Background/Objective: Maternal diet is an important determinant of gut microbiota composition in dams and offspring. This study investigated whether HDCA supplementation during maternal high-fat diet (HFD) exposure was associated with gut microbiota composition in dams and offspring and with selected obesity-related phenotypes. Methods: Nineteen C57BL/6J female mice were assigned to a control diet group (CON), a high-fat diet group (HFD), and a high-fat diet supplemented with 0.5% hyodeoxycholic acid group (HFD+HDCA). Fecal samples were collected from the dams before mating, following 8 weeks of dietary intervention, and from the offspring at weaning. All samples were analyzed using 5R 16S rRNA gene sequencing. Body weight was monitored in both dams and offspring, and liver histology was assessed by hematoxylin and eosin staining. Results: HFD exposure was associated with obesity-related phenotypes in dams and offspring, including increased maternal body weight and greater hepatic lipid accumulation and visceral adiposity in offspring. LEfSe and ANCOM-BC2 analyses identified concordant microbial changes between dams and offspring under corresponding dietary conditions. Lachnospiraceae_Unknown_genus3261 and Coprococcus increased with HFD exposure in both dams and offspring, whereas Bifidobacterium, Coprococcus, and Allobaculum decreased following HDCA supplementation. These findings indicate maternal–offspring concordance in microbiota responses to HFD and HDCA, without establishing direct vertical transmission. PICRUSt2 analysis suggested group association differences in predicted functional potential for pathways annotated to propionate, pyruvate, and β-alanine metabolism. Conclusions: HDCA supplementation during maternal HFD exposure was associated with differences in offspring gut microbiota at weaning and with attenuation of selected obesity-related phenotypes. These findings suggest a potential role of the gut microbiota–bile acid axis in mediating intergenerational dietary effects. However, the study does not establish direct microbial transmission, altered metabolic activity, or causality; these findings require confirmation in litter-aware and mechanistic studies.

The dietary habits from eastern coastal China have recently garnered widespread attention for their potential health benefits; however, empirical evidence remains limited. Here we applied unsupervised clustering to dietary data from 8,931 participants in the WELL-China cohort from the eastern coastal region and identified a healthful dietary pattern, designated as the ‘EastDiet’. This EastDiet comprised both well-recognized healthy foods (higher intakes of vegetables, fruits, seafood, whole grains, dairy, nuts and eggs; lower intakes of refined rice, red meat and fried foods) and distinctive Chinese dietary elements (greater consumption of freshwater fish, starchy tubers and roots, soy products and edible fungi). Three key aspects of the EastDiet were highlighted in our analysis: (1) approximately 46% of participants adhered to the EastDiet, and these individuals were more likely to be female and older and prefer lighter flavours; (2) adherence to the EastDiet was associated with lower odds of central obesity (odds ratio, 0.83; 95% confidence intervals, 0.75–0.92) and a 22% lower risk of incident major adverse cardiovascular events (hazard ratio, 0.78; 95% confidence intervals, 0.64–0.96); and (3) omics profiling revealed favourable metabolomic and gut microbial signatures associated with the EastDiet, which were linked to reduced risks of central obesity and major adverse cardiovascular events. This dietary pattern and its association with central obesity was successfully replicated in an independent cohort. In conclusion, the EastDiet identified in this study represents an evidence-based dietary pattern rooted in Chinese food traditions, which may serve as a framework for promoting healthy eating in China. Using dietary data from 8,931 participants in the WELL-China cohort, this study identifies a new diet rooted in traditional Chinese food elements associated with better adherence, favourable gut microbial profiles, lower rates of central obesity and reduced incidence of major cardiovascular events, and confirms these findings in an independent Achieving Better Omics validation cohort (n = 1,851).

Objective:This study aimed to examine the association between an overall healthy lifestyle and periodontitis in a Chinese population. We further sought to explore the features of lifestyle-related oral microbiota, gut microbiota and plasma metabolome in relation to periodontitis. Design:This cross-sectional study included 2,182 Chinese adults from the Lanxi cohort. The overall lifestyle assessment included waist circumference, smoking status, drinking status, physical activity and diet. Periodontitis was diagnosed in accordance with the criteria of the American Academy of Periodontology. 16S rRNA sequencing was used to analyze the oral and gut microbiota, while an untargeted metabolome was employed for plasma metabolite profiling. Results:Participants with a healthy lifestyle had a lower prevalence of periodontitis than those with an unhealthy lifestyle (adjusted OR = 0.75, 95% CI: 0.59-0.96). Significant differences were observed in oral microbiota, gut microbiota and plasma metabolome between participants in the healthy and unhealthy lifestyle groups. Further analysis identified 12 lifestyle-related oral microbial genera, 12 gut microbial genera and 10 plasma metabolites, suggesting potential biological links between lifestyle and periodontal health. Conclusions:These findings suggest a potential association between a healthy lifestyle and periodontitis, with the oral and gut microbiota and plasma metabolome potentially involved.

