Journal of Health, Population, and Nutrition最新文献

{"title":"Comparative management practices of Wilson disease in Californian and Italian providers.","authors":"Sandy Vien, Colin McNamara, Ronald Hsu, Massimo Zuin, Valentina Medici","doi":"10.1186/s41043-025-01072-1","DOIUrl":"10.1186/s41043-025-01072-1","url":null,"abstract":"","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"339"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-economic and rural-urban disparities in the double burden of childhood malnutrition in sub-Saharan Africa.","authors":"Anesu Marume, Simbarashe Kasanzu, Joconiah Chirenda","doi":"10.1186/s41043-025-01075-y","DOIUrl":"10.1186/s41043-025-01075-y","url":null,"abstract":"<p><strong>Background: </strong>Despite global efforts to reduce child malnutrition, sub-Saharan Africa (SSA) continues to face a high burden of childhood stunting, wasting, and overweight. Although nutrition interventions target disadvantaged populations, disparities in malnutrition reduction remain underexplored. This study examines the influence of household wealth and rural-urban residence on childhood stunting, wasting, and overweight in SSA.</p><p><strong>Methods: </strong>Using nationally representative Demographic and Health Survey (DHS) data from two time points across 22 SSA countries, we employed generalized linear models (GLMs) to estimate adjusted odds ratios (AORs) and assess temporal trends. Models accounted for socioeconomic and demographic confounders, with between-country variability quantified using random effects.</p><p><strong>Results: </strong>Higher household income was associated with decreased odds of stunting (AOR: 0.81; 95% CI: 0.80-0.82) and wasting (AOR: 0.80; 95% CI: 0.79-0.81), but increased odds of overweight (AOR: 1.22; 95% CI: 1.17-1.27). Rural residence, older age (24-59 months), and male sex were significantly associated with higher odds of stunting and wasting (p < 0.001). Temporal trends indicated significant declines in the odds of stunting (AOR: 0.67; 95% CI: 0.66-0.68), wasting (AOR: 0.58; 95% CI: 0.57-0.59), and overweight (AOR: 0.64; 95% CI: 0.60-0.68) over time. Moderate between-country variability was observed across models, with standard deviations ranging from 0.32 to 0.41.</p><p><strong>Conclusion: </strong>These findings highlight a shift in public health priorities, emphasizing the need for adaptive and inclusive nutrition strategies. Policy responses should adopt a comprehensive approach to address the double burden of under- and overnutrition among children.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"335"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between digestion-resistant and bioactive peptide content of dairy products and bladder cancer: a case-control study.","authors":"Atiyeh Sadat Hosseini, Seyyed Mostafa Jalali, Zainab Shateri, Marzieh Shoja, Milad Rajabzadeh-Dehkordi, Maede Makhtoomi, Melika Hajjar, Bahram Rashidkhani, Mehran Nouri","doi":"10.1186/s41043-025-01071-2","DOIUrl":"10.1186/s41043-025-01071-2","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer is the sixth most common cancer worldwide. Bioactive peptides (BP) are digestion-resistant (enzymatically stable) and absorbable fragments that exert physiological functions in the body. We conducted this case-control study to examine the association between dairy-derived BPs and bladder cancer.</p><p><strong>Methods: </strong>The present case-control study (103 cases and 200 controls) was a hospital-based investigation conducted in three referral hospitals in Tehran, Iran. Dietary intake was assessed using a validated 168-item Food Frequency Questionnaire (FFQ). Intake of BPs was estimated based on dairy product consumption recorded in the FFQ. Logistic regression analysis was used to examine the association between the content of digestion-resistant BPs in dairy products and the odds of bladder cancer.</p><p><strong>Results: </strong>After adjusting confounding factors, it was observed that the odds of bladder cancer were significantly lower in the second and last tertiles (T) of total peptide intake from dairy products compared to the first tertile (T₂: odds ratio (OR) = 0.285; 95% confidence interval (CI): 0.116-0.699, T₃: OR = 0.130; 95% CI: 0.032-0.527). Additionally, in the adjusted model, a significant inverse association was found between other dairy-derived peptides and the odds of bladder cancer.</p><p><strong>Conclusions: </strong>The findings suggest a potential inverse relationship between milk-derived BPs and bladder cancer risk, which warrants further investigation in longitudinal or interventional studies. However, further studies are needed to elucidate the biological properties and mechanism of action of milk-derived BPs.