BackgroundThe triglyceride glucose-waist height ratio (TyG-WHtR) index is a useful marker for predicting the risk of cardiovascular and metabolic diseases. Metabolic diseases are known to be high-risk factors for overactive bladder (OAB). However, no studies have explored the association between the TyG-WHtR index and the risk of developing OAB.MethodsData from the National Health and Nutrition Examination Survey (NHANES) was utilized, and a weighted multivariate logistic regression analysis was conducted to investigate the relationship between TyG-WHtR and OAB. Subgroup analyses and interaction tests were also performed. Additionally, sensitivity analyses were conducted to validate the robustness of the findings. A smooth curve fitting and threshold effect analysis explored the nonlinear relationship between TyG-WHtR and the risk of developing OAB. The predictive value of the TyG-WHtR index for OAB was assessed using Receiver Operating Characteristic (ROC) curves, and the area under the ROC curve (AUC) was calculated.ResultsA total of 14,652 adults aged 20 and above were included in this study. After weighting, the population size was estimated to be 197,598,146.7, among which 37,872,284.55 individuals were diagnosed with OAB. The median TyG-WHtR for the entire population was 4.98, while it was 5.44 for those with OAB. Weighted logistic regression analysis revealed a significant positive association between TyG-WHtR and the occurrence of OAB (OR=1.646; 95% CI: 1.562, 1.735; P<0.001). This positive association remained significant even after adjusting for confounding factors (OR=1.310; 95% CI: 1.157, 1.484; P<0.001). Sensitivity analysis demonstrated the robustness of the results. Subgroup and interaction analyses indicated that the impact of the TyG-WHtR index on OAB might be influenced by gender (OR=1.323; 95% CI: 1.138, 1.538; P<0.001) and age (OR=1.426; 95% CI: 1.180, 1.724; P<0.001). Smooth curve fitting and threshold effect analysis revealed a threshold of 3.579. ROC curve analysis demonstrated that the TyG-WHtR index has a good predictive ability for OAB (AUC=0.647; 95% CI: 0.636, 0.657).ConclusionsThe TyG-WHtR index is significantly positively associated with the occurrence of OAB and could potentially serve as a novel risk predictor for OAB. Future research is needed to validate findings, explore causality, and improve early detection through multifactorial models across diverse populations.

The Life’s Essential 8 (LE8) is a novel indicator of cardiovascular health proposed by the American Heart Association. While numerous studies have demonstrated its guiding value in chronic diseases, research on its role in lung function remains limited. This study utilized data from the National Health and Nutrition Examination Surveys (NHANES 2007–2012), which included comprehensive measurements of lung function, diet, physical activity, nicotine exposure, sleep patterns, body mass index (BMI), blood glucose, blood pressure, blood lipids, and relevant covariates. We calculated lung function Z-score and LE8 scores, employing multiple linear regression, multivariable logistic regression, and restricted cubic spline models to evaluate their correlations. In this study of 10,400 participants (mean age 44 years; 48.75% male), participants were classified into threeforcedexpiratory volume in one second (FEV1) Z-score groups: Z1 (normal lung function, n = 9,600), Z2 (mild impairment, n = 618), and Z3 (moderate to severe impairment, n = 182). Significant differences in demographic characteristics and health parameters were observed among the groups. Notably, variations in the Healthy Eating Index 2015 (HEI-2015), physical activity, nicotine exposure, and sleep patterns were identified within the LE8 health behavior domain. Higher LE8 scores were found to be positively associated with lung function, even after adjusting for demographic and health factors. Further analysis revealed positive correlations between lung function and favorable dietary habits, higher physical activity levels, reduced nicotine exposure, and improved sleep quality. Conversely, BMI, blood lipids, blood glucose, and blood pressure exhibited variable effects. Subgroup and sensitivity analyses consistently supported findings, confirming a positive correlation between LE8 and lung function. Our study highlights significant associations between LE8 scores and lung function, demonstrating that higher LE8 scores, which reflect better cardiovascular health behaviors, are positively correlated with improved lung function.

