Medicine最新文献

{"title":"Pre-exam anxiety during COVID-19: A cross-sectional study of medical and paramedical students in the Arab community.","authors":"Ali Mohamed Naguib Elgendy, Amira Yasmine Benmelouka, Zain Douba, Abdelrahman M Attia, Jackleen Rasmy, Muhamad Zakaria Brimo Alsaman, Aya Zazo, Abdul Fattah Mohandes, Yasmine Adel Mohammed, Mohamed Abd-ElGawad","doi":"10.1097/MD.0000000000041960","DOIUrl":"10.1097/MD.0000000000041960","url":null,"abstract":"<p><p>Pre-exam anxiety is a condition that affects students before their exams, and significantly affects their academic performance, physical, and mental state. Medical and paramedical students are more likely to experience exam-related stress and anxiety. Here we aimed to evaluate the prevalence of exam anxiety and its associated risk factors among undergraduate Arab medical and paramedical students. We performed a multi-center cross-sectional study in 6 Arab countries: Egypt, Syria, Iraq, Palestine, Algeria, and Libya from March to April 2021. We used Epi Info version 7.2 software to calculate the sample size. An online questionnaire including The Depression, Anxiety, and Stress Scale-21 Items (DASS-21) was used to measure exam-related anxiety. A total of 18,979 participants filled out the questionnaire, 71.3% of them were females. The majority of the study participants were between the ages of 20 to 21 years 42.4% (n = 8055). On the DASS, 38.8% of participants experienced severe symptoms of depression, 47.6% of them experienced severe symptoms of anxiety, and 30.2% experienced severe symptoms of stress. Of the 3 subscales of the DASS, Females had a significantly higher risk than males of developing Depression, Anxiety, and Stress (B = 2.454, P < .001), (B = 4.256, P < .001), (B = 3.516, P < .001) respectively. Participants aged 22 years or more were less susceptible to test-related depression (B = -0.907, P < .001) and anxiety (B = -0.958, P < .001). Students who spend 13 to 18 hours a week studying, were considerably more likely to have lower scores on all DASS subscales than those who study more than 18 hours per week, depression (B = -0.983, P < .001), Anxiety (B = -1.334, P < .001) and stress (B = -1.693, P < .001). The prevalence of exam-related anxiety, stress, and depression is high among medical and paramedical students in the Arab region. Medical educators should be aware of the impacts of this comorbidity and should work on implementing new and effective strategies to help students cope with psychological changes during exams. This paper gives a clearer insight into the level of exam anxiety and its predictors, which will enable the responsible authorities to intervene, based on the findings.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41960"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurofibromatosis type 1 accompanied by acromelanoma: A case report.","authors":"Shuai Dong, Mingrui Zhang, Yuanchen Zhang, Yuan Ma, Yan Mou","doi":"10.1097/MD.0000000000041845","DOIUrl":"10.1097/MD.0000000000041845","url":null,"abstract":"<p><strong>Rationale: </strong>Neurofibromatosis is an autosomal dominant genetic disorder characterized by developmental abnormalities of the nervous system, skin, and bones. Clinically, it is relatively rare and is often associated with various benign and malignant tumors.</p><p><strong>Patient concerns: </strong>However, reports of its association with malignant melanoma are scarce, and has been reported as a case report in this study. Case reports and treatment options are discussed below.</p><p><strong>Diagnoses: </strong>A 71-year-old male presented with long-standing skin nodules and plaques including a growing and itchy black patch on his left heel. Pathological examination revealed neurofibroma in the nodules and malignant melanoma in the heel lesion. The diagnosis was neurofibromatosis type l with acromelanoma.</p><p><strong>Interventions: </strong>Due to financial constraints, the patient refused surgical excision of the tumor and opted for conservative treatment with interferon injections.</p><p><strong>Outcomes: </strong>The patient is currently under follow-up observation.</p><p><strong>Lessons: </strong>This rare case underscores the importance of monitoring genetic disorder patients for tumor risk, emphasizing timely intervention.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41845"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive factors as a risk factor for STEMI: A retrospective case-control study.","authors":"Azam Soleimani, Fatemeh Sadat Khademi, Zahra Soleimani, Mohammad Hossein Paknahad, Hamidreza Roohafza, Masoumeh Sadeghi","doi":"10.1097/MD.0000000000041974","DOIUrl":"10.1097/MD.0000000000041974","url":null,"abstract":"<p><p>This study explored connections between women's reproductive factors and acute ST-segment elevation myocardial infarction (STEMI). A retrospective case-control study was conducted between 2016 and 2017. The study included 110 women diagnosed with STEMI and 110 control participants. Data on reproductive factors were collected through structured questionnaires and analyzed using statistical methods. Findings showed that increased STEMI risk was associated with longer lactation period, a higher number of parities, gravidity, and abortions. No significant relationships were observed for menopausal status, menopausal age, menarche age, reproductive duration, or oral contraceptive use. This study revealed that higher gravidity, parity, history of abortion, and longer breastfeeding duration were linked to an increased risk of STEMI. However, no significant differences were found between the case and control groups regarding menopausal status, age at menopause, age at menarche, reproductive duration, or oral contraceptive use.