Historically, Yichun City has borne the highest burden of Hemorrhagic Fever with Renal Syndrome (HFRS) in China, with incidence exhibiting marked fluctuations between 2005 and 2023. Despite this, HFRS-weather associations in Yichun remain poorly characterized. We analyzed weekly time-series data on HFRS cases and meteorological factors (mainly temperature, humidity, and precipitation) from 2005 to 2023 using random forest models to identify optimal lags, distributed lag non-linear models, and generalized additive models. We identified a symmetric unimodal relationship for temperature (peak risk at 13.66 °C; RR = 1.77, 95% CI: 0.92-3.39), a right-skewed pattern for relative humidity, and a distinct inverse J-shaped pattern for precipitation. Lag-response analysis indicated that the strongest associations occurred at 26 weeks for temperature, 12 weeks for relative humidity, and 16 weeks for precipitation. Temperature showed complex delayed responses with both protective and risk-increasing phases (~ 4-6 months), while precipitation and humidity primarily exhibited protective effects. Formal interaction testing revealed no statistically significant two-way or three-way interactions among meteorological variables (all P > 0.05), indicating that each factor operates independently rather than synergistically. These findings offer actionable evidence for designing targeted, climate-informed HFRS prevention strategies in Yichun and similar high-burden regions.

Influenza-associated encephalopathy (IAE) in children is a rare but severe complication associated with high morbidity and mortality. Timely identification of high-risk cases remains challenging due to variable clinical presentations and limited pediatric-specific evidence. This retrospective cohort study included 198 children diagnosed with IAE between 2015 and 2022 in a pediatric intensive care unit. Patients were categorized by in-hospital prognosis, defined as either poor (including death, coma, or neurological sequelae at discharge) or favorable outcome. Clinical and laboratory parameters were compared between groups. Logistic regression identified independent risk factors, which were used to construct a prognostic model and corresponding nomogram. Discriminatory performance was evaluated using receiver operating characteristic analysis. Among the 198 patients (median age 26 months), 88 (44.4%) met criteria for poor prognosis. These included death (21.6%) and sequelae such as cognitive impairment (23.9%), motor dysfunction (20.5%), and epilepsy (15.9%). Poor outcome was significantly associated with lower Glasgow Coma Scale scores (median 7 vs 12, P < .001), cranial magnetic resonance imaging abnormalities (71.6% vs 39.1%, P < .001), acute respiratory distress syndrome, hyperglycemia, and elevated brain natriuretic peptide levels. Multivariable logistic regression identified 5 independent predictors: Glasgow Coma Scale ≤ 8 (adjusted odds ratio [aOR] 3.42, 95% confidence interval [CI]: 1.76-6.64), abnormal magnetic resonance imaging (aOR 3.25, 95% CI: 1.59-6.67), acute respiratory distress syndrome (aOR 2.92, 95% CI: 1.46-5.85), glucose > 8.3 mmol/L (aOR 2.51, 95% CI: 1.23-5.12), and brain natriuretic peptide > 100 pg/mL (aOR 1.98, 95% CI: 0.96-4.12). The model showed strong predictive performance (area under the curve = 0.84, sensitivity of 82.3%, and specificity of 88.2% at the optimal cutoff value). Among children with IAE, nearly half experienced poor in-hospital outcomes. A combination of neurological severity, radiologic findings, respiratory status, and metabolic derangements independently predicted prognosis. These findings may aid early risk stratification and clinical decision-making in pediatric critical care.

BackgroundThe role of selenium intake on the association of fat intake with hypertension remains unclear. This study aimed to investigate the relationship among selenium intake, dietary fat and hypertension risk among Chinese adults.MethodsData from the China Health and Nutrition Survey were used. Individuals who were free of hypertension at baseline (2004) and participated at least once in the subsequent surveys (2006, 2009, and 2011) were included in this study. Generalized estimating equation models were used to explore the relationship between fat intake and systolic and diastolic blood pressure, and hypertension risk, as well as the modifying effect of selenium intake.ResultsAmong a total 5,643 participants, 1,722 adults developed hypertension during the follow-up period. After adjusting for covariates, participants in the highest fat intake group had significantly increased risk of hypertension compared with the lowest group (OR: 1.22, 95% CI: 1.01–1.47). The risk of hypertension tended to increase with increasing fat intake in the low selenium intake group, but not in the high selenium intake group. Systolic blood pressure increased by 0.69 mmHg (95% CI: 0.17–1.22) with increasing 50 g/day fat intake in the low selenium intake group (T1), whereas this association was not significant in the selenium intake T2 and T3 groups.ConclusionSelenium intake may modify the relationship between fat intake and hypertension, with high selenium intake attenuating the negative effects of fat intake on hypertension risk.

