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Gao Y, Bi L, Li A, Du M, Song M, Jiang G. Associations of Bisphenols Exposure and Hyperuricemia Based on Human Investigation and Animal Experiments. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:5290-5298. [PMID: 38468128 DOI: 10.1021/acs.est.4c00792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Hyperuricemia is characterized by elevated blood uric acid (UA) levels, which can lead to certain diseases. Epidemiological studies have explored the association between environmental contaminant exposure and hyperuricemia. However, few studies have investigated the role of chemical exposure in the development of hyperuricemia. Here, we sought to investigate the effects of bisphenol exposure on the occurrence of hyperuricemia. Fifteen bisphenol chemicals (BPs) were detected in human serum and urine samples collected from an area with a high incidence of hyperuricemia in China. Serum UA levels positively correlated with urinary bisphenol S (BPS), urinary bisphenol P (BPP), and serum bisphenol F (BPF). The effects of these three chemicals on UA levels in mice were explored at various exposure concentrations. An increase in serum UA levels was observed in BPS- and BPP-exposed mice. The results showed that BPS exposure increased serum UA levels by damaging the structure of the kidneys, whereas BPP exposure increased serum UA levels by disturbing purine metabolism in the liver. Moreover, BPF did not induce an increase in serum UA levels owing to the inhibition of guanine conversion to UA. In summary, we provide evidence of the mechanisms whereby exposure to three BPs disturbs UA homeostasis. These findings provide new insights into the risks of exposure to bisphenol chemicals.
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Affiliation(s)
- Yue Gao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lei Bi
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
| | - Aijing Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
| | - Mei Du
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Maoyong Song
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, China
- University of Chinese Academy of Sciences, Beijing 100049, China
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Xu F, Ma C, Wang S, Li Q, Zhang Z, He M. Higher Atherogenic Index of Plasma Is Associated with Hyperuricemia: A National Longitudinal Study. Int J Endocrinol 2024; 2024:4002839. [PMID: 38410172 PMCID: PMC10896650 DOI: 10.1155/2024/4002839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 02/28/2024] Open
Abstract
Background The association between atherogenic index of plasma (AIP) and hyperuricemia remains indistinct. This study was aimed to examine the relationship between AIP and hyperuricemia among the middle-aged and the elderly Chinese population. Methods Datasets were retrieved from the China Health and Retirement Longitudinal Study (CHARLS) survey conducted in 2011 and 2015. 13,021 participants in the CHARLS in 2011 and 7,017 participants involved both in 2011 and 2015 were included, respectively. The measurement of AIP and hyperuricemia was based on the test of fasting blood. Association between AIP and hyperuricemia was assessed by logistic regression, and the nonlinear association was examined by restricted cubic splines (RCS). The cutoff point of AIP was calculated using receiver operator curve (ROC). 1 : 1 propensity score matching (PSM) was adopted to further explore the relationship between AIP and hyperuricemia. Results In the section of a cross-sectional study, a positive association between AIP and hyperuricemia was found. The odds ratios (ORs) of hyperuricemia were 1.00 (reference), 1.52 (1.10-2.10), 1.80 (1.31-2.47), and 3.81 (2.84-5.11). Nonlinear association was not detected using RCS analysis. There were 664 hyperuricemia cases during the four years follow-up. The hyperuricemia prevalence was 9.5%. In the fully adjusted longitudinal analysis, the ORs for hyperuricemia across the quartiles of AIP were 1.00 (reference), 1.00 (0.74-1.37), 1.59 (1.20-2.11), and 2.55 (1.94-3.35), respectively. In the longitudinal analysis after PSM, the OR of hyperuricemia were 1.91 (1.45, 2.51) and 1.92 (1.45, 2.54) in the univariate and multivariate model, respectively. Conclusion AIP can predict the prevalence of hyperuricemia in the Chinese middle-aged and elderly population.
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Affiliation(s)
- Feifei Xu
- Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu 610041, China
| | - Chengyong Ma
- Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shouping Wang
- Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qin Li
- Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongwei Zhang
- Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Min He
- Department of Intensive Care Medicine, West China Hospital, Sichuan University, Chengdu, China
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Yu S, Zhu Y, He H, Hu Y, Zhu X, Diao W, Li S, Shan G, Chen X. Prevalence and risk factors of oral human papillomavirus infection among 4212 healthy adults in Hebei, China. BMC Infect Dis 2023; 23:773. [PMID: 37940841 PMCID: PMC10634102 DOI: 10.1186/s12879-023-08759-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is an essential cause of oropharyngeal squamous cell carcinoma that is increasing in incidence worldwide. However, little is known about the epidemiology of oral HPV infection among healthy adults in China. METHODS A study in northern China was conducted in 2021 as baseline data of Diverse Life-Course Cohort (DLCC). Residents who aged above 20 were eligible to participate. Oral swab specimens and questionnaires were collected from 4226 participants. HPV DNA in oral exfoliated cells was tested by Nested Polymerase Chain Reaction approach and sequencing. Univariate and multivariate analyses were performed to assess the associations between exposure factors and oral HPV infection. RESULTS Overall prevalence of oral HPV infection was 4.08% (95%CI, 3.69%-4.68%). The most prevalent HPV type detected was HPV-81 (1.35%; 95% CI, 1.00%-1.70%), followed by HPV-16 (0.64%; 95% CI, 0.40%-0.88%). Oral HPV infection presented a bimodal pattern with respect to age in male and female participants. Oral HPV prevalence of male participants was significantly higher than prevalence of female participants (5.0% versus 3.6%, P = 0.041). Prevalence of oral HPV was higher among current smokers (OR = 1.59; 95% CI, 1.11-2.29; P = 0.039) and current drinkers (OR = 1.60; 95% CI, 1.14-2.25; P = 0.023). Current alcohol consumption was independently associated with oral HPV infection (OR = 1.74; 95% CI, 1.22-2.50; P = 0.010). CONCLUSIONS Among healthy adults aged above 20 in Hebei, China, the prevalence of high-risk HPV infection was 1.92% (95%CI, 1.51%-2.34%). Oral HPV prevalence was independently associated with alcohol consumption. More tailored prevention strategies are needed to prevent oral HPV infection through smoking cessation, reduction of alcohol consumption, and HPV vaccination.