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"336"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the association between dietary patterns and cardiovascular metabolic comorbidities among adults.","authors":"Danhui Mao, Lu He, Yajing Li, Mohan Zhang, Xiaoyu Wang, Gongkui Li, Xingrong Liu, Shiyun Wang, Mingyan Ma, Xiaojun Ren","doi":"10.1186/s41043-025-01085-w","DOIUrl":"10.1186/s41043-025-01085-w","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of cardiovascular metabolic comorbidities (CMM) among adults is relatively high, imposing a heavy burden on individuals, families, and society. Dietary patterns play a significant role in the occurrence and development of CMM. This study aimed to identify the combined types of CMM in adult populations and explore the association between dietary patterns and CMM.</p><p><strong>Methods: </strong>Participants in this study were from the sixth wave of the China Health and Nutrition Survey (CHNS) in 2009. Dietary intake was assessed using a three-day unconsecutive 24-hour dietary recall method among 4,963 participants. Latent profile analysis was used to determine dietary pattern types. Two-step cluster analysis was performed to identify the combined types of CMM based on the participants' conditions of hyperuricemia, dyslipidemia, diabetes, renal dysfunction, hypertension, and stroke. Logistic regression analysis with robust standard errors was used to determine the impact of dietary patterns on CMM.</p><p><strong>Results: </strong>Participants were clustered into three dietary patterns (Pattern a, b and c) and five CMM types (Class I to V). Class I combined six diseases, with a low proportion of diabetes. Class II also combined six diseases but with a high proportion of diabetes. Class III combined four diseases, with a high proportion of hypertension. Class IV combined three diseases, with the highest proportions of hyperuricemia, diabetes, and renal dysfunction. Class V combined two diseases, with high proportions of dyslipidemia and renal dysfunction. Patients with Class III CMM had a significantly higher average age than the other four classes (P < 0.05). Compared to those with isolated dyslipidemia, individuals with a low-grain, high-fruit, milk, and egg (LCHFM) dietary pattern had a higher risk of developing dyslipidemia combined with renal dysfunction (Class V CMM) with an odds ratio of 2.001 (95% CI: 1.011-3.960, P < 0.05).</p><p><strong>Conclusion: </strong>Individuals with isolated dyslipidemia should avoid a low-grain, high-fruit, milk, and egg (LCHFM) dietary pattern to reduce their dyslipidemia combined with renal dysfunction.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"345"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison the effect of continuous and bolus enteral nutrition methods on serum albumin and prealbumin in critical ill patients: A randomized clinical trial.","authors":"Javad Seyyedi, Zahra Rooddehghan, Mostafa Mohammadi, Shima Haghani, Raoofeh Karimi","doi":"10.1186/s41043-025-01042-7","DOIUrl":"10.1186/s41043-025-01042-7","url":null,"abstract":"<p><strong>Background and aims: </strong>Mechanically ventilated patients in intensive care units frequently require enteral nutrition. The choice of an appropriate feeding method may significantly influence nutritional status and clinical outcomes. Among biomarkers used for nutritional assessment, serum albumin, and prealbumin are widely accepted as reliable indicators for evaluating the effectiveness of nutritional interventions. This study aimed to compare the effects of two common enteral feeding methods-bolus and continuous feeding-on serum albumin and prealbumin levels in mechanically ventilated ICU patients.</p><p><strong>Methods: </strong>This parallel, single-blind clinical trial was conducted at Imam Khomeini Hospital in Tehran, Iran, with 34 ICU patients receiving mechanical ventilation. Participants were randomly assigned to either the continuous feeding group (Intervention, n = 17) or the bolus feeding group (Control, n = 17). Enteral feeding was delivered via a nasogastric tube for one week. Serum albumin and prealbumin levels were measured before and one week after the intervention. Data were analyzed using SPSS version 16, and hypotheses were tested using paired and independent t-tests.</p><p><strong>Results: </strong>No significant changes were observed in serum albumin levels within or between the groups over the intervention period. However, patients in the continuous feeding group (Intervention group) showed a statistically significant increase in serum prealbumin levels (from 0.11 ± 0.06 to 0.15 ± 0.02 g/L, p = 0.004). In contrast, the change in the Bolus feeding group (Control group) was not significant (from 0.10 ± 0.04 to 0.12 ± 0.06 g/L, p = 0.39). The between-group comparison of post-intervention prealbumin levels approached significance in favor of the continuous feeding group (p = 0.08).