Background and aimsWith the global population aging, this study aimed to estimate the prevalence of healthy aging and its associated factors in China.MethodsThis cross-sectional study was conducted in Henan Province, China, in 2023. A multi-stage, stratified, probability-proportional-to-size (PPS) sampling method was employed to enroll 9,180 community-dwelling older adults aged ≥60 years. Healthy aging was defined as “no major chronic diseases,” “no disability,” “high cognitive function,” “high physical function,” and “active social engagement.” The weighted prevalence of healthy aging was evaluated. Weighted Poisson regression models were used to estimate the prevalence ratios (PRs) for the association between sociodemographic/lifestyle factors and healthy aging.ResultsThe overall weighted prevalence of healthy aging was 6.1%. The weighted prevalence of no major chronic diseases, no disability, high cognitive function, high physical function, and active social engagement was 23.7, 82.2, 42.4, 39.0, and 71.8%, respectively. The PR of healthy aging was inversely associated with age (PR = 0.65 in those aged 70–79 years and PR = 0.30 in those aged ≥80 years). Older adults residing in urban areas had a higher PR of healthy aging than those in rural areas (PR = 1.44, 95% CI 1.30–1.59). Higher education, higher income, alcohol consumption, and physical activity were all positively associated with healthy aging (p < 0.05).ConclusionThe prevalence of healthy aging among community-dwelling older adults in Henan Province was low. Fewer than half of the participants were free from major diseases or maintained high cognitive and physical function. Promoting healthy aging requires a multifaceted approach that integrates healthcare, economic, and educational initiatives. Particular attention should be given to female individuals, rural residents, individuals with lower education and income levels, and individuals who are divorced, widowed, cohabiting, or living alone.

Smoking poses a major global health threat, and although cessation can reduce mortality risk, the health effects of smoking cessation in older adults with long-term smoking history warrant further investigation. The study included Chinese older adults from the Shenzhen Healthy Ageing Research cohort, a community-based prospective study conducted between 2018 and 2021. We estimated the hazard ratios with 95

Due to the significant advancement of modern societies, higher education, career growth, and economic independence, more young girls are likely to delay childbearing beyond 30 years of age. The trend of delayed childbearing is more pronounced in industrialized countries but is also becoming common in emerging countries. Delayed childbearing has been linked with several adverse maternal-perinatal outcomes, including hypertensive disorders of pregnancy, abnormal placentation, gestational diabetes mellitus, preterm births, low birthweight, perinatal mortality, congenital birth defects, and chromosomal abnormalities. In this review, we have highlighted the trend of delayed childbearing age, the role of education and employment in delayed childbearing age, and its potential impact on adverse maternal-perinatal outcomes in developed and developing countries.

Aims The study aims to quantify the changes in the age-standardized prevalence of Type 1 and type 2 diabetes among the elderly in the Western Pacific Region (WPR) from 1990 to 2021. Methods We analyzed data on diabetes prevalence, mortality, and DALYs among the elderly from the GBD, stratified by sex, age, and SDI. We calculated ASR, used APC and AAPC to assess trends, and conducted correlation, decomposition, and health inequality analyses. Results From 1990 to 2021, the age-standardized prevalence of type 1 and type 2 diabetes increased in the region's elderly. In 2021, rates were 19,573.81 per 100,000 for type 2 and 191.98 per 100,000 for type 1. Men experienced a higher burden, and type 2's burden increased with age. A negative SDI-diabetes burden correlation was observed, highlighting socio-economic complexities. Conclusion The rising trends in diabetes prevalence and DALYs among the elderly in the Western Pacific Region underscore the growing challenge of managing diabetes in an aging society. This highlights the need for targeted interventions and policies to address the health impacts of diabetes on the elderly population.

