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Atherosclerosis has become a leading public health problem. Previous studies suggest that enhanced muscle strength and muscle-derived cytokines (myokines) are linked with atherosclerosis. However, no previous prospective study has examined the relationship between grip strength (GS) and carotid atherosclerosis (CAS) in middle-aged and older adults. We therefore designed a cohort study to investigate the association between GS and the incidence of CAS in a population aged 45 years and over.The cohort study (n = 1258; follow-up range: 1-6 years, median: 4.0 years, age range: 45-85 years) was performed from 2013 to 2019 in Tianjin, China. CAS was measured using a carotid artery B-mode ultrasound system and defined by increased carotid intima-media thickness and plaques. GS was measured using a handheld digital dynamometer. Adjusted Cox proportional hazards regression models were used to assess the association between quartiles of GS and CAS.The incidence of CAS was 122 cases per 1000 person-years. In the final multivariable models, the adjusted hazard ratios (HRs) [95 % confidence interval (CI)] for CAS across quartiles of weight-adjusted GS (Q1-Q4) were as follows: 1.00 (reference), 0.82 (0.63, 1.06), 0.92 (0.71, 1.19), 0.69 (0.52, 0.91) and the HRs (95 % CI) across quartiles of GS (Q1-Q4) were as follows: 1.00 (reference), 1.06 (0.83, 1.36), 0.78 (0.59, 1.02), 0.76 (0.58, 0.995). For one unit and one standard deviation (SD) increase in weight-adjusted GS, the adjusted HRs (95 % CI) of CAS were 0.16 (0.05, 0.52) and 0.82 (0.72, 0.93), respectively. For one unit and one SD increase in GS, the adjusted HRs (95 % CI) of CAS were 0.98 (0.96, 0.995), and 0.47 (0.26, 0.83), respectively.Higher GS was associated with a lower incidence of carotid atherosclerosis in middle-aged and older adults. Further studies are required to clarify the causality.

The prospective studies on the effect of particular type of tea consumption, especially green tea, on depressive symptoms are limited.The aim of this study is to investigate the prospective association between green tea consumption and depressive symptoms in a large general adult population.This prospective cohort study investigated 7524 participants aged 25 to 90 years from May 2013 to December 2018 and they were free of cardiovascular disease, cancer, and depressive symptoms at baseline. Green tea consumption was obtained through a validated food frequency questionnaire. Depressive symptoms were assessed by using the Self-Rating Depressive Scale (SDS). The association between green tea consumption and depressive symptoms was analyzed by Cox proportional hazards regression models.A total of 1064 first incident cases of depressive symptoms (SDS ≥45) occurred during 14,661 person-years of follow-up (median follow-up of 2.0 years). In the crude model, the hazard ratios (95% confidence intervals) were 1.00 (reference), 0.95 (0.81, 1.12), 0.97 (0.83, 1.14) and 0.95 (0.79, 1.14), respectively. After adjusting for demographic characteristics, lifestyle factors, and dietary intake, the multivariable adjusted hazard ratios (95% confidence intervals) were 1.00 (reference), 0.88 (0.74, 1.05), 0.84 (0.69, 1.02) and 0.78 (0.63, 0.97), respectively.The prospective study suggests that frequent green tea consumption is associated with a decreased risk of depressive symptoms in the general Chinese population.

Summary Background and aims Prospective cohort studies linking dietary patterns and non-alcoholic fatty liver disease (NAFLD) are limited, especially in Asian populations. This study aimed to prospectively investigate the association between dietary patterns and risk of NAFLD in a general Chinese adult population. Methods This study included a total of 17,360 participants free from NAFLD at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated 100-item food frequency questionnaire. NAFLD was diagnosed by abdominal ultrasound after excluding other causes related to chronic liver disease. Cox proportional regression models were used to assess the association between dietary patterns and risk of NAFLD. Results During a median follow-up of 4.2 years, 4034 NAFLD cases were documented. Three main dietary patterns were extracted: sugar rich dietary pattern, vegetable rich dietary pattern, and animal food dietary pattern. After adjusting for age, sex, body mass index, smoking, alcohol, education, occupation, income, physical activity, total energy intake, personal and family history of disease, depressive symptoms, dietary supplement use, inflammation markers, and each other dietary pattern score, comparing the highest with the lowest quartiles of dietary pattern scores, the multivariable hazard ratios (95% confidence interval) of NAFLD were 1.11 (1.01, 1.23) for sugar rich dietary pattern, 0.96 (0.86, 1.07) for vegetable rich dietary pattern, and 1.22 (1.10, 1.36) for animal food dietary pattern. Further adjustment for waist circumference instead of body mass index provided similar results. Conclusion Dietary patterns rich in animal foods or sugar were associated with a higher risk of NAFLD among Chinese adults, whereas a vegetable rich dietary pattern was not associated.

