significant global health burden, particularly in low-SDI regions. These findings underscore the need for targeted prevention and intervention strategies, especially for high-risk populations, such as females and the elderly, to reduce the global health impact of PAH.

The mechanism of Bovis Culus Sativus protecting BBB damage in stroke: Insights from network pharmacology, bioinformatics, and experiments

ETHNOPHARMACOLOGICAL RELEVANCE

Bovis calculus (BC) has a medicinal history of over 2000 years in treating stroke in China. Bovis Culus Sativus (BCS) has similar pharmacological effects to BC. Due to the scarcity of BC, BCS is often used as a substitute for BC in clinical practice for treating stroke in traditional Chinese medicine.

AIM OF THE STUDY

This study aims to investigate the inhibitory effect of BCS on blood-brain barrier (BBB) damage following stroke, and to elucidate the molecular basis of BCS neuroprotection through network pharmacology and bioinformatics.

MATERIALS AND METHODS

The contents of bilirubin and bile acids in BCS were quantified using HPLC. A cerebral ischemia-reperfusion injury (CIRI) rat model was established to assess neurological function, cerebral infarction, pathological damage, and Evans Blue staining. R language was used to analyze GEO public data to identify therapeutic targets for ischemic stroke. Public databases and literature were utilized to screen for active components of BCS, and the Swiss Target Prediction database was used to predict the active drug targets. Network pharmacology analysis was conducted on drug and disease targets, followed by immune infiltration and molecular docking of key targets. Finally, ELISA, RT-PCR, Western blot, IHC, and TEM were employed to validate the effectiveness of the targets.

RESULTS

The content of bile acids and bilirubin in the tested BCS was 6.9% and 37.89%, respectively. The study showed that BCS reduced neurological function scores and cerebral infarction rates in stroke rats, prevented Evans Blue leakage, and mitigated histopathological damage in the ischemic brain region. Additionally, BCS improved the structural and functional integrity of the BBB, enhancing the expression of Occludin, ZO-1, and Claudin-5 while downregulating the expression of MDR1, aquaporin-4, MMP-9, and MMP2. Bioinformatics and network pharmacology analyses indicated that the therapeutic effects of BCS in stroke are primarily associated with the inhibition of inflammatory pathways, including TNF, NFKB, and MAPK. ELISA, RT-PCR, and Western blot results further confirmed that BCS significantly suppressed neuroinflammation in stroke rats.

CONCLUSION

BCS shows promising efficacy against ischemic stroke, maintaining the function and structural integrity of the BBB. Its protective effect on the BBB may be related to the inhibition of the TNF-NFκB-MAPK signaling pathways.

Optimizing DSA parameters for enhanced radiation safety in interventional surgery

Objective

The study aims to establish a reliable method for reducing radiation dose by analyzing variations in radiation dose from digital subtraction machines (DSA).

Methods

The study investigates changes in bed plate height (80-110 cm), detection height (0-30 cm), visual field size (6 × 6 inches and 12 × 12 inches), and radiation doses affecting various body parts, including the lens, thyroid, chest, gonads, and lower limbs. Radiation doses were measured using Raysafe X2 dosimetry for patients and AT1123 meter for operators.

Results

Compared to ordinary fluoroscopy, the low-dose fluoroscopy mode reduced the patient's radiation dose by 50.8% (from 13.2 to 6.5 mGy/min) and the operator's scattered radiation dose by 25-34% (lens dose reduced from 0.72 to 0.47 mGy). In photographic mode, the radiation dose was 3-4 times higher than in ordinary fluoroscopy (e.g., 53.9 vs. 13.2 mGy/min). Raising the bed plate height from 80 to 110 cm reduced the patient's direct radiation dose by 45.5% (from 24.2 to 13.2 mGy/min). The correct application of protective devices reduced the operator's scattering radiation by more than 10 times (e.g., gonads dose reduced from 4.07 to 0.41 mGy).

Conclusion

Selecting the appropriate bed plate (90-100 cm) and detector height (10-20 cm), along with an optimal visual field (6 × 6 inches), can effectively reduce radiation doses for both patients and operators. The proper use of protective devices in peripheral interventional surgery is crucial for reducing scatter radiation, with reductions exceeding 90% in some cases.

Full title: prevalence and risk factors of overweight in Beijing infants basing generalized estimating equation: a longitudinal study

BACKGROUND

The prevalence of childhood overweight and obesity in China has been rapidly increasing in recent years. The purposes of this study were to investigate the prevalence of infant overweight in Beijing and to explore the influencing factors using a generalized estimating equation (GEE) model.

METHODS

This is a birth cohort study from January 2022 to December 2022 in Beijing, involving 2,008 newborns from local residents. Four times of follow-up visits were conducted at 2, 5, 8, and 12 months of age for physical measurements and health information collection. Multiple exposures were considered, including demographic characteristics of infants, maternal pregnancy information, feeding pattern and outdoor activities of infants. The GEE model was utilized to identify influencing factors for infant overweight while adjusting for potential confounders.