Study Objectives:To investigate the relationships between Traditional Chinese Medicine (TCM) body constitution and sleep quality in a large population-based cohort. Methods:This cross-sectional study included 8517 participants from the WELL China cohort. We used the Wang Qi Nine Body Constitution Questionnaire (WQ-9BC) to assess TCM body constitution and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. We used multivariable logistic regression analyses to estimate odds ratios (ORs) for the association between body constitution and poor sleep quality (PSQI score > 5), adjusting for demographics, lifestyle factors, and comorbidities. Results:Compared with a balanced body constitution (1898; 22%), individuals with an unbalanced constitution had a 2.6-fold risk (95% CI = 2.3% to 3.0%), and those with an unbalanced tendency had a 1.5-fold risk of poor sleep quality (95% CI = 1.3% to 1.8%). All eight unbalanced constitutions were associated with a higher risk of poor sleep quality, with Qi stagnation (OR 4.0 [95% CI = 3.0% to 5.5%]) and blood stasis (OR 3.8 [95% CI = 2.3% to 6.2%]) having the highest ORs. About 52% of participants had multiple unbalanced constitutions and/or tendencies. The OR for poor sleep quality increased with the composite number of Yang deficiency, Yin deficiency, Qi deficiency, heat dampness, blood stasis, and Qi stagnation constitutions and/or tendencies. Conclusions:All eight unbalanced constitutions are associated with poor sleep quality in a dose-dependent manner, with Qi stagnation and blood stasis displaying the strongest associations. Multiple unbalanced constitutions and/or tendencies are cumulatively associated with poor sleep quality. Identifying TCM body constitution could help in detecting high-risk groups and designing targeted interventions.

Traditional Chinese medicine (TCM) views body constitution as a foundational determinant of health and disease risk. Understanding the distribution of body constitutions across the population can help in developing personalized strategies to prevent disease, but few studies have examined composite constitutions or unbalanced tendencies. This cross-sectional study assessed the prevalence of singular and composite (multiple) TCM body constitutions and tendencies in a sample of adult residents of Hangzhou, China. We used the 2016 version of the Constitution in Chinese Medicine Questionnaire (CCMQ, 54 items) to classify participants into nine body constitutions and tendencies toward those body constitutions and examined variations in those distributions by demographics and selected lifestyle factors. Among 8,665 participants aged 18–80 years, 74.2

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BACKGROUND:Studies have shown that obesity contributes to colorectal tumors (CRC). Hyodeoxycholic acid (HDCA) has been found to have a therapeutic effect on obesity-related diseases such as nonalcoholic fatty liver (NAFLD). However, there are still no studies revealing whether HDCA has effects on CRC, which may suggest new uses for HDCA. METHODS:C57BL/6 mice fed with high-fat diet supplemented with 0.5% HDCA were injected with MC38 cells subcutaneously to construct the subcutaneous metastasis model of CRC. The trend of body weight and tumor volume were evaluated, and blood metabolites and gut microbiota sequencing were analyzed. RESULTS:Compared with HFD-fed mice, HDCA-treated mice had higher fecal and serum HDCA levels. After tumor inoculation, the HDCA mice had smaller subcutaneous tumor volumes, as well as higher HDCA and THDCA levels in feces and blood. Blood metabolomics revealed significant enrichment in pathways of bile secretion, arachidonic acid metabolism, primary bile acid metabolism, and taurine and hypotaurine metabolism. Analysis of gut microbiota at the completion of obesity modeling revealed the Chao1 index of the feces being lower in the HDCA mice. The relative abundance of a total of nine genera were significantly higher and eighteen genera were lower. The KEGG results indicated significant upregulation of nine metabolic pathways and downregulation of sixteen metabolic pathways. CONCLUSIONS:HDCA intake ameliorates HFD-induced obesity phenotype, inhibiting colorectal tumor growth in mice, and decreases the abundance of gut microbiota. Gut microbiota affected by HDCA may participate in metabolism-related effects through circulation, which might be one way that HDCA affects colorectal tumors.