BACKGROUND Although preserved egg is a traditional Chinese delicacy widely consumed in China and Southeast Asian countries, whether habitual preserved egg consumption is associated with nonalcoholic fatty liver disease (NAFLD) remains unknown. OBJECTIVES This study aimed to examine the association between preserved egg consumption and risk of NAFLD in a cohort of Chinese adults. METHODS This prospective cohort study included 15,883 participants aged 19-88 y (58% women) from the TCLSIH (Tianjin Chronic Low-grade Systemic Inflammation and Health) cohort study who were free of liver diseases, cancer, and cardiovascular disease at baseline. Preserved egg consumption was assessed using an FFQ at baseline. NAFLD was diagnosed by transabdominal sonography during an annual health examination. Multivariable Cox proportional hazards regression models were used to calculate HRs and 95% CIs across categories of preserved egg consumption. RESULTS During 56,002 person-years of follow-up, 3683 first incident cases of NAFLD were recorded. After adjustment for sociodemographic characteristics, lifestyle risk factors, total energy intake, egg intake, and eating patterns, the multivariable HRs (95% CIs) of incident NAFLD according to categories of preserved egg consumption were 1.00 (reference) for never, 1.05 (0.98, 1.14) for

The independent role of muscular strength in the prevention of chronic disease is increasingly being recognized. However, no cohort study has assessed the relationship between handgrip strength and the incidence of hypertension among the middle-aged and older population. The aim of this prospective cohort study was to investigate whether handgrip strength is related to incident hypertension among people aged 40 years and over.This prospective cohort study (n = 8,480) was performed between 2013 and 2019 as part of the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study, Tianjin, China.Participants without baseline hypertension were followed up for ~6 years (median 4.0 years). Hypertension was defined according to the JNC7 criteria. Handgrip strength was measured using a hydraulic handheld dynamometer. Adjusted Cox proportional hazards regression models were used to assess the relationships between weight-adjusted handgrip strength and the risk of incident hypertension.The incidence rate of hypertension per 1000 person-years was 70. The fully adjusted hazards ratios (95% confidence interval) of the incidence of hypertension for increasing quartiles of weight-adjusted handgrip strength were: 1.00(reference), 0.84 (0.75-0.95), 0.78 (0.69-0.88), and 0.66 (0.58-0.75) (P for trend0.0001). Moreover, the adjusted hazards ratio (95% confidence interval) of incident hypertension for per unit increase in weight-adjusted handgrip strength was 0.17 (0.10-0.27) (P0.0001). Similar results were observed in males and females.The present cohort study is the first to find that high weight-adjusted handgrip strength, but not absolute handgrip strength, is significantly and independently related to low risk of incident hypertension among the middle-aged and older population.

Results of in vitro and in vivo studies showed that green leafy vegetables (GLV) could attenuate liver steatosis. However, little is known regarding the association between GLV intake and nonalcoholic fatty liver disease (NAFLD) in human. We examined the association of GLV intake with NAFLD in a large-scale adult population.This cross-sectional study investigated 26,891 adults in China who participated in health examinations from 2013 to 2017. Newly diagnosed NAFLD was detected by liver ultrasonography. Dietary intake was assessed by using a validated and standardized food frequency questionnaire. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) across categories of GLV intake. After adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the OR (95% CI) for comparing the highest vs. lowest GLV intake categories (≥7 times/week vs. almost never) was 0.72 (0.59, 0.90) (P 0.0001). In addition, a linear inverse association was demonstrated between GLV intake and NAFLD in women (P for trend = 0.04), but ORs for any intake category did not reach significance. Stratified analyses suggested a potential effect modification by obesity status; the ORs (95% CIs) for comparing the highest vs. lowest GLV intake categories was 0.72 (0.54, 0.97) in normal/overweight individuals and 1.04 (0.65, 1.65) in obese individuals (P-interaction 0.0001).This large population-based study shows that high GLV intake is inversely associated with NAFLD, particularly in women and non-obese participants.

