Phosphatidylcholine （PC） and lysophosphatidylcholine （LPC） homologues are closely associated with coronary atherosclerosis. Accurate determination of their contents can provide an important basis for the clinical diagnosis and prognosis of coronary artery disease （CAD）. In this study， an analytical method based on liquid chromatography-tandem mass spectrometry was established， which enabled the simultaneous and accurate determination of 30 PC and LPC homologues using only 10 μL of human serum. Methanol-acetonitrile-methyl tert-butyl methyl ether-water was used as the extraction system， and an XBridge C18 column was selected as the stationary phase. The mobile phase consisted of an acetonitrile-water mixture （1∶1， volume ratio） and isopropanol， both containing 7.5 mmol/L ammonium formate and 0.15% （volume ratio） formic acid， and gradient elution was adopted for separation. Detection was performed using an electrospray ionization source in the positive ion mode with multiple reaction monitoring. Method validation results showed that the method exhibited a good linear relationship， with an average linear correlation coefficient of ≥0.999 7 over a linear range of 0.125-100 μg/mL. The limits of detection and limits of quantification were 0.01-1.94 μg/mL and 0.03-6.48 μg/mL， respectively. The recoveries ranged from 85.4% to 114.3%， while the intra-day precision and inter-day precision were no more than 4.6% and 12.6%， respectively. Serum samples from 110 clinical volunteers who underwent coronary angiography were determined using this method. The average population concentration of PC homologues was 526.80 μg/mL， and that of LPC homologues was 73.67 μg/mL. Spearman correlation analysis revealed that PC and LPC homologues were closely correlated with the severity of CAD， as well as with related clinical biochemical and lipid metabolism indicators， suggesting that they could serve as potential CAD-related metabolites in clinical practice. Designed to meet clinical analysis needs， this method features small serum sample volume， simple operation， and excellent response. It can efficiently determine 30 PC and LPC homologues in human serum， providing an important reference for exploring the association between these two lipid classes and CAD， as well as the translational application of related biomarkers.

Aging is the primary risk factor for most chronic diseases, yet substantial heterogeneity highlights a fundamental gap between chronological age and biological aging processes. Despite the high predictive accuracy of multi-omics clocks, their clinical implementation remains limited by cost and complexity, underscoring the need for scalable and clinically actionable alternatives. Here, we developed a physical clock that integrates routine clinical biomarkers with multidimensional physical performance using ElasticNet regression in the large-scale PENG ZU cohort. This model was further reduced to a simplified 11-marker model, primarily capturing key domains of kidney function, glucose metabolism, and physical performance. Accelerated aging, as measured by physical clock-derived ΔPhysicalAge, was strongly associated with chronic disease incidence, functional decline, reduced intrinsic capacity, and mortality. Across independent validation in UKB Biobank and NHANES, it robustly predicted disease onset, disease-specific, and all-cause mortality. Notably, ΔPhysicalAge outperformed ΔPhenoAge in predicting major age-related diseases and enabled effective risk stratification even among individuals conventionally classified as low risk. We observed an association between postmenopausal HRT use and lower ΔPhysicalAge, providing preliminary evidence supporting the validity and responsiveness of the physical clock. To facilitate clinical translation, we established age- and sex-specific healthy reference intervals (HRI) derived from individuals with normal or decelerated aging, demonstrating that maintenance within these ranges is associated with substantially reduced mortality risk. Furthermore, modifiable lifestyle and psychosocial factors, including healthy diet, physical activity, health consciousness, and social engagement, were associated with slower aging, highlighting actionable intervention pathways. Together, the physical clock bridges the gap between biological aging assessment and real-world clinical practice, offering a clinically accessible tool for risk stratification and personalized intervention to promote healthy aging.

