At present, the diagnosis of cerebral artery dissection (CeAD) worldwide still relies on imaging findings, making rapid clinical differentiation in the early stages challenging. Our purpose is to explore the distribution characteristics of the cholesterol, high-density lipoprotein, and glucose (CHG) index, triglycerides-glucose (TyG) index, and non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in patients with CeAD at admission through case–control design, so as to evaluate the potential value of the three indicators in the early identification of acute phase and provide guidance for early clinical identification and timely intervention. We collected data on CeAD patients admitted to Tongji Hospital, Wuhan, China, from March 2015 to September 2025, with non-CeAD intracerebral hemorrhage (ICH) patients as the control group. After 1:1 propensity score matching, 128 samples were retained in each group. Logistic regression analysis was used to analyze the correlation between the three indicators and the presence of CeAD. The identification efficacy and dose–response relationship of each indicator were evaluated by receiver operating characteristic (ROC) curve and restricted cubic spline (RCS) curve, and the net benefit of clinical application of each index was evaluated by decision curve analysis (DCA). The results were expressed as odds ratio (OR) and 95

AIM:This study aimed to assess the associations between particulate matter (PM) exposures and depressive symptom trajectories, as well as the potential contributing role of loneliness in these associations. METHODS:The analysis included 11,758 participants (≥45 years), with depressive symptoms and covariate data from the China Health and Retirement Longitudinal Study (2011-2020) and PM data from the ChinaHighAirPollutants dataset. Depressive symptom trajectories were identified using group-based trajectory modeling. Individual and combined effects of PM on depressive symptom trajectories were assessed using multivariable logistic regression and weighted quantile sum (WQS) regression, with results reported as odds ratio (OR) and 95% confidence interval (CI). A serial multiple mediator model was used to evaluate the contributing role of loneliness. RESULTS:Five depressive symptom trajectories were identified: stable-low, stable-moderate, stable-high, decreasing, and increasing. PM exposures were positively associated with more severe depressive symptom trajectory groups (stable-high [PM10: OR = 1.10, 95% CI 1.04-1.16; WQS: OR = 1.41, 95% CI 1.09-1.82] and increasing [PM1.0: OR = 1.44, 95% CI 1.06-1.98; PM2.5: OR = 1.10, 95% CI 1.02-1.19; PM10: OR = 1.10, 95% CI 1.06-1.13; WQS: OR = 1.21, 95% CI 1.01-1.45]) compared to the stable-low symptoms trajectory. Loneliness contributed to 26.73%-29.73% of the associations between PM exposure and depressive symptom trajectories. CONCLUSION:Exposures to individual and mixed PM pollutants increase the risk of severe depressive symptom trajectory groups, and reducing loneliness alleviates these effects. The findings underscore the need for further coordinated control of PM pollutants and alleviating loneliness to prevent depressive symptoms.

Purpose:The objective of this study is to conduct a Bayesian multilevel network meta-analysis to compare the effectiveness of various exercise modalities on anxiety symptoms and to assess how exercise and individual characteristics moderate these effects. Methods:A comprehensive search of Web of Science, PubMed, Embase, and Cochrane databases identified randomized controlled trials (RCTs) on exercise and anxiety. Literature screening, data extraction, and analysis were conducted independently by two researchers. A Bayesian-based network meta-analysis was applied, and the Confidence in Network Meta-Analysis (CINeMA) tool assessed evidence quality. Results:Forty-five studies (97 groups, 2643 participants) were included. Compared to control groups, meditation (Hedges' g = -0.72, 95% CI: -1.20 to -0.24), yoga (Hedges' g = -0.59, 95% CI: -0.93 to -0.27), and tai chi/qigong (Hedges' g = -0.52, 95% CI: -0.88 to -0.17) had the strongest effects. Resistance training (Hedges' g = -0.40), aerobic exercise (Hedges' g = -0.40), and walking/jogging (Hedges' g = -0.39) were also effective. However, mixed aerobic exercise did not achieve statistical significance. Conclusion:Static, breath-focused exercises (eg, meditation, yoga, tai chi/qigong) and dynamic exercises (eg, resistance training, walking/jogging) may be effective interventions for anxiety reduction, with broad applicability across populations.

