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  • 文章类型: Journal Article
    背景:不同的减肥策略对健康的影响差异很大,以及减肥策略之间的关系,特别是多种策略的组合,死亡仍不清楚。我们旨在研究各种数量和组合的减肥策略与全因死亡率和特定原因死亡率的关联,并进一步评估不同总体重减轻量与死亡率的关联。
    方法:使用来自NHANES(1999-2018)的48,430名20岁及以上参与者的数据,我们收集了14项自我报告的减肥策略,并使用潜在类别分析确定了5个集群.使用Cox比例风险模型来检查体重减轻策略的数量和集群与死亡率之间的关联。
    结果:在48,430名参与者的平均9.1年随访中,记录了7,539例死亡(包括1,941例心血管疾病和1,714例癌症)。采用2、3-4和≥5种减肥策略的参与者全因死亡率风险较低,HR为0.88(95%CI,0.81至0.97),0.89(95%CI,0.81至0.96)和0.71(95%CI,0.61至0.82)。无论减肥或体重增加的类别,随着减重策略数量的增加,死亡率有显著下降趋势(P趋势<0.05).采用第1组(四项战略)的与会者,第2组(五种策略)和第3组(三种策略)的全因死亡率风险明显降低,HR为0.71(95%CI,0.60至0.84),0.70(95%CI,0.55至0.89)和0.81(95%CI,0.70至0.94)。其中,集群1和集群2的特征都是少吃食物,锻炼,多喝水,降低卡路里和少吃脂肪。相反,集群4(五种策略)和集群5(四种策略)的影响不显著,他们都有更高的实际总能量摄入量。对于CVD和癌症死亡率观察到类似的关联。
    结论:采用两种或两种以上的减肥策略可以降低死亡风险,即使是那些体重增加的人。少吃食物,锻炼,多喝水,降低卡路里和少吃脂肪是更好的组合策略。在此基础上,限制总能量的实际摄入是必要的。
    BACKGROUND: The health effects of different weight loss strategies vary greatly, and the relationship between weight loss strategies, especially the combination of multiple strategies, and death is still unclear. We aimed to examine the associations of various numbers and combinations of weight loss strategies with all-cause and specific-cause mortality and to further evaluate the associations of different total weight loss volumes with mortality.
    METHODS: Using data from NHANES (1999-2018) with 48,430 participants aged 20 and above, we collected fourteen self-reported weight loss strategies and identified five clusters using latent class analysis. Cox proportional hazards models were used to examine the association between the amounts and clusters of weight loss strategies and mortality.
    RESULTS: During a median follow-up of 9.1 years of 48,430 participants, 7,539 deaths were recorded (including 1,941 CVDs and 1,714 cancer). Participants who adopted 2, 3-4, and ≥ 5 weight loss strategies had a lower risk of all-cause mortality, with HRs of 0.88 (95% CI, 0.81 to 0.97), 0.89 (95% CI, 0.81 to 0.96) and 0.71 (95% CI, 0.61 to 0.82). Regardless of weight loss or weight gain categories, there was a significant trend toward reduced mortality as the number of weight loss strategies increased (P trend < 0.05). Participants who adopted cluster-1 (four strategies), cluster-2 (five strategies) and cluster-3 (three strategies) had a significantly lower risk of all-cause mortality, with HRs of 0.71 (95% CI, 0.60 to 0.84), 0.70 (95% CI, 0.55 to 0.89) and 0.81 (95% CI, 0.70 to 0.94). Among them, cluster-1 and cluster-2 are both characterized by eating less food, exercising, drinking plenty of water, lowering calories and eating less fat. Conversely, cluster-4 (five strategies) and cluster-5 (four strategies) had marginally significant effects, and they both had actual higher total energy intakes. Similar associations were observed for CVDs and cancer mortality.
    CONCLUSIONS: Employing two or more weight loss strategies was associated with a lower risk of death, even among those who gained weight. Eating less food, exercising, drinking plenty of water, lowering calories and eating less fat is a better combination of strategies. On this basis, limiting the actual intake of total energy is necessary.