Background: Platelet morphological indices, such as mean platelet volume and distribution width, reflect platelet turnover and thrombo-inflammatory activity relevant to acute coronary syndrome (ACS), but their individual prognostic value remains inconsistent. This study aimed to derive an Integrated Platelet Index (IPI) using principal component analysis (PCA) to capture a multidimensional platelet morphological phenotype influenced by cardiometabolic and inflammatory stress and to examine its association with long-term major adverse cardiovascular and cerebrovascular events (MACCE) in ACS. Methods: This prospective observational study included 1,467 ACS patients from the Beijing Hospital Atherosclerosis Study. Five routinely measured platelet indices—platelet count, mean platelet volume, platelet distribution width, plateletcrit, and platelet large-cell ratio—were integrated via PCA to construct the IPI. The primary endpoint was MACCE. Cox models, restricted cubic splines, Kaplan?Meier curves, and prespecified subgroup analyses assessed the prognostic relevance of the IPI and its consistency across metabolic and clinical strata. Results: Over a median follow-up of 55.0 months, 141 patients (9.6%) experienced MACCE. Lower IPI values were associated with higher risk. Each unit increase in IPI was independently associated with a 27% lower MACCE risk after full adjustment (HR 0.73; 95% CI: 0.59?0.90). A significant L-shaped nonlinear relationship was observed, with steep risk reduction at lower IPI values. Event-free survival increased progressively across IPI tertiles. Associations remained consistent across cardiometabolic subgroups, with no significant interactions. Conclusions: The PCA-derived IPI represents an integrated platelet morphological phenotype associated with long-term atherothrombotic risk in ACS. Its nonlinear behavior and robust performance across metabolic backgrounds support its potential as an accessible, phenotype-based marker for refining secondary prevention risk stratification. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial NCT03072797 ### Funding Statement This work was supported by Capital's Funds for Health Improvement and Research (2024-1-405), National Science and Technology Major Project for the Prevention and Treatment of Cancer, Cardiovascular and Cerebrovascular, Respiratory, and Metabolic Diseases (2025ZD0546402), National High Level Hospital Clinical Research Funding (Grant BJ-2025-117; No BJ-2024-140; BJ-2025-124; BJ-2025-121),and National Natural Science Foundation of China (grant numbers 82370338). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: the Ethics Committee of Beijing Hospital (Approval No. 2016BJYYEC-121-03) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Part data generated or analysed during this study are included in this published article [and its supplementary information files] The clinical data used in this study contain sensitive personal health information and cannot be shared publicly due to privacy and ethical restrictions. De-identified analytical datasets and statistical code used in the analysis are available from the corresponding authors upon reasonable request. Requests may be directed to Prof. Xue Yu (yuxuemd{at}aliyun.com) or Prof. Wei Gong (gongwei5180{at}bjhmoh.cn).

BACKGROUND:Serum free thiols (FTs) are sensitive biomarkers of oxidative stress, closely associated with aging and chronic disease risk. Existing DTNB-based detection methods suffer from product instability, affecting analytical reliability. A more stable and high-throughput method is needed. METHODS:We developed an automated FT assay using 2,2'-dithiodipyridine (2,2'-DTDP) on a clinical chemistry analyzer. Serum samples reacted with 2,2'-DTDP under optimized conditions, and absorbance at 340 nm was used to quantify FT levels. Method performance, stability, and associations with cardiovascular disease (CVD) risk factors were assessed in 341 healthy individuals. RESULTS:FTs reacted with 2,2'-DTDP to generate 2-TP, a stable product with maximum absorbance at 340 nm. The method demonstrated excellent linearity (0-1200 μmol/L), low imprecision (1.8 %-3.3 %), and reasonable recovery (≥80 %). Serum FTs were stable for at least one year at -70 °C, 12 h at 2-8 °C, and 2 h at room temperature. In the study population, FT levels were positively correlated with serum albumin, a major thiol carrier, and negatively correlated with age, triglyceride, glucose and creatinine, suggesting links to redox status and CVD risks. These associations support the potential of FTs as indicators of systemic oxidative balance and aging-related health decline. CONCLUSION:This simple and robust 2,2'-DTDP-based method enables accurate, high-throughput measurement of serum FTs. It is well suited for exploring thiol antioxidant function and evaluating age-related and cardiovascular risk in clinical and research settings.