</p><p><strong>Conclusion: </strong>Continuous enteral feeding may have a positive effect on serum prealbumin levels in mechanically ventilated patients, while bolus feeding showed no such impact. However, due to the small sample size and short duration of the intervention, these findings should be interpreted cautiously. Further research with larger sample sizes and longer follow-ups is needed to confirm these results (Fig. 1).</p><p><strong>Trial registration: </strong>The protocol of this clinical trial has been registered in the Iranian Clinical Trial Registration Center (registration code: IRCT20190128042528N1). Registered 18 January 2020- Retrospectively registered, date of first recruitment: 6 October 2018, https://www.irct.ir/ .</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"337"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the dietary inflammatory index with multi-organ biological age acceleration.","authors":"Lu Long, Jiang Cheng, Yufei Zhang, Peng Yu, Qing Li, Xiao Liu, Juxiang Li","doi":"10.1186/s41043-025-01080-1","DOIUrl":"10.1186/s41043-025-01080-1","url":null,"abstract":"<p><strong>Aim and background: </strong>In recent years, the dietary inflammation index (DII) has become an important tool widely used to assess the inflammatory potential of an individual's diet. The aim of this study was to investigate the relationship between the DII and the biological aging of multiple organs (heart, liver, and kidneys) in American adults.</p><p><strong>Methods: </strong>A cross-sectional study was performed using data from the National Health and Nutrition Examination Survey of American adults between 2003 and 2018. The DII was calculated using 28 nutrients from daily dietary intake. The biological age (BA) of the heart, liver, and kidneys was calculated using the Klemera-Doubal method. ∆ age was determined by assessing the difference between an individual's estimated BA and their actual age.</p><p><strong>Results: </strong>A total of 14,873 individuals were included; the mean (SD) age was 45.59 (16.54) years, and 7,639 (51.44%) were female. In the fully adjusted final model, the highest tertile of the DII was significantly correlated with the Δ age of each organ (cardiovascular Δ age: β = 0.87, liver Δ age: β = 2.86, kidney Δ age: β = 0.80; all p values ≤ 0.01). The DII was positively correlated with the cardiovascular (r = 0.06) (p ≤ 0.01), liver (r = 0.16), and kidney (r = 0.03) Δ age (all p ≤ 0.01). However, sensitivity analyses confirmed only significant positive associations of the DII with the heart and liver Δ age. The log-transformed and standardized (z score) values of either C-reactive protein or high-sensitivity CRP and white blood cell count were demonstrated to mediate the relationships between the DII and heart, liver, and renal Δ age.</p><p><strong>Conclusion: </strong>Our analyses demonstrated significant associations between an elevated DII and accelerated biological aging in both the cardiovascular and hepatic systems, albeit with modest effect sizes that may reflect both genuine biological relationships and inherent limitations of cross-sectional dietary assessment. Prospective studies with repeated measures are warranted to validate these associations and elucidate the underlying physiological mechanisms.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"343"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of long-term care insurance on health outcomes and medical services utilization: based on an analysis of moderating effect of disability.","authors":"Wenjing Jiang, Hongyan Yang","doi":"10.1186/s41043-025-01070-3","DOIUrl":"10.1186/s41043-025-01070-3","url":null,"abstract":"<p><strong>Background: </strong>Long-term care insurance (LTCI) in China may alleviate stress among middle-aged and older adults with disabilities, while potentially influencing their health outcomes and medical services utilization.</p><p><strong>Objective: </strong>To evaluate the effect of LTCI on both health outcomes and medical services utilization among middle-aged and older adults, with specific focus on assessing disability's moderating effect.</p><p><strong>Methods: </strong>Using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS), we employed a time-varying differences-in-differences approach to evaluate the effect of LTCI on both health outcomes and medical services utilization, and to analyze disability's moderating effect.