To determine the risk factors for poor prognosis of influenza-associated encephalopathy (IAE), 56 eligible children with IAE who were treated in the pediatric intensive care unit of Wuhan Children’s Hospital from January 2022 to December 2023 were selected for retrospective analysis and grouped according to poor prognosis or not, and independent risk factors for poor prognosis were found by regression analysis. Results showed 26 children (26/30, 46.4%) had a poor prognosis. In the univariate analysis, the poor prognosis group compared with the clinically cured group showed a significant increase in the number of days of hospitalization (3.0 vs. 9.5 days, P < 0.001), high-sensitivity C-reactive protein (6.80 vs. 1.88 mg/L, P = 0.003), interleukin-6 (20.26 vs. 8.24 pg/mL, P = 0.001), interleukin-10 (11.75 vs. 4.72 pg/mL, P = 0.003), alanine aminotransferase (104.0 vs. 20.0 U/L, P = 0.011), aspartate azelotransferase (186.5 vs. 37.0 U/L, P = 0.003), serum albumin (37.99 vs. 40.76 g/L, P = 0.042), prothrombin time (13.2 vs. 11.4 s, P = 0.017), D-dimer (4.34 vs. 0.44 mg/L FEU, P < 0.001), peripheral blood CD19 B-cell count (35.11 vs. 32.75 cells/µL, P = 0.018), and cerebrospinal fluid chloride (126.82 vs. 125.50 mmol/L, P = 0.027) were statistically different in the above 11 indicators. After binary logistic regression analysis, it was concluded that D-dimer was an independent risk factor for poor prognosis (odds ratio = 1.440, 95% confidence interval 1.052–1.972, P = 0.023), and the area under the curve (95% confidence interval) was 0.802 (0.680–0.924), P < 0.001. When D-dimer was ≥ 1.18 mg/L FEU, the occurrence of poor prognosis was predicted with sensitivity and specificity of 65.4% and 96.7%, respectively. In conclusion, IAE has a high incidence of poor prognosis, in which D-dimer is a possible risk factor with discriminatory value in assessing the occurrence of poor prognosis. However, due to the limitations of retrospective single-center small sample size data, more confirmation from multicenter large sample size studies is needed in the future.

BackgroundCesarean section (C-section) rates have increased dramatically over the last few decades worldwide, and China's C-section rate has continuously remained much higher than the World Health Organization (WHO)'s suggested threshold. This study aimed to (1) estimate the temporal trends and factors for C-sections and (2) examine the association of a previous C-section with adverse outcomes in a subsequent pregnancy.MethodsWe conducted a tertiary-level hospital-based retrospective cohort study in the Hubei Province, China between 2011 and 2019. A chi-squared test was used to estimate the baseline disparities between C-sections and normal delivery among singleton and twin pregnancies. A multiple binary logistic regression model was conducted to predict factors associated with C-sections and their impact on subsequent pregnancy outcomes. The secular trend of C-section was determined by using the joinpoint regression model.ResultsBetween 2013 and 2019, the trend of C-section was significantly increased among singleton women with a high education level (annual percentage change (APC), 9.8%; 95%CI: 5.3, 14.5) and professional services (APC, 7.9%; 95%CI: 2.9, 13.2). The leading five factors, including previous C-section followed by fetal breech presentation, abnormal placentation, oligohydramnios, and macrosomia, were associated with a higher risk of C-section among singleton pregnancies. Hypertensive disorders of pregnancy (HDP) increase the risk of C-section in women with twin gestations. Previous C-section associated with a higher likelihood of gestational diabetes mellitus (GDM) in the subsequent pregnancy of singleton (aOR, 1.30; 95%CI: 1.14, 1.49) and twin (aOR, 1.78; 95%CI: 1.05, 3.01) women. Moreover, previous C-sections increased the odds of C-sections (aOR, 3.41; 95%CI: 3.11, 3.75) in the subsequent pregnancy of singleton women.ConclusionThe secular trend of C-sections significantly increased among women with high socioeconomic status, and a previous C-section was associated with a higher likelihood of repeated C-sections in singleton women and GMD in the subsequent pregnancy of both singleton and twin women.