Acute poisoning remains a significant cause of admission to the emergency intensive-care unit (EICU). Despite a reduced mortality rate, attention is increasingly focusing on the impact of post-intensive-care syndrome (PICS) on readmission. Due to the significant role of oxidative stress (OS) in the pathological mechanisms of poisoning, 8-oxo-7,8-dihydroguanosine (8-oxoGuo) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) may hold great potential as biomarkers for OS biomarkers to evaluate the severity and prognosis of poisoning. Therefore, we investigated the longitudinal changes of urinary 8-oxoGuo levels during hospitalization in poisoned patients, their association with organ failure, and their predictive value for 30-day readmission risk. In total, 43 poisoning patients were enrolled from the EICU of the First Affiliated Hospital of Wenzhou Medical University between July 2021 and November 2022. The 30-day readmission rate was 18.6%. Group-based trajectory modeling (GBTM) was used to explore the potential trajectories of urinary OS markers and organ failure scores during hospitalization. Spearman's correlation analysis revealed a significant association between a high trajectory of 8-oxoGuo/creatinine (Cr) and the increased severity of overall organ failure, as well as respiratory and coagulation dysfunctions. Binary logistic regression analysis indicated that a high 8-oxoGuo/Cr trajectory, high respiratory failure score trajectory, and 8-oxoGuo/Cr values at three key points in disease progression (including admission, transfer from EICU, and discharge), along with 8-oxodGuo/Cr levels at admission, were all risk factors for 30-day readmission. The 8-oxoGuo/Cr value at discharge exhibited the best predictive performance. The urinary 8-oxoGuo/Cr ratio may serve as a potential biomarker for prognostic evaluations in patients with poisoning.

Background: Oxidative stress is a major mechanism underlying aging and health damage, and it is associated with decreased serum free thiol levels. Monitoring serum free thiol levels provides a valuable reference for assessing the body's health status. However, it is a key challenge in clinical analysis to simultaneously monitor serum total free thiols and specific low-molecular-mass free thiol compounds in a single run. Traditional methods often struggle to avoid interference from side reactions due to the high reactivity of free thiols in alkaline derivatization environments. Results: In this study, we developed an integrated non-alkaline derivatization strategy using 2,2 '-dithiodipyridine and high-performance liquid chromatography. 2,2 '-Dithiodipyridine can react rapidly with free thiols under acidic to neutral environments, and all derivatives exhibit similar absorbance characteristics to the substrates. Taking advantage of these properties, this method combines reliable derivatization with efficient chromatographic separation, enabling the simultaneous analysis of total free thiols and five main specific low-molecular-mass thiol compounds within a single injection cycle. Eight chromatographic peaks including free thiol derivatives, the derivatization reagent, and internal standard were observed during a 14-min analysis. The peak corresponding to 2-thiopyridone indicates the total concentration of free thiols while specific pyridyldithio derivative peaks represent the individual levels of low-molecular-mass free thiols. Using the developed method, a significant negative correlation was observed between free thiol levels and both age and health risk factors in a study involving 260 volunteers. Significance: This study presents a robust and simple method for the simultaneous measurement of total free and low-molecular-mass free thiols, providing a facile technique for population analysis and for investigating the relationship between free thiols and human health.

Hematological parameters are among the most accessible and routinely performed clinical tests. Recent studies have gradually revealed their potential for risk prediction. This study aimed to assess the association between hematological parameters and major adverse cardiovascular events (MACEs) in patients with coronary artery disease. This prospective study included 2,970 Chinese participants who underwent coronary angiography, with hematological and biochemical indicators measured at baseline. MACEs, comprising myocardial infarction, stroke, revascularization, and all-cause mortality, were recorded during follow-up. Univariate and multivariate analyses were conducted to evaluate the relationship between the hematological parameters and MACEs. Over a median follow-up period of 79 months, 474 MACEs were documented. Kaplan-Meier analysis indicated that the participants with lower levels of RBC, PLT, PCT, LYMPH% and BASO%, as well as higher RDW-CV, RDW-SD, MONO% and NEUT%, exhibited reduced survival probability. Multivariate Cox regression analysis identified elevated RDW-CV as a significant risk factor for MACE (T3 HR, 1.292; 95% CI, 1.013-1.647; P=0.039), while lower BASO% demonstrated a protective effect (T3 HR, 0.750, 95 % CI: 0.591-0.953; P=0.018). LYMPH% also showed a significant association with MACEs. Additionally, nonlinear correlations were observed between PLT and PCT and MACEs. In conclusion, RDW-CV, BASO%, PLT, PCT and LYMPH% were closely associated with MACEs and may serve as potential predictors for cardiovascular risk in patients with coronary artery disease.