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Affiliation(s)
- Shuting Yu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China
| | - Xiaoli Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Wenwen Diao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China
| | - Shuguang Li
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, 43 Baojiajie, Xicheng District, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China.
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China.
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Yang L, Wei Q, Sun Y, Guo J, Xu X, Zhang Z, Zhu L, Zheng X, Liu F, Wu J, Xie X, Lin S, Li H, Wu S. Hyperuricemia and coronary heart disease: The mediating role of blood pressure and thrombospondin 3. Nutr Metab Cardiovasc Dis 2023; 33:1969-1980. [PMID: 37524613 DOI: 10.1016/j.numecd.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/07/2023] [Accepted: 06/01/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND & AIMS Although hyperuricemia is a known risk factor for coronary heart disease (CHD), little is known about the role of blood pressure in mediating this association. The purpose of this study is to investigate the role of blood pressure-related indicators and Thrombospondin 3 (THBS3) in the association between hyperuricemia and CHD. METHODS AND RESULTS Our observational epidemiology study included 593 CHD cases and 760 controls from a residential stable sample. We also chose 43 new CHD patients and 43 controls to test the expression levels of THBS3 using ELISA kits. We used logistic regression models and mediating effect analysis to investigate the relationships between hyperuricemia and CHD, as well as the mediating role of blood pressure-related indicators and THBS3. In the general population (OR: 2.001 [95% CI: 1.528-2.622]), male population (OR: 1.591 [95% CI: 1.119-2.262]), and female population (OR: 2.813 [95% CI: 1.836-4.310]), hyperuricemia is an independent risk factor for CHD. In general, average systolic blood pressure (SBP) and average pulse pressure difference (PPD) mediated 3.35% and 4.59%, respectively, of the association between hyperuricemia and CHD, and 6.60% and 6.60% in women. However, in the male population, we have not yet found that blood pressure-related indicators had a significant mediating effect. Meanwhile, we found that THBS3 mediated 19.23% of the association between hyperuricemia and CHD. CONCLUSIONS Average SBP, PPD, and THBS3 all play a role in the association of hyperuricemia and CHD. In the female population, similar mediating results in blood pressure-related indicators were observed.
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Affiliation(s)
- Le Yang
- School of Public Health, Fujian Medical University, Fujian, China
| | - Qinfei Wei
- School of Public Health, Fujian Medical University, Fujian, China
| | - Yu Sun
- School of Public Health, Fujian Medical University, Fujian, China
| | - Jianhui Guo
- School of Public Health, Fujian Medical University, Fujian, China
| | - Xingyan Xu
- School of Public Health, Fujian Medical University, Fujian, China
| | - Zhiyu Zhang
- School of Public Health, Fujian Medical University, Fujian, China
| | - Li Zhu
- School of Public Health, Fujian Medical University, Fujian, China
| | - Xiaofeng Zheng
- School of Public Health, Fujian Medical University, Fujian, China
| | - Fang Liu
- School of Public Health, Fujian Medical University, Fujian, China
| | - Jiadong Wu
- School of Public Health, Fujian Medical University, Fujian, China
| | - XiaoXu Xie
- School of Public Health, Fujian Medical University, Fujian, China
| | - Shaowei Lin
- School of Public Health, Fujian Medical University, Fujian, China
| | - Huangyuan Li
- School of Public Health, Fujian Medical University, Fujian, China
| | - Siying Wu
- School of Public Health, Fujian Medical University, Fujian, China.
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Chen R, Wang Q, Wang D, Liu X, Wang H, Guo J, Liu X. Post-healing perceptions and experiences of alcohol withdrawal and life management in men with alcoholic pancreatitis: a qualitative study. Front Psychol 2023; 14:1192835. [PMID: 37655196 PMCID: PMC10466781 DOI: 10.3389/fpsyg.2023.1192835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/02/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction The aim of this study was to examine the perceptions and experiences of male patients with alcoholic pancreatitis after healing regarding alcohol withdrawal and life management. Methods This study used a qualitative descriptive design, and participants were selected by purposive sampling from two tertiary care hospitals in Shandong Province, China. Semi-structured in-depth interviews were conducted with 18 male patients discharged from the gastroenterology department who had recovered from alcoholic pancreatitis. Colaizzi's method was used to analyze the interview data, and the findings were reported using COREQ criteria. Results By analyzing the interview data, we summarized five themes, (1) the dilemma of sobriety, (2) role change, (3) illness status, (4) family influence, and (5) life management. Conclusion By profiling the perceptions and experiences of post-healing alcoholic pancreatitis patients' alcohol cessation and life management in men, it helps to grasp the details of alcohol cessation and health direction of patients' home management, which provides more directional guidance to help patients maintain positive and good lifestyle habits and active management awareness, followed by targeted personalized interventions to provide patients with knowledge of disease care and health management.
