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Background: Serum cholinesterase (ChE) is positively associated with incident diabetes and dyslipidemia. We aimed to investigate the relationship between ChE and the incidence of diabetic retinopathy (DR). Methods: Based on a community-based cohort study followed for 4.6 years, 1133 participants aged 55–70 years with diabetes were analyzed. Fundus photographs were taken for each eye at both baseline and follow-up investigations. The presence and severity of DR were categorized into no DR, mild non-proliferative DR (NPDR), and referable DR (moderate NPDR or worse). Binary and multinomial logistic regression models were used to estimate the risk ratio (RR) and 95% confidence interval (CI) between ChE and DR. Results: Among the 1133 participants, 72 (6.4%) cases of DR occurred. The multivariable binary logistic regression showed that the highest tertile of ChE (≥ 422 U/L) was associated with a 2.01-fold higher risk of incident DR (RR 2.01, 95%CI 1.01-4.00; P for trend < 0.05) than the lowest tertile (< 354 U/L). The multivariable binary and multinomial logistic regression showed that the risk of DR increased by 41% (RR 1.41, 95%CI 1.05–1.90), and the risk of incident referable DR was almost 2-fold higher than no DR (RR 1.99, 95%CI 1.24–3.18) with per 1-SD increase of loge-transformed ChE. Furthermore, multiplicative interactions were found between ChE and elderly participants (aged 60 and older; P for interaction = 0.003) and men (P for interaction = 0.044) on the risk of DR. Conclusions: In this study, ChE was associated with the incidence of DR, especially referable DR. ChE was a potential biomarker for predicting the incident DR. [ABSTRACT FROM AUTHOR]

Background: The risk of cardiovascular diseases has rapidly increased among middle-aged and elderly. However, little is known about the relationship of body composition changes with the risk of cardiovascular events among this population in China. We explored the associations of 2-year changes in fat percentage (fat%) and fat-free mass percentage (FFM%) with subsequent cardiovascular events in a middle-aged and elderly community-based cohort. Methods: This study included 1048 participants (456 men [43.51%], aged 50–80 years) without overt cardiovascular disease, who underwent two examinations during 2013–2014 and 2015–2016. All participants were followed up until 2022 for cardiovascular events. A bioelectrical impedance analyzer was used to calculate fat% and FFM% change. Results: At baseline, the median body mass index (BMI), fat%, and FFM% were 23.9 (22.1–25.9) kg/m2, 27.2 (20.8–33.6)%, and 72.8 (66.4–79.2)%, respectively. Two-year changes in fat% and FFM% were 0.31 (− 5.53 to 6.87)% and − 0.12 (− 2.36 to 2.06)%. During an average follow-up of 5.5 years, 86 cardiovascular events (8.21%) occurred. Cox regression models showed that hazard ratios (HRs) of every 2% change in fat% and FFM% for cardiovascular events were 1.04 (95% confidence interval [CI] 1.01–1.07) and 0.84 (95% CI 0.74–0.95), respectively. Compared with participants with stable fat% (–2% ≤ ⊿fat% < 2%), those with fat% gain ≥ 2% had an increased risk of cardiovascular events (HR 2.07, 95% CI 1.08–3.97). FFM% loss > 8% was associated with a higher risk of cardiovascular events (HR 3.83, 95% CI 1.29–11.4). Conclusions: In a middle-aged and elderly community-based Chinese population, fat% gain or FFM% loss was associated with an increased risk of cardiovascular events. [ABSTRACT FROM AUTHOR]

