Project description:BackgroundInflammation exerts a critical role in the pathogenesis of infertility. The relationship between inflammatory parameters from peripheral blood and infertility remains unclear. Aim of this study was to investigate the association between inflammatory markers and infertility among women of reproductive age in the United States.MethodsWomen aged 20-45 were included from the National Health and Nutrition Examination Survey (NHANES) 2013-2020 for the present cross-sectional study. Data of reproductive status was collected from the Reproductive Health Questionnaire. Six inflammatory markers, systemic immune inflammation index (SII), lymphocyte count (LC), product of platelet and neutrophil count (PPN), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) were calculated from complete blood counts in mobile examination center. Survey-weighted multivariable logistic regression was employed to assess the association between inflammatory markers and infertility in four different models, then restricted cubic spline (RCS) plot was used to explore non-linearity association between inflammatory markers and infertility. Subgroup analyses were performed to further clarify effects of other covariates on association between inflammatory markers and infertility.ResultsA total of 3,105 women aged 20-45 was included in the final analysis, with 431 (13.88%) self-reported infertility. A negative association was found between log2-SII, log2-PLR and infertility, with an OR of 0.95 (95% CI: 0.78,1.15; p = 0.60), 0.80 (95% CI:0.60,1.05; p = 0.10), respectively. The results were similar in model 1, model 2, and model 3. Compared with the lowest quartile (Q1), the third quartile (Q3) of log2-SII was negatively correlation with infertility, with an OR (95% CI) of 0.56 (95% CI: 0.37,0.85; p = 0.01) in model 3. Similarly, the third quartile (Q3) of log2-PLR was negatively correlation with infertility, with an OR (95% CI) of 0.61 (95% CI: 0.43,0.88; p = 0.01) in model 3. No significant association was observed between log2-LC, log2-PPN, log2-NLR, log2-LMR and infertility in model 3. A similar U-shaped relationship between log2-SII and infertility was found (p for non-linear < 0.05). The results of subgroup analyses revealed that associations between the third quartile (Q3) of log2-SII, log2-PLR and infertility were nearly consistent.ConclusionThe findings showed that SII and PLR were negatively associated with infertility. Further studies are needed to explore their association better and the underlying mechanisms.
Project description:BackgroundPeriodontal disease is very common worldwide and is one of the main causes of tooth loss in adults. Periodontal disease is characterized by chronic inflammation that can destroy adjacent alveolar bone and lead to a loss of periodontal ligaments. Although previous studies have found that a daily diet can influence the development of periodontal disease (e.g., a diet low in carbohydrates and rich in vitamins C and D and fiber can have a protective effect). Periodontal disease may present as gingivitis or periodontitis. However, studies on the role of healthy eating index in periodontitis are lacking. The purpose of this study was to assess the association between healthy eating index and periodontitis.MethodsWe analyzed data collected from participants in the National Health and Nutrition Examination Survey (NHANES), a nationally representative survey conducted in 2-year cycles from 2013 to 2014. As part of our analysis, we developed multivariate logistic regression models to examine the independent association between the healthy eating index and periodontitis. We evaluated the significance of association using odds ratios (OR) with 95% confidence intervals (95%CI).ResultsIndividuals with a lower total healthy eating index had a higher prevalence of periodontitis. Adjusted multivariate regression models showed that a higher healthy diet index was associated with a lower prevalence of periodontitis (OR = 0.69, 95% CI: 0.55-0.86, P < 0.05).ConclusionThe results of the study showed that dietary structure was associated with the prevalence of periodontitis. Patients with a higher healthy eating index had a lower prevalence of periodontitis. These findings will need to be confirmed by longitudinal, prospective studies in the future.
