Gamma-glutamyl transferase (GGT) regarded as a biomarker of liver dysfunction or excessive alcohol consumption; however, existing genome-wide association studies (GWAS) have been conducted predominantly in European populations and East Asian populations from Japan and the Taiwan region, with limited investigation in ethnic minorities from Guizhou Province. Previous genetic studies have demonstrated that Guizhou ethnic minorities share an East Asian genetic background while exhibiting specific genetic structures, a pattern that is also confirmed by our principal component analysis (PCA) results. We therefore performed a GWAS in this population and identified a genome-wide significant signal at 8q12.3 in female ethnic minorities from Guizhou. Fine-mapping and functional annotation analyses suggest that a regulatory pathway involving Runt-related transcription factor 1 (Runx1)–Cytochrome P450 family 7 subfamily B member 1 (CYP7B1)–cholesterol–reactive oxygen species (ROS)–glutathione (GSH) may contribute to the regulation of GGT levels. Mendelian randomization (MR) analyses further supported a causal relationship between GGT levels and autoimmune hepatitis (AIH). These findings uncover a genetic mechanism underlying GGT variation at 8q12.3 in female ethnic minorities from Guizhou, implicating a pathway linked to cholesterol metabolism and oxidative stress, and providing potential targets and insights for precision prevention and treatment of related diseases.

Background:Sarcopenic obesity (SO) has been established as a reliable predictor of prognosis for several cancer types; however, its role in the prognosis of lung cancer patients receiving immune checkpoint inhibitors (ICIs) remains unclear. This study aimed to explore the potential predictive value of SO on survival outcomes in lung cancer patients undergoing ICI therapy. Methods:From May 2018 to October 2020, lung cancer patients who received immunotherapy at a tertiary hospital in Henan Province were retrospectively evaluated using data from the electronic medical record system. Data on demographic characteristics, biochemical markers, current illnesses and treatments, and nutrition-related information were documented. Sarcopenia was evaluated using the skeletal muscle index (SMI) (cm2/m2), which was calculated by measuring the muscle mass area from a cross-sectional CT image at the L3 vertebra level prior to immunotherapy. Results:The 119 participants were divided into four groups: control, sarcopenia, obesity, and SO. Among these participants, 15.13% were diagnosed with SO. The results demonstrated that for 3-year survival rates, patients with SO had the highest mortality rate (with a median survival of 22.55 months), followed by those with sarcopenia alone (median survival: 28.29 months) and those with obesity alone (median survival: 28.99 months) (p < 0.05). Multivariate Cox regression analysis indicated that SO (HR = 3.479, 95% CI = 1.374-8.814), creatinine level (HR = 0.963, 95% CI = 0.936-0.990), receiving ICIs as second-line therapy (HR = 4.274, 95% CI = 1.941-9.411), receiving ICIs as third-line or later therapy (HR = 2.980, 95% CI = 1.169-7.597), and an Eastern Cooperative Oncology Group performance status (ECOG-PS) score of ≥3 (HR = 5.274, 95% CI = 2.670-10.418) are independent factors associated with reduced 3-year survival time. Conclusion:SO is an independent prognostic factor for lung cancer patients receiving immunotherapy. Early identification and targeted management of sarcopenic obesity are crucial for optimizing treatment strategies and improving survival outcomes in ICI-treated lung cancer patients.

AIMS:This study quantified cardiovascular benefits attributable to China's Clean Air Act (CCAA), expressed as cases averted for cardiovascular disease (CVD), and estimated additional gains under stricter air-pollution interventions. METHODS AND RESULTS:We used data from the China Multi-Ethnic Cohort to estimate the numbers of averted CVD cases under CCAA policy and potential stricter intervention strategies for two air pollutants (PM2.5 and O3), including CCAA benefit evaluation (simulating the scenario without CCAA implementation), threshold intervention (limiting pollutant levels to specified thresholds), ratio intervention (reducing pollutant concentrations by a fixed percentage annually), and phased intervention (staged reductions at specific intervals over time). The parametric G-formula was employed to estimate the number of CVD cases averted per 100 000 people and relative risk. All interventions significantly reduced the cumulative morbidity of CVD. In CCAA benefit evaluation, the number of CVD cases averted per 100 000 people (95% CI) was 541 (184, 914) for PM2.5. Among potential stricter interventions, WHO AQG in threshold intervention yielded the largest number of CVD cases averted per 100 000 participants, 13 530 (7,400, 17,405) for PM2.5, 6498 (1,189, 10,840) for O3, and 15 449 (10,148, 17,998) for joint pollutant intervention, respectively. CONCLUSION:Existing air pollutant intervention policies have achieved considerable public health benefits in reducing CVD risk, and there is still significant room for improvement. Potential stricter interventions can be used as future target-oriented strategies to minimize the impact of air pollution on cardiovascular health.

