Obesity is a leading global health challenge and risk factor for cardiometabolic disorders, driven in part by industrialization and low-fiber, ultra-processed diets. While the gut microbiome has been implicated in obesity, the contribution of the oral microbiome-the body's second largest microbial ecosystem-remains underexplored. We analyze a prospective cohort of 628 Emirati adults, including multi-omics profiling of 97 obese individuals and 95 matched controls, generating the most comprehensive oral microbiome analysis to date. Obese participants show altered microbial diversity, composition, functions, and metabolites with enrichment of proinflammatory Streptococcus parasanguinis, Actinomyces oris, and lactate-producing Oribacterium sinus. Pathways for carbohydrate metabolism, histidine degradation, and obesogenic metabolites are upregulated, whereas B-vitamin and heme biosynthesis are depleted. Corresponding metabolites-including lactate, histidine derivatives, choline, uridine, and uracil-are elevated and correlate with obesity-linked cardiometabolic markers. These findings reveal mechanistic oral microbiome-metabolite shifts, highlighting oral microbiome-host interactions as novel targets for obesity prevention and intervention.

BackgroundObstructive sleep apnea (OSA) is a significant contributor to cardiometabolic diseases, yet its burden and metabolic consequences remain underexplored in the United Arab Emirates (UAE). Additionally, little is known about how OSA risk relates to early metabolic and renal abnormalities in young adults. This study evaluated the association between OSA risk and a comprehensive profile of cardiometabolic and renal biomarkers in a large cohort of young Emirati adults.MethodsThis cross-sectional study included 5,242 participants from the UAE Healthy Future Study. OSA risk was assessed using the STOP-Bang questionnaire and classified as no-to-low (score 0–2) or intermediate-to-high (score ≥3). Biomarkers assessed included HbA1c, lipid profile, ApoA, ApoB, C-reactive protein (CRP), serum creatinine, and urine microalbumin. Group differences were examined using t-tests and χ2 tests. Multivariable linear regression models adjusted for sociodemographic, lifestyle, and clinical covariates were used to assess associations between OSA risk and biomarker levels. Sensitivity analyses were conducted excluding participants with diabetes or dyslipidaemia.ResultsThe mean age was 27.5 years, and 30% of participants were classified as intermediate-to-high OSA risk. The intermediate-to-high OSA risk group exhibited greater adiposity, higher blood pressure, and more adverse cardiometabolic profiles than the no-to-low risk group. After adjustment, intermediate-to-high OSA risk was associated with elevated HbA1c (β = 0.18%, 95% CI: 0.14–0.23), higher total cholesterol, LDL-C, triglycerides, and ApoB, and lower HDL-C and ApoA (all p < 0.001). Inflammatory and renal markers were similarly elevated, including CRP (β = 0.14 mg/dL, 95% CI: 0.10, 0.18), serum creatinine (β = 0.11 mg/dL, 95% CI: 0.09, 0.13), and urine microalbumin (β = 3.61 mg/dL, 95% CI: 1.64, 5.60). Sex-stratified analyses showed higher median blood pressure and creatinine in males, and higher HDL-C and CRP in females. Sensitivity analyses produced consistent results for most biomarkers, except for urine microalbumin, which became non-significant.ConclusionsElevated OSA risk was consistently associated with adverse cardiometabolic and renal profiles in young adults. These findings suggest that STOP-Bang may serve as a useful screening tool for early risk detection, warranting validation in longitudinal studies.