ABSTRACT Given that the evidence of a longitudinal association between cumulative blood pressure (BP) levels and cognitive function is inadequate and inconclusive, we conducted this study to determine whether higher cumulative BP was independently associated with subsequent cognitive decline and to evaluate the potential dose‐response relationship between them. This cohort study used data from the 2011 to 2018 China Health and Retirement Longitudinal Study (CHARLS). All cognitive test scores were transformed into standardized z‐scores, with negative values indicating worse performance. We used linear mixed models and restricted cubic splines to assess the association of cumulative BP levels with cognitive function. A total of 7877 participants were included (mean [SD] age, 58.4 [9.0] years; 46.8% men; median follow‐up duration, 6.9 [IQR, 3.8–7.0] years). After controlling for multiple factors, compared with the lowest quartile, the highest quartiles of cumulative systolic BP (SBP, β = −0.096 SD/year, 95% CI: −0.149 to −0.044) and pulse pressure (PP, β = −0.099 SD/year, 95% CI: −0.154 to −0.043) were independently associated with faster cognitive decline, whereas no significant association was observed for diastolic BP (DBP, β = −0.023 SD/year, 95% CI: −0.075 to 0.029). Each SD increment in cumulative SBP and PP, but not DBP, was also associated with accelerated cognitive decline. Additionally, nonlinear dose‐response relationships were observed between cumulative SBP and DBP levels and the rate of cognitive decline (all p < 0.05). In conclusion, elevated cumulative SBP and PP, but not DBP, were independently associated with accelerated cognitive decline among middle‐aged and older Chinese adults.

Non-traditional lipid indices are diabetes risk factors, but their combined effects with inflammatory markers remain unclear. The present study systematically investigated and compared the associations between eight non-traditional lipid-inflammatory parameters and new-onset diabetes. Data were obtained from the 2011–2020 China Health and Retirement Longitudinal Study. The lipid-inflammatory parameters were created by integrating non-traditional lipid indices and high-sensitivity C-reactive protein (hsCRP). Cox regression and restricted cubic spline models examined the associations of baseline and cumulative lipid-inflammatory parameters with diabetes risk. Time-dependent receiver operating characteristic analyses evaluated the predictive performance of these parameters. Mediation analyses explored the reciprocal links between non-traditional lipid indices, hsCRP, and diabetes risk. The study enrolled 7,356 participants, with 1,173 (15.95

Background Despite numerous efforts to reduce the elevated mortality rate of patients with stroke admitted to the hospital during weekends or nights, it remains unclear whether the off-hour treatment has been improved. We aim to assess the treatment delay and outcomes of patients with stroke admitted to the hospital during off-hours.Methods Searches were conducted of PubMed, Embase, Medline, and Web of Science from inception to July 2022. Cohort studies reporting the door-to-treatment time, short-term mortality rate, and 90-day function of adult patients with stroke admitted to the hospital on weekends or at night were included. A random-effect meta-analysis model was applied to pool the odds ratio (OR) and mean difference with 95% CI.Results A total of 84 studies were included. Treatment delay on weekends or nights was significant, with extended door-to-needle time (mean difference, 5.93 [95% CI, 1.88-9.98] minutes) and door-to-groin time (mean difference, 13.54 [95% CI, 5.02-22.06] minutes). Off-hour patients were less likely to receive intravenous thrombolysis within 60 minutes (OR, 0.65 [95% CI, 0.46-0.92]). Off-hour admission was associated with an increased short-term mortality rate for patients with ischemic stroke (OR, 1.07 [95% CI, 1.03-1.11]), intracerebral hemorrhage (OR, 1.10 [95% CI, 1.03-1.18]), and subarachnoid hemorrhage (OR, 1.05 [95% CI, 1.02-1.09]).Conclusions This review indicates that off-hour admission was associated with treatment delay and increased risk of stroke death. Patients with stroke admitted on weekends and nights may require more attention, especially those with more severe and complex conditions.