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41974"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe pneumonia combined with septic shock caused by community-acquired methicillin-resistant Staphylococcus aureus treated with veno-venous ECMO: A case report.","authors":"Linya He, Jian Wang, Yaxin Ning, Keqi Pan, Yan Chen, Jun Lu, Danqiong Wang","doi":"10.1097/MD.0000000000041627","DOIUrl":"10.1097/MD.0000000000041627","url":null,"abstract":"<p><strong>Rationale: </strong>Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) pneumonia is a severe and rapidly progressing infection that can lead to acute respiratory distress syndrome and septic shock. The use of venovenous extracorporeal membrane oxygenation (ECMO) may improve outcomes in critically ill patients who fail conventional mechanical ventilation.</p><p><strong>Patient concerns: </strong>Two female patients, aged 14 and 32 years, presented with fever and cough before hospital admission. Both patients rapidly developed severe respiratory distress and hemodynamic instability, raising concerns for a life-threatening infection.</p><p><strong>Diagnoses: </strong>Both patients were diagnosed with severe pneumonia caused by CA-MRSA, complicated by acute respiratory distress syndrome and septic shock. Microbiological testing confirmed the presence of CA-MRSA in respiratory samples.</p><p><strong>Interventions: </strong>The patients were initially treated with broad-spectrum anti-infective agents, including linezolid, targeting CA-MRSA. Due to the failure of conventional mechanical ventilation to maintain adequate oxygenation, venovenous ECMO was initiated to support respiratory function. The patients also received hemodynamic support and other adjunctive therapies for septic shock.</p><p><strong>Outcomes: </strong>Following the initiation of ECMO and targeted antibiotic therapy, both patients showed significant clinical improvement. Lung function recovered well, and they were successfully weaned off ECMO and mechanical ventilation. Both patients were eventually discharged with favorable outcomes.</p><p><strong>Lessons: </strong>CA-MRSA pneumonia can progress rapidly to severe respiratory failure and septic shock, necessitating aggressive interventions. Venovenous ECMO, combined with timely and appropriate antibiotic therapy can be life-saving in such cases. This report highlights the importance of early recognition, multidisciplinary management, and the potential benefits of ECMO in severe CA-MRSA pneumonia. It serves as a clinical reference for the treatment of similar cases.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41627"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare invasive inflammatory fibroid polyp presenting as small bowel intussusception: Two case reports and review of the literature.","authors":"Yuqiang Tang, Xinye Cui, Zhengdong Zhao, Yu Chen, Boyang Dai, Fuwen Luo","doi":"10.1097/MD.0000000000041956","DOIUrl":"https://doi.org/10.1097/MD.0000000000041956","url":null,"abstract":"<p><strong>Rationale: </strong>Inflammatory fibroid polyp (IFP) is a rare benign neoplasm of uncertain etiology and mostly occurs in the stomach, emerging from the submucosal layers. Intussusception causing bowel obstruction due to IFP is even rare. We present 2 cases of IFP in adults, which caused small bowel intussusception and broke through the submucosa uncommonly.</p><p><strong>Patient concerns: </strong>This article reports 2 patients presenting with abdominal pain. One patient was an 81-year-old Chinese man, who presented with a 7-day history of intermittent left abdominal pain. The other patient was a 49-year-old Chinese woman with a 5-day history of intermittent lower abdominal distension pain. Their abdominal computed tomography both demonstrated small bowel intussusception.</p><p><strong>Diagnoses: </strong>The 2 patients were diagnosed with small bowel intussusception.</p><p><strong>Interventions: </strong>Both patients underwent surgical resection of a segment of the small intestine. During the old man's operation, a 2.5 cm × 3.5 cm polypoid tumor was found in the jejunum, at a distance of 60 cm from the ligament of Treitz. During the women's operation, a 3.6 × 3.7 cm polypoid lesion was found in the ileum, which protruded into, and completely occluded the lumen.