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Objective·To evaluate the relationship between body mass index (BMI) and chronic metabolic diseases.Methods·The elderly (≥60 years old) who were underwent physical examination in the Physical Examination Center of Renji Hospital, Shanghai Jiao Tong University School of Medicine from 2014 to 2021 were studied. Their results of biochemical indicators were collected. Their height, body weight, and blood pressure were measured by trained nurses. The history of chronic metabolic diseases was collected by self-reported questionnaire. Systolic blood pressure ≥140 mmHg (1 mmHg=0.133 kPa), diastolic blood pressure ≥90 mmHg, or self-reported hypertension history was defined as hypertension. Fasting blood glucose ≥7.0 mmol/L or self-reported history of diabetes was defined as diabetes. Total cholesterol≥6.2 mmol/L, triglyceride≥2.3 mmol/L, or self-reported history of dyslipidemia was defined as dyslipidemia. The relationship between BMI and hypertension, diabetes, and dyslipidemia was evaluated by using receiver operator characteristic (ROC) curve analysis and binary logistic regression.Results·Data of 59 083 subjects were collected [30 807 men and 28 276 women, average age: (67.9±6.3) years old]. The prevalence of hypertension, diabetes and dyslipidemia was 76.5% (45 219/59 083), 24.1% (14 225/59 083) and 50.0% (29 544/59 083), respectively. Compared to the elderly people aged 60‒74 years, those aged 75 years and above had a higher proportion of hypertension and diabetes, and a lower proportion of dyslipidemia and no metabolic abnormalities. With ROC analysis, the BMI cut-off values for hypertension, diabetes, and dyslipidemia were 24.3, 23.9, and 23.9 kg/m2. The BMI cut-off values for hypertension and diabetes in elderly men were similar to those in elderly women (for hypertension: 24.3 kg/m2 in elderly men vs 24.2 kg/m2 in elderly women; for diabetes: 24.0 kg/m2 in elderly men vs 23.7 kg/m2 in elderly women); however, BMI cut-off value for dyslipidemia was obviously higher in elderly men than that in elderly women (24.0 kg/m2 in elderly men vs 22.5 kg/m2 in elderly women). The BMI cut-off value for chronic metabolic diseases was higher in the elderly people aged 60‒74 years than that in the elderly people aged 75 years and above (24.2‒24.7 kg/m2 vs 22.9‒23.8 kg/m2).Conclusion·Elderly people aged 60‒74 years should maintain the BMI below 24.0 kg/m2, while those aged 75 years and above should aim for the BMI below 23.0 kg/m2, so as to reduce the risk of chronic metabolic diseases.

Background: Data is limited on the prevalence of hypophosphatemia in general hospitalized patients, and its association with length of hospital stay (LOS) and mortality remained unclear. We aimed to investigate the prevalence of admission phosphate abnormality and the association between serum phosphate level and length of hospital stay and all-cause mortality in adult patients. Methods: This was a multi-center retrospective study based on real-world data. Participants were classified into five groups according to serum phosphate level (inorganic phosphorus, iP) within 48 h after admission: G1, iP < 0.64 mmol/L; G2, iP 0.64–0.8 mmol/L; G3, iP 0.8–1.16 mmol/L; G4, iP 1.16–1.45 mmol/L; and G5, iP ≥ 1.45 mmol/L, respectively. Both LOS and in-hospital mortality were considered as outcomes. Clinical information, including age, sex, primary diagnosis, co-morbidity, and phosphate-metabolism related parameters, were also abstracted from medical records. Results: A total number of 23,479 adult patients (14,073 males and 9,406 females, aged 57.7 ± 16.8 y) were included in the study. The prevalence of hypophosphatemia was 4.74%. An "L-shaped" non-linear association was determined between serum phosphate level and LOS and the inflection point was 1.16 mmol/L in serum phosphate level. Compared with patients in G4, patients in G1, G2 or G3 were significantly associated with longer LOS after full adjustment of covariates. Each 0.1 mmol/L decrease in serum phosphate level to the left side of the inflection point led to 0.64 days increase in LOS [95% confidence interval (CI): 0.46, 0.81; p for trend < 0.001]. But there was no association between serum phosphate and LOS where serum levels of phosphate ≥ 1.16 mmol/L. Multivariable logistic regression analysis showed that adjusted all-cause in-hospital mortality was 3.08-fold greater in patients in G1 than those in G4 (95% CI: 1.52, 6.25; p for trend = 0.001). Similarly, no significant association with either LOS or mortality were found in patients in G5, comparing with G4. Conclusions: Hypophosphatemia, but not hyperphosphatemia, was associated with LOS and all-cause mortality in adult inpatients. It is meaningful to monitor serum levels of phosphate to facilitate early diagnosis and intervention. [ABSTRACT FROM AUTHOR]