IntroductionFamily history of cardiovascular disease (CVD) is an independent risk factor for coronary heart disease, and the risk increases with number of family members affected. It offers insights into shared genetic, environmental and lifestyle factors that influence heart disease risk. In this study, we aimed to estimate the association of family history of CVD and its risk factors, as well as the number of affected parents or siblings, with the prevalence of major cardiometabolic risk factors (CRFs) such as hypertension, dysglycemia, dyslipidemia and obesity in a sample of young adults.MethodsThe study utilized a cross-sectional analysis of baseline data from the UAE Healthy Future Study (UAEHFS), involving 5,058 respondents below the age of 40 years. Information on parental and sibling health regarding heart disease and stroke, hypertension, type 2 diabetes (T2D), high cholesterol and obesity, was gathered through a self-completed questionnaire. CRFs were estimated based on body measurements, biochemical markers and self-reported conditions. Multivariate regression analyses were used to examine the associations between categories of family history and the estimated CRFs.ResultsMore than half (58%) of the sample reported having a positive family history of CVD or its risk factors. The most common family history reported was T2D and hypertension, which accounted for 39.8% and 35% of the sample, respectively. The prevalence of all CRFs was significantly higher among those with a positive family history compared to those without family-history (P < 0.001). The prevalence and likelihood of having a CRF increased as the number of parents and/or siblings affected increased, indicating a potential dose-response trend. The odds were highest among individuals with both parental-and-sibling family history of disease, where they increased to 2.36 (95% CI 1.68-3.32) for hypertension, 2.59 (95% CI 1.86-3.60) for dysglycemia, 1.9 (95% CI 1.29-2.91) for dyslipidemia and 3.79 (95% CI 2.83-5.06) for obesity.ConclusionIn this study, we addressed the effect of family history as an independent risk factor on the major CRFs for the first time in the region. We observed that the majority of young Emirati adults had a positive family history of CVD-related diseases. Family history showed a strong association with the increased prevalence of CRFs. Additionally, having more relatives with specific diseases was associated with a higher risk of developing CRFs. Identifying people with a history of these conditions can help in early intervention and personalized risk assessments.

Women with polycystic ovary syndrome (PCOS) have a higher susceptibility to infections compared to those without PCOS. Studies evaluating antibiotic use based on PCOS status are scarce. Therefore, we aimed to (i) assess the associations between self-reported PCOS and antibiotic use, and (ii) whether PCOS treatment and the age at PCOS diagnosis modified the associations above. This cross-sectional analysis used the United Arab Emirates Healthy Future Study (UAEHFS) conducted from February 2016 to March 2023 involving 2063 Emirati women aged 18–62 years. We performed ordinal logistic regressions under unadjusted and demographic-health-characteristic-adjusted models to obtain the odds ratios (ORs) and 95% confidence intervals (CIs) to analyze PCOS and antibiotic use. Subgroup analyses were performed by treatment status and age at diagnosis. We found that women with PCOS were 55% more likely to frequently take a course of antibiotics in the past year (aOR 1.55; 95% CI 1.26–1.90). Similar likelihoods were also found among those being treated for PCOS and those without treatment but with a PCOS diagnosis at ≤25 years. Our study suggests that PCOS was associated with an increased use of antibiotics among Emirati women. Understanding the frequent antibiotic use susceptibility among those with PCOS may improve antibiotic use surveillance and promote antibiotic stewardship in these at-risk individuals.

In the past three decades, dietary and lifestyle changes worldwide have resulted in a global increase in the prevalence of obesity in both adults and children. Known to be highly influenced by genetic, environmental and lifestyle factors, obesity is characterized by a low-grade chronic inflammation that contributes to the development of other metabolic diseases such as diabetes and cardiovascular disease. Recently, the gut microbiome has been added as a cause/contributor to the development of obesity. As differences in the microbiome between obese and normoweight individuals have been observed, we set out to determine whether infants harbor an obesogenic microbiome early on and whether the pre-pregnancy status of the mother (obese or normoweight) is correlated to their infant’s microbiome composition. Using shotgun sequencing, we analyzed stool samples throughout the first year of life from infants born to obese (n = 23 participants, m = 104 samples) and normoweight (n = 23 participants, m = 99 samples) mothers. We found that the infants’ microbiome diversity at taxonomic and functional levels was significantly influenced by time (ANOVA p < 0.001) but not by the mother’s pre-pregnancy status. Overall, no deterministic succession of taxa or functions was observed. However, infants born to obese mothers were found to have a significantly higher Bacillota/Bacteroidota ratio (p = 0.02) at six months, were significantly depleted from six months old of the well-established obesity biomarkers Akkermansia municiphila and Faecalibacterium prausnitzii (p < 0.01), and were at one week old, significantly enriched in pathways such as the UDP-N-acetyl-D-glucosamine biosynthesis II (p = 0.02) involved in leptin production, suggesting perhaps that there may exist some underlying mechanisms that dictate the development of an obesogenic microbiota early on.

