• 期刊

Association between serum ferritin and non-alcoholic fatty liver disease among middle-aged and elderly Chinese with normal weight

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) in normal-weight population is becoming an important health issue. This study aimed to assess the association between serum ferritin (SF) and NAFLD among middle-aged and elderly Chinese with normal weight. Methods and Study Design: A total of 2029 Chinese adults aged 35-70 years with normal weight were involved in this cross-sectional study. General information, lifestyle factors and laboratory characteristics were collected. The concentrations of serum alanine aminotransferase (ALT) and SF were recorded. Receiver operating characteristic (ROC) was applied to assess predictive performance of SF for NAFLD. Logistic regression analysis was conducted to evaluate the associations of SF with NAFLD and elevated ALT. Results: Compared with controls, subjects with NAFLD had higher SF concentrations (p＜0.001). In multivariate logistic regression analyses, the odds ratios (ORs) with 95% confidence intervals (CIs) of NAFLD were 3.19 (2.07-4.92) for the highest versus lowest quartile of SF. ROC analysis revealed a predictive ability of SF for NAFLD with an area under the curve of 0.660 (95% CI, 0.63-0.69). In addition, higher SF was significantly associated with increased risk of elevated ALT (OR=1.84, 95% CI: 1.32-2.55). In stratified analyses by gender and age, the positive associations of SF with the risk of NAFLD and elevated ALT were only observed in women and 35~49y group. Conclusions: SF was positively associated with the risk of NAFLD and elevated ALT among normal-weight Chinese adults. ROC analysis suggested that SF may serve as an indicator of predicting NAFLD.

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Higher serum magnesium concentration is associated with lower hearing thresholds and risk of hearing loss among a Chinese population

Background and Objectives: Hearing loss is a sensory impairment caused by genetic and environmental factors. Previous epidemiological studies of magnesium intake and hearing loss have yielded conflicting results. Methods and Study Design: We investigated the association between serum magnesium concentrations and hearing loss in a population from the Zhejiang region of China. A cross-sectional study of 3,267 participants aged 18 years and older from five hospitals was conducted from October 2016 to May 2018. An audiometric examination was conducted, and hearing thresholds were computed as pure-tone averages (PTAs) at speech (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz). Magnesium concentrations were measured using an inductively coupled plasma mass spectrometer. Results: A linear regression analysis revealed a negative association between magnesium levels and hearing losses from lower to high PTAs. After the adjustment of potential confounders, participants in the highest magnesium quartile had a lower PTA (quartile 4: -1.89%; 95% confidence interval (CI: -3.07 to -0.701); p=0.022) and high PTA (quartile 4: -3.05%; 95% CI: -4.64 to -1.46; p=0.005) than those in the lowest quartile. A logistic regression analysis showed a dose-dependent reduction in the odds of high frequency hearing loss across magnesium quartiles. In model 3, after adjusting for all potential confounders, participants with the highest magnesium quartiles had a 54.0% (OR: 0.460; 95% CI: 0.339-0.587) reduction in the odds of high-frequency hearing loss. Conclusions: Higher whole blood levels of magnesium in this population were associated with lower hearing thresholds and risk of hearing loss.

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Association between serum copper and heart failure: a meta-analysis

Background and Objectives: Copper dyshomeostasis can lead to many diseases, including cardiovascular disease. However, there are conflicting reports on the relationship between serum copper and heart failure (HF). To explore the relationship between serum copper levels and HF by performing a meta-analysis. Methods and Study Design: The PubMed and ScienceDirect databases until June 2019 were searched for reports on the association between serum copper levels and HF. Results: A total of thirteen studies including 1504 subjects were chosen for the meta-analysis. The pooled analysis indicated that patients with HF had higher serum copper than the control subjects [standardized mean difference (SMD), 0.982; 95% confidence interval (CI), (0.679, 1.285)]. Subgroup analysis stratified by different geographic locations found that HF patients had higher copper than the control subjects in Asia and Europe [Asia: SMD, 0.948 and 95% CI, (0.569, 1.327); Europe: SMD, 1.275 and 95% CI, (0.633, 1.917)], but not in America [America: SMD, 0.637 and 95% CI, (-0.109, 1.383)]. Additionally, subgroup analysis revealed that patients with ischemic cardiomyopathy (ICM) [SMD, 1.171; 95% CI, (0.717, 1.624)], idiopathic dilated cardiomyopathy (IDCM) [SMD, 0.569; 95% CI, (0.097, 1.042)] and other types of HF [SMD, 1.152; 95% CI, (0.594, 1.710)] all had higher copper levels than controls. Further subgroup analysis stratified by Newcastle-Ottawa Scale (NOS) scores also found higher serum copper in patients with HF than controls within each subgroup. Conclusions: Our meta-analysis identified a significant association between high serum copper and HF.