BackgroundPrevious research has focused on the risk factors of adverse birth outcomes and its short-term and long-term consequences. However, study on the temporal trends of adverse birth outcomes is few. Furthermore, the population-level correlation between the rate of advanced maternal age (AMA) and the prevalence of adverse birth outcomes remains underexplored. This study aimed to provide the most recent temporal trends of adverse birth outcomes in Shanghai, China, and analyze the correlation between the prevalence of AMA and the prevalence of these adverse birth outcomes.MethodsA total of 173,690 birth data was collected from four regionally influential hospitals in Shanghai from 2010 to 2023. The prevalence of adverse birth outcomes (including preterm birth, low birth weight, small for gestational age, and birth defect) was calculated. Joinpoint regression analysis was conducted to estimate the temporal trends and calculate the Average Annual Percentage Change (AAPC) and Annual Percentage Change (APC) of adverse birth outcomes and AMA. A correlation study design was employed to evaluate the population-level correlation between the prevalence of adverse birth outcomes and AMA.ResultsThere were 13,445 (7.74%) preterm birth (PTB), 10,226(5.89%) low birth weight (LBW), 7,152 (4.12%) small for gestational age (SGA), and 3,227 (1.86%) birth defects (BD) over the past 14 years. Sex differences were observed across different adverse birth outcomes. The prevalence of PTB (AAPC = 0.87%, P = 0.045) and LBW (AAPC = 2.94%, P < 0.001) showed significant upward trends from 2010 to 2023. The prevalence of SGA (APC = 2.42%, P < 0.001) presented an increasing trend from 2012 to 2023, while the prevalence of BD (AAPC = 5.73%, P = 0.227) remained relatively stable. The rate of AMA (AAPC = 10.14%, P < 0.001) also showed a significant upward trend from 2010 to 2023. Additionally, this study found a strong positive correlation between the rate of AMA and the prevalence of LBW (r = 0.89, P < 0.001) and BD (r = 0.92, P < 0.001). Moderate positive correlations were observed between AMA and the prevalence of PTB (r = 0.61, P = 0.022) and SGA (r = 0.75, P = 0.002).ConclusionThe overall prevalence of PTB, LBW, and SGA has shown an increasing trend, aside from BD. AMA also has risen annually and was significantly associated with these adverse birth outcomes. This suggests that enhancing support for advanced-age mothers could potentially mitigate adverse birth outcomes. Besides, gender differences on these adverse birth outcomes demonstrate the implementation of gender-specific healthcare strategies.

Background This study aimed to assess the predictive value of body mass index (BMI) and skeletal maturity for the occurrence of early menarche in Chinese girls.Methods A cross-sectional analysis was conducted on 785 girls aged 8.1–14.6 years who visited our hospital within 3 months of menarche onset. Early menarche was defined as menarche age (MA) <10 years. Skeletal maturity was classified based on the difference between bone age (BA) and chronological age (CA), termed BA-CA; advanced BA was defined as BA-CA>2 years.Results The average MA was 10.7 (SD: 1.1) years, with a prevalence of early menarche of 23.3%. BA exhibited relative stability compared with MA, with an average of 12.8 (SD: 0.5) years at menarche onset. At menarche onset, the average height, weight and BMI were 149.1 (SD: 5.1) cm, 43.3 (SD: 7.2) kg and 19.4 (SD: 2.8) kg/m², respectively. Logistic regression analyses indicated that every 1-year increment in BA-CA was independently associated with a 18.90-fold higher risk of early menarche (95% CI 11.77 to 30.32), respectively, and remained statistically significant even after adjusting for height or mid-parental height. Furthermore, the prediction of BA-CA for early menarche demonstrated a dose-dependent pattern across BMI categories, with the greatest risk observed in normal-weight girls, the lowest risk in obese girls and an intermediate risk in overweight girls at the same degree of BA advancement.Conclusions Our findings provide evidence supporting the significant contributions of BMI and skeletal maturity in predicting early menarche among Chinese girls at menarche onset. Additionally, the results suggest a dose-dependent relationship between skeletal maturity and BMI categories, with normal-weight girls displaying a higher risk of early menarche compared to overweight and obese girls with the same degree of BA advancement.