BackgroundCD38, a glycoprotein with a single transmembrane structure, is extensively found in erythrocytes, immune cells, and endothelial cells. Primarily located on cell membranes, it plays a critical role in metabolizing nicotinamide adenine dinucleotide (NAD), thereby maintaining NAD homeostasis in vivo. As a vital coenzyme, NAD is involved in numerous biological processes, including energy metabolism, apoptosis, and DNA repair. CD38, as a major NAD-depleting enzyme, is pivotal in regulating intracellular NAD levels and various physiological processes. Given its significance, understanding the function of CD38 and its implications in aging and age-related diseases is crucial for elucidating disease pathogenesis and developing therapeutic strategies.MethodsThis study conducted a bibliometric analysis to explore recent research trends and advancements in the field of CD38. Research articles were retrieved from the Web of Science database, followed by a bibliometric assessment using CiteSpace and VOSviewer to visualize key publication trends, contributions by countries and institutions, and keyword distributions. Based on the bibliometric analysis, key insights were synthesized to elucidate the role of CD38 in aging and age-related diseases, its underlying mechanisms, and its applications in clinical evaluation, detection methods, interventions, and therapeutic targets.ResultsThe bibliometric analysis revealed an exponential increase in the number of published articles over time, with the United States and China emerging as the leading research hubs. The predominant keywords included ‘CD38’ and ‘blood-related disorders’. Furthermore, key findings highlighted the critical role of CD38 in aging and age-related diseases, emphasizing its mechanisms in NAD metabolism and its potential as a therapeutic target. Moreover, current applications of CD38 in clinical evaluation and detection methods were discussed, showcasing its growing importance in biomedical research.ConclusionThis study underscores the growing interest in CD38 research, particularly its role in aging and age-related diseases. The findings highlight the significance of CD38 in maintaining NAD homeostasis and its potential as a therapeutic target. The exponential growth in publications and the dominance of the United States and China in this field reflect the global importance of CD38 research. Future studies should further explore the mechanistic insights and clinical applications of CD38 to advance therapeutic strategies for age-related diseases.

Purpose The purpose of this study was to investigate the relationship between serum immunoglobulin M (IgM) and the severity of coronary artery disease in Chinese patients who underwent coronary angiography. Methods A total of 2,045 patients who underwent coronary angiography (CAG) from March 2017 to March 2020 at Beijing Hospital were included in this study. Serum IgM concentration and biochemical indicators were measured before coronary angiography (CAG). The triquartile IgM levels at baseline in the population were analysed. Spearman rank correlation was used to analyse the association between IgM and traditional risk factors for coronary artery disease (CAD). CAD patients were divided into subgroups by affected area, number of affected vessels, and Gensini score to analyse the relationship between IgM and CAD severity. Multivariable logistic regression analysis was used to evaluate the association between IgM and CAD severity. Results Serum IgM levels were significantly lower in the CAD group (63.5 mg/dL) than in the non-coronary artery disease (NCAD) group (72.3 mg/dL) (P < 0.001). Serum IgM levels were significantly associated with sex. Serum IgM levels were positively correlated with traditional CAD risk factors such as TG, TC and LDL-C (P < 0.05), and negatively associated with the number of obstructed vessels, the number of affected areas, and Gensini scores. After adjusting for age, sex, smoking status, hypertension, dyslipidaemia, diabetes, stroke, and statin use history, a high IgM level was independently negatively associated with the severity of CAD expressed by the Gensini score. Conclusion We determined that serum IgM was independently negatively associated with the severity of CAD diagnosed by angiography in Chinese adults.

This study aimed to evaluate the relationship between aromatic amino acids (AAAs), - phenylalanine (Phe), tyrosine (Tyr) and tryptophan (Trp) - and coronary artery disease (CAD) in a prospective study involving 2970 participants undergoing coronary angiography at Beijing Hospital. Serum levels of Phe, Tyr and Trp were analysed. The cross-sectional data revealed that serum Tyr and Trp levels were significantly and inversely associated with CAD. During a median follow-up period of 44 months, 343 major adverse cardiovascular events (MACEs) and 138 all-cause deaths were recorded. MACE included myocardial infarction, stroke, revascularisation and all-cause mortality. Low serum Trp levels predicted an increased risk of MACE and death. High serum Phe levels were linked to an increased risk of MACE, while low Tyr levels were associated with a higher risk of death. Collectively, our findings underscore a close correlation between AAAs and CAD, as well as their potential predictive value for adverse cardiovascular outcomes.