Objective. The association between vitamin D status and inflammation remains unclear in hospitalized patients. Materials and Methods. We performed the current study based on real-world data from two teaching hospitals. Serum level of vitamin D (assessed by 25-hydroxyvitamin D) was evaluated within 2 days after admission. All the patients were further classified into three groups: deficiency (<12 ng/mL), insufficiency (12–20 ng/mL), and adequate (≥20 ng/mL). White blood cell (WBC) count, serum level of C-reactive protein (CRP), and procalcitonin were also measured and used to evaluate inflammation. Other potential covariates were abstracted from medical records. Charlson comorbidity index (CCI) was calculated to assess the severity of disease. Results. A total number of 35,528 hospitalized adult patients (21,171 men and 14,357 women) were included. The average age and BMI were 57.5 ± 16.2 years and 23.4 ± 3.7 kg/m2, respectively, while medium vitamin D level was 16.1 ng/mL (interquartile range: 11.4 ng/mL, 21.6 ng/mL) and median CCI was one point (interquartile range: 0 point, two points). The prevalence of deficiency and insufficiency was 28.0% and 40.5%. Multivariate linear regression model showed that serum level of vitamin D was significantly associated with WBC and CRP but not associated with procalcitonin. Each standard deviation (≈7.4 ng/mL) increase in vitamin D was associated with a decrease in WBC by 0.13 × 109/mL (95% CI: 0.2 × 109/mL, 0.06 × 109/mL) and 0.62 mg/L (95% CI: 0.88 mg/L, 0.37 mg/L) for CRP. Subgroup analysis and sensitivity analysis (excluding those whose eGFR <60 ml/min/1.73 m2, those whose daily calorie intake <1,000 kcal, and those who were recruited from Xin Hua hospital) generated similar results. Conclusions. The deficiency and insufficiency of vitamin D in the hospitalized adult patients was very common. However, the results should be interpreted with caution for limited representation of the whole inpatients. Low level of vitamin D was associated with inflammatory biomarkers, which provide the evidences to early intervention for lower the risk of infection. [ABSTRACT FROM AUTHOR]

Whether paternal epigenetic changes resulting from nutrition might be inherited by their offspring remains unknown. This study evaluated the relationship between preconception paternal body weight and their offspring's birth weight in 1,810 Chinese mother-father-baby trios. Information on paternal and maternal preconception body weight and height was collected via a self-reported questionnaire. Birth weight was collected from medical records. Paternal preconception body weight was associated with offspring's birth weight (p trend =.02) after multivariate adjustment. Each standard deviation increment of paternal body mass index was associated with an additional 29.6 g increase of birth weight (95% confident interval: 5.7 g, 53.5 g). The association was more pronounced in male neonates, and neonates with overweight mothers, and with mothers who gained excessive gestational weight, compared to their counterparts (all p interaction <.05). Sensitivity analyses showed similar pattern to that of the main analysis. Paternal preconception body weight was associated with birth weight of their offspring. What is already known on this subject? More efforts have previously been put on the maternal contribution to birth weight, however, it is uncertain whether paternal pre-conceptional body weight, an indicator for epigenetic information, might be inherited by their offspring. What do the results of this study add? In the current study that included 1,810 Chinese mother-father-baby trios, a small but significant association was observed between paternal preconception body weight and offspring's birth weight (p trend =.02). What are the implications of these findings for clinical practice and/or further research? Paternal epigenetic information of nutrition could be inherited by their offspring. [ABSTRACT FROM AUTHOR]

Objective: We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults.Design: Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up.Results: Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis.Conclusion: BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults. [ABSTRACT FROM AUTHOR]