Evidence is a core element of evidence-based medicine, with diverse classifications and extensive sources. Most of it is based on journals and is commonly found in databases or websites such as PubMed, Web of Science, and CNKI. The number of literatures is countless, which also puts enormous pressure on researchers to consult and read literature. The field of urology is no exception. This article started with analyzing the characteristics of common clinical questions in the field, introduced the four criteria for their screening and two types of structured templates, clarified the definition, categories, identification, and three requirements for the application of the four evidence classification methods, and explained the selection of retrieval resources, construction of retrieval strategies, specific operational steps, and precautions for the retrieval process to develop and use evidence. In addition, combined with artificial intelligence technology, the future development trend of evidence classification and retrieval in the field of evidence-based urology has been clarified, which provided reference for further promoting the development of evidence-based urology.

BACKGROUND:The prognostic significance of circulating biomarkers in appendiceal neoplasms remains inconsistent across studies, hindering their clinical implementation for prognostic stratification. This meta-analysis aims to estimate and compare the prognostic value of various circulating biomarkers in appendiceal neoplasms. MATERIALS AND METHODS:We conducted a systematic literature search across PubMed, Web of Science, Cochrane Library, OVID platforms (Embase/MEDLINE) and Scopus from database inception to February 23, 2025, to identify studies investigating associations between circulating biomarkers and survival outcomes. Only retrospective cohorts are included. Hazard ratios (HRs) derived from Cox regression analyses were pooled using random-effects models. Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies. We performed pairwise and Bayesian network meta-analysis to establish prognostic hierarchy among biomarkers. RESULTS:19 studies comprising 8478 patients evaluating six circulating biomarkers (CA125, CA19-9, CEA, Neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), and circulating tumor DNA (ctDNA)) were included. CA125 demonstrated independent prognostic value for both OS (HR=2.46[1.78-3.38, 95 % CI]) and DFS/PFS (HR=1.72[1.14-2.59, 95 % CI]), while CA19-9 specifically predicted DFS/PFS deterioration (HR=2.69[2.01-3.61, 95 % CI]). CEA elevation was independently associated with poorer OS (HR=2.04[1.45-2.88, 95 % CI]). ctDNA detection also showed prognostic value for adverse outcomes. Elevated NLR and PLR levels showed no significant associations with survival outcomes. Bayesian network analysis revealed no significant differences. CONCLUSIONS:Preoperative elevation of serum CA125, CA19-9, and CEA levels demonstrates significant prognostic value in appendiceal neoplasms. While ctDNA retains prognostic significance, inflammatory markers NLR and PLR show limited clinical utility.

OBJECTIVES:To examine the associations of cumulative systolic blood pressure (SBP)/diastolic blood pressure (DBP)/pulse pressure (PP) with the incident heart disease and stroke, as well as the dose-response relationship between them. STUDY DESIGN:Longitudinal prospective cohort study. METHODS:The present cohort was drawn from the China Health and Retirement Longitudinal Study during 2011-2018. The Kaplan-Meier method was used to calculate the cumulative incidence of heart disease and stroke by quartiles of cumulative BP among participants, and the hazard ratios (HRs) and 95% confidence intervals (CIs) for heart diseases and stroke risk associated with the cumulative BP were estimated using Cox proportional hazards models. Restricted cubic spline plots were used to elucidate the dose-response relationship. RESULTS:After adjusting for multiple covariates, higher levels of cumulative SBP/DBP were found to be associated with the increased risk of incident stroke (HR for cumulative SBP: 2.11, 95% CI: 1.31-3.41; HR for cumulative DBP: 1.97, 95% CI: 1.25-3.11), but not heart diseases (HR for cumulative SBP: 1.21, 95% CI: 0.83-1.78; HR for cumulative DBP: 1.17, 95% CI:0.81-1.68). In stratified analyses, we found that age modified the positive association between high cumulative DBP and incident stroke, which more evident in subjects younger than 65 years. Besides, cumulative BP had no nonlinear dose-response relationship with the risk of heart diseases or stroke (P > 0.05). CONCLUSIONS:These findings suggested that higher levels of cumulative SBP/DBP increased the risk of incident stroke, while no significant association was observed for incident heart disease and cumulative BP level.