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  • 文章类型: Journal Article
    本研究检查了血红蛋白糖化指数(HGI)与高血压患者死亡风险之间的关系,并探讨了性别特异性影响。
    分析了1999年至2018年国家健康与营养检查调查(NHANES)的数据。构建了三个模型来评估HGI和死亡风险之间的关系,控制各种协变量。使用受限三次样条(RCS)和阈值效应分析探索了非线性关系。
    这些发现揭示了在调整多个协变量后,HGI与心血管疾病(CVD)和全因死亡率之间的U形关系。性别特异性分析表明男性是U型关系,阈值点分别为-0.271和0.115。在阈值点之前,HGI与CVD死亡率(HR:0.64,95CI:0.44,0.93,P=0.02)和全因死亡率(HR:0.84,95CI:0.71,0.99)呈负相关,在阈值点之后,HGI与CVD死亡率(HR:1.48,95CI:1.23,1.79,P<0.01)和全因死亡率(HR:1.41,95CI:1.24,1.60)呈正相关。相比之下,在女性中,HGI与CVD死亡率呈J型关系,与全因死亡率呈L型关系。在阈值点之前,全因死亡率风险降低(HR:0.66,95CI:0.56,0.77,P=0.04),在阈值点之后,随着HGI的增加,CVD死亡率的风险逐渐增加(HR:1.39,95CI:1.12,1.72,P<0.01)。
    该研究强调了在高血压患者中维持适当的HGI水平的重要性,并验证了HGI是心血管和全因死亡风险的显着指标。它还强调了性别在HGI与这些风险之间的关系中的重要作用。
    UNASSIGNED: This study examines the association between Hemoglobin Glycation Index (HGI) and the risk of mortality among individuals with hypertension and to explore gender-specific effects.
    UNASSIGNED: Data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were analyzed. Three models were constructed to assess the relationship between HGI and mortality risks, controlling for various covariates. Nonlinear relationships were explored using restricted cubic splines (RCS) and threshold effect analysis.
    UNASSIGNED: The findings reveal a U-shaped relationship between HGI and the cardiovascular disease (CVD) and all-cause mortality after adjusting for multiple covariates. Gender- specific analysis indicated a U-shaped relationship in men, with threshold points of -0.271, and 0.115, respectively. Before the threshold point, HGI was negatively associated with CVD mortality (HR: 0.64, 95%CI: 0.44, 0.93, P=0.02) and all-cause mortality (HR: 0.84, 95%CI: 0.71, 0.99), and after the threshold point, HGI was positively associated with CVD mortality (HR: 1.48, 95%CI: 1.23, 1.79, P<0.01) and all-cause mortality (HR: 1.41, 95%CI: 1.24, 1.60). In contrast, HGI had a J-shaped relationship with CVD mortality and a L-shaped relationship with all-cause mortality in females. Before the threshold points, the risk of all-cause mortality decreased (HR: 0.66, 95%CI:0.56, 0.77, P=0.04) and after the threshold points, the risk of CVD mortality increased (HR: 1.39, 95%CI:1.12, 1.72, P<0.01) progressively with increasing HGI.
    UNASSIGNED: The research highlights the significance of maintaining proper HGI levels in individuals with hypertension and validates HGI as a notable indicator of cardiovascular and all-cause mortality risks. It also highlights the significant role of gender in the relationship between HGI and these risks.