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Affiliation(s)
- Runpeng Chen
- Department of Nursing, Binzhou Medical University, Yantai, Shandong Province, China
| | - Qinghua Wang
- Department of Nursing, Binzhou Medical University, Yantai, Shandong Province, China
| | - Dongyang Wang
- Faculty of Nursing, Mahidol University, Nakhon Pathom, Thailand
- Department of Nursing, The Third People’s Provincial Hospital of Henan Province, Zhengzhou, Henan Province, China
| | - Xinyue Liu
- Shengli Oilfield Central Hospital, Dongying, Shandong Province, China
| | - Haiyun Wang
- Shengli Oilfield Central Hospital, Dongying, Shandong Province, China
| | - Jiaoyang Guo
- Shengli Oilfield Central Hospital, Dongying, Shandong Province, China
| | - Xinghui Liu
- Shandong Vheng Data Technology Co., Ltd., Yantai, Shandong Province, China
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Wu Z, Jiang Y, Li P, Wang Y, Zhang H, Li Z, Li X, Tao L, Gao B, Guo X. Association of impaired sensitivity to thyroid hormones with hyperuricemia through obesity in the euthyroid population. J Transl Med 2023; 21:436. [PMID: 37403157 DOI: 10.1186/s12967-023-04276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/14/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Impaired sensitivity to thyroid hormones is a newly proposed clinical entity associated with hyperuricemia in the subclinical hypothyroid population. However, it is unknown whether the association exists in the euthyroid population. This study aimed to explore the association of impaired sensitivity to thyroid hormones (assessed by the thyroid feedback quantile-based index [TFQI], parametric thyroid feedback quantile-based index [PTFQI], thyrotrophic thyroxine resistance index [TT4RI] and thyroid-stimulating hormone index [TSHI]) with hyperuricemia and quantify the mediating effect of body mass index BMI in the euthyroid population. METHODS This cross-sectional study enrolled Chinese adults aged ≥ 20 years who participated in the Beijing Health Management Cohort (2008-2019). Adjusted logistic regression models were used to explore the association between indices of sensitivity to thyroid hormones and hyperuricemia. Odds ratios [OR] and absolute risk differences [ARD] were calculated. Mediation analyses were performed to estimate direct and indirect effects through BMI. RESULTS Of 30,857 participants, 19,031 (61.7%) were male; the mean (SD) age was 47.3 (13.3) years; and 6,515 (21.1%) had hyperuricemia. After adjusting for confounders, individuals in the highest group of thyroid hormone sensitivity indices were associated with an increased prevalence of hyperuricemia compared with the lowest group (TFQI: OR = 1.18, 95% CI 1.04-1.35; PTFQI: OR = 1.20, 95% CI 1.05-1.36; TT4RI: OR = 1.17, 95% CI 1.08-1.27; TSHI: OR = 1.12, 95% CI 1.04-1.21). BMI significantly mediated 32.35%, 32.29%, 39.63%, and 37.68% of the associations of TFQI, PTFQI, TT4RI and TSHI with hyperuricemia, respectively. CONCLUSIONS Our research revealed that BMI mediated the association between impaired sensitivity to thyroid hormones and hyperuricemia in the euthyroid population. These findings could provide useful evidence for understanding the interaction between impaired sensitivity to thyroid hormone and hyperuricemia in euthyroid individuals and suggest the clinical implications of weight control in terms of impaired thyroid hormones sensitivity.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Yue Jiang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Pingan Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Yutao Wang
- Shanghai Fufan Information Technology Co., Ltd, No.323 Guoding Road, Yangpu District, Shanghai, 200433, China
| | - Haiping Zhang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, 3086, Australia
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
| | - Bo Gao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
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He H, Pan L, Wang D, Liu F, Du J, Pa L, Wang X, Cui Z, Ren X, Wang H, Peng X, Zhao J, Shan G. The association between muscle-to-fat ratio and cardiometabolic risks: The China National Health Survey. Exp Gerontol 2023; 175:112155. [PMID: 36940562 DOI: 10.1016/j.exger.2023.112155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/25/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND The relationship between muscle mass and fat mass might be an indicator to assess the cardiometabolic risk independently from overweight/obesity, but evidence from a representative general Chinese population is lacking. OBJECTIVE To understand the age- and sex-specific associations between muscle-to-fat ratio (MFR) and cardiometabolic risks in Chinese population. METHODS 31,178 (12,526 men and 18,652 women) subjects from the China National Health Survey were included. Muscle mass and fat mass were assessed by a bioelectrical impedance device. MFR was calculated as muscle mass divided by fat mass. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum lipids, fasting plasma glucose and serum uric acid were measured. General linear regressions, quantile regressions and restricted cubic-spline (RCS) regressions were applied to assess the effect of MFR on cardiometabolic profiles. RESULTS Per unit increase of MFR was associated with a 0.631 (0.759-0.502) mmHg SBP decrease in men, 2.648 (3.073-2.223) in women; 0.480 (0.568-0.392) mmHg DBP decrease in men, 2.049 (2.325-1.774) in women; a 0.054 (0.062-0.046) mmol/L total cholesterol decrease in men, 0.147 (0.172-0.122) in women; 0.084 (0.098-0.070) mmol/L triglycerides decrease in men, 0.225 (0.256-0.194) in women; a 0.045 (0.054-0.037) mmol/L low-density lipoprotein decrease in men, 0.183 (0.209-0.157) in women; a 2.870 (2.235-3.506) μmol/L serum uric acid decrease in men, 13.352 (14.967-11.737) in women; and a 0.027 (0.020-0.033) mmol/L high-density lipoprotein increase in men, 0.112 (0.098-0.126) mmol/L in women. The effect in overweight/obese people was much significant than in under/normal weight counterparts. The RCS curves revealed both linear and non-linear relationships between increased MFR and lower cardiometabolic risk. CONCLUSIONS Muscle-to-fat ratio is independently associated with multiple cardiometabolic parameters among Chinese adults. Higher MFR is related with better cardiometabolic health, and the effect is much significant in overweight/obese people and women.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Dingming Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Jianwei Du
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Xianghua Wang
- Integrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Hailing Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Hohhot, China
| | - Xia Peng
- Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Jingbo Zhao
- Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China.