Fish contain many important nutrients and are primarily known for high n-3 polyunsaturated fatty acids (n-3 PUFA) content. Studies have shown that supplementation of fish oil-derived n-3 PUFA improves muscle mass and strength. Here, we hypothesized that fish consumption might improve muscle strength. To test this hypothesis, we performed this cross-sectional study (n = 29,084) in Tianjin, China. The frequency of fish consumption was assessed using a valid self-administered food frequency questionnaire. Handgrip strength (HGS) was used as the indicator of muscle strength, and was measured using a handheld digital dynamometer. Analysis of covariance was used to examine the relationship between fish consumption and HGS. In men, after adjusted potential confounding factors, the least square means (95% confidence intervals) of HGS across saltwater fish consumption categories were 41.5 (41.1, 43.7) kg for1 time/week, 44.6 (43.2, 45.8) kg for 1 time/week, and 44.7 (43.3, 46.1) kg for ≥2 to 3 times/week (P for trend0.001). In men, the least square means (95% confidence intervals) of HGS across the ascending quartiles of dietary n-3 PUFA intake were 43.6 (43.2, 44.4) kg, 43.7 (43.2, 44.6) kg, 44.4 (43.0, 45.8) kg, and 44.6 (43.1, 46.0) kg (P for trend0.01). The results showed that saltwater fish consumption was positively related to HGS in men, but not in women, suggesting that saltwater fish contain nutrients that may be used to improve HGS.

Thyroid hormones (THs) play an important role in both serum uric acid (SUA) excretion and purine nucleotide metabolism. Past research mainly focused on the relationships between thyroid dysfunction and hyperuricemia. Although most subjects at risk for hyperuricemia are euthyroid, few studies have investigated the predictive values of THs on incident hyperuricemia in euthyroid adults. This study aimed to examine how free triiodothyronine, thyroxine, and thyroid-stimulating hormone are related to incident hyperuricemia in euthyroid subjects.Participants without baseline hyperuricemia were recruited from Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study and followed up for ∼6 years. Thyroid function was determined by chemiluminescence immunoassay methods. Hyperuricemia was defined as SUA ≥416.5 μmol/L for males and ≥357.0 μmol/L for females. Thyroid function and SUA were assessed yearly during follow-up. Adjusted Cox proportional hazards regression models were used to assess the relationship between thyroid function and hyperuricemia.The incidence rates of hyperuricemia were 109 and 50 per 1000 person-years in males and females, respectively. In males, compared with the lowest quartile, the multivariable-adjusted hazards ratios for hyperuricemia in the highest quartiles of triiodothyronine, thyroxine, and thyroid-stimulating hormone were 0.57 (0.50-0.66), 0.63 (0.54-0.73), and 1.03 (0.90-1.19) (P for trend.0001,.0001, and .51), respectively. However, no statistically significant correlations between thyroid function and incident hyperuricemia in females were found.This cohort study is the first to demonstrate that higher THs are related to lower risk of incident hyperuricemia in a male population with euthyroid status.

Background Previous studies suggest that muscle-derived cytokines (myokines) are linked with brain function. Although muscle strength measured by handgrip strength is a prognostic indicator of functional decline, epidemiological studies directly examining the association between grip strength and mental health remain scarce. The aim of this study is to clarify the association between grip strength and depressive symptoms in the general adult population. Methods This is a cross-sectional study of 24,109 Chinese adults (41. 5 ± 11.9 years; 46.0% females). Grip strength was measured by dynamometer and the greatest force was normalized to body weight (NGS, kg/kg). Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Models of logistic regression were conducted to assess the association between NGS and depressive symptoms, with adjustment for established confounding factors. Results Of the 24,109 participants, the prevalence of depressive symptoms (SDS ≥45) was 16.8% (males 15.7%, females 18.0%). After adjusting for multiple confounding factors, the odds ratios and 95% confidence interval for depressive symptoms in the quartiles of NGS were 1.00, 0.96 (0.84–1.10), 0.91 (0.79–1.05), and 0.91 (0.78–1.07) (P = 0.03) in males; 1.00, 0.92 (0.80–1.06), 0.90 (0.77–1.04), and 0.80 (0.69–0.94) (P = 0.0002) in females, respectively. Limitations This cross-sectional study cannot determine causality. Conclusions Grip strength was inversely associated with depressive symptoms, with stronger association observed among females than males. Further prospective studies or randomized trials are required to clarify these findings.