INTRODUCTION:Patients with gastric cancer in the peri-operative period often face a high risk of malnutrition, which is closely related to poor prognosis. Currently, clinical practice pays insufficient attention to this issue. The existing evidence suggests that improving the quality of nutritional screening, assessment, and management can significantly reduce the incidence of malnutrition and its related adverse outcomes. OBJECTIVES:This project aimed to implement evidence-based practices to improve the quality of nutritional screening, assessment, and management of peri-operative gastric cancer patients in a tertiary hospital in central China. METHODS:This project was guided by the JBI Evidence Implementation Framework and used the JBI PACES tool to establish six review criteria for the baseline and follow-up audits. The CFIR framework was used to identify barrier factors, and the CFIR-ERIC implementation strategy matching tool was used to develop targeted strategies. Meanwhile, the GRiP method was used to organize resources and develop improvement plans. To assess the compliance of baseline and follow-up audits with best practices, this study used nursing records, medical records, and direct patient interviews as data sources. RESULTS:The project led to substantial improvements in evidence-based nutritional practices. Compliance with regular nutrition screening increased from 9.4% to 96.9%, while peri-operative nutritional support rose from 6.3% to 96.9%. Additionally, the use of a validated nutrition assessment tool, quantitative nutritional evaluation, and individualized dietary support before and after surgery improved from 0% to 87.5%. Notably, the use of a validated nutrition screening tool consistently achieved a 100% compliance rate. CONCLUSIONS:This evidence-based practice project improved health care professionals' compliance with best practices for nutritional screening, assessment, and management of peri-operative gastric cancer patients. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A656.

Trace elements such as zinc (Zn) and iron (Fe) may influence obesity risk; however, the role of their balance, reflected by the urinary zinc-to-iron ratio (ZIR), remains unclear. We analyzed baseline data from 14,761 adults aged 30–79 years in the China Multi-Ethnic Cohort. Urinary zinc and iron concentrations were normalized using urinary specific gravity to account for variations in urine dilution. Urinary Zn and the ZIR were positively associated with waist circumference and general obesity. Urinary Fe was linked to increased hip circumference (β = 0.196, 95

BackgroundObesity has become a significant contributor to non-communicable diseases worldwide, making it imperative to explore effective weight-loss methods. Alternate day modified fasting (ADMF) has emerged as a popular approach, but its effects on uric acid (UA) dynamics and body composition in Chinese populations remain unclear. This study aimed to investigate whether ADMF could change body composition and cardiometabolic parameters in individuals with obesity, and to analyze the correlation between changes in body composition indices and UA levels.MethodsA total of 35 adults were recruited and completed a 62-day trial, which consisted of a 32-day high-controlled fasting phase (HCFP) and a 30-day low-controlled fasting phase (LCFP). Body composition was measured by bioelectrical impedance analysis, and blood pressure (BP) and metabolic parameters were assessed at baseline, day 16, day 32, and day 62.ResultsOf the 35 participants (20 males, 15 females; mean age 36.23 ± 8.98 years; baseline body weight 100.02 ± 16.89 kg; baseline BMI 35.47 ± 4.15 kg/m2), body weight decreased significantly over the entire 62-day ADMF intervention (absolute loss: −6.83 ± 4.26 kg; −7.02%, P < 0.001). The proportion of total weight loss attributable to fat free mass (FFM) was 22.68%. During HCFP, weight decreased by −6.38% (absolute loss: −6.29 ± 3.11 kg, P < 0.001), with significant reductions in body fat mass (BFM, −11.14%, P < 0.001), FFM (−3.32 %, P < 0.001), visceral fat area (VFA, −13.10%, P < 0.001), and waist circumference (WC, −5.35%, P < 0.001). However, significant losses in soft lean mass (SLM; −3.40%, P < 0.001) and fat free mass (FFM; −3.32%, P < 0.001) were observed during HCFP, with partial improvement during LCFP (SLM: +0.73%, P = 0.031; FFM: +0.78%, P = 0.022). A transient but significant increase in UA occurred during HCFP (+27.30 ± 79.60 umol/L, +8.85% from baseline, P = 0.047), which subsequently decreased during LCFP (−33.70 ± 72.48 μmol/L, −6.67% from Day 32 to Day 62, P = 0.012). This UA elevation was correlated with concurrent loss of SLM (r = −0.340, P = 0.025).ConclusionA phased ADMF intervention was associated with effective reduction in adiposity and improvement in cardiometabolic risk factors. However, the transient hyperuricemia and lean muscle loss during the intensive phase suggest that UA monitoring and muscle-preserving strategies may be considered to optimize the safety and efficacy of ADMF protocols.