BACKGROUND:The association between changes in physical functions and stroke incidence remains uncertain. METHODS:A total of 7978 participants without stroke from the China Health and Retirement Longitudinal Study (CHARLS) were recruited in 2011-2012 and followed up until 2020. We assessed annual changes in physical functions from 2011 to 2015, including absolute grip strength, relative grip strength, walking speed, chair-rising time and standing balance. The Cox proportional hazards model was applied to assess the longitudinal associations between annual changes in physical functions and stroke. Restricted cubic spline analyses were used to explore the dose-response relationships. RESULTS:During 71 714 person-years of follow-up, 549 incident stroke cases were reported. For each 1-kg absolute grip strength increment, 0.1-unit relative grip strength increment, or 1-point standing balance test score increment, the hazard of stroke was reduced by 12% [hazard ratio (HR): 0.88; 95% confidence interval (CI): 0.84-0.93], 53% (HR: 0.47; 95% CI: 0.34-0.64), 55% (HR: 0.45; 95% CI: 0.30-0.67), respectively. We found a negative linear dose-response association of the annual change in absolute and relative grip strength with incident stroke, as well as a nonlinear association between the annual change in standing balance and incident stroke. However, neither the annual change in walking speed nor chair-rising time was related to the incident stroke. CONCLUSIONS:A greater improvement in absolute grip strength, relative grip strength or standing balance was suggested to be associated with a lower risk of stroke amongst middle-aged and older people. These objectively measured physical function changes are imperative for high-risk population classification and stroke prevention.

BACKGROUND:The number of chronic diseases in a patient may change over time, but how multimorbidity developmental trajectories affect subsequent cognitive decline remains unknown. METHODS:Data were drawn from eight waves (2004-2018) of the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS), involving 5300 and 4357 participants, respectively. Group-based trajectory modeling was used to identify multimorbidity trajectories over six years (2004-2010) according to ten chronic diseases. We performed linear mixed-effects models to investigate the association between multimorbidity trajectories and subsequent cognitive decline in global cognition and three cognitive domains, including memory, executive function, and orientation. RESULTS:Three multimorbidity trajectories (low-stable, moderate-increasing, and rapid-increasing) were identified in two cohorts. Compared to the low-stable trajectory group, the moderate-increasing trajectory group exhibited faster declines in memory [pooled β = -0.027 standard deviation (SD)/year, 95 % confidence interval (CI): -0.044 to -0.011], orientation (pooled β = -0.036 SD/year, 95 % CI: -0.066 to -0.006), and global cognition (pooled β = -0.043 SD/year, 95 % CI: -0.084 to -0.002). Furthermore, the rapid-increasing trajectory group was associated with steeper declines in memory (pooled β = -0.049 SD/year, 95 % CI: -0.084 to -0.015), executive function (pooled β = -0.044 SD/year, 95 % CI: -0.065 to -0.022), orientation (pooled β = -0.077 SD/year, 95 % CI: -0.116 to -0.037), and global cognition (pooled β = -0.138 SD/year, 95 % CI: -0.211 to -0.065). LIMITATIONS:Limited by the structure of questionnaire, some of the information was derived by self-report, which may lead to recalling bias. CONCLUSIONS:Both moderately and rapidly increased multimorbidity are associated with accelerated cognitive decline among older people. Multimorbidity surveillance and management might help to delay the decline rate of cognition.

Objective To construct an ARIMA multiplicative seasonal model suitable for predicting the clinical demand of red blood cells in Wuhu City, and provide a scientific basis for blood collection organizations to formulate red blood cell collection and supply balance programs and recruitment plans.Methods The ARIMA model was constructed based on the clinical use of red blood cells in Wuhu City Central Blood Station from January 2012 to December 2021. The data were processed through time series stabilization, model identification, and parameter verification to determine the optimal model. The red blood cell clinical use demand from January 2022 to August 2022 was predicted using the optimal model, and the prediction effect was verified using actual values.Results The optimal model was ARIMA (0,1,0) (1,1,0)12, with BIC=12.162. The ACF and PACF of the residual sequence were basically within the 95% confidence interval, and the Ljung-Box Q value was 15.265, with P=0.576>0.05, which met the requirements of white noise sequence, and the model fitting was validated. Except for April and May, the actual values of each month were within the 95% confidence interval of the predicted value, and the average relative error between the ARIMA model prediction value and the actual value was -0.00375, and the mean absolute percentage error (MAPE) was 7.087%, with good prediction effect.Conclusion The ARIMA (0,1,0) (1,1,0)12 model can be used to predict the clinical demand of red blood cells, and it can provide a reference for blood collection, non-remunerated blood donation recruitment and inventory management.