BACKGROUND Animal studies have shown that soy protein and isoflavones can increase antioxidant capacity and improve insulin resistance, and thus ameliorate nonalcoholic fatty liver disease (NAFLD). However, only limited epidemiological studies have examined the association of soy food intake with NAFLD. OBJECTIVES We investigated the association between soy food intake and NAFLD in a Chinese cohort. METHODS A total of 24,622 participants aged 20-90 y were included in the study. Diet information was collected using a validated 100-item FFQ. NAFLD was defined as having fatty liver diagnosed by ultrasonography and excluding men and women who consumed >210 g alcohol/wk and >140 g/wk, respectively. Logistic regression analysis was used to assess the association of soy food intake with NAFLD. RESULTS After adjustment for potential confounders, and taking those with

Research evidence supports a positive link between sugar-containing soft beverages and hyperuricemia. However, data thus far are mostly from Caucasian populations. And in sugar-containing soft beverages overall, sugar-containing carbonated beverages are purchased most often. Therefore, we investigated whether the high consumption of sugar-containing carbonated beverages was associated with the prevalence of hyperuricemia among adults in China.A cross-sectional study was conducted with 25,507 adults (13,013 men and 12,494 women) in Tianjin, China. Sugar-containing carbonated beverages intake was assessed by a validated semi-quantitative food frequency questionnaire. Hyperuricemia was defined as serum uric acid levels ≥7.0 mg/dL in men and ≥ 6 mg/dL in women. The association between carbonated beverages consumption and hyperuricemia was assessed by multiple logistic regression analysis. The prevalence of hyperuricemia in men and women was 23.4% and 8.2%, respectively. After adjustments for potential confounding factors, the odds ratios (95% confidence interval) for hyperuricemia across sugar-containing carbonated beverages consumption were 1.00 (reference) for almost never, 1.18 (1.05, 1.32) for1-3 cups/week, 1.49 (1.25, 1.77) for ≥4 cups/week in men (P for trend 0.005) and 1.11 (0.91, 1.34) for1-3 cups/week (P for trend = 0.27), 1.70 (1.23, 2.31) for ≥4 cups/week in women (P for trend0.001), respectively.This cross-sectional survey demonstrated that increased consumption of sugar-containing carbonated beverages is associated with hyperuricemia among adults in China. Restricted sugar-containing carbonated beverages intake might be beneficial to the prevention of hyperuricemia in the general population.

Garlic-derived organosulfur compounds have numerous potential benefits (e.g. antioxidant and anti-inflammatory effects) on human health. Although these functions might be related to the onset and progression of muscle strength decline, no studies have explored the relationship between garlic consumption and muscle strength in the general population. The aim of this study was to investigate whether raw garlic consumption is related to handgrip strength in a large-scale adult population.A cross-sectional study (n = 28,958) was performed in Tianjin, China. Frequency of raw garlic consumption was assessed using a valid self-administered food frequency questionnaire. Handgrip strength was measured using a handheld digital dynamometer. Analysis of covariance and multiple logistic regression were used to evaluate the relationship between raw garlic consumption and handgrip strength.In males, after adjusted potential confounding factors, the least square means (95% confidence intervals) of handgrip strength across raw garlic consumption categories were 42.5 (40.2-44.9) for almost never; 43.0 (40.7-45.5) for1 time/week; 43.4 (41.0-45.8) for 1 time/week; and 43.8 (41.5-46.3) for ≥2-3 times/week (P for trend0.0001). The adjusted odds ratios (95% confidence intervals) of low handgrip strength (20th percentile of handgrip strength) across the categories of raw garlic consumption in males were 1.00, 0.86 (0.76, 0.98), 0.76 (0.67, 0.87), and 0.66 (0.58, 0.74) (P for trend0.0001). Similar results were also observed in females.The study firstly revealed a positive correlation between raw garlic consumption and handgrip strength in both males and females. Further studies are needed to explore the casual relationship.