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Dietary intakes of fruits and vegetables and lung cancer risk in participants with different smoking status: A meta-analysis of prospective cohort studies

Background and Objectives: The results from epidemiological studies are controversial between vegetable and fruit consumption and lung cancer risk in participants with different smoking status. The present meta-analysis aimed to investigate these associations with prospective cohort studies. Meanwhile, the potential dose-response relationship was evaluated. Methods and Study Design: Relevant studies were identified with PubMed and Scopus databases up to June 2019. Multivariate-adjusted relative risks for the highest versus the lowest category and 95% confidence intervals were calculated by using a random-effects model. The dose-response relationship was examined by using restricted cubic spline regression model. Results: Eight prospective studies were included for data synthesis. The summary estimates indicated that higher vegetable and fruit intake was significantly associated with lower risk of lung cancer in participants with current smokers (RR: 0.84, 95% CI: 0.73, 0.95; I^2=25.2%). No significant association was found in former smokers (RR: 0.97, 95% CI: 0.88, 1.07; I^2=15.0%) and never smokers (RR: 0.90, 95% CI: 0.74, 1.11; I^2=6.6%). Dose-response analysis showed that 100 g/day increment of vegetable and fruit intake was associated with a 2% reduction in lung cancer risk among current smokers (95% CI: 0.97, 0.99). Conclusions: The present meta-analysis provides significant evidence of an inverse association between vegetable and fruit intake and lung cancer risk in current smokers.

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Citrus fruit intake and the risk of nasopharyngeal carcinoma

Background and Objectives: Citrus fruit are suggested to be associated with reduced risk of nasopharyngeal carcinoma (NPC), but findings from epidemiologic studies have been inconsistent. We aimed to synthesize the association by conducting a meta-analysis of existing evidence. Methods and Study Design: Databases including Medline, EMBASE, Web of science, and the Cochrane Library were searched for eligible studies up to March 2019 using a series comprehensive searching terms. The adjusted odds ratios (ORs) of citrus fruit intake with NPC risk from each study were extracted to calculate a pooled association estimate with its 95% confidence interval (CI). Results: Nine studies totaling 3304 cases and 3850 controls were included in this analysis. Citrus fruit intake was significantly associated with reduced risk of NPC (OR: 0.72, 95% CI 0.58-0.91, p=0.005). In addition, this association tended to be stronger in Chinese (OR: 0.67, 95% CI 0.54-0.84, p＜0.001). Dose-response analysis using cubic splines showed the risk of NPC decreased by 21% for citrus fruit intake of 4 times/week (OR: 0.79, 95% CI 0.66-0.94). Conclusions: Consumption of citrus fruit was associated with a significantly reduced risk of NPC, especially in Chinese.

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Postpartum anemia is a neglected public health issue in China: a cross-sectional study

Background and Objectives: Anemia impairs the health and wellbeing of women and increases the risk of maternal and neonatal adverse outcomes. The objectives of this study are to determine the prevalence of postpartum anemia among urban lactating women; investigate the predictors of anemia and explore the potential health effects on lactating performance. Methods and Study Design: Multi-stage sampling methods were used to recruit 495 lactating women from 3 cities of China. Blood and breast milk samples were collected to analyze hemoglobin levels and iron content, respectively. The intakes and sources of iron-rich food and nutrients were investigated based on Food Frequency Questionnaire and 24 h dietary recall. Results: The overall prevalence of postpartum anemia was 32.7%; no cases of severe anemia were encountered. Women who living in Guangzhou had a significant higher anemia prevalence. Regards to dietary intake, the amount of iron intake was generally good with a high proportion of heme iron. The animal sources ratio was 23.0%. Total iron intake and the sources of iron were not associated with anemia. Vitamin C intake was significantly higher in non-anemic women (Median (25th, 75th) was (72.6 (38.4, 130.0) mg/d)) than anemic women (54.7 (30.7, 111.3) mg/d). Other nutrient enhancers were not associated with anemia. There were no significant differences in the iron content of breast milk between women with and without anemia (r=0.047, p=0.302). Conclusions: Postpartum anemia is common in urban Chinese women. A combination of interventions, including managing antenatal anemia and correcting inappropriate dietary habits will help to prevent postpartum anemia.

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Colostral and mature breast milk protein compositional determinants in Qingdao, Wuhan and Hohhot: maternal food culture, vaginal delivery and neonatal gender

Background and Objectives: Breast milk proteins are essential to infants as they provide nutrition and protection. This study evaluated multiple factors that might influence breast milk proteins to identify the determinants that lead to inter-individual and longitudinal differences. Methods and Study Design: Five major breast milk proteins (β-casein, α-lactalbumin, lactoferrin, serum albumin and κ-casein) from breast milk samples collected from 55 mothers in three cities (Hohhot, Wuhan and Qingdao) in China were analyzed using a validated ultra-performance liquid chromatography-mass spectrometry method. Various factors were statistically evaluated for their associations with breast milk proteins: mother's age, parity, delivery mode, infant gender and infant birth-weight. Results: Although decreased in concentrations, the proportions of β-casein and α-lactalbumin increased from colostrum (33.8% and 26.8%) to mature milk (40.3% and 31.6%), respectively. Mothers of older age were found to produce a lower concentration of total protein. Compared with vaginal delivery, caesarean section was associated with lower concentrations of κ-casein, lactoferrin and β-casein in mature milk. Infant gender influenced breast milk proteins in colostrum: mothers who delivered a girl tended to produce more κ-casein, lactoferrin and total protein. Furthermore, regional differences were found, and mothers from Hohhot produced significantly higher concentrations of α-lactalbumin and lactoferrin than those from Qingdao and Wuhan. This regional difference might be linked to the different dietary patterns of these mothers among cities. Conclusions: Our study deepens the understanding of breast milk protein dynamics in Chinese population and provides evidence on potential determinants, which can serve as guidance for infant nutrition optimization.