Abstract Background The UAE Healthy Future Study (UAEHFS) is one of the first large prospective cohort studies in the Gulf region which examines causes and risk factors for chronic diseases among adult UAE nationals. Missing values are often unavoidable in empirical research and can in many cases, lead to bias. The aim of this study is to estimate the percentage of depression in the UAEHFS pilot data using the eight-item Patient Health Questionnaire (PHQ-8) variables, using different statistical methods. Methods Five common statistical machine learning methods of handling missing values were included in this analysis. These are mode imputation, k-nearest neighbor (KNN) imputation, classification, and regression trees (CART), random forest (RF) imputations, and random sample from observed values (Sample). 100 multiple imputations were used. Results 487 (94.2 %) eligible participants were included in the analysis. 231 (44.7%) were included in the complete case analysis. The median age was 30 years (Interquartile-Range: 23 - 38). More males (67.8%) than females included in the analysis. The estimated percentage of depression was 8.4%, 8.9%, 9.9%, 12.5%, 15.4% and 17.9% by the mode, complete case, sample, RF, CART, and KNN respectively. In additional analyses, the estimated proportions of depression were 11.5% by the Complete Case, 11.9% by KNN, 13.2% by K-means clustering, and 13.2% by Random Forest. Conclusions The estimated percentage of depression in the UAEHFS pilot data varies between the applied methods of handling missing values. This shows that the problem of missing values in the variables is not negligible. Further research is needed using multiple imputations in the main UAEHFS dataset after completing recruitment. Key messages • For the depression missing values, we recommend using multiple imputations not to generate data but to prevent the exclusion of observed data. • To have a better estimate of the percentage of depression, is recommended to use different machine learning methods.

IntroductionObstructive sleep apnea (OSA) can have negative impacts on the health outcomes of individuals with type 2 diabetes. However, in the United Arab Emirates (UAE), there is a lack of understanding regarding the relationship between OSA and type 2 diabetes despite the significant implications it has on health. The primary objective of this study is to investigate the association between OSA risk and type 2 diabetes, associated risk factors, and gender differences in OSA symptoms among Emirati adults.MethodsWe conducted a cross-sectional analysis of the baseline data from the UAE Healthy Future Study (UAEHFS) collected between February 2016 and March 2023. Our sample consisted of 4578 participants aged 18-71 who completed the STOP-BANG survey, provided body measurements and blood samples. We stratified the patients according to their OSA risk and diabetes. We used univariate and multivariate logistic regression models to analyze the relationship between OSA risk and type 2 diabetes and to identify factors associated with risk for OSA and type 2 diabetes. We estimated odds ratios (ORs) with corresponding 95% confidence intervals (95% CI).ResultsThe mean age was 27.5 years (± 8.35), and 55.81% (n=2555) were men. The overall prevalence of high risk for OSA was 16.58% and was higher in men compared to women (26.46% vs 4.10%). Women reported feeling tired more often than men (68.02% vs 48.96%). Both genders have similar rates of stop breathing and BMI ≥ 35. There was a significant association between the OSA risk and type 2 diabetes in the unadjusted model (OR=2.44; 95% CI: 1.78-3.35; p-value <0.0001) and (OR=6.44; 95% CI: 4.32-9.59; p-value < 0.0001) among those who reported intermediate and high OSA risk, respectively. After adjusting the model for education attainment, marital status, waist circumference, and smoking, the association remained significant between diabetes and OSA risk, with an OR of 1.65 (95%CI: 1.18-2.32; p-value =0.004) for intermediate OSA risk and 3.44 (95%CI: 2.23-5.33; p-value <0.0001) for high OSA risk.ConclusionsThis study conducted in the UAE found a significant correlation between OSA risk and type 2 diabetes. We suggest introducing routine screening of OSA for individuals with diabetes.

A growing interest has been recently reported in exploring sleep duration within psychology context in particular to its relation to some mental chronic diseases such as depression. The aim of this study is to investigate the association between self-reported sleep hours as an outcome and self-perceived depression among Emirati adults, after adjusting for sociodemographic factors such as age, gender, marital status, and employment status. We performed a cross-sectional analysis using 11,455 participants baseline data of the UAE Healthy Future Study (UAEHFS). Univariate and multivariate logistic regression models were performed with self-reported sleep hours as an outcome. The predictors were the selfreported depression by measuring the PHQ-8 score, sociodemographic factors (age, gender, marital status, and employment status) Odds ratios with 95% confidence intervals (CI) were reported. In a sensitivity analysis, a multivariate imputation by chained equations (MICE) procedure was applied with classification and Regression Trees (CART) to impute missing values. Overall, 11,455 participants were included in the final analysis of this study. Participants' median age was 32.0 years (Interquartile-Range: 24.0, 39.0). There were 6,217 (54.3%) males included in this study. In total, 4,488 (63.6%) of the participants reported sleep duration of more than 7 hours. Statistically significant negative association was observed between the total PHQ-8 score as a measure for depression and binarized self-reported sleep, OR = 0.961 (95% CI: 0.948, 0.974). For one unit increase in age and BMI, the odds ratio of reporting shorter sleep was 0.979(95% CI: 0.969, 0.990) and 0.987 (95% CI: 0.977, 0.998), respectively. The study findings indicate a correlation between selfreported depression and an increased probability of individuals reporting shorter self-perceived sleep durations especially when considering the sociodemographic factors as predictors. There was a variation in the effect of depression on sleep duration among different study groups. In particular, the association between reported sleep duration and reported