Hypertrophic scars (HS) are the result of abnormal tissue repair after dermal tissue trauma. Their histological characteristics are fibroblast proliferation and excessive deposition of extracellular matrix. This study aimed to identify the role of autologous fat granule (AFG) combined with platelet-rich plasma (PRP) in HS formation and its possible mechanism through in vivo experiments. A rat wound healing HS model was established, and AFG and PRP alone or in combination treated HS model rats. After 8 weeks of intervention, HS tissues were collected for HE staining, VG staining, immunohistochemistry, ELISA and Western blot analysis. AFG treatment could significantly inhibit angiogenesis and hypertrophic scar proliferation in HS tissue, and reduce collagen fiber content and inflammatory cell infiltration, and the above changes were more significant when combined with PRP treatment, indicating that AFG combined with PRP treatment had a better therapeutic effect in HS animal model. In addition, AFG treatment can significantly reduce the expression of TGFBRI and Smad3 proteins in HS tissues, and compared with AFG alone, AFG combined with PRP treatment can further reduce the expression of TGFBRI and Smad3 proteins in HS tissues. AFG combined with PRP can reduce inflammatory cell infiltration and collagen fiber content in HS tissue, and inhibit angiogenesis and scar proliferation, which may be related to inhibiting the activation of TGF-β/Smad signaling pathway. Our study provides a reference for the clinical treatment of HS. No level of evidence is needed for Basic Science, Animal Study, and Experimental Study Articles. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Introduction:Obesity and multimorbidity are prevalent worldwide. However, the relationships of obesity severity and fat distribution with multimorbidity patterns among the Chinese population are still unclear. We sought to investigate multimorbidity patterns among people with various obesity severity and fat distribution in Anhui, China. Methods:We used cross-sectional data including 123,148 adults aged 35-76 years in 12 districts from Anhui Province, China. Multimorbidity referred to the presence of at least two chronic conditions from a defined set of nine. We used logistic regression models, stratified by gender, to analyze the associations of different obesity severity and fat distribution with the risk of multimorbidity by adjusting for confounders of age, region, marriage, education level, annual income, insurance, smoking, drinking, rational diet, weight control, physical exercise, adequate sleep and regular checkup. Subgroup and interaction analyses examined how varying obesity severity and fat distribution relate to multimorbidity risk. Association rule mining (ARM) utilized the Apriori algorithm to analyze disease combinations under different obesity subgroups in males and females. Results:Multimorbidity occurred in 10.3%(n=12,644) of the participants, with 10.7%(n=5,324) in males and 9.96% (n=7,320) in females, and the majority (80.5%, n=10,177) had two chronic diseases. Compared to normal-weight participants, there were progressively higher odds of multimorbidity in overweight, mild, moderate, and severe obesity in both males and females (P for trend <0.001). Individuals with general obesity (male: OR = 1.366, 95% CI: 1.234-1.513; female: OR = 1.315, 95% CI: 1.197-1.445), central obesity (male: OR = 2.168, 95% CI: 1.857-2.532; female: OR = 1.567, 95% CI: 1.401-1.752), or compound obesity (male: OR = 2.223, 95% CI: 1.996-2.476; female: OR = 1.998, 95% CI: 1.822-2.190) had significantly higher multimorbidity rates than their non-obese counterparts. Subgroup analysis and interaction analysis results showed that males, people aged < 60 years, and smokers may worsen the effects of obesity on multimorbidity. ARM revealed that the disease cluster comprising diabetes, hypertension, and dyslipidemia exhibited the strongest association. Notably, males with severe obesity face an elevated risk of cardiovascular metabolic comorbidity. Conclusions:Both overweight and obesity are independent risk factors for multimorbidity, and males exhibit significantly higher multimorbidity risks than females. Individuals with obesity are more vulnerable to multiple coexisting conditions such as diabetes, hypertension, and dyslipidemia. Therefore, adopting health management and intervention measures for obesity individuals can help control multimorbidity.