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  • 文章类型: Journal Article
    目标:广泛的癌症幸存者中心血管相关和全因死亡风险的证据很少,但需要为预防和管理提供信息。方法:我们使用来自美国连续国家健康和营养调查(NHANES)和相关死亡率随访文件的信息进行了全国性的前瞻性队列研究。可供公共访问。进行1:1比例的倾向评分匹配分析,以减少有和没有癌症的参与者之间的基线差异。使用加权Cox比例风险回归检查癌症状态与心血管相关和全因死亡风险之间的关系。还进行了独立分层分析和癌症特异性分析。结果:研究样本包括44,342名参与者,年龄20-85岁,1999年至2018年期间接受采访。其中,4149名参与者患有癌症。全因死亡发生在6,655名参与者中,其中2053人死于心血管疾病。倾向评分匹配确定了4,149对匹配的患者。完全校正的Cox比例风险回归表明,在倾向评分匹配之前和之后,癌症与心血管相关和全因死亡率的风险升高有关。分层分析和癌症特异性分析证实了结果的稳健性。结论:我们的研究证实癌症与心血管相关和全因死亡率密切相关。即使在调整了可能影响风险的其他因素之后,包括美国心脏协会(AHA)的生活简单7心血管健康评分,年龄,性别,种族,婚姻状况,收入,和教育水平。
    Objectives: Evidence on cardiovascular-related and all-cause mortality risks in a wide range of cancer survivors is scarce but needed to inform prevention and management. Methods: We performed a nationwide prospective cohort study using information from the Continuous National Health and Nutrition Examination Survey (NHANES) in the United States and the linked mortality follow-up files, available for public access. A propensity score-matched analysis with a 1:1 ratio was conducted to reduce the baseline differences between participants with and without cancer. The relationship between cancer status and the cardiovascular-related and all-cause mortality risk was examined using weighted Cox proportional hazards regression. Independent stratification analysis and cancer-specific analyses were also performed. Results: The study sample included 44,342 participants, aged 20-85, interviewed between 1999 and 2018. Of these, 4,149 participants had cancer. All-cause death occurred in 6,655 participants, of whom 2,053 died from cardiovascular causes. Propensity-score matching identified 4,149 matched pairs of patients. A fully adjusted Cox proportional hazards regression showed that cancer was linked to an elevated risk of cardiovascular-related and all-cause mortality both before and after propensity score matching. Stratification analysis and cancer-specific analyses confirmed robustness of results. Conclusion: Our study confirmed that cancer was strongly linked to cardiovascular-related and all-cause mortality, even after adjusting for other factors that could impact a risk, including the American Heart Association (AHA)\'s Life\'s Simple 7 cardiovascular health score, age, sex, ethnicity, marital status, income, and education level.
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  • 文章类型: Journal Article
    慢性阻塞性肺疾病(COPD)住院后的再入院率惊人地高,频繁的再入院代表着更高的死亡风险和沉重的经济负担。然而,关于COPD患者全因再入院的信息有限.
    本研究旨在系统总结出院后30天和90天内全因COPD再入院率及其潜在危险因素。
    检索了8个电子数据库,以确定从开始到2022年8月1日关于COPD再入院的相关观察性研究。采用纽卡斯尔-渥太华量表进行方法学质量评价。我们采用随机效应模型或固定效应模型来估计合并的全因COPD再入院率和潜在危险因素。
    共纳入28项研究,其中27项和8项研究总结了30天和90天的全因再入院,分别。合并的30天和90天内的全因COPD再入院率分别为18%和31%。分别。世界卫生组织区域最初被认为是异质性的来源。我们确定了酒精的使用,排放目的地,前一年两次或两次以上住院,以及心力衰竭等合并症,糖尿病,慢性肾病,贫血,癌症,或肿瘤作为全因再入院的潜在危险因素,而女性和肥胖是保护因素。
    COPD患者的全因再入院率很高,我们还发现了一些潜在的风险因素。因此,迫切需要加强早期随访和有针对性的干预措施,出院后调整或避免危险因素,从而减轻因频繁再入院而造成的重大卫生经济负担。
    该系统评价和荟萃分析方案在PROSPERO进行了前瞻性注册(编号:CRD42022369894)。
    The readmission rate following hospitalization for chronic obstructive pulmonary disease (COPD) is surprisingly high, and frequent readmissions represent a higher risk of mortality and a heavy economic burden. However, information on all-cause readmissions in patients with COPD is limited.
    This study aimed to systematically summarize all-cause COPD readmission rates within 30 and 90 days after discharge and their underlying risk factors.
    Eight electronic databases were searched to identify relevant observational studies about COPD readmission from inception to 1 August 2022. Newcastle-Ottawa Scale was used for methodological quality assessment. We adopt a random effects model or a fixed effects model to estimate pooled all-cause COPD readmission rates and potential risk factors.
    A total of 28 studies were included, of which 27 and 8 studies summarized 30- and 90-day all-cause readmissions, respectively. The pooled all-cause COPD readmission rates within 30 and 90 days were 18% and 31%, respectively. The World Health Organization region was initially considered to be the source of heterogeneity. We identified alcohol use, discharge destination, two or more hospitalizations in the previous year, and comorbidities such as heart failure, diabetes, chronic kidney disease, anemia, cancer, or tumor as potential risk factors for all-cause readmission, whereas female and obesity were protective factors.