Background and aimsThe immuno-inflammatory response is a crucial early step in the development of acute coronary syndrome (ACS). In this study, we investigated whether immunoglobulin M (IgM) in the body's initial immune response can predict the prognosis of patients with ACS.MethodsThis prospective cohort study enrolled 1556 ACS patients at Beijing Hospital between March 2017 and October 2020. All patients underwent coronary angiography (CAG). The serum IgM concentration and biochemical indicators were evaluated prior to CAG. The primary endpoint was the composite endpoint of major adverse cardiovascular and cerebrovascular events (MACCEs). Multivariate Cox proportional hazards models was used to explore the association between IgM levels and the endpoint.ResultsThe average serum IgM levels of the population was 61.3 (42.6 - 88.4) mg/dL. During the median follow-up period of 55 months, 150 MACCEs occurred. Kaplan-Meier analysis showed that low serum IgM levels were associated with occurrence of MACCEs (log-rank p = 0.009). Univariate Cox proportional hazards models showed that low serum IgM ( ≤ 78.05mg/dL) was associated with MACCEs (hazard ratio (HR) 1.648, 95% confidence interval (CI): 1.129-2.406, p = 0.010). In patients with IgM ≤ 78.05mg/dL, the HR for partially adjusted MACCEs events was 1.576 (95% CI: 1.075-2.310) and 1.930 (95% CI: 1.080-3.449) after adjusting for multiple covariates. The subgroup analysis showed that for patients in ≤ 24 BMI, never smoking and non-dyslipidemia subgroup, the lower serum IgM levels was significantly associated with the risk of MACCEs (pinteraction < 0.001, pinteraction = 0.037, pinteraction = 0.024, respectively).ConclusionsLow serum IgM levels was independently associated with MACCEs in ACS patients, especially for patients without obesity, smoking and dyslipidemia.

Purpose:Individuals with chronic kidney disease (CKD) face an elevated residual risk of cardiovascular events, but the relationship between this residual risk and 1,5-anhydroglucitol (1,5-AG) is uncertain. Our study aimed to examine the effect of 1,5-AG on major adverse cardiovascular events (MACEs) and all-cause mortality in acute coronary syndrome (ACS) individuals. Methods:1253 ACS participants hospitalized were enrolled at Beijing Hospital between March 2017 and March 2020. All participants were classified into 2 groups based on their eGFR (60 ml/min/1.73 m2). The link between 1,5-AG and adverse outcome was investigated in non-CKD and CKD participants. Results:CKD patients had reduced concentrations of 1,5-AG than those without CKD. Throughout a median follow-up duration of 43 months, 1,5-AG was an autonomous hazard factor for MACEs and all-cause mortality. 1,5-AG<14 μg/ml participants had greater MACEs and all-cause mortality risk than those with 1,5-AG≥14 μg/ml, regardless of renal function. Furthermore, concomitant reduced concentrations of 1,5-AG and CKD portended a dismal prognosis in ACS patients. Conclusions:1,5-AG was autonomously linked to MACEs and all-cause mortality in ACS participants with both non-CKD and CKD. Co-presence of reduced concentrations of 1,5-AG and CKD may portend adverse clinical outcomes.