BACKGROUND:Fatty liver disease, a growing global health issue, is closely tied to metabolic disorders. The 2023 definition of metabolic-associated steatotic liver disease (MASLD) incorporates cardiometabolic risk factors, but the potential role of persistent organic pollutants (POPs) like polychlorinated biphenyls (PCBs), remains underexplored. Investigating the impact of environmental toxins on liver health is crucial for understanding emerging public health risks. METHODS:1080 participants were included from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). We employed weighted generalized linear models, weighted quantile sum regression, and Bayesian kernel machine regression to assess the relationship between serum PCB levels and MASLD, with NAFLD included for comparison. Protein interaction and enrichment analyses were also conducted to explore the underlying mechanisms. RESULTS:PCB146, PCB156, PCB187, PCB174, and PCB180 were significantly associated with an increased MASLD risk in the GLM. Significant positive associations were found between serum PCB mixtures and MASLD in the WQS model (β: 0.411, p: 0.0056) and BKMR model (p < 0.05), with PCB180 contributing the most (β: 0.644, PIP: 0.903). NAFLD did not show significant associations. Network pharmacological analysis demonstrated enrichment in the regulation of lipolysis of adipocytes and the cAMP signaling pathway, and PPAR-γ and MAOA show significant importance in the protein-protein interaction networks. CONCLUSION:This study underscores the epidemiological and mechanical link between MASLD and PCB exposure, highlighting the superiority of MASLD in identifying the impact of POPs on liver disease risk and particularly identifying PCB180 as a sentinel marker for PCB surveillance.

Background: Dietary diversity is reported to be beneficial for cognitive function, while the effect may be offset by weight change status. We aimed to examine the association of dietary diversity and weight change with cognitive impairment among older adults. Methods: We used three waves from 2008 to 2014 of the Chinese Longitudinal Survey of Health and Longevity, which included 16,954 participants for the subsequent screening and analysis. Dietary diversity information was collected from the food frequency questionnaire. Cognitive function was assessed using the Mini Mental State Examination. The relation of dietary diversity and weight change with cognitive impairment was investigated using Cox proportional hazards models and cubic spline regression. Results: Compared with those reported poor dietary diversity at baseline, participants with good dietary diversity had a 16 % (hazard ratio [HR] = 0.84, 95 % confidence interval [CI]: 0.71-0.99) lower risk of cognitive impairment. The HR and 95 % CI of participants with consistently good dietary diversity from 2008 to 2011 was 0.71 (0.57-0.89) for cognitive impairment compared to those with consistently poor dietary diversity. Compared with the weight stable group, the HRs and 95 % CI for cognitive impairment were 1.34 (1.10-1.64) in weight loss group, and 1.08 (0.88-1.33) in weight gain group. Restricted cubic splines showed the risk of cognitive impairment decreased with higher dietary diversity score or less weight change, though no significant interaction between dietary diversity and weight change was found. Limitation: Given the observational nature of this study, there might be a reverse causation for the observed association. Conclusion: Establishing and maintaining good dietary diversity were associated with a lower risk of cognitive impairment regardless of weight change status, whereas weight loss was associated with increased cognitive impairment risk independently among older Chinese adults.