</p><p><strong>Outcomes: </strong>The 2 patients had an uneventful recovery, being discharged about 1 week postoperatively without any postoperative complications. Morphologically, the old man's intraluminal intestinal mass had invaded muscularis propria, and was negative for CD34 immunohistochemically, creating difficulties in diagnosing IFP. The woman's intraluminal intestinal mass had infiltrated into the serosal layer. Ultimately, the pathological diagnosis for both patients was IFP.</p><p><strong>Lessons: </strong>We described 2 rare cases of small bowel intussusception caused by IFP. IFP commonly involves only the submucosa, rarely breaks through the submucosa, and invades the muscularis propria and subserosa layer. Its invasive nature is extremely rare and may provide additional evidence to support the neoplastic nature of IFP. Besides, a differential diagnosis is essential When an IFP is negative for CD34 expression.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41956"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Crimson puzzle: Two case reports/case series of hemorrhagic cystitis after combination chemotherapy with docetaxel, carboplatin, trastuzumab and pertuzumab in breast cancer.","authors":"Juan C Ramirez, Mitchel E Lacey, Maya S Gowda, Grace Wang, Yolcar Chamorro, Ana C Sandoval-Leon","doi":"10.1097/MD.0000000000041906","DOIUrl":"10.1097/MD.0000000000041906","url":null,"abstract":"<p><strong>Rationale: </strong>Hemorrhagic cystitis can be a serious side effect of some chemotherapy drugs like cyclophosphamide and ifosfamide. Docetaxel is a taxane that is used to treat several malignancies including breast and prostate cancer. Hemorrhagic cystitis has not been described as a complication of combination chemotherapy with docetaxel, particularly docetaxel with carboplatin, trastuzumab and pertuzumab (TCHP) in breast cancer patients.</p><p><strong>Patient concerns: </strong>Both patients had a history of locally advanced human epidermal growth factor receptor 2 positive breast cancer and complaint of hematuria after their first treatment with TCHP.</p><p><strong>Diagnoses: </strong>They were diagnosed with hemorrhagic cystitis.</p><p><strong>Interventions: </strong>Docetaxel was discontinued and changed to paclitaxel.</p><p><strong>Outcomes: </strong>Both patients completed neoadjuvant chemotherapy and did not have further episodes of hemorrhagic cystitis.</p><p><strong>Lessons: </strong>Hemorrhagic cystitis is a rare complication of combination chemotherapy with docetaxel (TCHP). Clinicians should be vigilant for signs and symptoms of hemorrhagic cystitis in patients receiving docetaxel and alternative treatment option should be considered.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41906"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of obesity on cardiovascular morphofunctional phenotype: Study of Mendelian randomization.","authors":"Xiaoyu Jiang, Longqing Yu, Jingyi Li, Xizhuang Gao, Jinlin Wang, Guangyi Qu, Cheng Shen, Lijun Gan","doi":"10.1097/MD.0000000000041858","DOIUrl":"10.1097/MD.0000000000041858","url":null,"abstract":"<p><strong>Background: </strong>Obesity is an independent factor for cardiovascular diseases, impacting health across different age groups. cardiovascular magnetic resonance (CMR) imaging is considered the gold standard for noninvasive assessment of cardiovascular structure and function. We conducted a Mendelian randomization (MR) study to explore the associations between obesity-related traits and the clinical pre-phenotype of cardiac and aortic structure and function.</p><p><strong>Methods: </strong>Independent genetic variations significantly correlated with adult body mass index, adult waist-to-hip ratio, birth weight, child body mass index, and excess visceral fat were selected as instrumental variables. Eighty-two CMR imaging features were obtained from the UK Biobank Genome-Wide Association Study. These features served as clinical pre-phenotypes, providing early indications of the structure and function of the 4 cardiac chambers and 2 aortic slices. Preliminary analyses were conducted using MR and inverse variance-weighted methods. Causal directions were determined through Steiger filtering and testing, achieving confirmation. Sensitivity analyses were performed using weighted median, MR-Egger, and MR-PRESSO methods.</p><p><strong>Results: </strong>Adult BMI was positively correlated with left ventricular end-systolic volume, right ventricular end-diastolic volume, right ventricular end-systolic volume, and right ventricular volume per beat. The adult waist-to-hip ratio was inversely proportional to right atrial volume per beat, right atrial maximum volume, right atrial minimum volume, partial regional longitudinal strain, regional peak circumferential strain, and regional radial strain, and positively proportional to partial regional peak circumferential strain and partial end-diastolic local myocardial wall thickness characteristics. Birth weight was positively correlated with maximum right atrial volume, minimum right atrial volume, right atrial volume per beat, right ventricular end-diastolic volume, right ventricular output per beat, maximum area of the ascending aorta, minimum area of the ascending aorta, and negatively correlated with longitudinal strain in some regions. Body mass index in children is positively correlated with left ventricular end-diastolic volume, left ventricular end-systolic volume, left atrial volume per beat, right ventricular end-diastolic volume, and right ventricular volume per beat.