The relationships between urinary metal mixture exposures and CKD, as well as the mediating role of serum uric acid (SUA), remain unexplored. The study analyzed baseline data from the China Multi-Ethnic Cohort (CMEC) of 14,806 adults. Urinary concentrations of 21 metals were quantified using inductively coupled plasma mass spectrometry. Least absolute shrinkage and selection operator (LASSO) regression was used to identify key metals, and their associations with CKD were assessed using logistic regression and restricted cubic splines. To comprehensively assess all possible combinations of the selected metals, Mixture effects were analyzed through Qgcomp and WQS regression. Significant metal combinations and their interactions were further assessed, while the mediating role of SUA was evaluated using generalized linear models. Multiple sensitivity analyses were used to ensure robustness. LASSO regression identified six primary urinary metals (Zn, Sr, Mo, Pb, B, and Fe) from a total of 21 metals analyzed. In the single-metal models, Sr and Fe exhibited inverse associations with CKD, though causality requires further investigation given potential confounding by altered renal excretion. Conversely, Zn indicated a significant positive association with CKD. In mixture analyses, the qgcomp revealed significant heterogeneity across all 63 combinations, and the directional consistency with single-metal models was maintained. WQS confirmed stability in the weight directions. Among 63 metal combinations. Zn + Pb exhibited risk-enhancing effects through a synergistic interaction, while Sr + Fe demonstrated the strongest inverse association without significant multiplicative interaction. Uric acid mediated 24.9% and 22.7% of the Sr + Fe-CKD and Zn + Pb-CKD effects, respectively. This study highlights the individual or combined effects of six urinary metals (Zn, Sr, Mo, Pb, B, and Fe) on CKD, focusing on the specific urinary metal combinations (Zn + Pb and Sr + Fe) mediated by SUA, providing novel insights into the associations of metal with CKD.

Background: The association between early adulthood body mass index (BMI) and future type 2 diabetes (T2DM) risk, and whether later lifestyle factors modify this association, remain unclear. Methods: We used data from the China Multi-Ethnic Cohort including participants aged 35–70 years. Early adulthood BMI was assessed by recalled weight at age 25 years. Incident T2DM was identified through health databases and active follow-up. Fine-Gray competing risk models, with death without T2DM as the competing event, estimated subdistribution hazard ratios (SHR). Multiplicative and additive interactions between early adulthood BMI and a healthy lifestyle score were assessed. Findings: Among 13 285 participants (mean age 49.8 years; 57.6% women), 489 incident T2DM cases occurred over 6.1 years. Each 1 kg/m2 higher early adulthood BMI was associated with a 15% increased T2DM risk (SHR 1.15, 95% CI 1.11–1.20). Compared with underweight or normal at age 25 years, overweight and obesity gave SHRs of 1.70 (1.34–2.15) and 3.68 (2.31–5.88), respectively. Restricted cubic spline analysis revealed a non-linear dose–response relationship (P for non-linearity <0.001). Those maintaining obesity from early adulthood had the highest risk (6.07, 2.66–13.84); even those who reduced from obesity to underweight or normal weight remained at elevated risk (5.32, 1.55–18.22). No multiplicative (P=0.624) or additive interaction was observed with middle and later life lifestyle. Interpretation: Higher early adulthood BMI independently increases T2DM risk in Chinese adults, not offset by later lifestyle changes. Weight management in young adulthood is crucial for primary prevention, supporting life-course approaches.