Oxidative stress, which is characterized by an imbalance between antioxidants and free radicals, plays a pivotal role in the pathogenesis of coronary heart disease, a common and serious cardiovascular condition, and contributes significantly to its development and progression. Serum free thiols are crucial components of the body's antioxidant defense system. The accurate determination of serum free thiol levels provides a reference basis for understanding the body's status and monitoring the risk factors associated with the occurrence and progression of coronary heart disease. In this study, a high performance liquid chromatographic (HPLC) method based on the derivatization reaction of 2,2'-dithiodipyridine was developed to simultaneously obtain the concentrations of total free thiols (Total-SH), low-molecular-mass free thiols (LMM-SH), and protein-free thiols (P-SH) in human serum. An Agilent Eclipse XDB-C18 column (150 mm×4.6 mm, 5 μm) was used for the analysis, and gradient elution was performed at a flow rate of 1 mL/min. A 0.1% formic acid aqueous solution was used as mobile phase A, and a 0.1% formic acid acetonitrile solution was used as mobile phase B. The gradient elution program was as follows: 0-0.1 min, 12%B-30%B; 0.1-2 min, 30%B; 2-2.1 min, 30%B-100%B; 2.1-6 min, 100%B; 6-6.1 min, 100%B-12%B; 6.1-7 min, 12%B. Well-separated peaks appeared after a run time of 5 min. The peak of 2-thiopyridone represented the Total-SH content of the samples, and the peak of the pyridyldithio derivative represented the LMM-SH content. The difference between these two peaks indicated the P-SH content. The derivatization reaction conditions were optimized, and the method was validated. The method demonstrated good linearity, with a correlation coefficient ≥0.9994, over the concentration range of 31.25-1000 μmol/L. The limits of detection for Total-SH and LMM-SH were 2.61 and 0.50 μmol/L, and the limits of quantification for Total-SH and LMM-SH were 8.71 and 1.67 μmol/L, respectively. The recoveries of Total-SH and LMM-SH were in the range of 91.1%-106.0%. The intra- and inter-day precisions ranged from 0.4% to 9.1%. The developed method was used to analyze serum samples from 714 volunteers. The Total-SH concentrations ranged from 376.60 to 781.12 μmol/L, with an average concentration of 555.62 μmol/L. The LMM-SH concentrations varied from 36.37 to 231.65 μmol/L,with an average of 82.34 μmol/L. The P-SH concentrations ranged from 288.36 to 687.74 μmol/L, with an average of 473.27 μmol/L. Spearman's correlation test showed that serum thiol levels were correlated with the severity of coronary artery disease and common clinical biochemical indicators. The proposed study provides a simple and reliable HPLC method for detecting serum free thiols and exploring their relationship with coronary heart disease, offering a new reference for the study of markers related to the risk of coronary heart disease.

BackgroundGut microbiota has significant impact on the cardio-metabolism and inflammation, and is implicated in the pathogenesis and progression of atherosclerosis. However, the long-term prospective association between trimethylamine N-oxide (TMAO) level and major adverse clinical events (MACEs) in patients with coronary artery disease (CAD) with or without diabetes mellitus (DM) habitus remains to be investigated.MethodsThis prospective, single-center cohort study enrolled 2090 hospitalized CAD patients confirmed by angiography at Beijing Hospital from 2017-2020. TMAO levels were performed using liquid chromatography-tandem mass spectrometry. The composite outcome of MACEs was identified by clinic visits or interviews annually. Multivariate Cox regression analysis, Kaplan-Meier analysis, and restricted cubic splines were mainly used to explore the relationship between TMAO levels and MACEs based on diabetes mellitus (DM) habitus.ResultsDuring the median follow-up period of 54 (41, 68) months, 266 (12.7%) developed MACEs. Higher TMAO levels, using the tertile cut-off value of 318.28 ng/mL, were significantly found to be positive dose-independent for developing MACEs, especially in patients with DM (HR 1.744, 95%CI 1.084-2.808, p = 0.022).ConclusionsHigher levels of TMAO are significantly associated with long-term MACEs among CAD patients with DM. The combination of TMAO in patients with CAD and DM is beneficial for risk stratification and prognosis.

Background Malnutrition is a common geriatric syndrome that is closely associated with adverse clinical outcomes and poses significant harm to older adults. Early assessment of nutritional status plays a crucial role in preventing and intervening in cases of malnutrition. However, there is currently a lack of measurable methods and biomarkers to evaluate malnutrition in older adults accurately. The aim of this study is to investigate the independent correlation between serum levels of amino acids and malnutrition in older adults, and to identify effective metabolomics biomarkers that can aid in the early detection of geriatric malnutrition. Methods A total of 254 geriatric medical examination participants from Beijing Hospital were included in the study, consisting of 182 individuals with normal nutritional status (Normal group) and 72 patients at risk of malnutrition or already malnourished (MN group). Malnutrition was assessed using the Mini-Nutritional Assessment Short-Form (MNA-SF). Demographic data were collected, and muscle-related and lipid indexes were determined. Serum amino acid concentrations were measured using isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation between serum amino acid levels and malnutrition was analyzed using non-parametric tests, partial correlation analysis, linear regression, and logistic regression. Results The geriatric MN group exhibited significantly lower serum aromatic amino acid levels (P < 0.05) compared to the normal group. A positive correlation was observed between serum aromatic amino acid levels and the MNA-SF score (P = 0.002), as well as with known biomarkers of malnutrition such as body mass index (BMI) (P < 0.001) and hemoglobin (HGB) (P = 0.005). Multivariable logistic or linear regression analyses showed that aromatic amino acid levels were negatively correlated with MN and positively correlated with the MNA-SF score, after adjusting for some confounding factors, such as age, gender, BMI, smoking status, history of dyslipidemia, diabetes mellitus and frailty. Stratified analyses revealed that these trends were more pronounced in individuals without a history of frailty compared to those with a history of frailty, and there was an interaction between aromatic amino acid levels and frailty history (P = 0.004). Conclusion Our study suggests that serum aromatic amino acids are independently associated with malnutrition in older adults. These results have important implications for identifying potential biomarkers to predict geriatric malnutrition or monitor its progression and severity, as malnutrition can result in poor clinical outcomes.