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Yin T, Lu Y, Xiong W, Yu C, Yin D, He H. Occupational Risk Factors for Physical and Mental Health in Primary Healthcare Providers: A National Cross-Sectional Survey from 62 Urban Communities in China. J Multidiscip Healthc 2023; 16:751-762. [PMID: 36969734 PMCID: PMC10032140 DOI: 10.2147/jmdh.s401914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Purpose To understand the physical and mental health status of primary healthcare providers (PHPs) including physicians, nurses and other staff and the workplace risk factors for depression, anxiety and intention-to-leave. Patients and Methods In December 2021, a national cross-sectional survey was conducted from 62 urban communities in China, and all PHPs were invited to complete a standardized questionnaire. Information on demographic, health-related lifestyle, cardiovascular risk factors and physical health status, occupational stress and intention-to-leave was collected. Depression and anxiety were assessed using the Zung Self-Rating Anxiety/Depression Scale (SAS/SDS). Results A total of 4901 PHPs were included. 67.0% males currently drank alcohol vs 25.3% in females; 36.0% males currently smoked cigarettes vs 1.4% in females. Notably, more than half males were overweight or obese, but this proportion was 24.2% in females. The prevalence of chronic diseases, including hypertension, diabetes, dyslipidemia, non-alcoholic fatty liver disease, gout, and disease clustering were higher in males than in females. The prevalence of depression and anxiety were high, 50% had depression, of whom 15.6% had moderate/severe depression. Over 15% participants had varied levels of anxiety, and approximately 4% had moderate/severe anxiety. PHPs who aged 18-29 (OR: 1.31, 95% CI: 1.05-1.64), were males (OR: 1.34, 95% CI: 1.14-1.57), with lower professional title (comparing with staff with senior title, the ORs of the intermedium, junior and none were 1.83, 2.18 and 2.49, respectively), took charge in nursing (OR: 1.41, 95% CI: 1.20-1.65), with higher perceived stress level (OR: 1.82, 95% CI: 1.41-2.34), and suffering from severe fatigue (OR: 2.55, 95% CI: 1.99-3.27) were more likely to have depression. Likewise, PHPs who were younger, with intermedium professional title, had higher perceived pressure level, and higher fatigue levels were more likely to have anxiety. Conclusion The mental health of PHPs is worrisome, with a high burden of chronic diseases and occupational risk factors. Younger PHPs, nurses, and those with higher levels of work pressure and fatigue are more vulnerable to psychological problems. The high prevalence of intention-to-leave calls for strategies that relieve the workplace stress and enhance the human resource capability.
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Affiliation(s)
- Tao Yin
- Department of Technology, Capital Institute of Pediatrics, Beijing, People’s Republic of China
| | - Yan Lu
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Wei Xiong
- Department of Gynecology Endocrine & Reproductive Center, National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College/Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Chengdong Yu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing, People’s Republic of China
| | - Delu Yin
- Department of Child Health Care, Capital Institute of Pediatrics, Beijing, People’s Republic of China
- Delu Yin, Department of Child Health Care, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing, 100020, People’s Republic of China, Tel +8613810349722, Email
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Huijing He, Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, People’s Republic of China, Tel +8615010086743, Email
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9
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Vafa L, Amini M, Kamran H, Aghakhani L, Hosseini SV, Mohammadi Z, Haghighat N. The Impact of Obesity Surgery on Serum Uric Acid in People With Severe Obesity: A Retrospective Study. Clin Nutr Res 2023; 12:21-28. [PMID: 36793775 PMCID: PMC9900075 DOI: 10.7762/cnr.2023.12.1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Studies indicate an association between hyperuricemia (HUA) and metabolic syndrome risk factors. On the other hand, obesity is a major modifiable and independent risk factor for HUA and gout. However, evidence concerning the effects of bariatric surgery on serum uric acid levels is limited and not completely clarified. This retrospective study was carried out with 41 patients who underwent sleeve gastrectomy (n = 26) and Roux-en-Y gastric bypass (n = 15) from September 2019 to October 2021. Anthropometric, clinical, and biochemical data, including uric acid blood urea nitrogen and creatinine fasting blood sugar (FBS), serum triglyceride (TG), and serum cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), were measured preoperatively and postoperative 3, 6 and 12 months. From baseline to 6 and 12 months, bariatric surgery resulted in a significant decrease in serum uric acid of patients with severe obesity (p < 0.001). The decreases in serum FBS, TG, and cholesterol of patients were significant during 6 and 12 months of follow-up (p < 0.05). However, the HDL increase of patients was not statistically significant in 6 and 12 months (p > 0.05). Besides, although patients' serum level of LDL decreased significantly during the 6 months of follow-up (p = 0.007), it was not significant after 12 months (p = 0.092). Bariatric surgery significantly reduces serum uric acid levels. Therefore, it may be an effective supplementary therapy for lowering serum uric acid concentrations in morbidly obese patients.
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Affiliation(s)
- Leila Vafa
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Masoud Amini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Hooman Kamran
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Ladan Aghakhani
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Seyed Vahid Hosseini
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Zahra Mohammadi
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Neda Haghighat
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
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10
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Association between Serum Uric Acid and Liver Enzymes in Adults Aged 20 Years and Older in the United States: NHANES 2005-2012. J Clin Med 2023; 12:jcm12020648. [PMID: 36675577 PMCID: PMC9864736 DOI: 10.3390/jcm12020648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/31/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Although the relationship between serum uric acid (SUA) and nonalcoholic fatty liver disease has been widely reported, the relationship between SUA and liver enzymes has rarely been reported. The purpose of this study was to evaluate the association of SUA levels with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in populations aged 20 years and older in the United States. We analyzed 7165 individuals aged 20 years and older from the National Health and Nutrition Examination Survey (NHANES) in the United States. Weighted multiple linear regression models were used to analyze the relationship between SUA and ALT and AST. A generalized additive model and a smooth curve fitting were used to observe the linear relationship. SUA was positively correlated with ALT and AST. In addition, the overall increasing trend of ALT and SUA was observed across the SUA quartile groups. In the stratified analysis by sex and race, the SUA levels in male, female, Mexican American, and Non-Hispanic White individuals, and those of another race, were positively correlated with ALT and AST. However, the SUA levels in Non-Hispanic Black individuals had a nonlinear relationship with ALT and AST. In individuals aged 20 years and older in the United States (excluding Non-Hispanic Black individuals), SUA levels were positively associated with ALT and AST. Therefore, with a rise in SUA levels, liver function should be monitored or intervened with in people aged 20 years and older in the United States.