Project description:BackgroundThe triglyceride-glucose (TyG) index, combined with obesity-related indicators such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), has been proven to be reliable for assessing insulin resistance (IR). The objective of this study is to investigate the relationships between TyG-related parameters and the prevalence of kidney stones among adults in the United States (US).MethodsThis cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007-2020 to evaluate the associations of TyG-related parameters with kidney stones. Weighted logistic regression, restricted cubic spline (RCS) analysis, receiver operating characteristic (ROC) analysis, and subgroup analysis were employed to investigate these relationships.ResultsA total of 15,590 participants were included in the analysis. Significant differences were observed in the distributions of TyG-related parameters between those with and without kidney stones. In the fully adjusted model, participants in the highest quartile of TyG-related parameters had a higher risk of kidney stones compared to those in the lowest quartile [TyG-WC: odds ratio (OR): 2.08, 95% confidence interval (CI): 1.66-2.60; TyG-BMI: OR: 2.03, 95% CI: 1.61-2.57; TyG-WHtR: OR: 2.21, 95% CI: 1.72-2.84]. RCS analysis indicated that these associations were non-linear (P for nonlinearity <0.05). ROC analysis showed that TyG-WC had the highest diagnostic accuracy (area under curve: 0.6130). Subgroup analysis further revealed a stronger positive association between TyG-WC and TyG-WHtR and the prevalence of kidney stones in participants without hypertension (P for interaction <0.05).ConclusionsTaken together, there are strong positive correlations between TyG-related parameters and the prevalence of kidney stones in US adults. Our findings suggest that managing IR and preventing obesity may help reduce the risk of kidney stone formation.
Project description:PurposeThe exposure of Ethylene oxide (EO) is linked to systemic inflammatory response and various cardiovascular risk factors. Hemoglobin's binding to ethylene oxide (HbEO) was used to measure serum EO level. This research aims to explore the association between metabolic syndrome (MetS) and HbEO, and between HbEO and components of metabolic syndrome.MethodThis research included 1842 participants from 2013 to 2020 in National Health and Nutrition Examination Survey (NHANES) database. Weighted logistic regression models were used to analyze the relationship between HbEO and metabolic syndrome risk, using odds ratio (OR) and 95% confidence interval (CI). The restricted cubic spline plot explores whether there is a dose-response relationship between HbEO and MetS risk. Subgroup analysis was performed to analyze study heterogeneity.ResultsSignificant differences were found in gender, educational level, marital status, diabetes status and hypertension among different groups (P < 0.001, P = 0.007, P = 0.003, P < 0.001, P < 0.001, respectively). The serum HbEO level exhibited positive correlation with metabolic syndrome risk in Q2 level (OR=1.64, 1.04~2.48), Q3 level (OR=1.99, 1.29~3.08), and Q4 level (OR=2.89, 1.92~4.34). The dose-response association suggested a possible linear association between serum HbEO and metabolic syndrome risk (P-overall=0.0359, P-non-linear=0.179). L-shaped association was found between HbEO and the risk of MetS in female population, obese population and mid-age and elder population (P-overall<0.001, P-non-linear=0.0024; P-overall=0.0107, P-non-linear=0.0055 P-overall<0.001 P-non-linear=0.0157).ConclusionThis study indicates a linear correlation between MetS and HbEO, with MetS risk escalating as HbEO levels increase. The prevalence of MetS varies depending on BMI, age and gender, and these factors can also influence MetS prevalence when exposed to EO.
Project description:IntroductionChronic kidney disease(CKD) is a global medical problem. Serum methylmalonic acid(MMA) is a serum marker associated with many diseases. This study aimed to investigate the association between MMA and CKD.MethodsData from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 were downloaded and analyzed. The association between MMA and CKD was confirmed by using multiple logistic regression modeling. The smooth curve fitting method was used to investigate the nonlinear relationship between them. Subgroup analyses and interaction tests were used to verify the stability of the association between different subgroups. Threshold effect analysis was used to determine the optimal control point for MMA.ResultsThere was a unique W-shaped nonlinear relationship between MMA and the risk of CKD, with a positive correlation between them (OR=1.66,95% CI:1.27, 2.17; P=0.0002). As the stage of CKD progressed, MMA levels increased. Age, hypertension, and serum vitamin B12 had significant influences on the association between MMA and the risk of CKD.ConclusionOur findings revealed that serum MMA accumulation was positively associated with the risk of CKD. Serum MMA level may be a novel index to predict the development and course of CKD. This study may help in the early identification of people at risk for chronic kidney disease and provide new ideas and approaches for prevention and treatment.