    Patients with COPD had a high all-cause readmission rate, and we also identified some potential risk factors. Therefore, it is urgent to strengthen early follow-up and targeted interventions, and adjust or avoid risk factors after discharge, so as to reduce the major health economic burden caused by frequent readmissions.
    This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (no. CRD42022369894).
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  • 文章类型: Journal Article
    本研究旨在通过检查全因死亡率和心血管(CVD)事件死亡率的预后因素,开发两个预测列线图,用于评估血液透析(HD)患者的长期生存状态。
    本研究共纳入551名平均年龄超过60岁的HD患者。从我们医院收集患者的医疗记录,并随机分配到两个队列:训练队列(n=385)和验证队列(n=166)。我们采用多变量Cox评估和精细灰色比例风险模型来探索HD患者全因死亡率和心血管事件死亡风险的预测因素。根据预测因子建立两个列线图来预测患者3年、5年和8年的生存可能性。使用曲线下面积(AUC)评估两个模型的性能,校准图,和决策曲线分析。
    全因死亡率预测的列线图包括七个因素:年龄≥60岁,性别(男性),糖尿病和冠状动脉疾病史,舒张压,总甘油三酯(TG),和总胆固醇(TC)。心血管事件死亡率预测的列线图包括三个因素:糖尿病史和冠状动脉疾病,和总胆固醇(TC)。两种模式都表现出良好的鉴别力,3、5和8年全因死亡率的AUC值为0.716、0.722和0.725,分别,心血管事件死亡率为0.702、0.695和0.677,分别。校准图表明预测和决策曲线分析之间的良好一致性,证明了列线图的有利临床实用性。
    我们的列线图经过了很好的校准,并显示了显着的估计效率,为预测HD患者的预后提供了有价值的预测工具。
    UNASSIGNED: This study aimed to develop two predictive nomograms for the assessment of long-term survival status in hemodialysis (HD) patients by examining the prognostic factors for all-cause mortality and cardiovascular (CVD) event mortality.
    UNASSIGNED: A total of 551 HD patients with an average age of over 60 were included in this study. The patients\' medical records were collected from our hospital and randomly allocated to two cohorts: the training cohort (n=385) and the validation cohort (n=166). We employed multivariate Cox assessments and fine-gray proportional hazards models to explore the predictive factors for both all-cause mortality and cardiovascular event mortality risk in HD patients. Two nomograms were established based on predictive factors to forecast patients\' likelihood of survival for 3, 5, and 8 years. The performance of both models was evaluated using the area under the curve (AUC), calibration plots, and decision curve analysis.
    UNASSIGNED: The nomogram for all-cause mortality prediction included seven factors: age ≥ 60, sex (male), history of diabetes and coronary artery disease, diastolic blood pressure, total triglycerides (TG), and total cholesterol (TC). The nomogram for cardiovascular event mortality prediction included three factors: history of diabetes and coronary artery disease, and total cholesterol (TC). Both models demonstrated good discrimination, with AUC values of 0.716, 0.722 and 0.725 for all-cause mortality at 3, 5, and 8 years, respectively, and 0.702, 0.695, and 0.677 for cardiovascular event mortality, respectively. The calibration plots indicated a good agreement between the predictions and the decision curve analysis demonstrated a favorable clinical utility of the nomograms.
    UNASSIGNED: Our nomograms were well-calibrated and exhibited significant estimation efficiency, providing a valuable predictive tool to forecast prognosis in HD patients.
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  • 文章类型: Journal Article
    本研究旨在调查普通人群中睡眠持续时间与全因死亡率和心血管死亡率之间的相关性。
    共有26,977名年龄≥18岁的参与者被纳入2005年至2014年国家健康和营养调查(NHANES)数据库的分析。截至2019年12月,收集了心血管疾病和全因死亡的数据。使用结构化问卷评估睡眠时间,参与者根据报告的睡眠时间(≤5,6,7,8或≥9h)分为5组.采用Kaplan-Meier存活曲线来检查不同睡眠持续时间组的死亡率。利用多因素Cox回归模型来探讨睡眠持续时间与死亡率之间的关系。此外,我们采用限制性三次样条回归模型来确定睡眠时间与全因死亡率和心血管死亡率之间的非线性关系.