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11
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Lin B, Pan L, He H, Hu Y, Tu J, Zhang L, Cui Z, Ren X, Wang X, Nai J, Shan G. Spousal Similarities in Cardiovascular Risk Factors in Northern China: A Community-Based Cross-Sectional Study. Int J Public Health 2023; 68:1605620. [PMID: 36895713 PMCID: PMC9988901 DOI: 10.3389/ijph.2023.1605620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Objectives: The aim of this study was to explore spousal similarities in cardiovascular risk factors in northern China. Methods: We conducted a cross-sectional study of married couples from Beijing, Hebei, Gansu, and Qinghai provinces between 2015 and 2019. A total of 2,020 couples were included in the final analyses. The spousal similarities for metabolic indicators and cardiovascular risk factors (including lifestyle factors and cardiometabolic diseases) were evaluated using Spearman's correlation and logistic regression analyses, respectively. Results: All metabolic indicators showed positive spousal correlations (p < 0.001), with the strongest for fasting blood glucose (r = 0.30) and the lowest for high-density lipoprotein cholesterol (r = 0.08). Significant husband-wife associations were observed for several cardiovascular risk factors except for hypertension in multivariable models, with the strongest association for physical inactivity (odds ratios with 95% confidence intervals of 3.59 [2.85, 4.52] and 3.54 [2.82, 4.46] for husbands and wives, respectively). In addition, the interaction of age with spousal overweight/obesity status was statistically significant, and the association was stronger in people ≥50 years. Conclusion: There were spousal similarities in cardiovascular risk factors. The finding may have public health implications that targeted screening and interventions for spouses of people with cardiovascular risk factors.
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Affiliation(s)
- Binbin Lin
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ji Tu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Ze Cui
- Department of Chronic and Non-Communicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Xiaolan Ren
- Department of Chronic and Non-Communicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xianghua Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Jing Nai
- Clinical Laboratory, Beijing Hepingli Hospital, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
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12
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Elevated miR-143 and miR-34a gene expression in human visceral adipose tissue are associated with insulin resistance in non-diabetic adults: a cross-sectional study. Eat Weight Disord 2022; 27:3419-3428. [PMID: 36181617 DOI: 10.1007/s40519-022-01476-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/09/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE We aimed to evaluate the association of miR-143 and miR-34a expression in human visceral (VAT) and subcutaneous (SAT) adipose tissues with insulin resistance (IR). METHODS VAT and SAT were obtained from 176 participants without diabetes. miR-143 and miR-34a expressions in VAT and SAT were measured using qRT-PCR. Fasting serum insulin and glucose concentration, homeostatic model assessment of IR index (HOMA-IR) and β-cell function (HOMA-B), and quantitative insulin-sensitivity check index (QUICKI) were calculated. RESULTS After adjustment for age, sex and body mass index (BMI), VAT miR-143 expression was positively associated with fasting plasma glucose (FPG), insulin, and HOMA-IR, and negatively associated with HOMA-B and QUICKI. miR-34a expression in VAT was directly associated with FPG, insulin, and HOMA-IR and negatively associated with QUICKI. In SAT, miR-34a expression was positively associated with insulin and negatively associated with QUICKI. The interaction terms of HOMA-IR and BMI categories were significant for both miR gene expressions in VAT. After stratifying participants based on BMI, the association of miR-143 and miR-34a expressions in VAT with IR indices remained significant only in obese patients. CONCLUSION miR-143 and miR-34a expressions in VAT were independent predictors of IR in people without diabetes, and that this association was conditional on the degree of obesity. LEVEL OF EVIDENCE Level of evidence III, cross-sectional analytic study.
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Fat-to-Muscle Ratio Is Independently Associated with Hyperuricemia and a Reduced Estimated Glomerular Filtration Rate in Chinese Adults: The China National Health Survey. Nutrients 2022; 14:nu14194193. [PMID: 36235845 PMCID: PMC9573307 DOI: 10.3390/nu14194193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The effects of the fat-to-muscle ratio (FMR) on hyperuricemia and a reduction in the estimated glomerular filtration rate (eGFR) are still unclear. METHODS Data from the China National Health Survey were used to explore the associations of the FMR with hyperuricemia and reduced eGFR. The fat mass and muscle mass were measured through bioelectrical impedance analysis. Mediation analysis was used to estimate the mediated effect of hyperuricemia on the association between the FMR and reduced eGFR. RESULTS A total of 31171 participants were included. For hyperuricemia, compared with the Q1 of the FMR, the ORs (95% CI) of Q2, Q3 and Q4 were 1.60 (1.32-1.95), 2.31 (1.91-2.80) and 2.71 (2.15-3.43) in men and 1.91 (1.56-2.34), 2.67 (2.12-3.36) and 4.47 (3.40-5.89) in women. For the reduced eGFR, the ORs (95% CI) of Q2, Q3 and Q4 of the FMR were 1.48 (1.18-1.87), 1.38 (1.05-1.82) and 1.45 (1.04-2.04) in men aged 40-59, but no positive association was found in younger men or in women. Hyperuricemia mediated the association between the FMR and reduced eGFR in men. The OR (95% CI) of the indirect effect was 1.08 (1.05-1.10), accounting for 35.11% of the total effect. CONCLUSIONS The FMR was associated with hyperuricemia and reduced eGFR, and the associations varied based on sex and age. The effect of the FMR on the reduced eGFR was significantly mediated by hyperuricemia in men.