Background: This network meta-analysis aimed to assess the relative efficacy of macronutrient dietary groups with varying carbohydrate, fat, and protein ratios on weight control and cardiovascular risk factors improvement in adults. Methods: We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Web of Science Core Collection, and ClinicalTrials.gov from inception to 30 November 2024, as well as reference lists of related systematic reviews. Eligible randomized controlled trials (RCTs) were included. Literature screening, data extraction, and risk of bias assessment were conducted independently by two reviewers. The changes in body weight, blood glucose, systolic blood pressure, diastolic blood pressure, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, and total cholesterol were the study outcomes. Utilizing a Bayesian framework, a series of random-effects network meta-analyses were conducted to estimate mean difference (MD) with 95% credible interval (CrI) and determine the relative effectiveness of the macronutrient dietary groups. The quality of evidence for each pair of dietary groups was assessed based on the online tool called confidence in network meta-analysis (CINeMA). Results: This study initially identified 14,988 studies and ultimately included 66 eligible RCTs involving 4301 participants in the analysis. The very low carbohydrate–low protein (VLCLP, MD −4.10 kg, 95% CrI −6.70 to −1.54), the moderate carbohydrate–high protein (MCHP, MD −1.51 kg, 95% CrI −2.90 to −0.20), the very low carbohydrate–high protein (VLCHP, MD −1.35 kg, 95% CrI −2.52 to −0.26) dietary groups might lead to weight loss compared with the moderate fat–low protein (MFLP) dietary group. Among the dietary groups relative to the MFLP dietary group, the moderate carbohydrate–low protein (MCLP, MD 0.09 mmol/L, 95% CrI 0.02 to 0.16) and VLCHP (MD 0.16 mmol/L, 95% CrI 0.08 to 0.24) dietary groups were less effective in lowering HDL cholesterol, and the VLCHP (MD 0.50 mmol/L, 95% CrI 0.26 to 0.75) dietary group was less effective in lowering LDL cholesterol. In terms of triglyceride reduction, the MCLP (MD −0.33 mmol/L, 95% CrI −0.44 to −0.22), VLCHP (MD −0.31 mmol/L, 95% CrI −0.42 to −0.18), VLCLP (MD −0.14 mmol/L, 95% CrI −0.25 to −0.02), and moderate fat–high protein (MFHP, MD −0.13 mmol/L, 95% CrI −0.21 to −0.06) dietary groups were more efficacious than the MFLP dietary group, while any pair of dietary group interventions showed minimal to no difference in the effects on blood glucose, blood pressure, and total cholesterol. Conclusions: High or moderate certainty evidence reveals that the VLCLP dietary group is the most appropriate for weight loss, while the MCLP dietary group is best for reducing triglycerides. For control of blood glucose, blood pressure, and cholesterol levels, there is little to no difference between macronutrient dietary groups. Additionally, future studies in normal-weight populations are needed to verify the applicability of our findings.

Citation: Bu Q, Lyu J, Zhao L, Cao S, Jia D and Pan Z (2024) Editorial: Application of data mining in pharmaceutical research. Front. Pharmacol. 15:1388738. doi: 10.3389/fphar.2024.1388738

BackgroundMotor impairment is one of the most common defects after stroke, which could seriously affect the life quality of stroke patients. Exercise intervention gradually becomes a popular alternative rehabilitation therapy because of its safety and applicability.ObjectivesTo systematically assess the effect of Qigong exercise on motor function in stroke patients.MethodsRandomized controlled trials that evaluated the effect of Qigong on motor function of stroke patients were obtained from PubMed and Chinese National Knowledge Infrastructure through May 2022. Mean values and standard deviations of the post-intervention score in both experimental group and control group were collected to calculate the mean difference (MD) and corresponkding 95% confidence interval (95% CI) of each study, which were quantificationally summarized using the Review Manager 5.3 software.ResultsNineteen randomized controlled trials enrolling 1487 stroke patients were included. Pooled results indicated that Qigong exercise had beneficial effect on balance function (Berg Balance Scale [MD: 7.56, 95% CI: 4.09-11.02]), limb motor function (Fugl-Meyer Assessment [total score: MD: 7.54, 95% CI: 6.38-8.69; upper limb: MD: 3.57, 95% CI: 0.71-6.43; lower limb: MD: 2.44, 95% CI: 0.59-4.29]) and walking function (6-min walking test [MD: 62.21, 95% CI: 11.70-112.73]) of stroke patients. It was also found to be associated with an improvement in trunk function as indicated by the Trunk Impairment Scale.ConclusionsAvailable evidence supported potential benefits of Qigong exercise for improving motor functions of stroke patients. As a safe and widely applicable exercise, Qigong is worthy of further promotion in the rehabilitation of stroke patients.