Metabolic Syndrome (MetS) is a major public health problem that has imposed enormous socio-economic burdens in most countries and regions. This study aims to investigate the association of urinary Zinc (Zn) with the risk of MetS and its components among the Bouyei ethnic group, and the role of liver enzymes as mediators in this relationship. Zn concentrations in the urine of 5033 participants were measured by inductively coupled plasma mass spectrometry. An automatic biochemical analyzer was used to detect blood biochemical indexes. Binary logistic regression showed that compared with Q1, the OR (95

Ultrafine particulate matter (UFP) has been identified as a significant environmental risk for public health, yet the cardiovascular effects of long-term UFP exposure have been insufficiently explored. This study based on data from 98,797 participants across five provinces/regions in southwest China and UFP data from a high-resolution atmospheric chemistry model examined the associations between long-term UFP exposure and the prevalence of cardiovascular diseases (CVDs) in China. The findings reveal elevated prevalence of total and specific CVDs associated with a 3-year average UFP exposure. Specifically, the odds ratio for total CVDs was 1.17 (95% CI: 1.09, 1.24) for each interquartile range increase (5667 particles/cm3) in the 3-year average of UFP exposure. Additionally, UFP exposure was associated with significant increases in the prevalence of stroke (33%), coronary heart disease (19%), and hypertension (11%). The exposure-response relationships indicate no threshold for the cardiovascular effects of UFP exposure with linear increases in risks even at lower exposure levels. Older populations, minority groups, and urban residents experience a higher prevalence of CVDs associated with long-term UFP exposure. This large-scale, multicenter study in China provides novel epidemiological evidence that long-term UFP exposures increase the prevalence of total and several specific CVDs. The findings address a critical gap in understanding the cardiovascular effects of UFPs in developing countries with high exposure levels.

BACKGROUND:Pairwise associations among fine particulate matter (PM2.5), gut microbiota, and cardiovascular disease (CVD) have been established. However, the mediating role of gut microbiota in the relationship between PM2.5 and its components and CVD remains unclear. METHODS:We included 1459 participants from the China Multi-Ethnic Cohort between May 2018 and September 2019. CVD was identified using ICD-10 codes based on hospital surveillance system. PM2.5 and its components were sourced from the ChinaHighAirPollutants dataset. Gut microbiota was obtained from 16S rRNA sequencing of stool samples, and five α-indexes along with 1088 gut compositions were used as mediators. Cox proportional hazards and multiple linear regression were used to explore the associations among PM2.5 and its components, gut microbiota, and CVD. Causal mediation analysis was conducted to evaluate the potential mediating role of gut microbiota between PM2.5 and its components and CVD. RESULTS:Among all the participants, 204 (14.0 %) had developed CVD during a 5501 person-year follow-up (median, 3.8 years). The ACE, Chao1, and Obs indexes positively mediated the associations of PM2.5 and its components with both CVD and stroke, with mediation proportions ranging from 7.9 % to 8.9 % for CVD and 10.0 %-12.1 % for stroke. The ACE index had the highest mediation proportion (12.1 %) in the relationship between sulfate and stroke. The genus Pasteurella also demonstrated a mediating role, accounting for 2.6 %-3.2 % for CVD, and 2.5 %-3.6 % for stroke, exhibiting the highest mediation proportion (3.6 %) on the association between black carbon or nitrate and stroke. CONCLUSION:Three α-indexes (ACE, Chao1, and Obs) and the Pasteurella positively mediated the association between PM2.5 and its components and CVD risk. Enhancing the richness of gut microbiota could potentially reduce the risk of CVD induced by PM2.5 and its components.

Objectives: Human behaviors and blood pressure (BP) are closely intertwined, affecting health. However, few studies have demonstrated their complex relationships. Using network analysis, we aimed to untangle the intricate and potential causal relationships between BP and human instinctive behaviors, identifying potential action points for hypertension prevention and control. Study design: Cohort study. Methods: This study is based on two-wave data from 11,277 Chinese adults in the China Multi-Ethnic Cohort (CMEC) and an independent validation cohort of 21,947 adults from the Chinese Cohort of Working Adults (CCWA). We conducted a cross-sectional network analysis to estimate the interrelationships between measured BP and self-reported physical activity (PA), diet, and sleep. The centrality of each variable within the network was estimated using strength centrality index. Additionally, we performed a longitudinal network analysis to infer the potential causal relationships between BP and human instinctive behaviors in participants with normal or above-normal BP. Results: The network models suggested that BP exhibited negative associations with the dietary score (edge weight: -0.09) and sleep duration (-0.05). Non-sedentary behavior and dietary score were the most central variables, strongly connecting BP and other lifestyles. Higher BP predicted a poorer dietary score (beta = -0.21) in participants with above-normal BP. The effect of BP on dietary score was replicated in the validation cohort and validated by linear regression analysis. Conclusions: Non-sedentary behaviors and dietary behaviors may be the potential action points in promoting healthy behaviors and contributing to BP management. It is essential to manage individuals' BP status, nonsedentary behaviors, and dietary behaviors to disrupt malignant cycles.