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Association of Visceral Fat Area and Hyperuricemia in Non-Obese US Adults: A Cross-Sectional Study. Nutrients 2022; 14:nu14193992. [PMID: 36235645 PMCID: PMC9570922 DOI: 10.3390/nu14193992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
This study aimed to investigate the relationship between visceral fat area (VFA) and hyperuricemia (HUA) among non-obese adults. We extracted data from 6224 US adults aged 20−59 years from the National Health and Nutrition Examination Survey (NHANES) from 2011−2018. The VFA was divided into four quartiles (Q1−Q4). We used multivariable logistic regression models to control for known confounders. A generalized additive model (GAM) and restricted cubic spines were used to examine the association between VFA and HUA stratified by sex, and a two-piecewise linear regression model was used to calculate the threshold effect among males. The results revealed that the prevalence of HUA was 11.8% (men 15.8%, women 7.2%). In the fully adjusted model, there was a positive association between VFA and HUA [as a quartile variable, Q4 vs. Q1, odds ratio (OR): 3.77 and 95% confidence interval (CI): (2.47~5.75), p < 0.001, p for trend < 0.001; as a continuous variable, per 10 cm2 increment, OR (95%CI):1.10(1.07,1.14), p < 0.001]. Besides, this positive association remained significantly stratified by sex. Interestingly, we observed a nonlinear dose-response relationship between VFA and HUA in males (inflection point: 107.46 cm2). In conclusion, our study confirmed a significant positive relationship between VFA and HUA among non-obese adults and remained statistically significant when stratified by sex.
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Lin H, Xu Y, Zheng Y, Wu D, Ye Z, Xiao J. The association of urinary prostaglandins with uric acid in hyperuricemia patients. BMC Nephrol 2022; 23:302. [PMID: 36057582 PMCID: PMC9441060 DOI: 10.1186/s12882-022-02928-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To explore the association between uric acid and urinary prostaglandins in male patients with hyperuricemia. Methods A total of 38 male patients with hyperuricemia in outpatients of Huadong Hospital from July 2018 to January 2020 were recruited. Serum uric acid (SUA), 24 h urinary uric acid excretion and other indicators were detected respectively. 10 ml urine was taken to determine prostaglandin prostaglandin D (PGD), prostaglandin E1 (PGE1), prostaglandin E2 (PGE2), 6-keto-PGF1α, thromboxane A2 (TXA2) and thromboxane B2 (TXB2). Fraction of uric acid excretion (FEua) and uric acid clearance rate (Cua) were calculated. According to the mean value of FEua and Cua, patients were divided into two groups, respectively. The independent-samples t test and the Mann–Whitney U test were applied for normally and non-normally distributed data, respectively. Results After adjusting confounding factors (age, BMI, eGFR, TG, TC, HDL and LDL), SUA was negatively correlated with urinary PGE1(r = -0.615, P = 0.009) and PGE2(r = -0.824, P < 0.001). Compared with SUA1 group (SUA < 482.6 mg/dl), SUA2 (SUA \documentclass[12pt]{minimal}
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\begin{document}$$\ge$$\end{document}≥ 482.6 mg/dl) had lower urinary PGE1(P = 0.022) and PGE2(P = 0.019) levels. Cua was positively correlated with PGE2 (r = 0.436, P = 0.01). The correlation persisted after adjustment for age, BMI, eGFR, TG, TC, HDL and LDL by multiple linear regression analysis. In the Cua1 group (Cua < 4.869 mL /min/1.73 m2), PGE2 were lower than that in Cua2 (Cua \documentclass[12pt]{minimal}
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\begin{document}$$\ge$$\end{document}≥ 4.869 mL /min/1.73 m2) group (P = 0.011). Conclusions In male patients with hyperuricemia, SUA was negatively correlated with urinary PGE2, Cua was positively correlated with urinary PGE2. Urinary PGE2 were significantly different between different SUA and Cua groups.
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Affiliation(s)
- Huagang Lin
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Ying Xu
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P.R. China
| | - Yuqi Zheng
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P.R. China
| | - Deping Wu
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Zhibin Ye
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P.R. China. .,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.
| | - Jing Xiao
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P.R. China. .,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.
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16
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Chen Y, Yang Y, Zheng Z, Wang H, Wang X, Si Z, Meng R, Wang G, Wu J. Influence of occupational exposure on hyperuricemia in steelworkers: a nested case-control study. BMC Public Health 2022; 22:1508. [PMID: 35941633 PMCID: PMC9361698 DOI: 10.1186/s12889-022-13935-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Occupational exposure may be associated with an increased risk of developing hyperuricemia. This study sheds lights on the association between occupational exposure and hyperuricemia in steelworkers. METHOD A nested case-control study was conducted within a cohort of workers in steel companies to explore the association between occupational exposure and hyperuricemia. The case group consisted of a total of 641 cases of hyperuricemia identified during the study period, while 641 non-hyperuricemia subjects with the same age and gender distribution were randomly selected from the cohort as the control group. RESULTS The incidence rate of hyperuricemia among workers in the steel company was 17.30%, with an incidence density of 81.32/1,000 person-years. In comparison to the reference group, the risks of developing hyperuricemia for steelworkers undergoing ever shifts, current shifts, heat exposure, and dust exposure were 2.18 times, 1.81 times, 1.58 times and 1.34 times higher respectively. The odds ratios (ORs) and 95% confidence intervals (CIs) were 1.87(1.12-3.13) and 2.02(1.21-3.37) for the cumulative number of days of night work at 0-1,972.80 and ≥ 1,972.80 (days), respectively. Compared to the group with the cumulative heat exposure of 0 (°C/year), the ORs (95% CI) for the risk of developing hyperuricemia in the groups with the cumulative heat exposure of 0-567.83 and ≥ 567.83 (°C/year) were 1.50(1.02-2.22) and 1.64(1.11-2.43), respectively. The OR (95% CI) for the risk of developing hyperuricemia was 1.56(1.05-2.32) at the cumulative dust exposure of ≥ 30.02 (mg/m3/year) compared to that at the cumulative dust exposure of 0 (mg/m3/year). Furthermore, there was a multiplicative interaction between heat exposure and dust exposure in the development of hyperuricemia. CONCLUSION Shift work, heat, and dust are independent risk factors for the development of hyperuricemia in steelworkers. Additionally, there is a multiplicative interaction between heat exposure and dust exposure in the development of hyperuricemia. Interventions for shift work, heat and dust may help to reduce the incidence rate of hyperuricemia and improve the health of steelworkers.