    参与者的平均年龄为46.23±18.48岁,49.9%的受试者是男性。在9.42年的中位随访期内,3,153名(11.7%)参与者死于全因死亡率,其中819例(3.0%)归因于心血管原因.睡眠时间≥9小时和≤5小时组的全因死亡率和心血管死亡率的累积生存率最低。分别。当使用7小时的睡眠持续时间作为参考时,在≤5小时内,全因死亡率的风险比(95%置信区间)为1.28(1.14-1.44),1.10(0.98-1.23)持续6小时,1.21(1.10-1.34)持续8小时,和1.53(1.35-1.73)≥9小时。心血管死亡率的风险比(具有95%置信区间)≤5小时为1.32(1.04-1.67),1.22(0.97-1.53)持续6小时,1.29(1.05-1.59)持续8小时,和1.74(1.37-2.21)≥9小时。观察到睡眠持续时间与全因死亡率和心血管死亡率之间的U形非线性关系,拐点阈值在7.32和7.04h,分别。
    研究结果表明,当睡眠时间约为7小时时,全因死亡和心血管死亡的风险降至最低。
    UNASSIGNED: This study aims to investigate the correlation between sleep duration and all-cause and cardiovascular mortality in the general population.
    UNASSIGNED: A total of 26,977 participants aged ≥18 years were included in the analysis from the National Health and Nutrition Examination Survey (NHANES) database covering the period from 2005 to 2014. Data on cardiovascular and all-cause deaths were collected until December 2019. Sleep duration was assessed using a structured questionnaire, and participants were categorized into five groups based on their reported sleep duration (≤5, 6, 7, 8, or ≥9 h). Kaplan-Meier survival curves were employed to examine the mortality rates across different sleep duration groups. Multivariate Cox regression models were utilized to explore the association between sleep duration and mortality. Additionally, a restricted cubic spline regression model was employed to identify the non-linear relationship between sleep duration and all-cause and cardiovascular mortality.
    UNASSIGNED: The average age of participants was 46.23 ± 18.48 years, with 49.9% of the subjects being male. Over a median follow-up period of 9.42 years, 3,153 (11.7%) participants died from all-cause mortality, among which 819 (3.0%) were attributed to cardiovascular causes. The groups with sleep durations of ≥9 and ≤5 h exhibited the lowest cumulative survival rates for all-cause mortality and cardiovascular mortality, respectively. When using a sleep duration of 7 h as the reference, the hazard ratios (with 95% confidence intervals) for all-cause mortality were 1.28 (1.14-1.44) for ≤5 h, 1.10 (0.98-1.23) for 6 h, 1.21 (1.10-1.34) for 8 h, and 1.53 (1.35-1.73) for ≥9 h. The hazard ratios (with 95% confidence intervals) for cardiovascular mortality were 1.32 (1.04-1.67) for ≤5 h, 1.22 (0.97-1.53) for 6 h, 1.29 (1.05-1.59) for 8 h, and 1.74 (1.37-2.21) for ≥9 h. A U-shaped non-linear relationship between sleep duration and all-cause and cardiovascular mortality was observed, with inflection point thresholds at 7.32 and 7.04 h, respectively.
    UNASSIGNED: The findings suggest that the risk of all-cause and cardiovascular mortality is minimized when sleep duration is approximately 7 h.
