Prevalence and Associated Factors of Lupus in the United States: Third National Health and Nutritional Examination Survey (NHANES III)

Which Sex- and Gender-Based Explanatory Variables Are Associated With Memory Function Poststroke? A Cross-Sectional Analysis of the National Health and Aging Trends Study

OBJECTIVE

To identify sex- and gender-based variables associated with immediate and delayed recall in individuals with stroke.

DESIGN

This was a secondary analysis of data from the National Health and Aging Trends Study (NHATS) using general linear models with a standard stepwise approach.

SETTING

Community.

INTERVENTIONS

Not applicable.

PARTICIPANTS

Participants were eligible for the current analysis if they had a self-reported history of stroke at NHATS Round 1 (2011) and data available on our variables of interest. The final analyses included 366 participants for the immediate recall model and 365 participants for the delayed recall model.

MAIN OUTCOME MEASURES

Independent variables of interest included sex- (8 variables, for example biological sex, depression and anxiety, and comorbidities) and gender-related factors (14 variables, for example education, income, and independence with banking). The dependent variables of interest were the 10-word immediate and delayed recall tests, respectively.

RESULTS

Higher immediate recall scores were associated with younger age, female biological sex, independence with banking, higher income, giving financial gifts, not requiring assistance with activities of daily living, and higher education (P<.001-.04). Higher delayed recall scores were associated with younger age, higher body mass index, higher education, placing importance in socializing, and independence with banking (P<.001-.04).

CONCLUSIONS

We conducted the largest analysis to date of sex- and gender-based factors associated with cognition in individuals with stroke. Stroke rehabilitation scientists and clinicians may consider both biological and sociodemographic factors associated with cognitive function, which may guide holistic poststroke assessments and interventions.

Association of Anti-Smith, Anti-Ro, and Anti-ribonucleoprotein Combination With Accelerated Development of Lupus Nephritis in Systemic Lupus Erythematosus Patients in Saudi Arabia

INTRODUCTION

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disorder affecting multiple organs. Lupus nephritis (LN), one of its serious complications, is characterized by proteinuria and renal dysfunction.

OBJECTIVE

The objective of this study was to evaluate the association between a specific antibody profile (anti-Smith [anti-Sm], anti-Ro, and anti-ribonucleoprotein [anti-RNP]) and the time to develop LN in SLE patients.

METHODS

A retrospective, single-center cohort study was conducted at King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia, and included 128 patients with LN who visited the Rheumatology Clinic between 2014 and 2021. Patients were divided into two groups: a positive serological profile group, which included patients positive for all three antibodies (anti-Sm, anti-Ro, and anti-RNP), and a negative serological profile group (which included patients with at least one negative antibody result). Data on demographics, antibody profiles, time to proteinuria development, and LN classification were analyzed. The time to develop proteinuria from the initial diagnosis of LN to the first detection of proteinuria exceeding 500 mg was categorized into less than 1 year, 1-5 years, 6-10 years, and more than 10 years.

RESULTS

Our findings revealed that a substantial proportion (95%) of patients positive for all three antibodies (anti-Sm, anti-Ro, and anti-RNP) had a significantly higher likelihood of developing proteinuria within the first five years of their SLE diagnosis, compared to 89.66% of patients with a negative serological profile.

CONCLUSION

The findings suggest that the presence of anti-Sm, anti-Ro, and anti-RNP antibodies is associated with a higher risk of early LN development, specifically within five years after initial SLE diagnosis. Regular monitoring and proactive management of high-risk patients can reduce the burden of LN and its complications.

Association between sleep disorders and physical activity in middle-aged Americans: a cross-sectional study from NHANES

BACKGROUND

Among the numerous studies on physical activity and sleep disorders, few have focused on physical activity and sleep disorders in middle-aged people who are particularly stressed. A restricted cubic web (RCS) technique was applied to determine whether physical activity and the self-rated prevalence of sleep disorders exhibit a dose-response relationship in middle-aged adults.

METHODS

This study analyzed 8880 middle-aged adults aged 40-65 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Logistic regression was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) between physical activity and sleep disorders in middle-aged adults. Thereafter, the dose-response connection was examined using RCS.

RESULTS

After adjusting for potential confounders, subjects with MET values in the first quartile (Q1) had odds ratios (OR) for sleep disturbance of 0.851 (95% CI = 0.745-0.973), 0.800 (95% CI = 0.698-0.917), and 0.780 (95% CI = 0.680-0.895) compared to subjects with MET values in the second, third, and fourth quartiles respectively. RCS regression showed a non-linear association between physical activity and sleep disorders in middle-aged adults (non-linearity P = 0.0382). Furthermore, the prevalence of sleep disorders in middle-aged adults decreased with increasing physical activity, reaching a minimum when weekly physical activity was around 166.27MET*h (OR = 0.885, 95% CI = 0.799-0.981).

CONCLUSION

Our research demonstrates that physical activity was negatively associated with sleep disorders.

Trends in global health research among universities in China: a bibliometric analysis

BACKGROUND

There has been considerable progress in developing global health education and research in China. Nevertheless, evidence of the progress of Chinese universities' contributions to global health research is limited. More efforts are needed to depict the progress Chinese universities have collectively made in advancing the field of global health. This study aimed to examine Chinese universities' collective contributions to global health research by describing the longitudinal trends in global health research publications, uncovering research themes in global health, and exploring collaboration patterns.