Tissue fibrosis is a major cause of organ dysfunction. Preventing fibrosis in tissue pathological condition remains a significant clinical challenge. Here we investigate the role of fibroblast growth factor 7 (FGF7) in mitigating fibrosis and promoting regeneration of load-bearing tendons. Fgf7 knockout mice exhibit impaired motor function and disordered matrix assembly in tendons. Single-cell RNA sequencing reveals an enrichment of a pro-fibrotic cell subpopulation in Fgf7-deficient tendons, which is also predominant in human tendinopathy. Using ProTracer technology, we find that FGF7 deficiency drives proliferating cells toward this pro-fibrotic lineage. Furthermore, we find that FGF7 promotes the tenogenic differentiation of tendon stem/progenitor cells while suppressing their fibrotic differentiation. Importantly, a hydrogel loaded with recombinant FGF7 effectively reduces fibrosis and significantly promotes functional tendon regeneration in vivo. These findings elucidate FGF7's dual role in driving tenogenesis and inhibiting fibrosis, suggesting a potential therapeutic strategy.

Rotator cuff tendinopathy is the most common tendinopathy type with the worst prognosis. Conventional treatments often elicit heterogeneous drug responses due to the diversity of tendinopathy. Hence, this study attempted a classification of 126 diseased tendons into three distinct subtypes with opposite pathogenic mechanisms based on transcriptomic and clinical features. The hypoxic atrophic subtype with white appearance (Hw) exhibits downregulated neovascularization pathways. The inflammatory proliferative subtype with white appearance (Iw) shows a moderate upregulation of inflammatory characteristics. The inflammatory proliferative subtype with red appearance (Ir) exhibits the highest levels of upregulated neovascularization and inflammatory pathways, along with severe joint dysfunction. We then established research models, including subtype-specific simulations in animal models and clinical data analysis. These revealed that glucocorticoid, a controversial commonly used drug, was only effective in treating the Ir subtype. Hence, the tendinopathy subtypes elucidated in this study have significant implications for developing precision treatment of tendinopathy. This study classifies rotator cuff tendinopathy into three distinct subtypes that include a hypoxic atrophic, an inflammatory proliferative with white appearance and an inflammatory proliferative with red appearance subtype. Using both clinical data and animal models, the research reveals that glucocorticoid is only effective in treating the latter inflammatory proliferative subtype that has the highest level of neovascularization.

Obesity-prone (OP) and obesity-resistant (OR) individuals demonstrate significant metabolic differences, potentially influenced by variations in the gut microbiome. However, the influence of host-microbiota interactions on obesity susceptibility remains unknown. We performed an integrative multi-omics approach to explore microbial, metabolic, and genetic differences in high-fat diet (HFD)-fed OP and OR mice, with additional analyses of gut microbiota variations in humans. In OP mice, the dynamic gut microbiota was characterized by a stable presence of Longibaculum, while Kineothrix predominated in OR mice. We termed both as keystone bacteria. Beyond these, eight dominant bacterial genera were significantly associated with bile acid metabolites and amino acids. Three of these genera were also identified in OR humans and showed positive correlations with genes that may support intestinal barrier function. We identified 22 specific amino acid profiles as potential biomarkers for obesity susceptibility, along with significantly increased levels of ten non-12-OH bile acids in fecal of OR mice. In vivo, mouse experiments demonstrated that ursodeoxycholic and hyodeoxycholic acids could reduce HFD-induced obesity. Additionally, the colon of OP mice displayed a higher presence of inflammatory cells. These findings suggest that host-microbiota interactions may contribute to phenotypic differences between OP and OR. Our study offers insights into crucial intestinal markers associated with obesity, providing a valuable resource for advancing the understanding of obesity-prone and obesity-resistant phenotypes.

To develop an end-to-end radiomics-based pipeline for the prediction of International Society of Urological Pathology grade group (ISUP GG) in prostate cancer (PCa). This retrospective study includes 356 patients (241 in training set and 115 in independent test set) with histopathologically confirmed PCa who underwent [18F]PSMA-1007 PET/CT scan. Patients were classified into two groups according to their ISUP GG (1–3 vs. 4–5). Radiomics features were extracted from the whole, automatically segmented prostate on PET/CT images, 30 models were constructed by combining 6 feature selection algorithms and 5 machine learning classifiers. The clinical model incorporated age, total prostate-specific antigen (tPSA), maximum standardized uptake value (SUVmax), and prostate volume. The predictive performance of the models was evaluated using the area under the receiver operating characteristic curve (AUC), balanced accuracy (bAcc), and decision curve analysis (DCA). The best-performing radiomics model significantly outperformed clinical model (AUC 0.879 ± 0.041 vs. 0.799 ± 0.051, bAcc 0.745 ± 0.074 vs. 0.629 ± 0.045). On an external independent test set, best-performing radiomics model perform better than clinical model, with an AUC of 0.861 vs. 0.750, p = 0.002 (Delong), and bAcc of 0.764 vs. 0.582, p = 0.043 (McNemar). The learning curve, calibration curve and DCA demonstrated goodness-of-fit and improved benefits in clinical practice. The end-to-end radiomics-based pipeline is an effective non-invasive tool to predict ISUP GG in PCa.