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  • 文章类型: Journal Article
    目的:糖基化缺口(GGAP)作用的证据,HbA1c与其他血糖估计值之间差异的指标,死亡率仍不清楚。这项研究旨在调查美国成年人Ggap与全因和心血管(CV)死亡率的关系。
    方法:这是一项回顾性队列研究,包括1999年至2004年国家健康和营养调查(NHANES)的12,909名个体参与者数据以及截至2019年12月31日的死亡率数据。使用加权Cox比例风险回归模型和有限的三次样条来研究Ggap与死亡率之间的关联。
    结果:在16.8年的中位随访中,3,528人死亡,包括1140例CV死亡。Ggap与全因死亡率和CV死亡率的关系呈U型(非线性均P<0.001)。与Ggap为0.09-0.38%(第61-80分)的个体相比,GGAP小于-0.83%(第1-5百分位数)的个体和GGAP大于0.90%(第96-100百分位数)的个体的多变量校正HR和95%CI分别为1.36(1.10,1.69)和1.21(1.00,1.45),心血管死亡率为1.77(1.16,2.71)和1.43(1.04,1.95)。与全因死亡率和心血管死亡率最低风险相关的GGap值在普通人群中为0.38%,在糖尿病患者中为0.78%。
    结论:我们发现Ggap与全因死亡率和CV死亡率之间存在U型关联,具有与死亡风险增加相关的显著正或负的GGAP值,可能是由于血糖变异性和果糖胺-3-激酶活性。本文受版权保护。保留所有权利。
    To investigate the relationship of the glycation gap (GGap) with all-cause and cardiovascular (CV) mortality in US adults.
    This was a retrospective cohort study comprising 12 909 individual participant data from the National Health and Nutrition Examination Survey from 1999 to 2004 and their mortality data through 31 December 2019. Weighted Cox proportional hazards regression models and restricted cubic splines were used to investigate the associations between GGap and mortality.
    During a median follow-up of 16.8 years, 3528 deaths occurred, including 1140 CV deaths. The associations of GGap with risk of all-cause and CV mortality were U-shaped (both P for non-linearity < .001). Compared with individuals with a GGap of 0.09%-0.38% (61st-80th centiles), the multivariable-adjusted HRs and 95% CIs for individuals with a GGap less than -0.83% (first-fifth centiles) and individuals with a GGap greater than 0.90% (96th-100th centiles) were 1.36 (1.10, 1.69) and 1.21 (1.00, 1.45) for all-cause mortality, and 1.77 (1.16, 2.71) and 1.43 (1.04, 1.95) for CV mortality. The GGap value associated with the lowest risk of all-cause and CV mortality was 0.38% in the general population and 0.78% among individuals with diabetes.
    We found a U-shaped association between GGap and all-cause and CV mortality, with significant positive or negative GGap values associated with increased mortality risk, probably because of glycaemic variability and fructosamine-3-kinase activity.
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  • 文章类型: Journal Article
    未经证实:钙参与许多生物过程,但很少研究血清钙水平对一般人群长期死亡率的影响.
    UNASSIGNED:这项前瞻性队列研究分析了来自国家健康和营养检查调查(1999-2018)的数据。全因死亡率,心血管疾病(CVD)死亡率,癌症死亡率是通过与国家死亡指数挂钩获得的。进行调查加权多变量Cox回归,以计算钙水平与死亡风险的关联的风险比(HR)和95%保密间隔(CI)。进行了限制性三次样条分析,以检查钙水平与全因死亡率和疾病特异性死亡率的非线性关联。
    未经评估:本研究共纳入51,042人。在平均9.7年的随访中,确定了7592例全因死亡,包括2391例心血管疾病死亡和1641例癌症死亡。与参与者血清钙水平[≤2.299mmol/L]的第一四分位数(Q1)相比,第二个四分位数(Q2)的参与者的全因死亡风险较低[2.300-2.349mmol/L],第三四分位数(Q3)[2.350-2.424mmol/L]和第四四分位数(Q4)[≥2.425mmol/L],多变量调整HR为0.81(95%CI,0.74-0.88),0.78(95%CI,0.71-0.86),和0.80(95%CI,0.73,0.88)。对于CVD死亡率观察到类似的关联,HR为0.82(95%CI,0.71-0.95),0.87(95%CI,0.74-1.02),第二季度至第四季度四分位数为0.83(95%CI,0.72,0.97)。此外,检测到血清钙与全因死亡风险的L型非线性关联.低于2.350mmol/L的中位数,血清钙每0.1mmol/L升高与全因死亡率风险降低24%相关(HR:0.76,95%CI,0.70-0.83),然而,当血清钙高于中位数时,未观察到显著变化.检测到血清钙与CVD死亡风险的类似L形关联,每0.1mmol/L血清钙低于中位数,CVD死亡风险降低25%(HR:0.75,95%CI,0.65-0.86)。
    未经证实:在美国成年人中观察到血清钙与全因死亡率和CVD死亡率的L形关联,低钙血症与全因死亡率和CVD死亡率的高风险相关.
