Background Disability in aged people became one of the major challenges in China due to the acceleration of population aging. Nevertheless, there were limited methods to appropriately discriminate the degree of combined basic activity of daily living (BADL) and instrumental activity of daily living (IADL). The present study explored an empirical typology of the activity of daily living (ADL) and its association with health status among the elderly in China. Methods Data throughout the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was retrieved and Latent profile analysis (LPA) was conducted to identify the subgroups of ADL for included elderly subjects. Multinomial regression was performed to detect the effect of identified characteristics with ADL subgroups, and the restricted cubic spine was drawn to show the changes in the relationship between age-specific ADL disability and BMI. Results The overall participants (n=8108) were divided into three ADL classes by LPA - ‘no BADL limitation-no IADL limitation’ (Class one, n=6062, 75%), ‘no BADL limitation- IADL impairment’ (Class two, n=1526, 19%), and ‘BADL impairment- IADL impairment’ (Class three, n=520, 6%). Compared with the participants in Class one, the oldest-old, living without spouse, lacking of exercise, short in social activities, having experience of falls, having comorbidity of diabetes, heart disease, stroke, decreased cognitive function, depression symptom were highly associated with Class two and Class three. Additionally, malnutrition and asthma were associated with combined BADL/IADL impairment (Class three), while illiteracy was only associated with IADL impairment (Class two). Furthermore, a statistically significant U-shape association was detected between age and BADL/IADL disability (Class three vs. Class two) as well as BMI and BADL/IADL disability (Class three vs. Class one). The elderly aged 80–90 with IADL impairment were less likely to evolve into combined BADL/IADL impairment, and the elderly who were underweight or obese may have higher risk of combined BADL/IADL impairment. Conclusion A novel functional assessment was explored based on LPA, by which elderly people could be classified into three distinct classes of combined BADL/IADL. The predictors identified with particular IADL/BADL classes could draw early attention to the onset of functional disability and enlighten targeted interventions to address consequent problems of aged people.
BackgroundCausal research concerning the consumption of tea and the risk of chronic kidney disease (CKD) is limited. This study identified the potential causal effects of tea intake on CKD, the estimated glomerular filtration rate (eGFR), and albuminuria.MethodsGenome-wide association studies (GWASs) from UK Biobank were able to identify single-nucleotide polymorphisms (SNPs) associated with an extra cup of tea each day. The summary statistics for the kidney function from the CKDGen consortium include 11,765 participants (12,385 cases of CKD) and 54,116 participants for the urinary albumin-to-creatinine ratio who were mostly of European descent. A two-sample Mendelian randomization (MR) analysis was performed to test the relationship between the selected SNPs and the risk of CKD.ResultsA total of 2,672 SNPs associated with tea consumption (p < 5 × 10–8) were found, 45 of which were independent and usable in CKDGen. Drinking more cups of tea per day indicates a protective effect for CKD G3-G5 [odds ratio (OR) = 0.803; p = 0.004] and increases eGFR (β = 0.019 log ml/min/1.73 m2 per cup per day; p = 2.21 × 10–5). Excluding two SNPs responsible for directional heterogeneity (Cochran Q p = 0.02), a high consumption of tea was also negatively correlated with a lower risk of albuminuria (OR = 0.758; p = 0.002).ConclusionFrom the perspective of genes, causal relationships exist between daily extra cup of tea and the reduced risk of CKD and albuminuria and increased eGFR.
BackgroundResearch on the association between blood lead (Pb) and lipid biomarkers have yielded inconsistent results, and epidemiological studies on blood Pb levels and hyperlipidemia are scarce. The present study aimed to examine the association between blood Pb levels and hyperlipidemia in adults from the National Health and Nutrition Examination Survey (NHANES).MethodsA total of 43,196 participants in the NHANES from 1999 to 2018 were included in the final analysis. Hyperlipidemia was determined based on the National Cholesterol Education Program guidelines. Blood Pb levels were assessed using inductively-coupled plasma mass spectrometry. Weighted multivariable logistic regression analysis and subgroup analysis were conducted to determine the correlation between blood Pb levels and hyperlipidemia.ResultsIn the multivariable logistic regression model, high blood Pb levels were significantly associated with hyperlipidemia after adjusting for confounders (OR 1.41; 95%CI: 1.18–1.67). Furthermore, elevated blood Pb levels were associated with an increased risk of hyperlipidemia across the four quartile (Q) groups (Q1: OR 1.00; Q2: OR 1.16 [95%CI: 1.04–1.29]; Q3: OR 1.39 [95%CI: 1.21–1.59]; and Q4: OR 1.33 [95%CI: 1.15–1.54]; P for trend <0.05). Significant moderating effects were found in the subgroup analysis stratified by age, education, hypertension, and diabetes (P < 0.05). In sensitivity analysis, the ORs for hyperlipidemia across the quartiles of blood Pb levels were 1.00, 1.17 (95%CI: 1.05–1.30), 1.42 (95%CI: 1.24–1.62), and 1.38 (95%CI: 1.19–1.60) for Q1, Q2, Q3, and Q4, respectively (P for trend <0.001) after removing adults with arteriosclerotic cardiovascular disease, and the ORs were 1.00, 1.13 (95%CI: 1.01–1.25), 1.38 (95%CI: 1.21–1.56), and 1.32 (95%CI: 1.16–1.52) for Q1, Q2, Q3, and Q4, respectively (P for trend <0.001) after including pregnant women.ConclusionThe current study showed a positive association between blood lead levels and hyperlipidemia.