Banana contains many kinds of substances that are beneficial to depressive symptoms. However, there are no epidemiological researches directly to explore the association between banana consumption and depressive symptoms. This study aimed to investigate whether the banana consumption is related to depressive symptoms in a general adult population.A cross-sectional study was performed in 24,673 adults in Tianjin. Banana consumption was evaluated via a validated food frequency questionnaire. Depressive symptoms were assessed by using Self-Rating Depression Scale (SDS). The association between banana consumption and depressive symptoms was analyzed by multiple logistic regression analysis.The prevalence of depressive symptoms was 16.1% in males and 18.4% in females (SDS ≥ 45), respectively. In males, comparing to the reference group (almost never), the multivariable adjusted odds ratios (ORs) (95% confidence intervals) of depressive symptoms across banana consumption were 0.86 (0.74, 0.99) for1 time/week, 0.76 (0.66, 0.88) for 1-3 times/week and 0.97 (0.82, 1.16) for ≥4 times/week. By contrast, the multivariable adjusted ORs (95% confidence intervals) were 1.11 (0.94, 1.32) for1 time/week, 0.99 (0.85, 1.16) for 1-3 times/week and 1.22 (1.02, 1.46) for ≥4 times/week in females. Similar association was observed when other cut-offs (SDS ≥ 48 and 50) were used to define depressive symptoms.This is a cross-sectional study, causality remains unknown.Findings from this study suggested a negative association between moderate banana consumption and depressive symptoms in males. In females, high banana consumption is positively related to depressive symptoms.

Background and aims Metabolic syndrome (MetS) is a combination of metabolic disorders that increase the risk of developing cardiovascular disease, and inflammation is considered as a pathological basis for MetS. Immunoglobulins (Igs) are the major secretory products of the adaptive immune system. However, no large-scale population study has focused on a possible relationship between Igs and MetS. We designed a cross-sectional study to investigate the relationship between Igs and prevalence of MetS in a large-scale adult population. Methods and results A total of 10,289 participants were recruited among residents in Tianjin, China. Metabolic syndrome was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. Serum levels of Igs were determined by immunonephelometry. Multiple logistic regression models were used to assess the relationship between the quintiles of serum levels of Igs and the prevalence of MetS. The overall prevalence of MetS was 36.1%. The mean (standard deviation) values of Igs (IgG, IgE, IgM, and IgA) were 1205.7 (249.3) mg/dL, 93.1 (238.9) IU/mL, 105.7 (57.3) mg/dL, and 236.2 (97.6) mg/dL, respectively. The adjusted odds ratios (95% confidence interval) of MetS for the highest quintile of Igs (IgG, IgE, IgM, and IgA), when compared to the lowest quintile, were 0.81 (0.70, 0.95), 0.97 (0.83, 1.12), 1.13 (0.97, 1.33), and 1.52 (1.30, 1.77), respectively. Conclusions This study demonstrated that decreased IgG and increased IgA are independently related to a higher prevalence of MetS. The results indicate that the Igs might be useful predictive factors for MetS in the general adult population.

Prediabetes has been a growing health problem in China, and it is a high-risk state for developing diabetes and cardiovascular disease. In previous studies, low grip strength has been associated with diabetes. However, few population-based studies have examined the relationship between grip strength and prediabetes. Thus, the purpose of this study was to investigate whether grip strength is related to prediabetes in a large-scale adult population.A total of 27,295 participants aged 20 to 90 years were included from the 2013-2016 Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. Grip strength was assessed using an electronic hand-grip dynamometer and the greatest force was normalized to body weight. Prediabetes was diagnosed based on the American Diabetes Association criteria. Multiple logistic regression analysis was conducted in 2018 to assess the relationship of grip strength to the prevalence of prediabetes, while controlling for age, BMI, smoking, drinking, physical activities, dietary patterns, and other confounders.Of the 27,295 participants, 28.5% (7,783) had prediabetes. After adjusting for potential confounders, a one unit increase in grip strength per body weight was associated with 52% lower odds of having prediabetes for men (OR=0.48, 95% CI=0.30, 0.74, p0.01) and 62% lower odds of having prediabetes for women (OR=0.38, 95% CI=0.20, 0.70, p0.01).Increased grip strength is independently associated with lower prevalence of prediabetes in Chinese adults, suggesting that grip strength may be a useful marker for screening individuals at risk of prediabetes.