    UNASSIGNED: Calcium is involved in many biological processes, but the impact of serum calcium levels on long-term mortality in general populations has been rarely investigated.
    UNASSIGNED: This prospective cohort study analyzed data from the National Health and Nutrition Examination Survey (1999-2018). All-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality were obtained through linkage to the National Death Index. Survey-weighted multivariate Cox regression was performed to compute hazard ratios (HRs) and 95% confidential intervals (CIs) for the associations of calcium levels with risks of mortality. Restricted cubic spline analyses were performed to examine the non-linear association of calcium levels with all-cause and disease-specific mortality.
    UNASSIGNED: A total of 51,042 individuals were included in the current study. During an average of 9.7 years of follow-up, 7,592 all-cause deaths were identified, including 2,391 CVD deaths and 1,641 cancer deaths. Compared with participants in the first quartile (Q1) of serum calcium level [≤2.299 mmol/L], the risk of all-cause mortality was lower for participants in the second quartile (Q2) [2.300-2.349 mmol/L], the third quartile (Q3) [2.350-2.424 mmol/L] and the fourth quartile (Q4) [≥2.425 mmol/L] with multivariable-adjusted HRs of 0.81 (95% CI, 0.74-0.88), 0.78 (95% CI, 0.71-0.86), and 0.80 (95% CI, 0.73, 0.88). Similar associations were observed for CVD mortality, with HRs of 0.82 (95% CI, 0.71-0.95), 0.87 (95% CI, 0.74-1.02), and 0.83 (95% CI, 0.72, 0.97) in Q2-Q4 quartile. Furthermore, the L-shaped non-linear associations were detected for serum calcium with the risk of all-cause mortality. Below the median of 2.350 mmol/L, per 0.1 mmol/L higher serum calcium was associated with a 24% lower risk of all-cause mortality (HR: 0.76, 95% CI, 0.70-0.83), however, no significant changes were observed when serum calcium was above the median. Similar L-shaped associations were detected for serum calcium with the risk of CVD mortality with a 25% reduction in the risk of CVD death per 0.1 mmol/L higher serum calcium below the median (HR: 0.75, 95% CI, 0.65-0.86).
    UNASSIGNED: L-shaped associations of serum calcium with all-cause and CVD mortality were observed in US adults, and hypocalcemia was associated with a higher risk of all-cause mortality and CVD mortality.
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  • 文章类型: Journal Article
    背景:高血糖状态会破坏硝酸盐/亚硝酸盐和一氧化氮的代谢,和饮食中的硝酸盐摄入可以恢复一氧化氮的稳态。这项研究旨在检查尿中硝酸盐是否与高血糖患者的糖尿病并发症和长期生存有关。
    方法:纳入2005年至2014年参加全国健康和营养调查的6208名高血糖患者。糖尿病并发症包括充血性心力衰竭,冠心病,心绞痛,中风,心肌梗塞,糖尿病视网膜病变,和肾病。死亡率从国家死亡指数中获得,直到2015年。通过离子色谱-电喷雾串联质谱法测定尿硝酸盐,对数变换并分类为三元。分别采用Logistic回归模型和cox比例风险模型评估尿硝酸盐与糖尿病并发症风险和疾病特异性死亡率的关系。
    结果:在调整了潜在的混杂因素,包括尿高氯酸盐和硫氰酸盐,与硝酸盐含量最低的参与者相比,最高三分位数的参与者患充血性心力衰竭(奇数比[OR]=0.41,95CI:0.27~0.60)和糖尿病肾病(OR=0.50,95CI:0.41~0.62)的风险较低.同时,在总共41463人年的随访中,最高三分位数的参与者具有较低的全因死亡风险(危险比[HR]=0.78,95CI:0.62-0.97),心血管疾病(CVD)(HR=0.56,95CI:0.37-0.84)和糖尿病(HR=0.47,95CI:0.24-0.90),呈剂量依赖性线性关系(P为非线性>0.05)。此外,未观察到硝酸盐与癌症死亡率之间存在关联(HR=1.13,95CI:0.71~1.80).
