BACKGROUND:Assessing urinary symptoms poses a complex challenge for primary care practitioners. In evaluating urological function, authors' approach involves constructing an urological age through the analysis of laboratory parameters and indicators of the urinary system. METHODS:Based on the National Health and Nutrition Examination Survey (NHANES), urological laboratory tests and age-related symptoms were included in the development of urological age (UA) and urological age acceleration (UAA) through the Klemera Doubal method. In relation to mortality associated with UAA, the metric was categorized into grades (0, 1, 2) as a discrete variable. The authors investigated the correlation between UAA and its grades with mortality, conducted survival analysis based on UAA grades, and explored the correlation between multi-system ageing-related disorders and UAA grades based on the NHANES and the West China Natural Population Cohort Study. RESULTS:UA was related to age with the r to 0.85 in men and 0.84 in women. Each year the increase in UAA was related to higher 1% and 4% mortality for men and women. Those with UAA grades 1 and 2 were associated with more risk of mortality than individuals with UAA grade 0 (men 8% and 40%, women 24% and 157%). The advanced UAA grades kept pace with multi-system ageing. Healthy diets and lifestyle habits are associated with lower UAA. CONCLUSION:Urological age is related to multi-system ageing and increases mortality risk, and urological age can be used to screen high-risk individuals and inform precision clinical development for ageing intervention.

Background: Both sleep disturbance and anxiety are common problems that significantly affect human health, but little is known about their causal relationship. The aim of this study was to explore the causal relationship between them with a large sample of community-dwelling adults included. Methods: Data for this study were extracted from the baseline survey of West China Natural Population Cohort Study (WCNPCS) and follow-up in the following year. The sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI), and anxiety was screened using the Generalized Anxiety Disorder Scale (GAD-7). Age, gender, educational level, marital status, smoking status, drinking status, depressive symptoms, loneliness and chronic diseases were taken as covariant factors. Logistic regression and cross-lagged models were used for data analyses. Results: A total of 16699 participants (67.5 % females) were enrolled, with the average age of participants being 57.3 +/- 12.7 years. A total of 40.50 % of participants experienced poor sleep quality at baseline and 40.52 % at follow-up. The prevalence of anxiety was 7.58 % at baseline and 4.62 % at follow-up. The results showed that the risk of developing anxiety in individuals with sleep disturbance at baseline was 1.89 times higher than those without (95%CI = 1.43-2.48). Similarly, anxiety increased the risk of developing sleep disturbance by 1.20-fold (95%CI = 1.03-1.39). These results were further supported by the cross-lagged panel models. Conclusion: Sleep disturbance and anxiety are mutually causal, and the effect of poor sleep on anxiety seems to be more significant. Timely interventions targeting sleep may help to break the vicious circle between sleep disturbance and anxiety symptoms, and improve the quality of life.

Abstract BackgroundBenign prostatic hyperplasia (BPH) is a global age-related disease. It has been reported that over half of the Chinese male population aged 70 years or older are experiencing BPH. Solid fuel, which is the major source of household air pollution, has been reportedly associated with several adverse events, including sex hormone disorders. Due to the certain relationship between sex hormone levels and prostate disease, the relationship between solid fuel use and lower urinary tract symptoms (LUTSs) suggestive of BPH (LUTS/BPH) deserves further exploration. ObjectiveThis study mainly aimed to investigate the association between solid fuel use and LUTS/BPH. MethodsThe data used in this study were obtained from the West China Natural Population Cohort Study. Household energy sources were assessed using questionnaires. LUTS/BPH was evaluated based on participant self-reports. We performed propensity score matching (PSM) to reduce the influence of bias and unmeasured confounders. The odds ratio (OR) and 95% CI of LUTS/BPH for the solid fuel group compared with the clean fuel group were calculated. We also conducted stratified analyses based on BMI, metabolic syndrome, waist to hip ratio, drinking status, smoking status, and age. ResultsA total of 5463 participants were included in this study, including 399 solid fuel users and 5064 clean fuel users. After PSM, the solid fuel group included 354 participants, while the clean fuel group included 701 participants. Solid fuel use was positively correlated with LUTS/BPH before and after PSM (OR 1.68, 95% CI 1.31‐2.15 and OR 1.81, 95% CI 1.35‐2.44, respectively). In stratified analyses, the OR of the nonsmoking group was higher than that of the smoking group (OR 2.56, 95% CI 1.56‐4.20 and OR 1.47, 95% CI 0.99‐2.18, respectively). Similarly, the OR of the nondrinking group was higher than that of the drinking group (OR 2.70, 95% CI 1.46‐4.99 and OR 1.48, 95% CI 1.01‐2.17, respectively). ConclusionsA positive correlation between solid fuel use and LUTS/BPH was observed. The results suggest that improving fuel structure for household cooking and other household needs can possibly help reduce the risk of LUTS/BPH.