Project description:ObjectiveThis study aims to shed light on the correlation between Healthy Eating Index-2020 (HEI-2020) and heart failure (HF) in American adults aged 50 or above.MethodsData were from the National Health and Nutrition Examination Survey 2005-2020, encompassing 13,105 participants with an age of 50 or above. HEI-2020 score was utilized for rating the dietary quality. The link of HEI-2020 to HF was assessed via logistic regression, restricted cubic splines (RCS), generalized additive models (GAM), weighted quantile sum (WQS) regression, as well as quantile g-computation (Qgcomp) models.ResultsA negative association between HEI-2020 and HF risk was uncovered in middle-aged and older Americans (OR = 0.99, 95% CI: 0.98-1.00, p = 0.006). The highest quartile (Q4) exhibited a markedly lower HF risk than the lowest quartile (Q1) (OR = 0.70, 95% CI: 0.55-0.89, p = 0.004). RCS and GAM analyses demonstrated a linear dose-response relationship between HEI-2020 and HF. Finally, WQS regression and Qgcomp models revealed a beneficial combined influence of 13 dietary components on HF risk, with dairy and whole fruits emerging as the most influential.ConclusionElevated HEI-2020 scores are linked to decreased HF risks among Americans aged 50 or above, suggesting that adherence to the Dietary Guidelines for Americans can mitigate HF risk.
Project description:PurposeTo explore the association between Healthy Eating Index (HEI)-2015 and kidney stones in an American adult population.Materials and methodsNational Health and Nutrition Examination Survey (NHANES) datasets from 2007 to 2018 were used. Participants aged ≥ 20 years who reported kidney stone history and dietary recall were included. Weighted proportions, multivariable analysis and spline smoothing were used to evaluate the associations between HEI-2015 and nephrolithiasis by adjusting gender, age, race, poverty income ratio, body mass index, education level, marital status, smoking, alcohol intake, energy level, vigorous activity, moderate activity, and some comorbidities.ResultsTotally 30 368 American adults were included, with weighted mean age [standard deviation (SD)] of 47.69 (16.85) years. The overall mean HEI-2015 score (SD) was 50.82 (13.80). In the fully-adjusted multivariable model, HEI-2015 was negatively correlated with urolithiasis [odds ratio (OR) = 0.991; 95% confidence interval (CI) 0.988 to 0.994]. Compared with the first quartile of HEI-2015, the population in the fourth quartile of HEI-2015 had a lower prevalence of kidney stones (OR = 0.716; 95% CI 0.635 to 0.807). The association was modified by education and vigorous activity.ConclusionsHEI-2015 is inversely associated with the prevalence of kidney stones, which means better diet quality is associated with a lower risk of nephrolithiasis.
Project description:BackgroundInfertility is a significant national public health concern, and the World Health Organization (WHO) predicts that it will rank as the third most prevalent disease following tumors, cardiovascular and cerebrovascular diseases. The impact of dysfunctional lipoproteins on female infertility remains relatively understudied; therefore, the research focuses on exploring the relationship between serum high-density lipoprotein (HDL) concentration and infertility.MethodsThis is a retrospective cross-sectional study where we employed multivariate logistic regression analysis to examine the association between serum HDL concentrations and female infertility. The strength of association was quantified using odds ratios (OR) along with their corresponding 95% confidence intervals and statistical significance was evaluated at a level of P < 0.05 (two-tailed).ResultsThe study found that there was a significant correlation between serum HDL and infertility without adjusting the model (OR = 0.62, 95%CI 0.48-0.82, P<0.001). After adjusting for covariates, a weak correlation between HDL and infertility remained (OR = 0.70, 95%CI 0.49-1.00). When HDL concentrations were divided into quartiles, there was a trend of strengthened correlation between HDL and infertility risk with the increase in HDL concentrations. Specifically, individuals in the highest concentration quartile exhibited a 44.0% lower risk of infertility compared to those in the lowest concentration quartile (95% CI 0.38-0.84). In the age-stratified analysis, after adjusting for covariates, the correlation between HDL and infertility was statistically insignificant across all age groups. Furthermore, after categorizing HDL levels into quartiles, we observed a dose-dependent trend between HDL and the reduction of female infertility risk in the adjusted models of the secondary infertility group. Specifically, in the adjusted model, the high-concentration group exhibited a 67.0% lower risk of infertility compared to the low-concentration group (OR = 0.33; 95% CI: 0.12-0.940, P = 0.04).ConclusionOur research findings suggest weak negative correlation between serum HDL and female infertility. However, upon stratified analysis by age, the correlation between HDL and infertility did not attain statistical significance. In cases of secondary infertility, a subtle dose-dependent trend was observed between serum HDL and infertility.