Objectives Non-alcoholic fatty liver disease (NAFLD) is one of the most common public health issues worldwide. Oranges are the most popular fruit consumed in the world. Admittedly, flavonoids in oranges act as antioxidants and improve liver steatosis. However, oranges also are rich in fructose, which is a risk factor in the progress of NAFLD. Therefore, we hypothesize that orange intake may be a double-edged sword in the development of NAFLD. To our knowledge, there currently is little evidence of the effect of dietary orange intake on NAFLD. The aim of this study was to investigate how orange intake is related to NAFLD in a general adult population. Methods We randomly recruited 27,214 adults into the Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study. NAFLD was diagnosed by liver ultrasonography. Raw orange intake was assessed by a validated self-administered food frequency questionnaire. Multiple logistic regression analysis was used to evaluate the association between orange intake and the prevalence of NAFLD. Results There was a 27.18% prevalence of NAFLD among the participants. Consumption of orange was positively associated with the prevalence of NAFLD after adjustment for all potential confounding factors (Ptrend = 0.04). The odds ratios (95% confidence interval) of the categories of orange intake in the NAFLD were 1.00 (reference) for less than once per week, 1.02 (0.95–1.11) for 1 to 6 times per week, and 1.17 (1.03–1.33) for ≥7 times per week, respectively. Conclusions The present study demonstrated that orange intake is positively associated with the prevalence of NAFLD.

Radiation resistance is an obstacle to the successful treatment of lung cancer. Metformin, a first-line antidiabetic drug, has been studied for its potential use in radiotherapy, as several lines of evidence suggest that metformin enhances radiation sensitivity of cancer cells. However, the underlying mechanisms by which metformin exerts its radiosensitization effects on non-small cell lung cancer (NSCLC) cells remain obscure. Here, we confirmed that metformin increases the radiosensitivity of NSCLC cells and radiation-resistant NSCLC cells. Furthermore, we identified nuclear factor erythroid 2-related factor 2 (NRF2) as a critical target of radiosensitization effect of metformin, as the radiosensitization effect was abolished in NRF2 knockout cells. We also showed that metformin treatment increased the ubiquitination and proteasomal degradation of NRF2 through a KEAP1-independent mechanism. The decrease of NRF2 led to reduced transcription of downstream antioxidant-related proteins, inhibited the initiation of DNA damage repair pathways, and compromised G2/M phase arrest after radiation. In an orthotopic transplanted tumor model in nude mice, metformin treatment reduced NRF2 levels and led to fewer lung tumor nodules. Combination of irradiation further potentiated the antitumor efficacy compared to each of the single treatments. In conclusion, our results suggest that the degradation of NRF2 that is induced by metformin may play a pivotal role in radiosensitizing NSCLC cells and that metformin can be developed as a sensitizer of radiotherapy against lung cancer.

Background: Serum uric acid (SUA) is a major antioxidant molecule in the human blood. It provides a protective role in red blood cells (RBCs) and hemoglobin (Hb) by antioxidant defense. However, studies directly assessing the association between SUA and anemia are rare. This study aimed to prospectively investigate the association between SUA and incident anemia in a general adult population. Methods: A total of 23,004 participants with no history of anemia were enrolled in the cohort study. SUA levels were measured by enzymatic colorimetric test. Hb was determined by sodium lauryl sulfate methemoglobin methods and anemia was defined as fasting blood Hb below 130g/L for men and 120 g/L for women. Cox proportional hazards regression models were used to examine the association of SUA with incident anemia. Results: A total of 1,268 first incident cases of anemia occurred during 87,835 person-years of follow-up (median follow-up of 4.2 years). The fully adjusted hazards ratios (95% confidence interval) of anemia across increasing quartiles of SUA were 1.00(reference), 0.80(0.49, 1.30), 0.71(0.42, 1.22) and 0.83(0.49, 1.43) ( P for trend=0.92) in men, 1.00(reference), 0.84(0.71, 0.99), 0.82(0.69, 0.97) and 0.72(0.60, 0.86) ( P for trend=0.0003) in women, respectively. When comparing hyperuricemia to the lowest SUA level, the fully adjusted HRs (95% CIs) were 0.87 (0.49, 1.54) ( P value=0.64) in men and 0.77 (0.57, 1.03) ( P value=0.07) in women. Conclusions: Higher SUA is significantly associated with lower risk of incident anemia in women with normouricemia. This suggests that SUA may be a protective factor in the early detection of individuals at risk of anemia. Funding: This study was supported by grants from the National Natural Science Foundation of China (No. 91746205 and 81941024). Declaration of Interest: The authors declared they have no potential conflicts of interest. Ethical Approval: The study protocol complied with the Declaration of Helsinki and was approved by the institutional review board of the Tianjin Medical University.