Benign prostatic hyperplasia (BPH) is a global age-related disease. It has been reported that over half of Chinese males aged 70 years or older are suffering from BPH. Solid fuel, which is the major source of household air pollution, has been reportedly associated with several advent events, including sex hormone disorders. Due to the certain relationship between sex hormone levels and prostate disease, the relationship between solid fuel use and lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) deserves further exploration. This study mainly aimed to investigate the association between solid fuel use and LUTS/BPH. Data used in this study were obtained from the West China Natural Population Cohort Study. Household energy sources were assessed using a questionnaire, which divided participants into the clean fuel and solid fuel groups. LUTS/BPH was evaluated based on participant self-reports. To calculate the odds ratio (OR) and 95% confidence interval (CI) of LUTS/BPH for the solid fuel group compared with the clean fuel group, logistic regression models were performed. We further performed propensity score matching (PSM) to reduce the influence of bias and unmeasured confounders. A total of 5,463 participants were included in this study, including 399 solid fuel users and 5,064 clean fuel users. Solid fuel use was positively correlated with LUTS/BPH before and after PSM (OR 1.68, 95% CI 1.31–2.15, and OR 1.81, 95% CI 1.35–2.44, respectively). In stratified analyses, the ORs of nondrinking group and nonsmoking group were higher than drinking group and smoking group, and the interactions were significant. In this study, a positive correlation between solid fuel use and LUTS/BPH was observed. The results suggest that improving fuel structure for household cooking and other household needs can possibly help reduce the risk of LUTS/BPH. This trial was registered in the China Clinical Trial Registration Center (Registration No. ChiCTR1900024623) on 19/07/2019.

Abstract Background: Phthalates are chemical substances widely used in human consumer goods. Studies have shown that phthalates exposure can affect the physiological function of estrogen receptor (ER). However, there is no comprehensive discussion on the association between phthalates exposure and ER-related cancer risk. Objective: We conducted a cross-sectional study of urinary phthalate metabolite concentrations and self-reported ER-related cancers among 3,015 participants from two cycles of the national health and Nutrition Examination Survey (NHANES), 2003-2006. Methods: Seven compounds of phthalate metabolites were examined as expoure biomarkers. We used multivariate logistic regression to estimate odds ratio (ORs) and 95% confidence intervals (CIs), adjusting for potential confounding factors. The concentration of phthalate metabolites is non-normal distribution, so quantile and log-transformation are used for analysis. Account for urine dilution, the creatinine corrected phthalate concentration was applied in our analysis. In addition, we also conducted sensitivity analysis by gender stratification and trend test to explore whether there is a concentration increase effect, so as to explore the relationship between these seven phthalate metabolites and the risk of ER-related cancers. Results: We observed a higher prevalence of ER-related cancers in the maximal quantile of MCNP (OR=2.37; 95%Cl=1.01-5.55) in adjusted model. Meanwhile, trend test also confirmed that MCNP had a positive trend with the risk of ER-related cancer (P=0.036). In subgroup analysis, the higher concentration of MCNP, the higher the risk of breast cancer. At the same time, the trend test verified our results: the results are positive (OR=3.68;95%Cl=1.15-11.74) (P=0.014). Conclusion: We provide the main evidence that urinary phthalate metabolites concentrations are positively correlated with ER-related cancers. The positive relationship between MCNP exposure and breast cancer risk is more obvious in women. Further causal studies are needed to confirm the findings in our analysis and clarify the underlying mechanisms.