Background Cardiovascular disease (CVD) is the leading cause of death in the world. In the United Arab Emirates (UAE), it accounts for 40% of mortality. CVD is caused by multiple cardiometabolic risk factors (CRFs) including obesity, dysglycemia, dyslipidemia, hypertension and central obesity. However, there are limited studies focusing on the CVD risk burden among young Emirati adults. This study investigates the burden of CRFs in a sample of young Emiratis, and estimates the distribution in relation to sociodemographic and behavioral determinants. Methods Data was used from the baseline data of the UAE Healthy Future Study volunteers. The study participants were aged 18 to 40 years. The study analysis was based on self-reported questionnaires, anthropometric and blood pressure measurements, as well as blood analysis. Results A total of 5167 participants were included in the analysis; 62% were males and the mean age of the sample was 25.7 years. The age-adjusted prevalence was 26.5% for obesity, 11.7% for dysglycemia, 62.7% for dyslipidemia, 22.4% for hypertension and 22.5% for central obesity. The CRFs were distributed differently when compared within social and behavioral groups. For example, obesity, dyslipidemia and central obesity in men were found higher among smokers than non-smokers ( p < 0.05). And among women with lower education, all CRFs were reported significantly higher than those with higher education, except for hypertension. Most CRFs were significantly higher among men and women with positive family history of common non-communicable diseases. Conclusions CRFs are highly prevalent in the young Emirati adults of the UAE Healthy Future Study. The difference in CRF distribution among social and behavioral groups can be taken into account to target group-specific prevention measures.

Objective:The United Arab Emirates (UAE) 2022 Report Card provides a systematic evaluation of the physical activity (PA) levels of children and adolescents in the UAE. Methods:The 2022 Report Card utilized data from 2017 to 2021 to inform 10 core PA indicators that were common to the Global Matrix 4.0. Results:One in five (19%) UAE school children achieved the recommended amount of moderate-to-vigorous PA (i.e. ≥60 min/d; Total Physical Activity Grade F). Less than 1% of school children used active transport to and from school (Active Transportation Grade F). One in four (26%) secondary school children achieved the recreational screen time recommendations (i.e. ≤2 h/d; Sedentary Behaviours Grade D-). A quarter of adults reported achieving the recommended PA level (i.e. ≥150 min of moderate-intensity PA per week, or equivalent) (Family and Peers Grade D-). All school children are taught physical education (PE) by a specialist with at least a bachelor's degree in PE; however, the duration of weekly PE classes varied between schools (School Grade A-). The UAE Government has invested significant funds and resources into developing and implementing strategies and facilities that will increase PA across the entire population (Government Grade B+). Organised Sport and Physical Activity, Active Play, Physical Fitness, and Community and Environment indicators were graded 'Incomplete' (INC) due to a lack of available data. Conclusions:Overall, PA levels remain low and sedentary behaviours remain high amongst UAE children and adolescents. The UAE Government has sustained investment in further developing PA opportunities for all children and adults which should translate to increased PA and health improvements at a population level.