BACKGROUND:Growing evidence supports a link between ultra-processed food consumption and human health outcomes. However, the association between ultra-processed food consumption and non-alcoholic fatty liver disease (NAFLD) is not known. We aimed to explore the association between ultra-processed food consumption and risk of NAFLD.METHODS:The prospective study included 16 168 participants aged 18-90 years from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Information on ultra-processed food consumption was collected at baseline using a validated food frequency questionnaire. NAFLD was defined as the presence of sonographic fatty liver in the absence of significant alcohol intake (≥210 g/week for men and ≥140 g/week for women, respectively) and other liver diseases. Multivariable Cox proportional hazards models were used to examine the association between ultra-processed food consumption and risk of NAFLD.RESULTS:During 56 935 person-years of follow-up, we documented 3752 incident NAFLD cases. After adjusting for age, sex, body mass index, smoking, alcohol drinking, education, occupation, income, physical activity, total energy intake, personal and family history of disease and overall diet quality, the multivariable hazard ratios (95% confidence interval) of NAFLD across increasing quartiles of ultra-processed food consumption were 1.00 (reference), 0.99 (0.90, 1.08), 1.13 (1.03, 1.25) and 1.18 (1.07, 1.30), respectively (P for trend <0.0001). The hazard ratio (95% confidence interval) per one standard deviation increase in ultra-processed food consumption, equivalent to a 62.7 g/1000 kcal per day, was 1.06 (1.03, 1.09), P = 0.0001.CONCLUSIONS:Our study indicates that higher ultra-processed food consumption is associated with a higher risk of NAFLD. This finding suggests that ultra-processed food, which is widely consumed worldwide, might be a modifiable dietary target to reduce the risk of NAFLD.

BackgroundMushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases. We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the prevention of subclinical thyroid dysfunction (SCTD). Therefore, we designed a large-scale cohort study to examine whether mushrooms consumption is a protective factor for SCTD in adults.MethodsThis prospective cohort study investigated 6631 participants (mean age: (45.0 ± 10.2) years; 55.1 % men). Edible mushrooms consumption was measured at baseline using a validated food frequency questionnaire. SCTD was defined as abnormal serum thyroid-stimulating hormone levels and normal free thyroxine. Cox proportional hazards regression models were used to examine the association of edible mushrooms consumption with incident SCTD.ResultsDuring follow-up period, a total of 262 new cases of SCTD were identified, the incidence rate of subclinical hypothyroidism was 8.9/1000 person-years and subclinical hyperthyroidism was 7.2/1000 person-years. After adjusting potential confounding factors, the multivariable hazard ratios (95 % confidence intervals) for subclinical hypothyroidism were 1.00 (reference) for almost never, 0.53 (0.29, 0.97) for 1–3 times/week and 0.30 (0.10, 0.87) for ≥ 4 times/week (P for trend = 0.02). It also showed edible mushrooms consumption was inversely associated with subclinical hypothyroidism in obese individuals but not non-obese individuals, the final hazard ratios (95 % confidence intervals) were 0.14 (0.03, 0.73) (P for trend < 0.01).Conclusionshis population-based prospective cohort study has firstly demonstrated that higher edible mushrooms consumption was significantly associated with lower incidence of subclinical hypothyroidism among general adult population, especially in obese individuals.