AimTo examine the prevalence and potential risk factors of multimorbidity among older adult in China. In addition, we investigated the pattern of multimorbidity.MethodsThis study is based on data from the fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) in 2015, a comprehensive survey of individuals aged 60 years or older in China. We calculated baseline data and prevalence rates for comorbidities, stratified by household registration, age, sex, education, exercise, and health insurance. Univariate and multivariate logistic regression analyses were conducted to identify potential risk factors for comorbidities. Furthermore, we determined the prevalence rates for the three most frequent disease combinations.ResultsA total of 215,040 participants were included in our analysis. The prevalence of multimorbidity was 50.5% among the older adult in China. The prevalence rate was slightly higher in rural areas than in urban areas, with rates of 51.5 and 49.6%, respectively (p < 0.001). Moreover, the prevalence rate was higher in females than in males, with rates of 55.2 and 45.3%, respectively (p < 0.001). Multivariate logistic regression analysis revealed that individuals aged 70–79 years (OR:1.40, 95% CI: 1.38–1.43, p < 0.001) and over 80 years (OR:1.41, 95% CI: 1.38–1.45, p < 0.001) had a higher prevalence of multimorbidity than those aged 60–69 years. The most prevalent pair of comorbidities was hypertension and osteoarthropathy, with 19.6% of the participants having these two conditions, accounting for 5.4% of the total participants.ConclusionOur findings indicate a high prevalence of multimorbidity among the older adult in China. Increased expenditure on preventive health care, popularization of general medicine and popular medical education may be adopted by the Government to cope with the high prevalence of multimorbidity.

The eruption of primary teeth is a basic event during physical development of children, which is affected by heredity and environment. This study aimed to analyze the changes in primary teeth eruption among Chinese children with social development. A total of 249,264 healthy children under 2 years were extracted from the 1995, 2005, and 2015 National Survey on the Physical Growth and Development of Children in Nine Cities of China. Their primary teeth were examined and percentiles of primary teeth eruption age were calculated by probit analysis. The median primary teeth eruption age were 6.8 months, 6.7 months, 6.6 months in 1995, 2005 and 2015. Primary teeth eruption age of boys was 0.2 months, 0.3 months, 0.3 months earlier than that of girls in 1995, 2005 and 2015. Primary teeth eruption age was the earliest in children from northern region and was the latest in children from southern region, and this regional difference did not change over time. These findings suggest that primary teeth eruption age slightly advanced with social development, and their gender difference and regional difference have always existed, which supplied some data for understanding the secular trend of primary teeth development in stomatology, pediatrics, anthropology, and other related fields.

Nutritional status significantly impacts linear bone growth. We aimed to determine the relationship between the trajectories of four body composition indicators and pubertal advanced bone age. Trajectories of body mass index z-score (BMI z-score), visceral fat area z-score (VFA z-score), fat mass index z-score (FMI z-score), and fat-free mass index z-score (FFMI z-score) were identified based on three body composition measurements conducted from October 2018 to April 2023 within a pediatric cohort (the PROC study). We assessed pubertal bone age using the Tanner-Whitehouse 3-Chinese Radius-Ulna-Short (TW3-C RUS) method among 1402 primary school children. Children with a trajectory of higher BMI z-score, VFA z-score, FMI z-score, and FFMI z-score since childhood were more likely to have advanced bone age. The risk of advanced bone age was higher in children who were consistently in the high VFA z-score group (odds ratio [OR] = 6.73) or consistently in the high BMI z-score group (OR = 5.57), as compared to those in the low VFA z-score and low BMI z-score groups. Regular monitoring and maintenance of normal VFA during childhood may reduce the risk of advanced bone age at puberty. Furthermore, BMI monitoring is optional, especially in cases where specialized body composition equipment is not available.