Background:Cardiovascular health (CVH) profoundly impacts human health and quality of life. Increasing evidence suggests a close association between cardiovascular disease (CVD) and systemic immune-inflammatory levels. This study explores the potential correlation between Life's Essential 8 (LE8) scores and the systemic immune-inflammation index (SII), a novel immune-inflammatory index among US adults. This study provides evidence supporting the role of systemic inflammation reduction in promoting CVH. Methods:Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007-2018, we investigated information from 21,403 adult participants. Participants were categorized into low CVH (0-49), moderate CVH (50-79), and high CVH (80-100) groups based on LE8 scores. We employed weighted linear regression analysis and subgroup analysis, along with restricted cubic spline curves (RCS) to explore the association between LE8 and SII and the dose-response relationship. Result:A significant negative correlation was found between higher LE8 scores and lower SII levels. Compared to the low CVH group, the β coefficients for SII in the CVH moderate and CVH high groups were -40.02 (95% CI: -58.99 to -21.05, p < 0.001) and -77.62 (95% CI: -102.4 to -52.80, p < 0.001), respectively. Additionally, both LE8 scores and health behaviors scores showed a significant linear negative correlation with SII. There was an inverted "U-shaped" non-linear relationship between health factors scores and SII, and the health factor score was 284.724, with a maximum SII threshold of 518.010 (1,000 cells/μl). The health factor score is positively associated with SII below 518.010 and negatively associated above this threshold. Subgroup analyses showed that the negative association was stable in most subgroups. The negative correlation was insignificant among those aged >65 and Mexican Americans. Conclusion:LE8 showed a significant negative correlation with SII. The findings suggest that maintaining higher LE8 scores to some extent promotes CVH and helps alleviate systemic inflammation, potentially benefiting overall health.

Telomere length is closely associated with the occurrence and development of cardiovascular and other diseases. Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a novel indicator of inflammation, oxidative stress, and metabolic syndrome, with some predictive ability for related disease risks in clinical practice. However, there is no research on the correlation between these two factors. Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2002, we conducted analysis and research on the correlation between MHR and telomere length using the Kruskal-Wallis H test, Spearman rank correlation analysis, and partial correlation analysis. Weighted linear regression analysis assessed the strength of the association between the two variables, while restricted cubic spline regression (RCS) explored potential nonlinear relationships between them. The results of correlation analysis showed that MHR levels were negatively correlated with telomere length (ρ=-0.083, P < 0.001), and this relationship remained statistically significant after controlling for other covariates (P all < 0.001). Weighted linear regression analysis showed that after adjusting for all covariates, MHR remained negatively associated with telomere length (β = -0.020; 95

Background The mortality rate of sepsis-associated liver injury (SALI) is relatively high, but there is currently no authoritative prognostic criterion for the outcome of SALI. Meanwhile, lactate-to-albumin ratio (LAR) has been confirmed to be associated with mortality rates in conditions such as sepsis, heart failure, and respiratory failure. However, there is a scarcity of research reporting on the association between LAR and SALI. This study aimed to elucidate the association between LAR and the 28-day mortality rate of SALI. Methods In this retrospective cohort study, data were obtained from the Medical Information Mart for Intensive Care IV (v2.2). Adult patients with SALI were admitted to the intensive care unit in this study. The LAR level at admission was included, and the primary aim was to assess the relationship between the LAR and 28-day all-cause mortality. Results A total of 341 patients with SALI (SALI) were screened. They were divided into a survival group (241) and a non-survival group (100), and the 28-day mortality rate was 29.3%. Multivariable Cox regression analysis revealed that for every 1-unit increase in LAR, the 28-day mortality risk for SALI patients increased by 21%, with an HR of 1.21 (95% CI 1.11 ~ 1.31, p < 0.001). Conclusions This study indicates that in patients with SALI, a higher LAR is associated with an increased risk of all-cause mortality within 28 days of admission. This suggests that LAR may serve as an independent risk factor for adverse outcomes in SALI patients.

Abstract Background Bilirubin is known for its multifaceted attributes, including antioxidant, anti-inflammatory, immunomodulatory, and antiapoptotic properties. The systemic immune-inflammation index (SII) is a recent marker that reflects the balance between inflammation and immune response. Despite the wealth of information available on bilirubin’s diverse functionalities, the potential correlation between the total bilirubin (TB) levels and SII has not been investigated so far. Methods Leveraging data from the National Health and Nutrition Examination Survey spanning 2009–2018, the TB levels were categorized using tertiles. Employing the chi-squared test with Rao and Scott’s second-order correction and Spearman’s rank correlation analysis, the association between TB and SII was examined. The potential nonlinearities between TB and SII were evaluated using restricted cubic spline (RCS) analysis. Weighted linear regression, adjusted for covariates, was used to explore the correlation between TB and SII, with further subgroup analyses. Results A total of 16,858 participants were included, and the findings revealed significant SII variations across TB tertiles (p < 0.001). The third tertile (Q3) exhibited the lowest SII level at 495.73 (295.00) 1000 cells/µL. Spearman rank correlation disclosed the negative association between TB and SII. RCS analysis exposed the lack of statistically significant variations in the nonlinear relationship (p > 0.05), thereby providing support for a linear relationship. Weighted linear regression analysis underscored the negative correlation between TB and SII (β 95% CI − 3.9 [− 5.0 to − 2.9], p < 0.001). The increase in the TB levels is associated with a significant linear trend toward decreasing SII. After controlling for relative covariates, this negative correlation increased (p < 0.001). Subgroup analysis confirmed the significant negative TB–SII association. Conclusion A notable negative correlation between TB and SII implies the potential protective effects of bilirubin in inflammation-related diseases.