BACKGROUND:Both absolute (kg) and relative (kg per kg of body weight) handgrip strength (HGS) have been used as indicators of HGS. Multiple studies have explored HGS associations with type 2 diabetes (T2DM); however, prognostic values were inconsistent. We aimed to examine the associations between both absolute and relative HGS and incident T2DM.METHODS:A total of 12,957 participants aged 40 years and older (mean age 51.0 years, 58.4% men) were followed and enrolled in the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Cox proportional hazards regression models were used to examine the association of HGS with incident T2DM. Other prospective studies on HGS and risk of T2DM were identified by searching several electronic databases up to November 31, 2021. Meta-analysis was performed by combining the results from the TCLSIH study and previous prospective cohort studies.RESULTS:From the TCLSIH Cohort study, after adjustment, relative HGS was inversely associated with T2DM (hazard ratio per 0.1 higher relative HGS 0.667, 95% confidence interval [CI] 0.616, 0.722). However, no significant association between absolute HGS and incident T2DM was found. The meta-analyses showed that per 5 kg higher HGS was associated with a 5% (95% CI 2%, 8%) lower risk of T2DM and each 0.1 higher relative HGS was associated with a 22% (95% CI 14%, 29%) lower risk of T2DM.CONCLUSION:The results from our cohort study and meta-analysis suggest that relative HGS was better than absolute HGS in predicting incident T2DM. Adiposity was an important factor that mediates the association between HGS and T2DM.

Trimethylamine N-oxide (TMAO), a gut microbiota-dependent metabolite, has been shown to aggravate cardiovascular disease. However, the mechanisms of TMAO in the setting of cardiovascular disease progress remain unclear. Here, we aim to investigate the effects of TMAO on atherosclerosis (AS) development and the underlying mechanisms. Apoe -/- mice received choline or TMAO supplementation in a normal diet and a western diet for 12 weeks. Choline or TMAO supplementation in both normal diet and western diet significantly promoted plaque progression in Apoe-/- mice. Besides, serum lipids levels and inflammation response in the aortic root were enhanced by choline or TMAO supplementation. In particular, choline or TMAO supplementation in the western diet changed intestinal microbiota composition and bile acid metabolism. Therefore, choline or TMAO supplementation may promote AS by modulating gut microbiota in mice fed with a western diet and by other mechanisms in mice given a normal diet, even choline or TMAO supplementation in a normal diet can promote AS.

Objective: To investigate the predictive value of glycosylated hemoglobin A1c/apolipoprotein A-1 (HbA1c/ApoA-1) ratio for major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS). Methods: The present study is a retrospective cohort study. ACS patients who were hospitalized and underwent coronary angiography at Beijing Hospital from March 2017 to March 2019 were enrolled. Baseline information such as sex, age, previous history, Gensini score, HbA1c and ApoA-1 were analyzed. Patients were divided into two groups according to presence or absence of MACEs and the difference on HbA1c/ApoA-1 ratio was compared between the two groups. According to the tertiles of HbA1c/ApoA-1 levels, patients were divided into high (5.87-16.12), medium (4.50-5.83) and low (2.11-4.48) HbA1c/ApoA-1 groups. Cox proportional risk model was used to evaluate the differences in MACEs and all-cause mortality among the three groups. Kaplan-Meier survival analysis was used to compare the differences of MACEs between the various HbA1c/ApoA-1 groups. Results: A total of 366 ACS patients were included in this study. The mean age of the patients was (65.9±10.3) years. There were 59 MACEs and 10 all-cause deaths during the mean of (22.3±4.4) months follow-up. After adjusting for age, systolic blood pressure, history of diabetes and Gensini score, the incidence of MACEs was 2.45 times higher in the high HbA1c/ApoA-1 group than in the low HbA1c/ApoA-1 group (95%CI 1.16-5.18, P=0.019). There was no significant difference in all-cause mortality between the high and low HbA1c/ApoA-1 groups (P=1.000). Kaplan-Meier survival analysis showed that patients in the high HbA1c/ApoA-1 group had the highest risk of MACEs, while patients in the low HbA1c/ApoA-1 group had the lowest risk of MACEs (P<0.01). Spearman rank correlation analysis showed that HbA1/ApoA-1 ratio was positively correlated with Gensini score in ACS patients (r=0.274, P<0.01). Conclusion: High HbA1c/ApoA-1 ratio was an independent risk factor for MACEs in ACS patients. Patients with high HbA1c/ApoA-1 ratio had more severe coronary artery disease lesions. HbA1c/ApoA-1 ratio may be used as a potential risk stratification biomarker for ACS patients, it might be useful for the early identification of high-risk population and for predicting the incidence of MACEs among ACS patients.