    结论:较高的尿硝酸盐与较低的充血性心力衰竭和糖尿病肾病风险相关,降低所有原因的风险,CVD,和糖尿病死亡率。这些发现表明,补充无机硝酸盐可被视为高血糖患者的补充治疗。
    The hyperglycemia condition disrupts metabolism of nitrate/nitrite and nitric oxide, and dietary nitrate intake can restore nitric oxide homeostasis.
    This study aims to examine whether urinary nitrate is associated with diabetes complications and long-term survival among people with hyperglycemia.
    A total of 6208 people with hyperglycemia who participated in the National Health and Nutrition Examination Survey from 2005 to 2014 were enrolled. Diabetes complications included congestive heart failure, coronary heart disease, angina, stroke, myocardial infarction, diabetic retinopathy, and nephropathy. Mortality was obtained from the National Death Index until 2015. Urinary nitrate was measured by ion chromatography coupled with electrospray tandem mass spectrometry, which was log-transformed and categorized into tertiles. Logistic regression models and Cox proportional hazards models were respectively performed to assess the association of urinary nitrate with the risk of diabetes complications and disease-specific mortalities.
    After adjustment for potential confounders, including urinary perchlorate and thiocyanate, compared with the participants in the lowest tertile of nitrate, the participants in the highest tertile had lower risks of congestive heart failure (odds ratio [OR] 0.41; 95% CI, 0.27-0.60) and diabetic nephropathy (OR 0.50; 95% CI, 0.41-0.62). Meanwhile, during a total follow-up period of 41 463 person-years, the participants in the highest tertile had lower mortality risk of all-cause (hazard ratio [HR] 0.78; 95% CI, 0.62-0.97), cardiovascular disease (CVD) (HR 0.56; 95% CI, 0.37-0.84), and diabetes (HR 0.47; 95% CI, 0.24-0.90), which showed dose-dependent linear relationships (P for nonlinearity > 0.05). Moreover, no association between nitrate and cancer mortality was observed (HR 1.13; 95% CI, 0.71-1.80).
    Higher urinary nitrate is associated with lower risk of congestive heart failure and diabetic nephropathy, and lower risk of all-cause, CVD, and diabetes mortalities. These findings indicate that inorganic nitrate supplementation can be considered as a supplementary treatment for people with hyperglycemia.
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  • 文章类型: Journal Article
    目标:先前的研究揭示了听力损失(HL)与全因死亡率之间的关系。这项研究的目的是确定HL与所有原因之间的关联以及基于美国成年人的特定原因死亡率。方法:通过将国家健康访谈调查(NHIS)(2004-2013)与死亡率数据库的链接链接到2015年12月31日获得数据。HL分为四组:听力良好,有点听力困难,很多听力困难,极度聋。采用Cox比例风险回归模型分析HL与死亡风险的关系。结果:与参照组(良好)相比,患有轻度或中度听力问题的患者因各种原因导致死亡的风险增加(分别为小麻烦-HR:1.17;95%置信区间[CI]:1.13至1.20;大量麻烦-HR:1.45;95%CI:1.40-1.51);聋人-HR:1.54;95%CI:1.38-1.73)。结论:此外,聋人因各种原因和特定原因而死亡的风险最高。更多的老年人与美国成年人全因死亡的风险增加有关。
    Objectives: Previous research revealed the relationship between hearing loss (HL) and all cause mortality. The aim of this study was to determine the association between HL and all causes and cause-specific mortality based on US adults. Methods: Data were obtained by linking National Health Interview Survey (NHIS) (2004-2013) with linkage to a mortality database to 31 December 2015. HL were categorized into four groups: good hearing, a little hearing difficulty, a lot of hearing difficulty, profoundly deaf. The relationship between HL and mortality risk was analyzed using Cox proportional hazards regression model. Results: Compared with the reference group (Good), those who had light or moderate hearing problems were at an increased risk of mortality for all causes (A little trouble-HR: 1.17; 95% confidence interval [CI]: 1.13 to 1.20; A lot of trouble-HR: 1.45; 95% CI: 1.40-1.51); deaf-HR: 1.54; 95% CI: 1.38-1.73) respectively. Conclusion: In addition, those in the deaf category have the highest risk of death from all causes and cause-specific cancer. More older adults are associated with an increased risk of all-cause mortality in American adults.
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