ObjectiveTo investigate associations between visceral adiposity index (VAI) and cardiovascular and cerebrovascular diseases (CCDs) in the American population from 1999 to 2018.MethodsData from the National Health and Nutrition Examination Survey (1998–2018) were analyzed in this study. Specifically, VAI scores were calculated using sex-specific equations that incorporate body mass index, waist circumference (WC), high-density lipoprotein (HDL), triglycerides (TG), and cholesterol. Weighted logistic regression analysis was conducted to assess the relationship between VAI tertile and increased risk of CCDs. Restricted cubic splines were used to evaluate the non-linear relationship between VAI and CCDs, such as heart failure, angina, heart attack, stroke, hypertension, and coronary heart disease. Sensitivity analysis was conducted, using VAI quartiles as independent variables.ResultsA total of 22,622 subjects aged over 20 years were included. In the fully adjusted model after controlling for covariates, the third VAI tertile was more strongly associated with CCDs than the first VAI tertile, with odds ratio (OR) and 95% confidence interval (95% CI) values for angina of 2.86, 1.68–4.85; heart attack, 1.75, 1.14–2.69; stroke, 2.01, 1.23–3.26; hypertension, 2.28, 1.86–2.78; and coronary heart disease, 1.78, 1.32–2.41; but there was no significant association with heart failure (p > 0.05). Restricted cubic splines revealed parabolic relationships between VAI score and angina (p for non-linear = 0.03), coronary heart disease (p for non-linear = 0.01), and hypertension (p for non-linear < 0.001). Sensitivity analysis indicated that the fourth VAI quartile was more strongly associated with an increased risk of angina (OR = 2.92, 95% CI, 1.49–5.69), hypertension (OR = 2.37, 95% CI, 1.90–2.97), heart attack (OR = 1.77, 95% CI, 1.09–2.88), and coronary heart disease (OR = 1.89, 95% CI, 1.24–2.86) than the first VAI quartile. VAI had superior predictive power for prevalent CCDs than other independent indicators (p < 0.05).ConclusionVisceral adiposity index score is positively correlated with angina, heart attack, stroke, hypertension, and coronary heart disease, but not heart failure, and the relationships between VAI score and angina, hypertension, and coronary heart disease are non-linear.
BackgroundThe causal association between coffee consumption and the risk of OA is limited. This study was conducted to identify the potential causal effects of coffee consumption on total, knee, hip, and self-reported OA.MethodsGenome-wide association studies (GWAS) of OA were derived from the UK Biobank, comprising 50,508 participants of European ancestry (10,083 with cases and 40,425 controls), and genetic data for specific diagnosed knee OA (4462 cases and 17,885 controls), hip OA (12,625 cases and 50,898 controls), and self-reported OA (12,658 cases and 50,898 controls). Primary and secondary genetic instruments (11 SNPs and 8 SNPs) were selected as instrumental variants from GWAS among 375,833 and 91,462 participants. Two-sample Mendelian randomization (MR) analyses were performed to test the effects of the selected single nucleotide polymorphisms (SNPs) and the OA risk. The causal effects were primarily estimated using weighted median and inverse-variance weighted method with several sensitivity analyses.ResultsThe MR analyses suggested that genetically predicted 1% increase of coffee consumption was associated with an increased risk of overall OA (OR:1.009, 95% CI:1.003-1.016), knee OA (OR:1.023, 95% CI:1.009-1.038), self-reported OA (OR:1.007, 95% CI:1.003-1.011), but not hip OA (OR: 1.012, 95%CI:0.999-1.024) using primary genetic instruments. Similar results were found when using secondary genetic instruments that genetically predicted coffee consumption (cups/day). Additionally, the sensitivity analyses for leave-one-out methods supported a robust association between exposure traits and OA.ConclusionOur findings indicate that genetically predicted coffee consumption exerts a causal effect on total, knee, and self-reported OA risk, but not at the hip. Further research is required to unravel the role of coffee consumption in OA prevention.
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