Background Chronic low-grade inflammation contributes to the pathogenesis of the metabolic syndrome (MetS). Although some studies have demonstrated that several standard inflammatory markers provide diagnostic value for MetS, few studies have compared the diagnostic ability of various inflammatory markers. We demonstrated the diagnostic ability of several inflammatory markers in detecting MetS. Methods Complement component 3 (C3), C4, high-sensitivity C-reactive protein (hs-CRP), leukocyte count, neutrophil, lymphocyte and neutrophil-to-lymphocyte ratio (NLR) concentrations were measured in 6312 participants living in Tianjin, China. MetS was defined according to American Heart Association criteria. Adjusted logistic models were used to assess associations between inflammatory markers and MetS. Receiver operating characteristic (ROC) curves were performed to determine the diagnostic values of inflammatory markers for MetS. Results The adjusted odds ratio (95% CI) of MetS for the highest inflammatory markers (C3, leukocyte, neutrophil, lymphocyte) quintile, when compared to the lowest quintile were 2.68 (2.12–3.38), 2.53 (2.05–3.11), 1.31 (1.06–1.62) and 1.94 (1.60–2.37), respectively. ROC analysis showed that the optimal cut-off values were 101.0 mg/dl for C3 (Area under the ROC curve (AUC) = 0.68), 5.41 × 1000 cells/mm3 for leukocyte (AUC = 0.63), 3.20 × 1000 cells/mm3 for neutrophil (AUC = 0.60) and 1.82 × 1000 cells/mm3 for lymphocyte (AUC = 0.62). No significant association was observed between the other inflammatory markers and MetS. Conclusions Among the inflammatory markers assessed in this population, C3 has the strongest diagnostic value in detecting MetS. Further studies are encouraged to determine the efficacy of applying C3 to diagnosis and treatment in the clinical setting.

To investigate the association between red cell distribution width (RDW) and elevation of glucose/glycated hemoglobin (HbA1c).An analysis was conducted using data from a prospective cohort study of adults. People without prediabetes or diabetes (n=7,795) were followed for a mean of 2.90years (range: 1-7years, 95% confidence interval: 2.86-2.94years). Glucose elevation is defined as fasting glucose levels exceeding 5.6mmol/l, or 2-hour glucose values in the oral glucose tolerance test exceeding 7.8mmol/l. HbA1c elevation is defined as a HbA1c value exceeding a normal limit of 39mmol/mol (5.7%). Adjusted Cox proportional hazards regression models were used to assess the association between RDW quartiles and elevation of HbA1c/glucose.The multiple-adjusted hazard ratios (95% confidence interval) of HbA1c elevation for increased quartiles of RDW were 1.00 (reference), 1.08 (0.89, 1.30), 1.28 (1.07, 1.54), and 1.54 (1.29, 1.85) (P for trend0.0001). However, no significant association was observed between RDW and blood glucose (fasting and postprandial).Elevated RDW is independently related to future HbA1c elevation, but not to glucose elevation. This suggests that RDW may associate with HbA1c through a non-glycemic way, which should be taken into consideration when using HbA1c as a diagnostic criterion of prediabetes or diabetes.

Aims Prediabetes has received public attention owing to the increasing prevalence worldwide. Mounting evidence has indicated that inflammation directly contributed to the etiology of glucose metabolism disorders. Although immunoglobulins play a crucial role in immune responses, little research has been done on the link between immunoglobulins and prediabetes in adults. Hence, the aim of the present study was to explore the associations between immunoglobulins levels and prevalence of prediabetes in a general adult population. Methods A cross-sectional study was conducted among 8856 adults (mean ± standard deviation age: 48.4 ± 10.7 years) in Tianjin, China. The serum immunoglobulins concentrations were measured by the immunonephelometric technique. Prediabetes was diagnosed using the following parameters in accordance with the American Diabetes Association: fasting plasma glucose, postprandial glucose and glycosylated hemoglobin. The associations between concentrations of immunoglobulins and the prevalence of prediabetes were assessed using multiple logistic regression models. Results Overall, the prevalence of prediabetes was 37.4% (3311/8856). After controlling for confounders, compared with the lowest quintile, the odds ratios (95% confidence interval) of prediabetes for the highest quintile of immunoglobulins (immunoglobulin G, immunoglobulin E, immunoglobulin M and immunoglobulin A) were as follows: 1.06 (0.91–1.23), 1.31 (1.13–1.52), 0.86 (0.74–1.01), and 1.19 (1.03–1.38) (P for trend were 0.35, Conclusions Elevated immunoglobulin E and immunoglobulin A levels were independently and positively associated with prediabetes prevalence. There was also a trending association between immunoglobulin M concentrations and prediabetes prevalence. Further studies are necessary to clarify if there is a causal association of immunoglobulins in prediabetes or if they reflect early immunologic disturbances in these patients.