</p><p><strong>Results: </strong>LTCI effectively increased self-rated health by 0.0907 units and reduced depression levels by 0.4690 units among middle-aged and older adults. The policy also reduced the number of outpatient visits monthly by 0.0705, annual hospitalization probability by 0.0188, and number of hospitalizations by 0.0364. However, disability status attenuated LTCI's treatment effects, with stronger moderating effect observed in both the IADL subgroup and rural areas.</p><p><strong>Conclusions: </strong>After the implementation of LTCI, improvements in health outcomes and reductions in medical services utilization were observed among middle-aged and older adults. However, there was a critical moderating effect that disability status attenuated LTCI's treatment effects. These findings reveal disability's negative moderating role in LTCI's health effect and the importance of designing policy coverage and carrying out differentiated policy implementation according to disability types and urban-rural distribution.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"344"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the physical literacy scale for young and middle-aged patients with hypertension.","authors":"Guiyue Ma, Xiaoqin Ma","doi":"10.1186/s41043-025-01027-6","DOIUrl":"10.1186/s41043-025-01027-6","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the significance of physical literacy in enhancing the well-being of patients with hypertension has gained increasing recognition. Physical literacy, defined as the motivation, confidence, physical competence, and knowledge and understanding necessary to engage in physical activities, plays a crucial role in promoting a healthy lifestyle. However, most existing studies have focused on the general population or specific subgroups, such as children, adolescents, and older adults, with limited attention to the unique needs of young and middle-aged patients with hypertension.</p><p><strong>Objectives: </strong>The study aimed to develop and validate the physical literacy scale for young and middle-aged patients with hypertension (PLS-YMPH). We investigated the reliability and validity of this scale to evaluate its quality, providing a valid tool for assessing physical literacy in this specific group.</p><p><strong>Methods: </strong>Initial items were developed through a literature review and face-to-face interviews. The item pool was modified based on the results of the two-round Delphi method. After forming the initial draft of the PLS-YMPH, items were screened using the critical ratio method, correlation coefficient method, Cronbach's α coefficient method, and exploratory factor analysis. Finally, reliability and validity tests were conducted. The content validity, construct validity, discriminant validity, as well as content reliability, split-half reliability, and test-retest reliability of the scale were calculated.</p><p><strong>Results: </strong>The developed scale consists of 4 dimensions and 18 items. The Cronbach's α coefficient for the overall scale was 0.943, with individual dimensions ranging from 0.917 to 0.946. The split-half reliability coefficient was 0.833, and the dimensions ranged from 0.919 to 0.947. The test-retest reliability coefficient was 0.854, with dimensions ranging from 0.805 to 0.959. The S-CVI/Ave for the scale was 0.918, and the values for each dimension were 0.925, 0.906, 0.896, and 0.948, all exceeding 0.80.</p><p><strong>Conclusions: </strong>The developed PLS-YMPH demonstrates good reliability and validity. It provides a valuable tool for assessing the physical literacy of this specific patient group, laying the groundwork for further research in this area.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"338"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the use of microbiology services: A cross-sectional study in Ethiopian public hospitals.","authors":"Kibrewossen Kiflu Akililu, Workagegnehu Tarekegn, Zerihun Shimelis Kasa, Michael Solomon Tessema, Biniyam Tedla Mamo, Yemane Berhane","doi":"10.1186/s41043-025-01081-0","DOIUrl":"10.1186/s41043-025-01081-0","url":null,"abstract":"<p><strong>Background: </strong>Empiric management of infectious diseases is prevalent in low-resource settings. This has resulted in the emergence and spread of antimicrobial resistance. In Ethiopia, there is scarce evidence on the extent of use and factors influencing the utilization of microbiologic services in routine clinical practice. This study aims to address this gap.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 400 clinicians from eight public hospitals in Addis Ababa, Ethiopia. After obtaining informed consent, participants completed a self-administered questionnaire. The collected data was cleaned and analyzed using SPSS 27, with binomial and multinomial regression tests performed to measure statistical association between identified factors and microbiologic service utilization.