Background Whether healthy behaviors can attenuate the adverse association between ambient fine particulate matter (PM2.5) and cardiovascular disease (CVD) is inconclusive. METHODS AND RESULTS The parametric g‐formula was used to quantify the potential reduction in PM2.5 effect on CVD under different scenarios of hypothetical behavioral interventions (including dietary patterns, physical activity, body mass index, alcohol consumption, smoking, and dietary supplements). Feasible intervention scenarios, defined on the basis of values considered feasible in previous real‐world interventions (eg, overweight participants lose 6.69% of their weight). Intensive scenarios, in which all participants are adopting completely healthy behaviors (eg, maintain normal weight). We also estimate the effect of joint interventions that incorporate the above behaviors. Long‐term PM2.5 exposure was associated with incident CVD in both cohorts, with the risk difference per 1000 person‐years for a 5 μg/m3 increase in PM2.5 being 1.42 (95% CI, 1.04–1.79) in the UKB (UK Biobank) and 2.15 (95% CI, 1.65–2.59) in the Sichuan Cohort (China Multi‐Ethnic Cohort, Sichuan Region). In both feasible and intensive scenarios, improving diet, physical activity, and body mass index could significantly reduce the risk difference of PM2.5 on CVD, with the reduced proportion ranging from 4.59% to 37.22%. A feasible joint hypothetical intervention on 6 behaviors would reduce the effect of PM2.5 on CVD by 31.47% (10.13%–57.26%) and 19.75% (10.78%–42.89%) in the low‐pollution UK Biobank and high‐pollution Sichuan cohort, respectively. A combination of more intensive interventions would reduce risk difference by 57.51% (21.64%–100.69%) and 45.54% (22.66%–106.66%), respectively. Conclusions Healthier behaviors could serve as individual‐level complementary strategies to emission control for minimizing the health impact of PM2.5, whether in high‐ or low‐pollution areas.

BACKGROUND:The interrelationships between physical activity (PA), sleep disorders, and hypertension remain incompletely characterised, particularly regarding potential interactions between PA and sleep disorders on hypertension risk. This study aimed to investigate these associations using complementary epidemiological approaches. METHODS:We conducted a population-based observational analysis of 18,052 adults aged ≥18 years using data from the National Health and Nutrition Examination Survey, a nationally representative cross-sectional survey (2005-2018). Weighted multivariate logistic regression models were used to examine the associations between PA, sleep disorders, and hypertension, as well as the interaction effect of PA and sleep disorders on hypertension. Additionally, we performed a two-sample Mendelian randomisation (MR) analysis was conducted to assess the causal relationship between PA, sleep disorders, and hypertension. RESULTS:The analysis of observational data shows that sleep disorders are significantly associated with a higher risk of hypertension, with an odds ratio (OR) of 1.61 (95% CI: 1.10-2.35, p = 0.015). Restricted Cubic Spline (RCS) analysis revealed an S-shaped dose-response relationship between PA and hypertension (P-non-linear < 0.001). The MR analysis results were consistent with these findings. CONCLUSIONS:Convergent evidence from observational and genetic analyses identified sleep disorders as an independent risk factor for hypertension. The non-monotonic S-shaped association between PA and hypertension underscored the importance of personalised activity prescriptions for cardiovascular risk optimisation. Notably, no significant interaction was observed between PA and sleep disorders, suggesting that their effects on hypertension are likely independent.