Purpose: This study aimed to assess the prevalence of self-reported polycystic ovary syndrome (PCOS) among Emiratis and examine bi-directional associations of PCOS with self-reported chronic diseases, namely: diabetes, asthma, high cholesterol, and high blood pressure.Patients and Methods: A cross-sectional analysis was performed using the UAE Healthy Future Study (UAEHFS) data collected from February 2016 to April 2022 involving 1040 Emirati women aged 25-67 years from recruitment centers in the United Arab Emirates (UAE). The bi-directional associations between self-reported PCOS and self-reported chronic diseases were evaluated by establishing temporality based on reported age-at-diagnoses. Firstly, the associations between PCOS (diagnosed at >25 years) and chronic diseases (diagnosed at <25 years) were examined, followed by PCOS (diagnosed at <25 years) and chronic diseases (diagnosed at >25 years). Finally, a Poisson regression under unadjusted and age-and-body mass index (BMI) adjusted models was performed to obtain the risk ratio (RR) and its 95% confidence interval (CI).Results: The prevalence of PCOS in this study was 25.9%. Those with asthma and high cholesterol diagnosed at <25 years had increased risks of PCOS diagnosed at >25 years (RR = 1.79, 95% CI: 1.17-2.76 for asthma; and RR = 1.61, 95% CI: 1.01-2.59 for high cholesterol), compared to those respective healthier counterparts, after adjusting for age and BMI. No significant association was observed between PCOS diagnosed at <25 years and respective chronic diseases diagnosed at >25 years.Conclusion: PCOS prevalence among Emirati women was high. Asthma and high cholesterol in earlier life were associated with PCOS in later life. Understanding how chronic disease conditions and PCOS are associated in bi-directional ways may improve the surveillance of chronic disease conditions among women with PCOS and may also contribute to more targeted PCOS prevention strategies.

Background Individuals infected with SARS-CoV-2 vary greatly in their disease severity, ranging from asymptomatic infection to severe disease. The regulation of gene expression is an important mechanism in the host immune response and can modulate the outcome of the disease. miRNAs play important roles in post-transcriptional regulation with consequences on downstream molecular and cellular host immune response processes. The nature and magnitude of miRNA perturbations associated with blood phenotypes and intensive care unit (ICU) admission in COVID-19 are poorly understood. Results We combined multi-omics profiling—genotyping, miRNA and RNA expression, measured at the time of hospital admission soon after the onset of COVID-19 symptoms—with phenotypes from electronic health records to understand how miRNA expression contributes to variation in disease severity in a diverse cohort of 259 unvaccinated patients in Abu Dhabi, United Arab Emirates. We analyzed 62 clinical variables and expression levels of 632 miRNAs measured at admission and identified 97 miRNAs associated with 8 blood phenotypes significantly associated with later ICU admission. Integrative miRNA-mRNA cross-correlation analysis identified multiple miRNA-mRNA-blood endophenotype associations and revealed the effect of miR-143-3p on neutrophil count mediated by the expression of its target gene BCL2. We report 168 significant cis -miRNA expression quantitative trait loci, 57 of which implicate miRNAs associated with either ICU admission or a blood endophenotype. Conclusions This systems genetics study has given rise to a genomic picture of the architecture of whole blood miRNAs in unvaccinated COVID-19 patients and pinpoints post-transcriptional regulation as a potential mechanism that impacts blood traits underlying COVID-19 severity. The results also highlight the impact of host genetic regulatory control of miRNA expression in early stages of COVID-19 disease.

Abnormal birth weight, particularly low birth weight (LBW), is known to have long-term adverse health consequences in adulthood, with disrupted sleep being suggested as a mediator or modifier of this link. We thus aimed to assess the associations between birth weight and self-reported adult sleep characteristics: sleep duration, difficulty waking up in the morning, daily nap frequency, sleep problems at night, snoring, daytime tiredness or sleepiness, and ever-stop breathing during sleep. This cross-sectional analysis used the United Arab Emirates Healthy Future Study data collected from February 2016 to March 2023 involving 2124 Emiratis aged 18–61 years. We performed a Poisson regression under unadjusted and age-sex-and-BMI-adjusted models to obtain the risk ratio and its 95% confidence interval for our analysis of the association between birth weight and each adult sleep characteristics, compared to individuals with normal birth weight (≥2.5 kg). Those with LBW had significantly a 17% increased risk of difficulty waking up in the morning, compared to those with normal birth weight. In addition, females with LBW history were also at an increased risk of reporting difficulty waking up in the morning. Studies with objective sleep assessments that include measurements of more confounding factors are recommended to confirm these risks.