METHODS

A comprehensive bibliometric analysis was conducted for original research studies of the ten founding members of the China Consortium of Universities for Global Health, one of the largest networks of global health research and education in China.

RESULTS

We found that (1) the number of research publications in the field of global health has steadily increased from 2014 to 2020, (2) non-communicable disease was the most popular research topic, accounting for over one-third of total publications, followed by maternal and child health and neurological and mental disorders and diseases, (3) less than one-fifth of papers involved primary data collection, with the majority of the study populations from low-income and lower-middle-income countries in Asia and Africa, and (4) a sizable collaboration network has been established with co-authors from over 200 oversea universities or organizations, with about one third from the US.

CONCLUSIONS

Despite a variety of challenges and barriers, Chinese universities have been playing an increasingly important role in global health research as assessed by peer-reviewed publications over the last decade. More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China.

Race, Toxic Exposures, and Environmental Health: The Contestation of Lupus among Farmworkers

Extant research has established that low-wage workers of color are at higher risk for occupational exposures. While the medical sociology literature regarding contested illness provides insights into the dynamics surrounding workplace exposures, some environmental illnesses such as lupus have gotten scant analytical attention. This is a significant gap because women of color, who are more likely to hold these high-risk jobs, are disproportionately affected by the disease. We examine a case of pesticide exposure among Black women farmworkers in Florida. We investigate how race and occupation intersect to shape lived experiences with toxics and what role race plays in the process of contesting exposures and illness. Our data include in-depth interviews (N = 36), media coverage, and archival materials. Our findings indicate that race-related factors played an important part in shaping the farmworkers' experiences with exposures, illness, and interaction with elite actors.

Dose-Response Association of Waist-to-Height Ratio Plus BMI and Risk of Depression: Evidence from the NHANES 05-16

BACKGROUND

Obesity or underweight has been found to be associated with depression, but the relationship remains to be determined so that more precise prevention strategies can be implemented. Body mass index (BMI) and waist-height ratio (WHR) were used as indicators to study the dose-response relationship between depression and obesity or underweight.

METHODS

We obtained basic information and disease-related data for 13,975 adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2016 dataset. The depressive status was determined based on the PHQ-9 scale (>4). Logistic regression was used to analyze the association and risk of BMI, WHTR and depressive status. Based on the results of logistic regression, the dose-response relationship between BMI, WHTR and depressive state was analyzed using restricted cubic splines (RCS).

RESULTS

The adjusted model showed that compared with the fourth quartile (Q4) of BMI, the odds ratios (ORs) of depression for Q1, Q2 and Q3 were 0.63 (0.56-0.71), 0.61 (0.54-0.68) and 0.74 (0.66-0.82), and compared with the fourth quartile (Q4) of WHtR, the odds ratios (ORs) of depression for Q1, Q2 and Q3 were 0.55 (0.49-0.62), 0.57 (0.51-0.64) and 0.64 (0.57-0.71), respectively. The restricted cubic spline regression depicted a U-shaped dose-response relationship between continuous changes of obesity indicators and the risk of depression (P1, P2 < 0.001). When the participants' BMI reached approximately 25kg/m2 with the reference value of BMI was 18.5kg/m2, the risk of depression was minimized (OR=0.68, 95% Cl=0.56-0.83). When the WHtR reached approximately 0.52 with the reference value of WHtR was 0.40, the risk of depression was minimized (OR=0.69, 95% Cl=0.54-0.88).

CONCLUSION

We found a significant U-shape correlation between BMI, WHtR and depression. People with slight overweight have the lowest risk of depression. However, according to the International Obesity standards, the population at these levels of weight may have an obesity-chronic disease risk, and this is not recommended.

Association between physical activity and kidney stones based on dose-response analyses using restricted cubic splines

BACKGROUND

This study aimed to determine whether there is a dose-response relationship between physical activity and the self-reported prevalence of kidney stone, based on a restricted cubic splines (RCS) method.

METHODS

This study analyzed 8931 adults aged ≥20 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during 2013-16. Kidney stones and physical activity were defined using a standard questionnaire, and metabolic equivalents (MET) were used to quantify the physical activity level. Logistic regression was used to assess the association between physical activity and the risk of kidney stones, and the dose-response relationship was explored using RCS.

RESULTS

Kidney stones were present in 10.3% of the analyzed individuals: 11.5% of males and 9.2% of females. After adjusting for potential confounders, compared with the first quartile (Q1) of MET, the odds ratios (ORs) of kidney stones for those with Q2, Q3 and Q4 of MET were 0.72 [95% confidence interval (CI)=0.59-0.87], 0.77 (95% CI = 0.63-0.93) and 0.63 (95% CI = 0.51-0.78), respectively (all P < 0.01). The RCS regression showed that physical activity was related to kidney stones in a non-linear manner (P for non-linearity = 0.0100). The prevalence of kidney stones decreasing as physical activity increased, reaching a plateau for physical activity at approximately 2480 MET-min week-1 (OR = 0.75, 95% CI = 0.63-0.91).

CONCLUSIONS

Physical activity is inversely associated with the prevalence of kidney stones, and the dose-response relationship has a plateau, after which the prevalence of kidney stones does not change with the increase of physical activity.