Background The relationship between urinary metal exposure and lipid profiles remains unclear, particularly regarding potential mediators. This study aimed to investigate associations between urinary metals and lipid levels and to explore mediating health indicators. Methods We included 14 817 participants in the CMEC (Chinese Multi‐Ethnic Cohort) study baseline data. Twenty‐one urinary metals, 16 health indicators, and lipid profiles were measured to explore their relationships. Results In single‐metal models, each unit increase in urinary zinc was associated with higher total cholesterol by 12%, triglycerides by 29%, and low‐density lipoprotein cholesterol by 14%, along with lower high‐density lipoprotein cholesterol by 3%, and increased odds of dyslipidemia (odds ratio, 1.76 [95% CI, 1.55–2.01]). In contrast, higher urinary sodium was associated with lower total cholesterol (−12%), triglycerides (−6%), low‐density lipoprotein cholesterol (−7%), and decreased dyslipidemia risk (odds ratio, 0.87 [95% CI, 0.83–0.92]). In mixed exposure models, zinc, manganese, and cobalt were major contributors to dyslipidemia. Quantile regression revealed stronger effects of zinc in individuals with higher lipid levels. Mediation analysis showed that waist‐to‐hip ratio and uric acid mediated 27.2% and 12.0% of the metal–dyslipidemia relationship, respectively. Conclusions Urinary metal exposure is significantly associated with lipid abnormalities, particularly among individuals with higher lipid levels. Specific metals may influence lipid metabolism via adiposity and uric acid pathways. Therefore, reducing exposure to certain urinary metals may contribute to dyslipidemia prevention and cardiovascular risk reduction.

There are still insufficient studies exploring its relationship with the Insulin Resistance (IR) surrogates from the perspective of sleep structure. The aim of this study is to apply smart bracelets to monitor the sleep structure parameters of middle-aged and elderly people during natural sleep and investigate their association with the IR surrogates. A total of 723 individuals aged between 40 and 65 participated in the questionnaire surveys, sleep assessments, and regular hospital physical examinations. Sleep assessment involves the respondents wearing a smart bracelet (Honor Band5i) on their non-dominant hand and continuously measuring the sleep of natural people in the real world for three days. Generalised estimating equation regression analysis and robust poisson regression were used to analyse the association between sleep structural parameters and the three IR surrogates, and restricted cubic spline (RCS)regression analysis was used to explore the threshold and dose-response relationship. The proportion of REM sleep among the 723 respondents was 17.31% ± 4.76, the proportion of slow-wave sleep was 25.33% (21.83, 28.00), and the proportion of light sleep was 57.67% (53.33,62.00). Multifactorial regression analyses showed that an increase in the duration and proportion of REM sleep was associated with a reduced risk of IR (ORREM%-TyGWHtR =0.993, 95%CI: 0.987-0.999, p=0.029, ORREMmin-TyG =0.997, 95%CI: 0.994-0.999, p=0.038, ORREMmin-METSIR =0.994, 95%CI: 0.990-0.998, p=0.006); No significant associations were found between the length and proportion of slow wave sleep, the length and proportion of light sleep, and the three IR indices (p> 0.05). After the proportion and duration of REM sleep were later dichotomised by the nodes obtained from the RCS analysis, and this association was only observed in the male group in the gender stratification (ORREM%-TyG =0.853, 95%CI: 0.741-0.982, p=0.026, ORREMmin-TyG =0.855,95%CI: 0.742-0.985, p=0.030). Furthermore, even after excluding the REM (%) ≥30% (n=6) or patients with diabetes (n=50), the trend between REM sleep and IR remained consistent. This study found that the overall proportion and duration of REM sleep in the middle-aged and elderly population were relatively low. Additionally, the study also discovered that the increase in the proportion of REM sleep is associated with a reduced risk of IR surrogates. This research indicates that monitoring and optimizing the duration and proportion of REM sleep may be a new target for preventing metabolic diseases. Moreover, the widespread use of commercial watches in the home environment will facilitate the assessment of future sleep patterns. This will also provide a basis for people to manage their daily sleep health autonomously.

Few studies have examined the associations between long-term exposure to ultrafine particles (UFP) and type 2 diabetes (T2DM). This study aimed to investigate the impact of long-term UFP exposure on diabetes prevalence and stages, as well as glycemic markers, using data from a large multi-center cohort collected from 2017 to 2021. The health outcomes assessed included diabetes prevalence and stages (normoglycemia, prediabetes, and diabetes), as well as glycemic markers, i.e., fasting blood glucose (FPG) and glycated hemoglobin (HbA1c). The three-year average UFP concentration prior to baseline was used as the long-term UFP exposure level. This cross-sectional study included 93,990 participants, with a diabetes prevalence of 10.97 %. An interquartile range increase in UFP was significantly associated with diabetes prevalence and stages, with ORs of 1.20 (95 % CI: 1.14, 1.26) and 1.11 (95 % CI: 1.07, 1.44), respectively. Specifically, for comparison between normoglycemia and prediabetes, and between prediabetes and diabetes, the corresponding ORs were 1.01 (95 % CI: 0.96, 1.04) and 1.24 (95 % CI: 1.17, 1.31), respectively. UFP exposure was also significantly associated with elevated levels of FPG and HbA1c. These findings suggest that long-term UFP exposure may be a potential risk factor for diabetes with larger risks in the prediabetes population.