Introduction:Asthma and polycystic ovarian syndrome (PCOS) are linked in several possible ways. To date, there has been no study evaluating whether pediatric asthma is an independent risk factor for adult PCOS. Our study aimed to examine the association between pediatric asthma (diagnosed at 0-19 years) and adult PCOS (diagnosed at ≥20 years). We further assessed whether the aforementioned association differed in two phenotypes of adult PCOS which were diagnosed at 20-25 years (young adult PCOS), and at >25 years (older adult PCOS). We also evaluated whether the age of asthma diagnosis (0-10 vs 11-19 years) modified the association between pediatric asthma and adult PCOS.Material and methods:This is a retrospective cross-sectional analysis using the United Arab Emirates Healthy Future Study (UAEHFS) collected from February 2016 to April 2022 involving 1334 Emirati females aged 18-49 years. We fitted a Poisson regression model to estimate the risk ratio (RR) and its 95% confidence interval (95% CI) to assess the association between pediatric asthma and adult PCOS adjusting for age, urbanicity at birth, and parental smoking at birth.Results:After adjusting for confounding factors and comparing to non-asthmatic counterparts, we found that females with pediatric asthma had a statistically significant association with adult PCOS diagnosed at ≥20 years (RR=1.56, 95% CI: 1.02-2.41), with a stronger magnitude of the association found in the older adult PCOS phenotype diagnosed at >25 years (RR=2.06, 95% CI: 1.16-3.65). Further, we also found females reported thinner childhood body size had a two-fold to three-fold increased risk of adult PCOS diagnosed at ≥20 years in main analysis and stratified analyses by age of asthma and PCOS diagnoses (RR=2.06, 95% CI: 1.08-3.93 in main analysis; RR=2.74, 95% CI: 1.22-6.15 among those diagnosed with PCOS > 25 years; and RR=3.50, 95% CI: 1.38-8.43 among those diagnosed with asthma at 11-19 years).Conclusions:Pediatric asthma was found to be an independent risk factor for adult PCOS. More targeted surveillance for those at risk of adult PCOS among pediatric asthmatics may prevent or delay PCOS in this at-risk group. Future studies with robust longitudinal designs aimed to elucidate the exact mechanism between pediatric asthma and PCOS are warranted.

Population Medicine considers the following types of articles:• Research Papers -reports of data from original research or secondary dataset analyses.• Review Papers -comprehensive, authoritative, reviews within the journal's scope.These include both systematic reviews and narrative reviews.• Short Reports -brief reports of data from original research.• Policy Case Studies -brief articles on policy development at a regional or national level.• Study Protocols -articles describing a research protocol of a study.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.

Limited studies have focused on maternal early-life risk factors and the later development of gestational diabetes mellitus (GDM). We aimed to estimate the GDM prevalence and examine the associations of maternal early-life risk factors, namely: maternal birthweight, parental smoking at birth, childhood urbanicity, ever-breastfed, parental education attainment, parental history of diabetes, childhood overall health, childhood body size, and childhood height, with later GDM. This was a retrospective cross-sectional study using the UAE Healthy Future Study (UAEHFS) baseline data (February 2016 to April 2022) on 702 ever-married women aged 18 to 67 years. We fitted a Poisson regression to estimate the risk ratio (RR) for later GDM and its 95% confidence interval (CI). The GDM prevalence was 5.1%. In the fully adjusted model, females with low birthweight were four times more likely (RR 4.04, 95% CI 1.36–12.0) and females with a parental history of diabetes were nearly three times more likely (RR 2.86, 95% CI 1.10–7.43) to report later GDM. In conclusion, maternal birthweight and parental history of diabetes were significantly associated with later GDM. Close glucose monitoring during pregnancy among females with either a low birth weight and/or parental history of diabetes might help to prevent GDM among this high-risk group.

INTRODUCTION:Metabolic syndrome (MetS) is a multiplex of risk factors that predispose people to the development of diabetes and cardiovascular disease (CVD), two of the major non-communicable diseases that contribute to mortality in the United Arab Emirates (UAE). MetS guidelines require the testing of fasting samples, but there are evidence-based suggestions that non-fasting samples are also reliable for CVD-related screening measures. In this study, we aimed to estimate MetS and its components in a sample of young Emiratis using HbA1c as another glycemic marker. We also aimed to estimate the associations of some known CVD risk factors with MetS in our population. METHODS:The study was based on a cross-sectional analysis of baseline data of 5161 participants from the UAE Healthy Future Study (UAEHFS). MetS was identified using the NCEP ATP III criteria, with the addition of HbA1c as another glycemic indicator. Fasting blood glucose (FBG) and HbA1c were used either individually or combined to identify the glycemic component of MetS, based on the fasting status. Multivariate regression analysis was used to test for associations of selected social and behavioral factors with MetS. RESULTS:Our sample included 3196 men and 1965 women below the age of 40 years. Only about 21% of the sample were fasting at the time of recruitment. The age-adjusted prevalence of MetS was estimated as 22.7% in males and 12.5% in females. MetS prevalence was not statistically different after substituting FBG by HbA1c in the fasting groups (p > 0.05). Age, increased body mass index (BMI), and family history of any metabolic abnormality and/or heart disease were consistently strongly associated with MetS. CONCLUSION:MetS is highly prevalent in our sample of young Emirati adults. Our data showed that HbA1c may be an acceptable tool to test for the glycemic component of MetS in non-fasting samples. We found that the most relevant risk factors for predicting the prevalence of MetS were age, BMI, and family history.