BackgroundAntisaccade is closely associated with cognitive ability in Alzheimer's disease (AD). However, studies regarding antisaccade in the early stages of AD are scarce. Considering that first-degree family history is a well-established risk factor for AD, we explored the influence of family history on the performance of antisaccade tasks in individuals with normal cognition.MethodsIn total, 44 participants (aged 50–66 years) with a family history of AD (FH+) and 44 age-, gender-, and educational level-matched controls (FH-) were enrolled in our study. After cognitive assessment using the Montreal Cognitive Assessment and Mini-mental State Examination, participants underwent antisaccade trials, and all parameters were recorded using an eye tracker.ResultsWhile the average velocity was relatively lower in FH+ individuals than in FH− individuals (107.9 ± 14.3°/s vs. 132.9 ± 23.7°/s, p < 0.001), FH+ individuals surprisingly showed relatively fewer uninhibited reflexive saccades (44.7 ± 26.0% vs. 56.2 ± 24.7%, p = 0.037) than the control group. They also required a relatively shorter time to detect and correct false saccades (121.6 ± 40.7 ms vs. 143.9 ± 37.0 ms, p = 0.023).ConclusionsThis study showed that family history is associated with alterations in antisaccadic parameters, suggesting that eye tracking can be used to assess oculomotor control and executive function in individuals at risk of developing dementia.

Abstract Background Bisphenol A (BPA) exposure and its structural analogs (BPS and BPF) might cause endocrine alterations and adverse physiological effects. Few studies to date have directly explored the association between its structural analogs (BPS, BPF) and sex hormones in adult male participants. Therefore, we aimed to assess the associations between BPA, BPS, BPF, and sex hormones in American adult men. Methods We used data from the U.S. National Health and Nutrition Examination Survey 2011–2016. We excluded participants without data available on sex hormones and urinary bisphenols. Furthermore, participants consuming sex hormone medications were excluded. Multivariable regression models were performed to assess the association between bisphenols and sex hormones. Results In this study, 2367 participants were included. Of 2367, in 1575 participants, the data on BPS and BPF were available. We found that a per unit increase in BPF was associated with 0.575 ng/dL higher total testosterone (TT) (Model 2: 95% CI: 0.047, 1.103, P = 0.033). However, there was no significant association between BPA or BPS and TT. Furthermore, increased BPA and BPS levels were associated with higher levels of sex hormone-binding globulin (SHBG) (Model 2: β = 0.364, 95% CI: 0.158, 0.571; β = 0.25, 95% CI: 0.071, 0.429, respectively). Additionally, participants in the highest BPA exposure quartile (quartile 4) had 4.072 nmol/L higher levels of SHBG than those in quartile 1 (Model 2: 95% CI: 0.746, 7.397, P = 0.017; P for trend =0.005). Both BPA and BPS were negatively associated with free testosterone (FT, nmol/L) after full adjustment (Model 2, β = − 0.01%, P = 0.0211, P = 0.0211; Model 2, β = − 0.01%, P = 0.0258, respectively). However, BPF was positively associated with FT (Model 2, β = 0.0029%, P = 0.0028). Conclusion Our study indicated that exposure to both BPA and its substitutions could alter sex hormone levels. This finding supports the possibility that human exposure to bisphenols at environmental levels might affect the endogenous hormone balance.