BackgroundAdverse psychosocial factors play an important role in cardio-cerebral vascular disease (CCVD). The aim of this study was to evaluate the impact of the cumulative burden of loneliness on the risk of CCVD in the Chinese older adult.MethodsA total of 6,181 Chinese older adult over the age of 62 in the monitoring survey of the fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) were included in this study. The loneliness cumulative burden (scored by cumulative degree) was weighted by the loneliness score for two consecutive years (2017–2018) and divided into low- and high-burden groups. The outcome was defined as the incidence of CCVD 1 year later (2018–2019). A multivariate logistic regression model was used to examine the relationship between the cumulative burden of loneliness and the new onset of CCVD.ResultsAmong participants, 18.9% had a higher cumulative burden of loneliness, and 11.5% had a CCVD incidence within 1 year. After multivariate adjustment, the risk of developing CCVD in the high-burden group was approximately 37% higher than that in the low-burden group (OR 1.373, 95%CI 1.096–1.721; p = 0.006). Similar results were obtained when calculating the burden based on cumulative time. Longitudinal change in loneliness was not significantly associated with an increased risk of CCVD. A higher cumulative burden of loneliness may predict a higher risk of developing CCVD in older adult individuals aged 62–72 years or in those with diabetes.ConclusionThe cumulative burden of loneliness can be used to assess the risk of new-onset CCVD in the older adult in the short term.

Background: Few studies have examined the prevalence or risk factors of hyperuricemia among populations living at ultrahigh altitudes. Here we examined the prevalence of hyperuricemia and factors associated with it among young and middle-aged Tibetan men living at ultrahigh altitudes. Methods: This cross-sectional study analyzed 672 Tibetan men 18-60 years old living on the Qinghai-Tibet Plateau (mean altitude 4,014m) within the county of Litang in the Ganzi Tibetan autonomous prefecture of Sichuan Province, China. Demographic and clinical data were collected from self-administered questionnaires, physical examinations and laboratory tests. Participants whose blood uric acid (UA) contained >420 mu mol/l were classified as having hyperuricemia. Results: Of the 672 men analyzed, 332 (49.4%) had hyperuricemia. Multivariate logistic regression showed risk of hyperuricemia to correlate positively with body mass index (per 1U increase: odds ratio [OR] 1.172, 95% confidence interval [CI] 1.1066-1.243), triglycerides (OR 1.408, 95% CI 1.084-1.828), red blood cell count (OR 1.376, 95% CI 1.009-1.875), and creatinine level (per 1U increase: OR 1.051, 95% CI 1.033-1.070). Conversely, risk of hyperuricemia correlated negatively with the presence of diabetes mellitus (OR 0.412, 95% CI 0.175-0.968). Subgroup analyses showed that prevalence of hyperuricemia was significantly higher among those with polycythemia than among those without it, and that UA levels correlated positively with hematocrit and hemoglobin levels. Conclusions: Hyperuricemia is an important public health problem among Tibetan men living at ultrahigh altitudes in Ganzi autonomous prefecture. The region urgently requires appropriate prevention and management efforts.

Backgroud Frailty is a significant public health concern among the elderly, with social frailty closely linked to the development and progression of physical frailty. This study examines the current status and influencing factors of social frailty among older adults in China, and explores the impact of different dimensions of social frailty on the degree of physical frailty to provide insights for delaying physical frailty. Methods Data were sourced from the Fourth Sample Survey of the Aged Population in Urban and Rural China by the China National Committee on Aging. Physical frailty was assessed using a frailty index model, and principal component analysis determined the dimensions of social frailty. Multifactorial linear regression and logistic regression analyses were conducted to examine the relationships between various dimensions of social frailty and frailty, as well as their impacts on the degree of frailty. Results A total of 12,788 older adults were included in the analysis. The frailty index (FI) value was 0.14 ± 0.10, showing an exponential increase with age, and at any age, females had higher FI values than males. Principal component analysis revealed that social frailty in the elderly primarily encompasses dimensions of living conditions, social support, social participation, economic status, and living environment. Multivariate linear regression results indicated that older adults with higher degrees of frailty are more vulnerable in terms of social support, social participation, economic status, and living environment (r = 0.095, 0.198, 0.226, 0.199, all P = 0.000), while the association with living conditions was not statistically significant. Multifactorial logistic regression analysis showed that apart from the living conditions dimension, social support, social participation, economic status, and living environment are associated with an increased risk of frailty, with economic status having the most significant impact, followed by living environment, social support, or social participation. Conclusions Social frailty is common among the elderly, and there is a reciprocal and promotive interaction between social and physical frailty. The impacts of different dimensions of social frailty on frailty vary, suggesting that targeted interventions should be developed to address various dimensions of social frailty to mitigate its effects on the frailty of older adults.