Objectives: Although low muscle mass may make an underappreciated contribution to increasing the risk of cardiovascular diseases, no prospective studies have explored the association between low muscle mass and carotid atherosclerosis. We investigated whether muscle mass was related to a higher carotid intima-media thickness (C-IMT) and carotid artery plaque in a community-based population. Methods: The study included 1,253 asymptomatic participants without known cardiovascular disease, who underwent carotid ultrasonography at baseline in 2013–2014 and received a re-examination in 2015–2016. The skeletal muscle mass index was estimated using a bioelectrical impedance analyzer. We assessed the relationship between the skeletal muscle mass index and the development of C-IMT and carotid plaque, both, using multivariate-adjusted logistic regression models. Results: During the follow up, 400 (51.0%) subjects with normal C-IMT at baseline developed elevated C-IMT and 215 (17.2%) subjects developed carotid plaque. The risk of elevated C-IMT occurrence linearly decreased with an increase in skeletal muscle mass index quintiles or its continuous data, after multivariate-adjustment in men and women, respectively (both P for trend < 0.05; both P < 0.05). Subgroup analyses showed that this association was BMI-dependent. Besides, there was an inverse association between a high skeletal muscle mass index and carotid artery plaque in women, but the association disappeared after multivariate adjustment. In men, the skeletal muscle mass index was not associated with the incidence of carotid plaque. Conclusions: Skeletal muscle mass was inversely associated with the incidence of carotid atherosclerosis, suggesting muscle mass maintenance may play a role in modifying atherosclerosis. [ABSTRACT FROM AUTHOR]

Aim: Neck circumference (NC), a proxy for upper-body subcutaneous fat, is closely related to metabolic dysfunction, independent of other obesity indices. The purpose of this study was to explore the relationship between NC and the incidence and remission of metabolic associated fatty liver disease (MAFLD), a novel concept proposed by an international consensus panel in 2020 through a community-based longitudinal cohort. Methods: This study included 1,549 community participants and was conducted from 2013 to 2016. MAFLD was diagnosed using the International Expert Consensus (2020) criteria. All participants underwent NC measurement and biochemical measurements. Elevated NC was defined as NC ≥38.5 cm in men and NC ≥34.5 cm in women. Results: A total of 1,549 subjects (638 men and 911 women), with an average age of 59.6 ± 7.3 years, were included. During a mean follow-up of 2.1 years, MAFLD occurred in 146 of the 870 participants without baseline MAFLD and was resolved in 225 of the 679 participants with baseline MAFLD. After adjusting for confounding factors such as age, sex, body mass index, waist circumference, fasting plasma glucose, and liver enzyme levels, multivariable logistic regression showed that higher NC at baseline was positively correlated with MAFLD occurrence (OR 1.96, 95% confidence interval: 1.21–3.31; p = 0.003) and negatively correlated with MAFLD remission (OR 0.57, 95% confidence interval: 0.40–0.80; p < 0.001). Conclusion: A higher NC is associated with an increased risk of MAFLD occurrence and a reduced probability of MAFLD remission, making NC measurement a potential predictor in MAFLD management. [ABSTRACT FROM AUTHOR]

• Low muscle mass is a novel and effective predictive marker for incidence of cardiovascular events in a general population. • This relationship is independent of multiple well-established CVD risk factors such as smoking, diabetes, hypertension, and dyslipidemia. • Low muscle mass strengthens predicting future cardiovascular events over traditional risk score, especially among people with a moderate-to-high risk. We aimed to explore the association between skeletal muscle mass and cardiovascular events, and its additional value on the assessment of cardiovascular diseases (CVD) over traditional risk scores. The study included 1365 community-based participants aged over 50 years and free of CVDs at baseline. Participants completed detailed assessments at baseline and received a follow-up assessment in 2021–2022 via phone calls or electronic medical records. Skeletal muscle mass was measured using an automatic bioelectric analyzer. Predicted probabilities of 10-year atherosclerotic cardiovascular disease (ASCVD) risk were estimated individually with the China-PAR equation. After a mean follow-up of 7.6 years, 144 cardiovascular events were identified. The fully-adjusted hazard ratios (HRs) of cardiovascular events were 0.93 (0.88–0.98) and 1.08 (1.04–1.12) for skeletal muscle mass and predicted 10-year risk, respectively. Among participants over 60 years and with two or more risk factors, cardiovascular events risk increased progressively with each decreasing skeletal muscle tertile. Receiver operating characteristic curves showed that the C-statistic of predicting cardiovascular events for a 10-year risk assessment was slightly increased after adding skeletal muscle mass. The categorical net reclassification improvement (NRI) showed a 56.7% increase in the reclassification. The continuous NRI and integrated discrimination improvement increased as well. Participants with low skeletal muscle mass were more likely to have cardiovascular events. Low muscle mass improved the predictive power of CVD incidence over the original risk score, indicating that muscle mass could be a valuable parameter and a declining value needed early detection in the population. [ABSTRACT FROM AUTHOR]