AIM:To investigate the effect of sarcopenic obesity on the progression of glycaemic status in middle-aged and older adults without diabetes. MATERIALS AND METHODS:This research involved 4637 participants without diabetes from the China Health and Retirement Longitudinal Study 2011-2015. Sarcopenic obesity at baseline was evaluated based on the Asian Working Group for Sarcopenia 2019 criteria. According to the American Diabetes Association criteria, we used fasting plasma glucose and glycated haemoglobin to define glycaemic status. Cox proportional hazard models were applied to obtain adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS:The mean age of included participants was 58.98 ± 8.82 years, and 45.35% were men. During 18,497 person-years of follow-up, 1743 (37.59%) cases with glycaemic status progression were identified. Compared with participants without sarcopenia and obesity, participants with sarcopenic obesity, but not sarcopenia only or obesity only, exhibited a higher risk of progression from normoglycaemia to diabetes (HR = 2.11; 95% CI: 1.10-4.04). Moreover, participants with sarcopenic obesity (HR = 1.65; 95% CI: 1.04-2.63), sarcopenia only (HR = 1.78; 95% CI: 1.11-2.86), or obesity only (HR = 2.00; 95% CI: 1.29-3.12) had increased the risk of progression from prediabetes to diabetes. CONCLUSIONS:The effect of sarcopenic obesity on the progression of glycaemic status based on fasting plasma glucose and glycated haemoglobin may be more pronounced than that of sarcopenia only or obesity only.

OBJECTIVES:To examine the association of changes in plant-based diet consumption with all-cause mortality among older adults in China. DESIGN:Cohort study. SETTING:This cohort study of 11 years used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a long-term, nationwide survey covering 23 provinces in China. PARTICIPANTS:A total of 7843 older participants aged ≥60 years were included in this study. MEASUREMENTS:Changes in plant-based diets consumption (2008-2011) were assessed by 3 graded plant-based diet indices, including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). The main outcome was all-cause mortality. Multivariable-adjusted Cox proportional-hazards models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of mortality for changes in PDI, hPDI, and uPDI. RESULTS:A total of 7843 participants (mean [SD] age, 82.2 [10.9] years; 3588 [45.7%] men) were included in this study. During a median (IQR) of 9 (5-10) years of follow-up, 3749 deaths were documented. Compared with older adults whose plant-based diet indices were relatively stable, older adults with the greatest decrease (quintile 1) in PDI, hPDI, and uPDI had respectively 32% (95% CI, 19%-47%) higher, 21% (95% CI, 9%-33%) higher, and 10% (95% CI, 4%-21%) lower risk of death. Compared with older adults whose diet indices were relatively stable, older adults with the greatest increase (quintile 5) in uPDI had a 13% higher risk of death (95% CI, 1%-21%), while no significant associations of the increased PDI and hPDI with all-cause mortality were observed. CONCLUSION:Maintaining the consumption of overall and healthful plant-based diets, and decreasing the consumption of an unhealthful plant-based diet can be beneficial in preventing or delaying premature death among Chinese older adults.

BACKGROUND:Social isolation and loneliness have been proved to be associated with many adverse health outcomes, but their influence on hypertension remains unclear. This study aimed to assess the relationship of social isolation and loneliness with hypertension risk among middle-aged and older adults in China. METHODS:We used data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were assessed for social isolation and loneliness at baseline, and hypertension was identified by self-report and blood pressure measurement at follow-up in 2015. Binary logistic regression analyses were conducted to assess the association of social isolation and loneliness with the risk of hypertension. RESULTS:A total of 3711 residents were included. 13.7 % of the participants had high level of social isolation and 18.1 % felt lonely. During the four-year follow up period, 651 participants developed hypertension. People with high level of social isolation had an increased risk of hypertension (odds ratio [OR]: 1.40, 95 % confidence interval [CI]: 1.09-1.79). Similar results were found between social isolation score and hypertension risk (OR: 1.14, 95 % CI: 1.04-1.26). No significant association between loneliness and hypertension or any interaction effect of social isolation and loneliness on hypertension were observed. LIMITATIONS:Limited by the structure of questionnaire, some of the information was derived by self-report, which may lead to recalling bias. CONCLUSION:Social isolation, rather than loneliness was associated with hypertension for middle aged and older adults. Social support needs to be strengthened for hypertension prevention in community.