BackgroundChronic respiratory disease is an important public health problem in the United States and globally. Diet, an important part of a healthy lifestyle, is also relevant to chronic respiratory health. We aimed to explore the relationship between overall dietary quality and the risk of chronic respiratory disease (CRD), include chronic bronchitis (CB), emphysema and asthma.MethodA total of 4,499 United States adults were extracted from the National Health and Nutrition Examination Survey (NHANES) in 2017–2018. Diet quality was assessed using 2 day, 24 h dietary recall data and quantified as the Healthy Diet Index (HEI)-2020 score. Binary logistic regression models, restricted cubic splines (RCS) and generalized additive modeling (GAM), the weighted quartile sum (WQS) and qgcom models were used to assess the relationship between HEI-2020 scores and risk of CB, emphysema and asthma.ResultsHigh HEI-2020 scores are associated with low risk of chronic respiratory disease (CB: 0.98, 0.97–0.99; emphysema: 0.98, 0.97–0.99; asthma: 0.98, 0.97–0.99) and consistent results across different dietary variable categorization (Tertile: CB: 0.58, 0.42–0.81; asthma: 0.51, 0.35–0.74; Quartile: CB: 0.57, 0.34–0.97; asthma: 0.56, 0.36–0.86) and different weighting models. Negative dose-response relationship between dietary quality and risk of chronic respiratory disease also shown in RCS and GAM models. The WQS and qgcom models also showed a healthy mixing effect of dietary components on respiratory disease, with high-quality proteins, vegetables, and fruits making the heaviest contributions.ConclusionHigher HEI-2020 scores were associated with lower risk of CB, emphysema, and asthma. Following Dietary Guidelines for Americans 2020–2025 could support enhanced respiratory health.

This study aimed to analyse the association between sex hormones and bone age (BA) in boys aged 9-18 years, both individually and interactively, and further to explore whether nutritional status may influence this association. A retrospective analysis was performed among 1382 Chinese boys with physical measurements, sexual characteristics, BA radiographs and sex hormone indicators from February 2015 to February 2022. A total of 470 (34.0%) boys had advanced BA. BA was positively associated with estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone in both advanced and normal BA groups after adjusting for age, genetic height and body mass index. Multiple logistic regression showed that after adjusting for covariates, estradiol (odds ratio [OR] = 1.66, 95% confidence interval [CI]: 1.14-2.12), LH (OR = 1.43, 95% CI: 1.04-1.96), and testosterone (OR = 1.58, 95% CI: 1.17-2.13) were significantly associated with the increased risk of advanced BA in boys, and the association was reinforced when these hormones were interactively explored. Stratified by nutritional status, the interaction between estradiol, LH, and testosterone showed a strong association with advanced BA in boys with normal weight.

The objective of this study was to evaluate the effectiveness and cost-effectiveness of different therapy regimens for girls with central precocious puberty (CPP). This study retrospectively analyzed CPP girls from 2013 to 2021 and grouped them into GnRHa, Mixed, and GnRHa+GH based on therapy regimen. While comparing the differences among these groups, initial age and bone age of GnRHa group girls were significantly lower than Mixed and GnRHa+GH groups, but their growth level was significantly higher (P < .05). In the Mixed group, starting with GnRHa alone, the predicted adult height improvement (ΔPAH) decreased to -1.0 cm in the second year, prompting addition of growth hormone (GH) therapy in the third year, resulting in a ΔPAH increase to 3.0 cm. At therapy completion, final predicted adult heights (PAHs) were similar among the groups at 155.6 to 156.7 cm, with ΔPAH between 5.8 and 6.5 cm and no significant intergroup differences (P > .05). Younger CPP girls with greater height can begin therapy with GnRHa alone. Consideration of combining GH therapy depends on growth velocity and PAH during treatment.