Brominated flame retardants (BFRs) are a group of chemicals widely used in various applications to prevent or slow down the spread of fire. However, they have adverse effects on human health. There is a relative scarcity of population-based studies regarding BFRs, particularly their impact on the respiratory system. This study aimed to investigate the influence of BFRs on pulmonary function using data from the National Health and Nutrition Examination Survey. The study found that elevated serum concentrations of certain BFRs were associated with pulmonary ventilatory dysfunction. Adjusted analyses revealed positive correlations between PBDE47, PBDE183, and PBDE209 concentrations and ventilatory dysfunction. The analysis of mixed BFRs showed a positive relationship with pulmonary ventilation dysfunction, with PBDE47 making the most significant contribution. Our study demonstrates that both individual and combined BFRs exposure can lead to impaired pulmonary ventilation function. These findings provide evidence of the adverse effects of BFRs on lung function, emphasizing the importance of further investigating the potential health consequences of these compounds. Further large-scale longitudinal studies are needed to investigate this relationship in the future.

Background Klotho is an anti-aging protein that has multiple functions and may play a key role in the pathogenesis and progression of chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD). Fractional Exhaled Nitric Oxide (FeNO) is a non-invasive and novel biomarker that has the advantages of being simple, fast and reproducible. It can effectively assess the degree of airway inflammation in diseases such as asthma and COPD. Despite these insights, the relationship between serum Klotho levels and FeNO has not been explored yet. Methods Leveraging data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2012, we investigated the correlation between FeNO and serum Klotho levels. This association was scrutinized both as continuous variables and within quartile distributions, utilizing the Kruskal-Wallis H test. The correlation between the two variables was assessed through Spearman rank analysis. Employing survey weight-adjusted linear regression models, we gauged the strength of these associations. Results This study included 6,527 participants with a median FeNO level of 14.5 parts per billion (ppb). We found that FeNO levels varied significantly across different quartiles of Klotho protein (H = 7.985, P = 0.046). We also found a significant positive correlation between serum Klotho levels and FeNO levels in the whole population (Spearman’s rho = 0.029, P = 0.019). This correlation remained significant after adjusting for covariates such as age, gender, lung function, smoking status, alcohol use, BMI, cardiovascular disease (including hypertension, heart failure, coronary heart disease, and myocardial infarction), diabetes, inflammatory markers, serum vitamin D level and BUN ( P < 0.05 for all). Furthermore, this correlation was stronger at the high (K3) and super high (K4) levels of Klotho than at the low (K1) and medium (K2) levels (β = 1.979 ppb and β = 1.993 ppb for K3 and K4 vs. K1, respectively; 95% CI: 0.497 ~ 2.953 and 95% CI: 0.129 ~ 2.827, respectively; P = 0.007 and P = 0.032, respectively). The β coefficient for serum Klotho was 0.002 ppb/pg/ml. Conclusions Our study illuminates a positive correlation between serum Klotho levels and FeNO. Further study is needed to verify the causality of this association and elucidate the underlying mechanisms.

Asthma is a chronic inflammatory disease that affects millions of people worldwide. Obesity, particularly visceral adipose tissue (VAT), is known to secrete adipokines and pro-inflammatory factors, which are closely associated with various metabolic and cardiovascular diseases. Research indicates that these metabolic disturbances can exacerbate inflammatory conditions, contributing to both cardiovascular and respiratory diseases, including asthma. Despite these associations, studies on the specific relationship between VAT and asthma remain limited and warrant further investigation. Utilizing the NHANES database from 2011 to 2018, we included a total of 11,137 participants. Multivariable regression analysis was performed, stratifying subjects based on VAT levels and adjusting for various confounders. Subgroup interaction analysis and nonlinear analysis were conducted to explore potential effect modifiers and nonlinear associations. In this study, 11,137 participants were included, with 49.74% being female. Among the 509 asthma patients, 69.35% were female. The number of asthma patients among Non-Hispanic Whites was 212, representing 41.65% of the total, the highest proportion among the studied groups. The VAT for asthma patients was 529 g, significantly higher than the 455 g in the non-asthma group (P < 0.001). Multivariable regression analysis showed that for every 200 g increase in VAT, the risk of asthma increased by 10.4% (P = 0.032), 20.8% (P < 0.001), and 20.3% (P = 0.004) across three models (unadjusted, adjusted for demographic factors, and fully adjusted). Subgroup analysis indicated a stronger association between VAT and asthma risk in females and individuals over 40 years old. Nonlinear analysis uncovers a J-shaped relationship between VAT and asthma, with the lowest risk observed at 464.57 g (P < 0.001). The study findings suggest that increased VAT is associated with elevated asthma risk, particularly among females and older individuals. These results underscore the importance of considering VAT in asthma risk assessment and highlight potential targeted interventions to reduce asthma risk associated with excess visceral adiposity.