Aim To comprehensively and exhaustively assess the relationship between serum ferritin levels and incidence of prediabetes in a prospective study. Methods This prospective cohort study ( n =7380) with a mean follow-up of 3.07 years (range: 1–7, 95% CI: 3.03–3.12) was conducted in Tianjin, China. Blood fasting glucose, oral glucose tolerance test, serum ferritin levels and other potentially confounding factors were measured at baseline and at each year of follow-up. Adjusted Cox proportional hazards regression models were used to assess the gender-specific relationship between baseline and mean serum ferritin quintiles and prediabetes. Results The incidence of prediabetes was 85 per 1000 person-years among men and 44 per 1000 person-years among women during follow-up (from 2007 to 2014). After adjusting for potential confounders, hazard ratios (95% CI) for prediabetes across baseline ferritin quintiles were: for men, 1.00, 1.13 (0.90–1.40), 1.20 (0.97–1.48), 1.41 (1.14–1.73) and 1.73 (1.41–2.11); and for women, 1.00, 1.01 (0.74–1.38), 0.68 (0.48–0.96), 0.84 (0.61–1.15) and 1.07 (0.80–1.45), respectively. Similar results were also observed for mean ferritin levels. Conclusion Both baseline and mean serum ferritin levels were significantly and linearly related to prediabetes in men, whereas U-shaped relationships were observed between baseline and mean serum ferritin and prediabetes in women. The relationship between prediabetes risk and mean serum ferritin levels may be more stable than one with baseline serum ferritin levels.

Background: Type 2 diabetes mellitus (T2DM) has emerged as a global epidemic due to lifestyle changes and urbanization. Numerous experimental studies have demonstrated that inflammation plays an important role in the etiology of T2DM. However, very few prospective studies are available on the link between immunoglobulins concentrations and risk of T2DM in adults. Hence, the aim of the present study was to investigate the associations between immunoglobulin levels and the risk of incident T2DM in a large cohort. Methods: The prospective study was performed among 6,245 adults in Tianjin, China. Participants without T2DM history were followed up for 1 to 8 years with a mean follow-up duration of 3*64 years. T2DM were diagnosed in accordance with the guidelines of the American Diabetes Association. Serum immunoglobulins levels were measured by the immunonephelometric assay. T2DM and immunoglobulins levels were assessed yearly during the follow-up. Multiple COX regression models were used to assess the association between serum immunoglobulin concentrations and the incidence of T2DM. Findings: The incidence of T2DM was 16*58 per 1,000 person-years. After multivariate adjustments, compared with the lowest quartiles, the hazard ratios (95% confidence intervals) of T2DM for the highest quartiles of IgG, IgE, IgM and IgA were 0*64(0*47-0*89), 1*01(0*75-1*35), 0*64(0*46-0*90) and 1*80(1*34-2*42) (P for trend were

As common trace evidence, heavy mineral oil is particularly essential in the field of forensic science. An approach based on spectral fusion analysis and chemometrics was proposed to realize the fast, accurate and nondestructive identification of heavy mineral oil. The spectral data of one hundred and sixty heavy mineral oil samples from different categories and manufacturers were collected by a Fourier transform Raman spectroscopy. These heavy mineral oil samples were analyzed by chemometric methods, including principal component analysis (PCA), a radial basis function (RBF), a multilayer perceptron (MLP), a k-nearest neighbor (KNN) algorithm and Fisher discriminant analysis (FDA), and the results were discussed. The results showed that the models based on the fused spectra had a higher identification capacity than the individual data. Among them, the fusion models based on the first and second derivative spectra were superior to the other models. Compared with the KNN model, the RBF, MLP and FDA models reached 100.0% accuracy for the 5 categories of the 160 samples. For the different brands in the same category, the RBF, MLP, and FDA model further realized 98.1%, 100.0%, and 100.0% accuracy, respectively, which was ideal. As an emerging analysis technology, fusion spectroscopy is worthy of promotion and application in forensic science and other fields. The identification ability of models could be improved and strengthened by derivative processing of the spectra. The FDA model based on the first and second derivative spectral data treated by PCA was a more useful and practical approach than the other models for identifying the 160 heavy mineral oil samples.