Abstract Background The United Arab Emirates Healthy Future Study (UAEHFS) is one of the first large prospective cohort studies in the region which examines causes and risk factors for chronic diseases among adult UAE nationals. The aim of this study was to explore the relationship between body fat percentage (BF%) and the eight-item Patient Health Questionnaire (PHQ-8) as a screening instrument for depression among the UAEHFS pilot study participants. Methods We analyzed the UAEHFS pilot data to investigate the association between BF% and PHQ-8 adjusted for age and gender. We used multivariate logistic ordinal regression model. To impute missing values, 100 multiple imputations (MI) were performed using multivariate imputation of classification and regression tree. The statistical analysis was performed using R Statistical Software (version 4.2.0) Results Out of 517 participants, data from 487 (94.2%) were analyzed after excluding participants who didn't fill out the questionnaires. The median age was 30 years (Interquartile Range: 23 - 38). There were more males (67.8%) than females in the UAEHF pilot data. Approximately, 64 (13.1%) of the participant reported depression. The prevalence of obesity was 35.2% in this study population. The estimated odds ratio of BF% from the fitted multivariate logistic ordinal regression model was OR = 1.046 (95% CI: 1.012-1.08), and OR = 1.03 (95% CI: 1.003-1.057) for the omitted data, and MI (sensitivity analysis) respectively. Conclusions High body fat percentage was statistically significantly associated with high risk of reporting depression. Additional research is needed, using the main UAEHFS data (after recruitment is complete), to further investigate the association between body fat percentage and depression. Key messages • Our results can help contribute to the knowledge based on current and potential population mental health in the UAE and Gulf Region. • The main finding of this study that excess body fat is associated with an increased risk of developing depression and vice versa; thus, this could add to the future direction of mental health research.

BACKGROUND:Significant concerns about mental health were raised during the COVID-19 pandemic. We investigated the prevalence of depression and anxiety symptoms among the participants of the United Arab Emirates Healthy Future Study (UAEHFS); a national cohort study. We further explored the change in the prevalence of depression symptoms among those with comparable pre-pandemic data. METHODS:A sample of UAEHFS participants were invited to complete a COVID-19 online questionnaire during the first wave of the pandemic. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire Depression Scale (PHQ-8) and the Generalized Anxiety Disorder-7 Scale (GAD-7) respectively. Unpaired analyses were done to examine the effect of COVID-19 on depression and anxiety symptoms during the pandemic. Paired analysis was conducted to examine the change in depression symptoms. RESULTS:During the pandemic, we reported a prevalence of 32.8% (95% CI: 27.0, 39.1) for depression and 26.4% (95% CI: 21.0, 32.6) for anxiety symptoms. Younger people reported higher levels of depression (40.4%) and anxiety (34.5%) symptoms. Females reported higher levels of depression (36.5%) and anxiety (32.7%) symptoms. In paired analysis, the prevalence of depression symptoms during the pandemic was 34% (95% CI: 26.5, 42.4) compared to 29.9% (95% CI: 22.7, 38.1) before the pandemic. No statistically significant difference was observed, p-value = 0.440. Adjusted multivariate logistic regression models for PHQ-8 and GAD-7 during the pandemic showed that participants, who were experiencing flu-like symptoms, had higher odds of reporting depression symptoms compared to those without symptoms. Additionally, age was significantly negatively associated with anxiety symptoms. CONCLUSIONS:Overall, we found that depression and anxiety symptoms were more prevalent among young people and females. However, we did not find a significant change in the prevalence of depression symptoms among those with comparable pre-pandemic data. Identifying vulnerable groups and understanding trajectories through longitudinal studies would help with planning for effective mental health interventions for the current and future pandemics.