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Affiliation(s)
- Yuanyu Chen
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Yongzhong Yang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Ziwei Zheng
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Hui Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Xuelin Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Zhikang Si
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Rui Meng
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Guoli Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China.,Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, North China University of Science and Technology, Tangshan, Hebei, People's Republic of China
| | - Jianhui Wu
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China. .,Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, North China University of Science and Technology, Tangshan, Hebei, People's Republic of China.
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He H, Guo P, He J, Zhang J, Niu Y, Chen S, Guo F, Liu F, Zhang R, Li Q, Ma S, Zhang B, Pan L, Shan G, Zhang M. Prevalence of hyperuricemia and the population attributable fraction of modifiable risk factors: Evidence from a general population cohort in China. Front Public Health 2022; 10:936717. [PMID: 35968481 PMCID: PMC9366258 DOI: 10.3389/fpubh.2022.936717] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/08/2022] [Indexed: 12/03/2022] Open
Abstract
Data on updated hyperuricemia prevalence in Beijing-Tianjin-Hebei (BTH) region in China, which is one of the world-class urban agglomerations, is sparse. Overweight/obesity, alcohol consumption, smoking and sedentary behavior are modifiable risk factors (MRFs) for elevated serum uric acid (SUA), but their population attributable fractions (PAFs) for hyperuricemia is still unclear. Using baseline data from the BTH Physical Examination General Population Cohort, we calculated the crude- and adjusted-prevalence of hyperuricemia based on the 30,158 participants aged 18–80 years. Hyperuricemia was defined as SUA >420 μmol/L in men and >360 μmol/L in women, or currently use of uric acid lowering drugs. Overweight/obesity, alcohol consumption, smoking and sedentary behavior were considered as MRFs and their adjusted PAFs were estimated. The prevalence of hyperuricemia was 19.37%, 27.72% in men and 10.69% in women. The PAFs and 95% confidence intervals for overweight, obesity were 16.25% (14.26–18.25%) and 12.08% (11.40–12.77%) in men, 13.95% (12.31–15.59%) and 6.35% (5.97–6.74%) in women, respectively. Alcohol consumption can explain 4.64% (2.72–6.56%) hyperuricemia cases in men, but with no statistical significance in women. Cigarette smoking contributed to 3.15% (1.09–5.21%) cases in men, but a much lower fraction in women (0.85%, 0.49–1.22%). Compared with sedentary time <2 h per day, the PAFs of 2–4 h, 4–6 h, and more than 6 h per day were 3.14% (1.34–4.93%), 6.72% (4.44–8.99%) and 8.04% (4.95–11.13%) in men, respectively. Sedentary time was not found to be associated with hyperuricemia in women. These findings concluded that hyperuricemia is prevalent in this representative Chinese adult general population with substantial sex difference. Four MRFs (overweight/obesity, alcohol consumption, cigarette smoking and sedentary behavior) accounted for a notable proportion of hyperuricemia cases. The PAF estimations enable the exploration of the expected proportion of hyperuricemia cases that could be prevented if the MRFs were removed, which warrants the public health significance of life-style intervention.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Pei Guo
- School of Medicine, Nankai University, Tianjin, China
| | - Jiangshan He
- School of Medicine, Nankai University, Tianjin, China
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing, China
| | - Yujie Niu
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing, China
| | - Fenghua Guo
- School of Medicine, Nankai University, Tianjin, China
| | - Feng Liu
- Beijing Physical Examination Center, Beijing, China
| | - Rong Zhang
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China
| | - Qiang Li
- Beijing Physical Examination Center, Beijing, China
| | - Shitao Ma
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China
| | - Binbin Zhang
- School of Medicine, Nankai University, Tianjin, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Minying Zhang
| | - Minying Zhang
- School of Medicine, Nankai University, Tianjin, China
- Guangliang Shan
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18
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He H, Pan L, Ren X, Wang D, Du J, Cui Z, Zhao J, Wang H, Wang X, Liu F, Pa L, Peng X, Yu C, Wang Y, Shan G. Joint Effect of Beer, Spirits Intake, and Excess Adiposity on Hyperuricemia Among Chinese Male Adults: Evidence From the China National Health Survey. Front Nutr 2022; 9:806751. [PMID: 35273987 PMCID: PMC8902589 DOI: 10.3389/fnut.2022.806751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/04/2022] [Indexed: 12/22/2022] Open
Abstract
Alcohol intake and excess adiposity are associated with serum uric acid (SUA), but their interaction effect on hyperuricemia (HUA) remains unclear. Using data from the China National Health Survey (CNHS) (2012-2017), we analyzed the additive interaction of beer, spirits intake, excess adiposity [measured by body mass index (BMI), body fat percentage (BFP), and visceral fat index (VFI)] with HUA among male participants aged 20-80 from mainland China. The relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (SI) were calculated to assess the interaction effect on the additive scale. Both RERI and AP larger than 0 and SI larger than 1 indicate a positive additive interaction. Among 12,592 male participants, the mean SUA level was 367.1 ± 85.5 μmol/L and 24.1% were HUA. Overweight/obese men who were presently drinking spirits had an odds ratio (OR) of 3.20 (95%CI: 2.71-3.79) than the never drink group, with RERI, AP, and SI of 0.45 (95%CI: 0.08-0.81), 0.14 (95%CI: 0.03-0.25), and 1.25 (95%CI: 1.02-1.54), respectively. However, although combined exposures on beer intake and excess adiposity had the highest OR compared with no beer intake and nonobese participants, there was no additive interaction, with RERI, AP, and SI in the overweight/obesity and the beer intake group of 0.58 (-0.41-1.57), 0.17 (-0.08-0.41), and 1.30 (0.85-1.97), respectively. Other excess adiposity indexes revealed similar estimates. Our findings suggested that the exposures of both excess adiposity and alcohol drink could result in an additive interaction effect on HUA: the combined risk of excess adiposity with spirits intake but not with beer was greater than the sum of the effects among Chinese male adults.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Dingming Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Jianwei Du