Abstract Background A prospective study of multiple small samples found that idiopathic pulmonary fibrosis (IPF) is often accompanied by a deficiency in Vitamin D levels. However, the causal relationship between the two remains to be determined. Therefore, our study aims to investigate the causal effect of serum 1,25-hydroxyvitamin D (25(OH)D) on the risk of IPF through a two-sample Mendelian randomization (MR) analysis. Methods Through data analysis from two European ancestry-based genome-wide association studies (GWAS), including 401,460 individuals for 25(OH)D levels and 1028 individuals for IPF, we primarily employed inverse-variance weighted (IVW) to assess the causal effect of 25(OH)D levels on IPF risk. MR-Egger regression test was used to determine pleiotropy, and Cochran’s Q test was conducted for heterogeneity testing. Leave-one-out analysis was conducted to examine the robustness of the results. Results 158 SNPs related to serum 25(OH)D were used as instrumental variables (IVs). The MR analyses revealed no evidence supporting a causal association between the level of circulating 25(OH)D and the risk of IPF. The IVW method [OR 0.891, 95%CI (0.523–1.518), P = 0.670]; There was no significant level of heterogeneity, pleiotropy and bias in IVs. Cochran’s Q test for heterogeneity (MR Egger P = 0.081; IVW P = 0.089); MR-Egger regression for pleiotropy (P = 0.774). Conclusions This MR Study suggests that genetically predicted circulating vitamin D concentrations in the general population are not causally related to IPF.

目的 应用加权发病率综合征联合抗菌药物算法(WISCA)分析胆道感染(BTI)病原菌分布和耐药情况.方法 收集宁波市医疗中心李惠利医院2015年1月1日至2020年9月30日首次送检结果阳性的934例BTI患者的胆汁,标本培养分离后得到病原菌1251株,采用法国生物梅里埃公司的VITEK-2 Compact进行细菌鉴定及药物敏感试验,统计分析细菌分布及耐药率,再应用WISCA计算各药物的加权敏感性.结果 1251株病原菌中革兰阴性杆菌812株(64.9％),革兰阳性球菌363株(29.0％),真菌76株(6.1％);革兰阴性杆菌中位列前4位的是大肠埃希菌(31.3％)、肺炎克雷伯菌(10.6％)、铜绿假单胞菌(4.2％)、阴沟肠杆菌(3.8％);革兰阳性球菌中位列前4位的是粪肠球菌(10.1％)、鹑鸡肠球菌(4.4％)、铅黄肠球菌(4.3％)、鸟肠球菌(2.6％);最常见的真菌是白假丝酵母(3.4％)、光滑假丝酵母(2.1％).大肠埃希菌和肺炎克雷伯菌对三代头孢菌素的耐药率以头孢曲松最高,分别是68.2％和33.6％,对左氧氟沙星的耐药率分别为54.0％和24.4％,对亚胺培南的耐药率为1.5％和6.1％;铜绿假单胞菌对头孢哌酮/舒巴坦、哌拉西林他唑巴坦和亚胺培南的耐药率分别为16.7％、22.0％和42.3％;鹑鸡肠球菌和铅黄肠球菌对万古霉素耐药率分别为86.4％和91.7％.抗菌药物中对革兰阴性杆菌加权敏感性超过80.0％有阿米卡星(93.0％)、亚胺培南(83.0％);对革兰阳性球菌加权敏感性超过80.0％有替加环素(81.0％)、青霉素(80.2％);对真菌加权敏感性超过80.0％有两性霉素B(100.0％)、伏立康唑(86.8％)、氟康唑(82.9％);联合治疗加权敏感性超过80.0％的有亚胺培南联合替加环素(83.2％)、厄他培南联合环丙沙星(82.5％)、哌拉西林他唑巴坦联合环丙沙星(81.9％)、哌拉西林他唑巴坦联合替加环素(80.9％)、亚胺培南联合利奈唑胺(80.0％).结论 亚胺培南仍是胆道感染经验性用药的良好选择,替加环素可作为联合用药首选.