ObjectiveWe aimed to investigate the relationships among nut consumption, gut microbiota, and body fat distribution.MethodsWe studied 2255 Chinese adults in the Lanxi Cohort living in urban areas in Lanxi City, China. Fat distribution was assessed by dual-energy x-ray absorptiometry, and nut consumption was assessed using food frequency questionnaires. 16S ribosomal RNA (rRNA) sequencing was performed on stool samples from 1724 participants. Linear regression and Spearman correlation were used in all analyses. A validation study was performed using 1274 participants in the Lanxi Cohort living in rural areas.ResultsNut consumption was beneficially associated with regional fat accumulation. Gut microbial analysis suggested that a high intake of nuts was associated with greater microbial alpha diversity. Six genera were found to be associated with nut consumption, and the abundance of genera Anaerobutyricum, Anaerotaenia, and Fusobacterium was significantly associated with fat distribution. Favorable relationships between alpha diversity and fat distribution were also observed. Similar relationships between gut microbiota and fat distribution were obtained in the validation analysis.ConclusionsWe have shown that nut consumption is beneficially associated with body fat distribution and gut microbiota diversity and taxonomy. Furthermore, the microbial features related to high nut intake are associated with a favorable pattern of fat distribution.

Background: Numerous lines of evidence suggest that neuropeptide Y (NPY) is critically involved in the modulation of neuropathic pain. Postherpetic neuralgia (PHN) is characterized by prolonged duration, severe pain, and significant treatment resistance, substantially impairing patients' quality of life. This study aims to evaluate the potential of plasma NPY levels in patients with PHN as a predictive biomarker for the development of this condition. Methods: Between February 2022 and December 2023, 182 patients with herpes zoster (HZ) were recruited. Thirty-eight volunteers with no history of HZ were also recruited as controls. Clinical factors, NPY, brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) were assessed within 3 days of healing. Logistic regression analysis was used to predict the development of PHN. Results: NPY levels were lower and BDNF and NGF were higher in HZ patients than those in controls. Only NPY levels were lower in patients with PHN (n = 59) compared with those without PHN (n = 123). Age, acute pain severity, and rash area were independent predictors of PHN, as were NPY levels. The area under the curve (AUC) to predict the development of PHN based on the combination of NPY levels and clinical factors was 0.873 (95% CI: 0.805 to 0.940), and the AUC was 0.804 based on only clinical factors (AUC: 0.804, 95% CI: 0.728 to 0.881). Conclusion: Low plasma NPY levels are a predictor of developing PHN in patients with HZ. Combining clinical predictors with NPY levels may improve predictive accuracy.

Neuropathic pain (NP) is often caused by diabetic neuropathy, chemotherapy, or spinal cord lesions and is associated with significant economic burden and poor quality of life. Sophisticated etiology and pathology recognized different pharmacologic interventions, and hitherto, the reported analgesic efficacy and safety of guideline-recommended drugs are not satisfactory. Overall, this article reviews the mechanism of α2δ ligand, the clinical pharmacokinetics, efficacy, safety and cost-effectiveness of mirogabalin for the treatment of NP, offering clinical perspectives into potential benefits of NP-related syndrome or comorbidities. Mirogabalin, a novel voltage-gated Ca2+ channel (VGCC) α2δ ligand with selective binding affinities to α2δ-1 than α2δ-2 subunit, exhibited a wider safety margin and a relatively lower incidence of adverse events compared with other gabapentinoids. Randomized-controlled trials and open-label studies have demonstrated the efficacy and long-term safety of mirogabalin in Asian patients with diabetic peripheral neuropathic pain (DPNP), postherpetic neuralgia (PHN), and central NP. Analgesic effects of mirogabalin for the single or add-on treatment on chemotherapy-induced peripheral neuropathy and orthopedic disease/postoperation-related NP were also evidenced. To date, mirogabalin is approved for the general indication of NP in Japan, PNP in South Korea, and DPNP in the Chinese Mainland and DPNP, PHN in Taiwan (China). In summary, mirogabalin emerges as a promising option for NP; further research is warranted to refine wider treatment strategies, flexible dosing in real-world setting.