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The association between parental weight status and risk of hypertension in children aged 6 to 12 years

Background and Objectives: Parents may play important roles in the regulation of children's weight status and consequently the development of childhood hypertension. Thus, this study aimed to examine parental weight status, as a marker of parents' diet and lifestyle, in relation to risk of hypertension in their children. Methods and Study Design: A total of 1,949 children aged 6 to 12 years (1,012 girls, 52%) and their parents were included. Information on demographics, anthropometrics, lifestyle, diet, and medical history were obtained from the participants and their parents through self-administered questionnaires. Childhood hypertension and elevated blood pressure were defined as SBP and/or DBP ≥95th and ≥90th age- and gender-specific percentile, respectively. Parental overweight was defined as BMI ≥24.0 kg/m^2. Results: The prevalence of childhood hypertension was 8.4%, with no significant gender difference (p=0.36). Parents' weight status, especially maternal, was associated with childhood hypertension. After adjustment for potential confounders, children with two parents being overweight were two times more likely to have hypertension as compared with children who had both parents being of normal weight [multivariable-adjusted odds ratio=2.09; 95% confidence interval: (1.26, 3.46)]. After further adjustment for children's body mass index, the observed association was substantially attenuated and became statistically non-significant. Conclusions: Findings from this study suggest that parental weight status is associated with the prevalence of hypertension in children presumably through influencing children's weight. Further studies are needed to establish causal inference. This study highlights the importance of parental lifestyle in children's health.

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Associations between iron status and insulin resistance in Chinese children and adolescents: findings from the China Health and Nutrition Survey

Background and Objectives: Iron homeostasis abnormalities are associated with insulin resistance (IR), but studies on such associations in children and adolescents are limited and have contrasting results. The purpose of this study was to determine the associations between indicators of iron status and IR, and assesse if there are sex disparities in these associations. Methods and Study Design: We selected data of 689 children and adolescents (367 boys and 322 girls) aged 6-18 years in the analysis. Serum ferritin, transferrin, and soluble transferrin receptor (sTfR) levels were determined. The level of glycated hemoglobin (HbA1c) was assessed using high-performance liquid chromatography. Homeostasis model assessment of insulin resistance (HOMA-IR) was used to indicate the status of insulin resistance. Stepwise and multivariate logistic regression analyses were computed to evaluate associations between iron status and glucose parameters. Results: The prevalence of IR (HOMA-IR ＞3.16) and high HbA1c (HbA1c ≥5.7%) were 29.8% and 16.4%, respectively. Serum transferrin and sTfR were significant associated with HbA1c (p＜0.001), while serum transferrin was associated with HOMA-IR (p＜0.001). Furthermore, the highest transferrin concentrations were associated with higher risks of both HOMA-IR and high HbA1c, while decreased sTfR concentrations were associated with a risk of higher HbA1c in both children and adolescents. Conclusions: Serum transferrin and sTfR were statistically significantly associated with glucose parameters, which may suggest that transferrin and sTfR levels should be taken into consideration when studying IR in both boys and girls.

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Nutritional potential of underutilized food crops to improve diet quality of young children in food insecure prone areas of Madura Island, Indonesia

Background and Objectives: Attention is currently given to the nutrition potential of underutilized food crops; however, only few studies have focused on this potential for young children. We investigate the nutrient composition of selected underutilized food crops in Bangkalan District, Madura Island, Indonesia, to determine its potential in meeting the nutritional needs of young children during the complementary feeding period. Methods and Study Design: We obtained data on the availability of underutilized food crops from a cross-sectional study conducted in 2014 in Bangkalan District, Indonesia, and nutrient composition primarily from the Indonesian Food Composition Database. We considered underutilized food crops to hold nutritional potential if they contributed at least 15% per 100 g edible portion recommended nutrient intake for children aged 6-11 months and 12-23 months or 5% recommended nutrient intake per 100 kcal for iron, zinc, calcium, niacin and folate. Results: We identified nutritionally potential underutilized food crops from several food groups, including Sorghum bicolor, Canna edulis, Colocasia esculenta (the starchy roots and leaves), Plectranthus rotundifolius, Amorphophallus paeoniifolius, Moringa oleifera (the leaves and pods), Limonia acidissima, and Benincasa hispida-all of which can be utilized for formulating the complementary feeding diet of young children. Conclusions: In a food insecure area where malnutrition is prevalent, underutilized food crops have potential to improve the nutrient intake of young children in their complementary feeding period. These should be promoted through the creation of acceptable recipes and formulation of complementary feeding recommendations, which include these underutilized nutrient-dense crops.