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Jingbo Zhao
- Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Hailing Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Hohhot, China
| | - Xianghua Wang
- Integrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Xia Peng
- Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Chengdong Yu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ye Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
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He H, Pan L, Ren X, Wang D, Du J, Cui Z, Zhao J, Wang H, Wang X, Liu F, Pa L, Peng X, Wang Y, Yu C, Shan G. The Effect of Body Adiposity and Alcohol Consumption on Serum Uric Acid: A Quantile Regression Analysis Based on the China National Health Survey. Front Nutr 2022; 8:724497. [PMID: 35111792 PMCID: PMC8801605 DOI: 10.3389/fnut.2021.724497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 12/20/2021] [Indexed: 12/31/2022] Open
Abstract
Adiposity and alcohol consumption are reported to be associated with a higher level of serum uric acid (SUA), but whether their effect differs on SUA percentile distribution is still unclear. In this study, we aimed to investigate how alcohol intake and body fat percentage (%BF) integrated with body mass index (BMI) influence the distribution of SUA in Chinese adults. Data from the China National Health Survey (CNHS) which included adults from 10 provinces of China were used (n = 31,746, aged 20–80 years, 40% male). %BF and BMI were integrated into eight expanded body composition groups to understand how excess body adiposity affects the distribution of SUA in the populational level. Self-report alcohol intake information was collected by face-to-face questionnaire interview. Quantile regression (QR) was used to analyze the data. We found that adiposity and alcohol consumption were associated with SUA, especially at the upper percentile in both sexes. In obese men, the QR coefficients at the 75th and 95th percentiles were 74.0 (63.1–84.9) and 80.9 (52.5–109.3) μmol/L, respectively. The highest quartile of %BF in men had a 92.6 (79.3–105.9) μmol/L higher SUA levels at its 95th percentile than the 5th quartile (p < 0.001). Compared with normal or underweight with the lowest %BF group (NWBF1), the obesity-highest %BF group (OBBF4) had the strongest positive effect on SUA, especially at the higher percentile of SUA. In BMI-defined normal or underweight participants, a higher quartile of %BF had greater effect size in all SUA percentiles. In men, current alcohol drinking had the strongest effect at the 95th percentile of SUA (QR coefficient: 31.8, with 95% CI: 22.6–41.0) comparing with 14.5, 95% CI of 8.4 to 20.6 in the 5th SUA percentile. High risk of alcohol consumption had a greater effect on SUA, especially in the higher SUA percentile. The observation of stronger association at the higher percentile of SUA suggests that decreasing body adiposity and alcohol intake at the populational level may shift the upper tails of the SUA distributions to lower values, thereby reducing the incidence of hyperuricemia.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Dingming Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Jianwei Du
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Jingbo Zhao
- Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Hailing Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Hohhot, China
| | - Xianghua Wang
- Integrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Xia Peng
- Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Ye Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Chengdong Yu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
- *Correspondence: Guangliang Shan
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He H, Pan L, Liu F, Ren X, Cui Z, Pa L, Zhao J, Wang D, Du J, Wang H, Wang X, Peng X, Yu C, Wang Y, Shan G. The Mediation Effect of Body Composition on the Association Between Menopause and Hyperuricemia: Evidence From China National Health Survey. Front Endocrinol (Lausanne) 2022; 13:879384. [PMID: 35757401 PMCID: PMC9226682 DOI: 10.3389/fendo.2022.879384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/21/2022] [Indexed: 12/22/2022] Open
Abstract
Reproductive factors have been demonstrated to be associated with hyperuricemia. Body composition is an essential determinant influencing serum uric acid (SUA), but it is largely unknown whether increased SUA was influenced by changed body composition during the menopausal transition. As a secondary analysis of China National Health Survey from 2012-to 2017, this study included 18,997 women aged 20 to 80. Menarche age and menopause information were collected by questionnaire interview. Body mass index (BMI), body fat percentage (BFP), fat mass index (FMI), and fat-free mass index (FFMI) were used as body composition indexes. Hyperuricemia was defined as SUA higher than 360μmol/L (approximately 6 mg/dl). Mediation analysis was performed to explore the direct and indirect effects of menopause on hyperuricemia. A 1:2 age-matched case-control data set (n=6202) was designed to control age-related confounders and was used in multivariable analyses. After adjustment of covariates, postmenopausal women had 14.08 (10.89-17.27) μmol/L higher SUA than their premenopausal counterparts. Overweight/obesity and higher levels of BFP, FMI, and FFMI were all found to be positively associated with hyperuricemia. The mediation analysis showed that the total effect of menopause on hyperuricemia was positive, but was substantially mediated by body composition indexes. Forty-five percent of the total effect can be attributed to the indirect effect mediated by BMI (OR for the natural indirect effect (NIE): 1.09, 95%CI: 1.04-1.13), and over 80% mediated by BFP (OR for NIE: 1.23, 95%CI: 1.16-1.29). However, FFMI did not present the mediated role in the association (OR for NIE: 0.99, 95%CI: 0.96-1.02). The findings revealed that body composition, especially the fat mass indexes, significantly mediated the association between menopause and hyperuricemia. The role of body composition as mediator constitutes clinical and public health significance that should be recognized and considered in healthcare for women experiencing their menopause transition.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Jingbo Zhao
- Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Dingming Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Jianwei Du
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Hailing Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Hohhot, China
| | - Xianghua Wang
- Integrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin, China
| | - Xia Peng
- Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Chengdong Yu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ye Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
- *Correspondence: Guangliang Shan,
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