Body Mass Index Asian populations category and stroke and heart disease in the adult population: a longitudinal study of the Indonesia Family Life Survey (IFLS) 2007 and 2014

University Students' Sociodemographics, Physical Inactivity, and Inadequate and Poor-Quality Sleep Are Associated With Their Overweight/Obesity: Findings From a Case-Control Study in Bangladesh

Background and Aims

Evidence confirms a high prevalence of general and abdominal obesity among university students in Bangladesh. The primary objective of this case-control study was to examine the association between overweight/obesity and sleep patterns (including sleep duration and quality) among university students in Bangladesh. The secondary objective was to identify the sociodemographic and lifestyle-related factors that predict overweight/obesity in the study population.

Methods

The sociodemographics and body mass index (BMI) were gathered from a sample of 330 university students (setting: one public university in Bangladesh). Sleep health was measured by the 19-item Pittsburgh Sleep Quality Index (PSQI) and compared between the cases (BMI ≥ 23.0 kg/m2) and controls (BMI = 18.5-22.9 kg/m2). Bivariate and multiple stepwise regression analyses were performed.

Results

One hundred and sixty-five overweight/obesity students and 165 control subjects participated in the study. The peak age for overweight/obesity was 22-25 years in the students, and about 67% of the cases were poor-quality sleepers compared to 53% of the students in the control group. Multiple stepwise regression analysis showed that students' overweight/obesity was associated with being female (adjusted odds ratio, aOR = 2.12; 95% confidence interval, CI: 1.25, 3.61), short sleep duration ( ≤ 7 h/night) (aOR = 1.12, 95% CI: 1.04, 2.66), poor quality of sleep (aOR = 1.82, 95% CI: 1.16, 2.87), and physical inactivity (aOR = 1.89; 95% CI: 1.12, 3.55).

Conclusion

Key factors associated with overweight/obesity among Bangladeshi university students include age (22-25 years), gender (higher prevalence in female students), sleep duration and quality, and physical inactivity. These findings highlight the need for targeted interventions addressing sleep health, physical activity, and healthy lifestyles to mitigate overweight/obesity among university students.

A Retrospective Study of Clinical Biomarkers of Severe Dengue in a Tertiary Hospital in Johor Bahru, Malaysia

Management of severe dengue remains a clinical challenge. This retrospective study evaluated clinical features and laboratory biomarkers associated with severe dengue at Hospital Sultanah Aminah Johor Bahru from 1 January 2022 to 31 March 2023. Records of 99 patients, categorized into ICU (51) and non-ICU (48) groups, were identified and analyzed using SPSS version 28.0. Sociodemographic details, clinical features and laboratory biomarkers were collected. Patients aged 50 and older, those with obesity, and those with pre-existing comorbidities were significantly more likely to be admitted to the ICU. The four most common warning signs in both cohorts were lethargy/restlessness/confusion, abdominal pain, persistent vomiting, and diarrhea. Fever, or history of fever, and thrombocytopenia were the two most common severe dengue criteria present in both cohorts. ICU patients exhibited more signs of plasma leakage and abnormal laboratory findings, including normal white cell count, hypoalbuminemia, hyperbilirubinemia, and elevated creatine kinase. In contrast, leukopenia and normal albumin, bilirubin, and creatine kinase levels were more common in non-ICU patients. Hyponatremia and raised lactate dehydrogenase were seen in both groups. This study highlighted key differences and similarities in clinical features and laboratory biomarkers between ICU and non-ICU patients, emphasizing the need for further research to develop a comprehensive risk assessment tool for predicting severe dengue that resulted in ICU admission.

Atherogenic index of plasma and obesity-related risk of stroke in middle-aged and older Chinese adults: a national prospective cohort study

BACKGROUD

The association between the atherogenic index of plasma (AIP) and stroke risk is uncertain. Overweight and obese individuals frequently develop atherosclerosis, suggesting AIP may mediate the relationship between body mass index (BMI) and stroke risk. This study investigates whether AIP mediates the BMI-stroke association and evaluates the interaction effects of AIP and BMI on stroke risk in middle-aged and older Chinese adults.

METHOD

This study analyzes data from the China Health and Retirement Longitudinal Study (CHARLS), an ongoing nationally representative prospective cohort study that began in 2011. It includes 8 598 middle-aged and older Chinese adults without stroke at baseline. A mediation analysis, employing a novel two-stage regression method, was conducted to evaluate the indirect effect of BMI on stroke through AIP.

RESULTS

During a median follow-up of 7.1 years, 615 (7.2%) participants developed a stroke. After adjusting for confounders, AIP was significantly associated with stroke risk (hazard ratio [HR] per 1-SD increase, 1.24; 95% CI 1.14-1.35). Mediation analysis indicated that compared to normal weight, obesity similarly raised stroke risk by 78.0% (HR 1.78, 95% CI 1.40-2.27), with 29.67% (95% CI 14.27-45.08%) of the association mediated through AIP (HR 1.15, 95% CI 1.08-1.23). No significant multiplicative or additive interactions were observed between BMI and AIP on stroke.

CONCLUSIONS

This study found that the AIP appeared to be associated with stroke risk and mediates the association between obesity and stroke among middle-aged and older Chinese adults.

The mediating effect of sleep disturbance on the association between hypertension and depression: a national data analysis

BACKGROUND

Sleep disturbance is a common among people with hypertension. However, the mediating role of sleep disturbance in the association between hypertension and depression remains unclear. This study aims to investigate the mediating role of sleep disturbance in the association between hypertension and depression.

MATERIALS AND METHODS

This was cross-sectional study. The data were derived from the Indonesian Family Life Survey Fifth Wave (2014-2015). We include a total of 19,138 adults' participants with age range from 18 to 65 years old who completed response on the variable of hypertension, sleep disturbance, and depression. The mediating model analysis was processed using the PROCESS macro ins SPSS from Hayes model.

RESULTS

Depression was reported by 22% of total respondents. The group with hypertension showed a substantially higher prevalence of depression than non-hypertension group (P < 0.001). Hypertension had a significant overall effect on depression (β = 0.682; 95%CI 0.489 to 0.875, P < 0.001). The direct effect of hypertension on depression was significant (β = 0.418; 95%CI 0.244 to 0.592, P < 0.001) and the indirect effect that mediated by sleep disturbance was also significant (β = 0.264, 95%CI 0.174 to 0.356, P < 0.001). It is worth noting that sleep disturbance partially mediated the association between hypertension and depression.

CONCLUSION

The findings of this study indicated that sleep disturbance contributed to the etiology of depression and hypertension in adult populations. Nurses should be involved in managing sleep disturbances, such as using behavioral therapy, as it may serve as both a treatment and primary prevention measure for depression and hypertension.