Project description:Background and aimGallstone disease (GSD) is a major public health problem worldwide. The dietary inflammatory index (DII) and the energy-adjusted DII (E-DII) have been used to describe dietary inflammatory potential. The current study sought to investigate the pro-inflammatory role of diet on GSD among outpatients in the United States.MethodsCross-sectional data from 7,334 individuals older than 20 years who participated in the National Health and Nutrition Examination Survey (NHANES) from January 2017 to March 2020 were obtained. The relationship between GSD and DII was assessed using self-reported data. An association between DII and the risk of GSD was determined using sample-weighted logistic regression and restricted cubic splines (RCS). Subgroup analyzes were conducted to assess the interaction between DII and related factors. Sensitivity analysis was further used to confirm the stability of the relationship. To control for the effect of total energy intake, E-DII was calculated and analyzed.ResultsA total of 10.5% of the study participants had GSD. The DII ranged from -5.52 to 5.51, and the median DII was significantly higher for participants with GSD than those without (1.68 vs. 1.23, p < 0.001). There was a significant and stable positive relationship between DII and GSD in adjusted models (OR 1.10, 95% CI 1.00-1.20). In the fully adjusted model, subjects with DII scores in the highest tertile were more likely to have GSD than those in the lowest tertile (OR 1.52, 95% CI 1.19-1.93). An apparent dose-response association between DII and GSD was detected. The association between E-DII and GSD remained stable.ConclusionHigher DII/E-DII scores linked to the intake of a pro-inflammatory diet were positively associated with a higher risk of GSD. These findings suggest that pro-inflammatory dietary patterns can promote the formation of gallstones.
Project description:AimsGlomerular damage indicated by proteinuria is a main symptom in diabetic nephropathy. Mineralocorticoid receptor (MR) antagonists (MRAs) are beneficial irrespective of aldosterone availability. Thus, we hypothesized an alternatively activated MR to promote glomerular damage in proteinuric diabetic nephropathy. Specifically, we aimed first to demonstrate the presence of steroid hormones serving as alternative MR targets in type II diabetic patients with proteinuric kidney disease, second whether MR selectivity was modified, third to characterize MR and glucocorticoid receptor (GR) expression and activity in glomerular cell types exposed to eu- and hyperglycemic conditions, fourth to characterize the pro-fibrotic potential of primary human renal mesangial cells (HRMC) upon stimulation with aldosterone and cortisol, and fifth to specify the involvement of the MR and/or GR in pro-fibrotic signaling.Materials and methodsUrinary steroid hormone profiles of patients with diabetic kidney disease were analyzed by gas chromatography-mass spectrometry and compared to an age and gender matched healthy control group taken out of a population study. In both cohorts, the activity of the MR pre-receptor enzyme 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2), which inactivates cortisol to prevent it from binding to the MR, was assessed to define a change in MR selectivity. Expression of HSD11B2, MR and GR was quantified in HRMC and primary human renal glomerular endothelial cells (HRGEC). Activity of MR and GR was explored in HRMC by measuring the MR/GR down-stream signal SGK1 and the pro-fibrotic genes TGFB1, FN1 and COL1A1 in normal and high glucose conditions with the MR/GR agonists aldosterone/cortisol and the MR/GR antagonists spironolactone/RU486.ResultsPatients with diabetic kidney disease excreted more tetrahydroaldosterone than the control group reaching significance in men. The excretion of MR-agonistic steroid hormones was only increased for 18-hydroxytetrahydrocorticosterone in diabetic women. The excretion of most glucocorticoids was higher in the diabetic cohort. Higher apparent systemic HSD11B2 activity suggested less activation of the MR by cortisol in diabetic patients. Both cell types, HRMC and HRGEC, lacked expression of HSD11B2. Hyperglycemic conditions did not change MR and GR expression and activity. Stimulation with both aldosterone and cortisol promoted upregulation of pro-fibrotic genes in HRMC. This effect of MR and/or GR activation was more pronounced in high glucose conditions and partially inhibited by MRAs and GR antagonists.ConclusionsIn patients with diabetic kidney disease alternative MR activation is conceivable as cortisol and cortisone metabolites are increased. Systemic availability of active metabolites is counteracted via an increased HSD11B2 activity. As this cortisol deactivation is absent in HRMC and HRGEC, cortisol binding to the MR is enabled. Both, cortisol and aldosterone stimulation led to an increased expression of pro-fibrotic genes in HRMC. This mechanism was related to the MR as well as the GR and more marked in high glucose conditions linking the benefit of MRAs in diabetic kidney disease to these findings.