</p><p><strong>Result: </strong>Two-hundred-twelve (53.0%) of the 400 clinicians had limited knowledge on the availability and/or types of microbiologic services provided in their facilities. Only fifty-nine (14.8%) consistently sent out culture tests when clinically indicated. The primary reasons for clinicians' reluctance to prescribe culture tests included perceived gaps in availability, turnaround time, completeness of antimicrobial susceptibility test (AST) panels, and lack of concordance with clinical pictures. Besides their overall impact on diagnostic stewardship, these gaps have also left a negative impression on prescribers. Discordance with clinical profile (AOR = 0.28, 95% CI = 0.09, 0.88, P = 0.03), and incomplete AST panels (AOR = 0.82, 95% CI = 0.11, 0.94, P = 0.04) have negatively affected the perception interviewed clinicians had on reliability of services provided.</p><p><strong>Conclusion: </strong>The findings highlight key areas for targeted intervention in the knowledge, attitudes, and use of microbiology services in public healthcare, largely due to concerns about service quality and timeliness. The determinant factors identified present opportunities to improve laboratory services and better support clinicians in their practice. Despite the critical role of culture and sensitivity tests in combating antimicrobial resistance (AMR), their use remains limited. This underscores the urgent need for coordinated action to strengthen microbiology services as a key strategy in the fight against AMR.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"341"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does a modified metabolic syndrome definition improve prediction of cardiovascular events and mortality? findings from a 17-year cohort study.","authors":"Fatemeh Sabeti, Davood Shafie, Nasim Kakavand, Mohammad Fakhrolmobasheri, Amirparsa Abhari, Saina Paymannejad, Negin Raei, Maryam Heidarpour, Jamshid Najafian, Maryam Boshtam, Fatemeh Nouri, Nizal Sarrafzadegan","doi":"10.1186/s41043-025-01083-y","DOIUrl":"10.1186/s41043-025-01083-y","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) criteria include central obesity assessed by waist circumference (WC), which may be confounded by body weight. We evaluated whether substituting the weight-adjusted waist index (WWI) for WC improves prediction of long-term cardiovascular disease (CVD) events and mortality.</p><p><strong>Objectives: </strong>To compare the prognostic performance of a WWI-based MetS definition versus the classic WC-based MetS definition for predicting CVD events and mortality, utilizing 17 years of follow-up data from the Isfahan Cohort Study (ICS).</p><p><strong>Methods: </strong>Of the 6,504 participants aged ≥ 35 years without prior CVD at baseline, 919 (14.1%) were lost to follow-up over 17 years. The remaining 5,585 participants were included in the final analysis. The classic and modified MetS definitions were compared using Cox regression analysis, Kaplan-Meier survival analysis, receiver operating characteristic (ROC) analysis, and risk reclassification by net reclassification improvement (NRI) for CVD events, CVD mortality, and all-cause mortality.</p><p><strong>Results: </strong>The modified WWI-based MetS reclassified approximately 9.2% of participants and significantly improved risk classification for incident CVD events (NRI = + 0.41, p < 0.0001). In crude analyses, the modified MetS was associated with higher risk of incident CVD events compared to the classic definition. After full adjustment, associations attenuated but remained significant for CVD events (modified HR 1.19, 95% CI: 1.01-1.41; classic HR 1.25, 95% CI: 1.06-1.47), whereas associations with CVD and all-cause mortality lost significance. Kaplan-Meier analyses confirmed significant differences in survival by MetS status for both definitions. The modified definition demonstrated modest improvements in sensitivity, specificity, accuracy, and area under the ROC curve (AUC) (CVD events: 0.62 vs. 0.60; CVD mortality: 0.63 vs. 0.59; all-cause mortality: 0.59 vs. 0.55) for all outcomes compared to the classic definition.</p><p><strong>Conclusion: </strong>In this 17-year cohort, replacing WC with WWI in the MetS definition modestly improved prediction of cardiovascular events and mortality. Using WWI in MetS criteria may enhance risk stratification in clinical practice. Further studies are needed to validate these findings across diverse populations.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"44 1","pages":"342"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}