Objective:To outline the clinical manifestations observed in patients with scabies misdiagnosed as generalized eczema, analyse the factors contributing to these misdiagnoses and explore potential reasons for the resurgence of scabies.Patients and Methods:A retrospective analysis was performed to investigate the patients with scabies misdiagnosed as generalized eczema.Results:We included 23 patients, with twelve (52.17%) being male and eleven (47.83%) female. The illness duration ranged from 0.5 to 7 months. Among all patients, 12 (52.17%) were residents of nursing homes, 5 (21.74%) were staff members of these facilities, 4 (17.39%) were caregivers of long-term hospitalized relatives, 1 (4.35%) was a construction worker, and 1 (4.35%) had a history of tourism. The rash predominantly affected the trunk and extremities, 12 patients (52.17%) are each involved the perineum and fingers webbings. The presentations included erythema, papules, and nodules. The main complaint of all patients was nocturnal itch. Under direct microscopy, 5 patients (21.74%) tested positive for scabies mites, and 3 (13.04%) showed histopathological features consistent with scabies. All patients were initially misdiagnosed with generalized eczema.Conclusion:Over half of all patients diagnosed with scabies either resided or worked in long-term care facilities. The lack of awareness of scabies among medical staff in long-term care facilities readily led to frequent misdiagnosis. Comprehensive measures should be implemented urgently to strengthen disease management.

Iroquois homeobox gene 3 (Irx3) and Irx5 encode transcription factors that play crucial roles in limb development and bone formation. Previous studies using knockout mice have revealed a role of Irx3 and Irx5 in osteogenesis in young adult mice. However, whether these genes are also essential for bone homeostasis in adulthood and contribute to bone diseases remain poorly understood. Osteoporosis is a disease characterized by lower bone mineral density and disrupted bone microarchitecture, typically occurs in postmenopausal women. Here, we demonstrate that Irx3/5dHet mice with a half-reduction of Irx3 and Irx5 dosage serve as a novel model of osteoporosis. By micro-computed tomography, we found that Irx3/5dHet mice exhibited sex-dependent bone loss patterns. While male Irx3/5dHet mice progressively lost trabecular microstructures with aging, female mutants exhibited lower bone mineral density (BMD) and bone volume fraction (BV/TV) at early adulthood (9-15 weeks old) but without further loss later at 1 year of age. Bone marrow adipocytes are known to be elevated at the expenses of lower osteogenesis in osteoporotic bone marrow. Surprisingly, we found sex-dependent changes in adipogenesis at the age of skeletal maturity that bone marrow adipocytes were reduced in female Irx3/5dHet mice along with deteriorated osteogenesis, while male mice exhibited elevated adipogenesis. In summary, we reported a novel genetic model for osteoporosis-like phenotypes, highlighting sex-dependent bone mineral density and bone marrow adipocyte characteristics.

This study investigated the presence of 20 organophosphate esters (OPEs) in indoor dust samples collected from the Chinese cities of Lanzhou, Xining, and Lhasa. The results demonstrate the ubiquitous presence of most OPEs in these three cities, with the highest concentrations of ΣOPEs found in Xining. We also summarized the occurrence of OPEs in indoor environments from 38 studies with 1875 samples collected across various regions of mainland China from 2012 to 2023. The weighted-median concentration of ΣOPEs in indoor dust exhibited region-specific variations, range from 381.9 to 6622.5 ng/g. Chloroalkyl-OPEs (Cl-OPEs) (e.g., tris(2-chloroethyl) phosphate (TCEP), tri(1-chloro-2-propyl) phosphate (TCIPP), and tri (1,3-dichloro-2-propyl) phosphate (TDCIPP)) predominated in all seven regions (range: 38.9 %–71.4 %). TCIPP was predominant in the Central China, North China, Northeast China, Northwest China, Southwest China, and Southwest China regions, while TCEP dominated in the Eastern China region. A significant downward trend in OPE concentrations in indoor environments was observed during the investigated period. Dust ingestion was identified as the predominant pathway of human exposure to OPEs indoors. The hazard quotients for Cl-OPEs were below the non-carcinogenic threshold, suggesting significant health risks are unlikely. This study underscores the widespread occurrence of OPEs in indoor dust across mainland China, emphasizing the necessity for ongoing monitoring and regulation of these chemicals.