RESULTS

The prevalence of overweight for 2-, 5-, 8-, and 12-month-old infants were 14.4%, 21.6%, 24.4%, and 24.2%, respectively. Among the influencing factors, irregular exercise during pregnancy (OR = 1.190, P = 0.045), mixed feeding or artificial feeding (non-exclusive breastfeeding) (OR = 1.233, P = 0.025), high birth weight (OR = 1.468, P < 0.001), and high pre-pregnancy body mass index (BMI) (OR = 2.113, P = 0.005) were positively correlated with infant overweight. Conversely, weight gain ≤ 15.0 kg during pregnancy (OR = 0.778, P = 0.016), high birth length (OR = 0.990, P = 0.003), and longer duration of outdoor activity for infants (OR = 0.764, P < 0.001) were negatively correlated with infant overweight.

CONCLUSIONS

Our findings suggest certain factors are associated with infant overweight risk. Further research is required before making causal inferences and formulating preventive strategies for infant overweight.

Epidemiological trends and predictions of urinary tract infections in the global burden of disease study 2021

Urinary tract infections (UTIs) are prevalent; however, comprehensive and current epidemiological data remain scarce. This study examined the global, national, and regional burden of UTIs by sex, age, and socio-demographic index (SDI) from 1990 to 2021. The 2021 Global Burden of Disease study included age-standardised incidence rate (ASIR), age-standardised prevalence rate (ASPR), age-standardised death rate (ASDR), and age-standardised disability-adjusted life years rate (ASDAR). The estimated annual percentage change was used to depict temporal trends, whereas Pearson correlation analysis explore its correlation with the human development index (HDI), the SDI, and age-standardised rates (ASRs). An autoregressive integrated moving average model forecasted the UTI burden trends. From 1990 to 2021, the number of UTI cases increased by 66.45%, reaching 4.49 billion cases, with an ASIR of 5,531.88 per 100,000 population. The greatest incidence of UTIs was seen in women and older adult men. Tropical Latin America and low-middle SDI regions exhibited the highest ASIR, ASPR, ASDR, and ASDAR, while East Asia showed the lowest. ASDR and ASDAR decreased with higher SDI levels. ASR and HDI were weakly positively correlated with ASDR and ASDAR. ASIR, ASPR, and ASDAR are projected to increase until 2050. The global burden of UTIs is rising and is influenced by geographical location, age, sex, and economic development, crucial for guiding medical practices and forming relevant policies.

Global burden of burns among children and adolescents: a trend analysis from the global burden of disease study 2019

Precise

This study investigates global trends in burns among children and adolescents using data from the Global Burden of Disease Study 2019. Analyzing incidence and YLD rates across 204 countries from 1990 to 2019 reveals a general decline in burn-related injuries, with age and sex influencing trends. Notably, in high-SDI regions, incidence rates initially increased before reversing. These findings highlight the need for targeted public health policies and resource allocation to reduce burn-related risks in vulnerable populations.

Background

Given the lack of long-term trend studies on global burns among children and adolescents, this study examined trends in the global burden of burns among children and adolescents.

Methods

The Global Burden of Disease (GBD) Study 2019 provided the statistical data. Sex, age, region, and SDI were used as stratification variables in the study to evaluate the prevalence of burns injuries among kids and teenagers across 204 nations and territories between 1990 and 2019. YLD rates per 100,000 people and incidence rates together with their respective average annual percentage changes (AAPC) were computed to evaluate burden trends. Furthermore, AAPC in YLD rates and incidence rates spanning various age cohorts were analyzed using the Joinpoint software.

Results

The worldwide burns incidence and YLD rates of burns among kids and teenagers exhibited a general declining trend between 1990 and 2019. Concerning the general trend in new cases, incidence rates, and YLD rates, age was positively associated. In 2019, the incidence rate for females surpassed that of males, while YLD rates for females were consistently higher than those of males. New Zealand, Czechia, and Australia rank as the top three among the 204 countries studied. Interestingly, in the high SDI range, the expected values based on incidence rates reversed after first rising with the SDI.

Conclusion

Overall, the incidence and YLD rates of burns among children and adolescents have declined globally, though significant disparities exist across age groups, sexes, regions, and countries. These findings could help guide the development of more targeted strategies to reduce the burn burden in this population.

Understanding Adipose Tissue Dysfunction

Diseases affecting adipose tissue (AT) function include obesity, lipodystrophy, and lipedema, among others. Both a lack of and excess AT are associated with increased risk for developing diseases including type 2 diabetes mellitus, hypertension, obstructive sleep apnea, and some types of cancer. However, individual risk of developing cardiometabolic and other 'obesity-related' diseases is not entirely determined by fat mass. Rather than excess fat accumulation, AT dysfunction may represent the mechanistic link between obesity and comorbid diseases. There are people who remain metabolically healthy despite obesity, whereas people with normal weight or very low subcutaneous AT mass may develop typically obesity-related diseases. AT dysfunction is characterized by adipocyte hypertrophy, impaired subcutaneous AT expandability (ectopic fat deposition), hypoxia, a variety of stress, inflammatory processes, and the release of proinflammatory, diabetogenic, and atherogenic signals. Genetic and environmental factors might contribute to AT heterogeneity either alone or via interaction with intrinsic biological factors. However, many questions remain regarding the mechanisms of AT dysfunction initiation and whether and how it could be reversed. Do AT signatures define clinically relevant subtypes of obesity? Is the cellular composition of AT associated with variation in obesity phenotypes? What roles do environmental compounds play in the manifestation of AT dysfunction? Answers to these and other questions may explain AT disease mechanisms and help to define strategies for improving AT health. This review focuses on recent advances in our understanding of AT biology.