Abstract Background: Phthalates are chemical substances widely used in human consumer goods. Studies have shown that phthalates exposure can affect the physiological function of estrogen receptor (ER). However, there is no comprehensive discussion on the association between phthalates exposure and ER-related cancer risk.Objective: We conducted a cross-sectional study of urinary phthalate metabolite concentrations and self-reported ER-related cancers among 3,015 participants from two cycles of the national health and Nutrition Examination Survey (NHANES), 2003-2006.Methods: Seven compounds of phthalate metabolites were examined as expoure biomarkers. We used multivariate logistic regression to estimate odds ratio (ORs) and 95% confidence intervals (CIs), adjusting for potential confounding factors. The concentration of phthalate metabolites is non-normal distribution, so quantile and log-transformation are used for analysis. Account for urine dilution, the creatinine corrected phthalate concentration was applied in our analysis. In addition, we also conducted sensitivity analysis by gender stratification and trend test to explore whether there is a concentration increase effect, so as to explore the relationship between these seven phthalate metabolites and the risk of ER-related cancers.Results: We observed a higher prevalence of ER-related cancers in the maximal quantile of MCNP (OR=2.37; 95%Cl=1.01-5.55) in adjusted model. Meanwhile, trend test also confirmed that MCNP had a positive trend with the risk of ER-related cancer (P=0.036). In subgroup analysis, the higher concentration of MCNP, the higher the risk of breast cancer. At the same time, the trend test verified our results: the results are positive (OR=3.68;95%Cl=1.15-11.74) (P=0.014).Conclusion: We provide the main evidence that urinary phthalate metabolites concentrations are positively correlated with ER-related cancers. The positive relationship between MCNP exposure and breast cancer risk is more obvious in women. Further causal studies are needed to confirm the findings in our analysis and clarify the underlying mechanisms.

Background: To explore and understand associations between lung function and sleep architectures in healthy adults. Methods: Seventy-two participants (mean age 55.9 years, 72.2% female) were recruited from the Southwest China cohort study conducted at the West China hospital . Forced expiratory volume in first second (FEV1) and the ratio of FEV1 to forced vital capacity (FEV1/FVC) were measured using a spirometer for all participants. Participants’ objective sleep architectures, including sleep duration, rapid eye movement (REM) time, light and deep sleep were monitored using a Doppler radar sensor. Linear regression was used to analyze the associations between lung function measures and sleep architecture. Results: Results for FEV1/FVC were found to be positively correlated with REM sleep time (β = 0.29, p = 0.013). There was no positive correlation with sleep duration (p = 0.44 ), light sleep (p = 0.83) or deep sleep (p = 0.60) in regression model, including the use of lung function as the only predictor. Results for FEV1 demonstrated a tendency of positive correlation with REM sleep (β = 0.22, p = 0.07 ) and deep sleep (β = 0.21, p = 0.073), but it was not associated with sleep duration (p = 0.53) or light sleep (p = 0.54). After adjusting for all confounders, the results of FEV1/FVC remained positively correlated with REM sleep time (β = 0.28, p = 0.028). Conclusion: Our findings further confirmed that lung function is closely related to sleep architectures in healthy population, particularly, the result for FEV1/FVC is positively correlated with REM sleep.

Background: It have been reported that polycyclic aromatic hydrocarbons (PAHs) were associated with a variety of diseases, but it is still unclear that whether PAHs are associated with urinary incontinence (UI). This study aims to assess the association between PAHs and UI. Methods: Data were collected from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. 10 PAHs were detected totally. UI was diagnosed and distinguished into stress UI (SUI), urgency UI (UUI), and mixed UI (MUI) by answers of self-reported questions. Multivariate logistic regression analyses categorizing PAHs as quartiles were performed to detect the correlation between urinary PAHs and all three UI subtypes. Models were adjusted for common epidemiological factors including demographic and living habits factors. Results: A total of 12,393 participants of NHANES with available urine PAHs and UI data were eligible. No significant differences were observed between characteristics of participants with and without UI. Increasing prevalence of UUI was associated with the highest quantiles of 1-hydroxynapthalene (OR=1.208, 95%CI=1.026-1.422, p for trend=0.036), 1-hydroxyphenanthrene (OR=1.203, 95%CI=1.017-1.423, p for trend=0.004), and 1-hydroxypyrene (OR=1.251, 95%CI=1.062-1.475, p for trend=0.013) compared with the lowest quantiles. Increasing rate of SUI was observed in participants with higher exposure of all 9 PAHs (p for trend<0.025) except 3-hydroxyfluorene (OR=1.115, 95%CI=0.929-1.338, p for trend=0.241). Compared with the lowest quantiles, association between MUI and the highest quantiles of 1-hydroxyphenanthrene (OR=1.554, 95%CI=1.244-1.942, p for trend<0.001) and 1-hydroxypyrene (OR=1.307, 95%CI=1.047-1.630, p for trend=0.018) was observed. Conclusion: Our study suggested a positive relationship between U-PAHs and the prevalence of all three types of UI. Almost all PAHs are positively correlated with SUI.