Whether the role of gut microbial features lies in the pathways from lifestyles to dyslipidemia remains unclear. In this cross-sectional study, we conducted a metagenome-wide association analysis and fecal metabolomic profiling in 994 adults from the China Multi-Ethnic cohort. A total of 26 microbial species were identified as mediators between lifestyle factors and risk for dyslipidemia. Specifically, the abundance of [Ruminococcus] gnavus mediated the associations between lifestyles and risks for dyslipidemia, elevated low-density lipoprotein cholesterol, elevated total cholesterol, and elevated triglycerides. [Ruminococcus] gnavus, Alistipes shahii, and Lachnospira eligens were replicated to be associated with dyslipidemia in an external validation cohort. The potential metabolic pathways included arachidonic acid, bile acid, and aromatic amino-acid metabolism.

Comorbidity represents an increasingly significant public health challenge. While numerous studies have confirmed the association between metals and both hypertension and osteopenia, the relationship between the multi-faceted effects of mixed metal exposure and the comorbidity of hypertension with abnormal bone mass, as well as age-specific associations, remains unclear. This study utilized baseline data from the China Multi-Ethnic Cohort Study, investigating 9870 Chinese ethnic minorities (Dong and Miao) aged 30-79 years. We measured 17 urinary metal levels using inductively coupled plasma mass spectrometry. The study employed Least Absolute Shrinkage and Selection Operator (LASSO) penalized regression and Bayesian Kernel Machine Regression (BKMR) models to explore the association between urinary metals and comorbidity of hypertension and abnormal bone mass risk. In single-metal models, urinary nickel and zinc levels showed positive correlations with hypertension-related bone mass reduction risk, with ORs and 95 % CIs of 1.23 (1.01, 1.50) and 1.56 (1.27, 1.90), respectively. LASSO regression identified 11 urinary metals (aluminum, cobalt, chromium, copper, iron, manganese, lithium, lead, strontium, vanadium, and zinc) associated with hypertension and abnormal bone mass comorbidity. These selected metals were incorporated into subsequent analyses. BKMR analysis revealed an overall negative effect of metal mixtures on hypertension and abnormal bone mass comorbidity when all metals were fixed at their 50th percentiles. Vanadium and lithium showed negative correlations with the comorbidity. In subgroup analyses, age-stratified groups demonstrated consistent overall negative effects of metal mixtures on the comorbidity. Notably, in individuals over 60 years old, aluminum additionally exhibited a negative association alongside vanadium. Interactions were observed among metals in mixed exposures. Increasing urinary aluminum concentrations attenuated the negative correlation between manganese and hypertension-bone mass abnormality comorbidity. Similarly, increasing manganese concentrations weakened the positive association between urinary zinc and the comorbidity. In individuals under 60 years old, consistent with the general population, increasing urinary aluminum concentrations at P50 levels of other metals diminished the protective effect of manganese against hypertension-bone mass abnormality comorbidity. Interactions were identified between aluminum and lithium, and between manganese and zinc. This study provides substantial evidence linking mixed urinary metal exposure to hypertension and bone mass comorbidity, exploring the multifaceted effects of mixed metal exposure. These findings contribute to a deeper understanding of the role of metal exposure in chronic disease comorbidity, offering a scientific foundation and new directions for preventing and controlling hypertension and bone mass comorbidity, as well as informing public health policy formulation from an environmental metal perspective.

Numerous studies have shown that physical activity can effectively reduce blood pressure. And exercise is a physical activity that we can control, so which kind of exercise modalities is more closely related to the prevalence of hypertension needs further research. This study's data came from the baseline survey of the China Multi-Ethnic Cohort. Sociodemographic information, physical activity, and hypertension prevalence were extracted to analyze the relationship between different common exercise modalities and the prevalence of hypertension. A total of 40,308 participants were included, and the prevalence of hypertension was 34.0