</p><p><strong>Conclusion: </strong>This study suggests that obesity may lead to myocardial hypertrophy and dilation of the cardiac chambers and aorta, thereby exerting adverse effects on the cardiovascular system and increasing the susceptibility to HF.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41858"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of aberrantly expressed genes during aging in the mouse heart via integrated bioinformatics analysis.","authors":"Pianpian Huang, Jun Fu, Ji Hu, Yinghong Lei, Tingyu Wu, Ju Liu","doi":"10.1097/MD.0000000000041972","DOIUrl":"10.1097/MD.0000000000041972","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) represents a global problem and is associated with high levels of morbidity/mortality in the elderly (>65 years old). The present study aimed to identify the key candidate genes and pathways in cardiac aging via integrated bioinformatics analysis. The GSE43556 and GSE8146 gene expression datasets were obtained from the Gene Expression Omnibus (GEO) database, and differentially expressed genes (DEGs), defined as P < .05 and |log fold-change (FC)| >0.5, were identified. Functional enrichment and protein-protein interaction network construction were subsequently performed. First, 142 DEGs shared between the two GEO datasets were identified. Second, biological functional enrichment analysis illustrated that these DEGs mainly participate in \"inflammatory response\" and \"monocarboxylic acid metabolic process.\" Moreover, Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that the DEGs were mainly enriched in the PI3K-Akt signaling pathway. Subsequently, the association between the expression of DEGs in the aged heart was evaluated using the Search Tool for the Retrieval of Interacting Genes database and Cytoscape software. The present study elucidated the key genes and signaling pathways associated with cardiac aging, thus improving the understanding of the molecular mechanisms underlying cardiac aging. These identified genes may be used as molecular biomarkers for the diagnosis and treatment of cardiac aging.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41972"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septicemia caused by Eikenella corrodens in a previously healthy male: A case report.","authors":"Haoting Zhang, Yongfu Xia, Linhong Wang, Bin Zhang","doi":"10.1097/MD.0000000000041849","DOIUrl":"10.1097/MD.0000000000041849","url":null,"abstract":"<p><strong>Rationale: </strong>The bacterium Eikenella corrodens is part of the normal microbiota of the oropharynx. It typically causes disease in patients with bite wound, immunosuppression, and those undergoing surgery, but rarely affects healthy individuals. Despite the rarity of infection induced by E corrodens, early diagnosis and therapy are important.</p><p><strong>Patient concerns: </strong>The study reports a case of septicemia caused by E corrodens in a previously healthy male individual. The patient was admitted to hospital due to fever, fatigue, and mild cough lasting 4 weeks. Physical examination was unremarkable. Chest and abdominal computed tomography showed no obvious infiltrates. Transthoracic echocardiography did not reveal excrescence on the aortic valve.</p><p><strong>Diagnoses: </strong>E corrodens was isolated from blood, proving its pathogenic potential. To confirm the pathogen, 16S rRNA gene sequencing was performed directly from the blood culture, obtaining a sequence that aligned with E corrodens with a homology percentage of 99.8%. The patient was diagnosed as septicemia caused by E corrodens.</p><p><strong>Interventions: </strong>The patient was treated with moxifloxacin (0.4 g once daily) intravenously for 3 days, but continued to experience recurrent fever. Following the diagnosis of septicemia caused by E corrodens, antibiotic treatment was switched to cefoperazone-sulbactam (SCF; 3 g every 8 h) for 14 days in total.</p><p><strong>Outcomes: </strong>Fever, fatigue, and other discomfort were relieved after 1 day of treatment with SCF. The white blood cell count, C-reactive protein concentration, and procalcitonin levels were gradually normalized after 14 days of treatment with SCF. Blood culture was performed after 14 days of treatment with SCF, yielding negative results.</p><p><strong>Lessons: </strong>The present case report highlights that E corrodens should be considered as a cause of septicemia even in healthy individuals. For the avoidance of delayed diagnosis, it is vital to perform blood culture before initiating antibiotic treatment. Furthermore, SCF should be considered as a preferred treatment option for such infections.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41849"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol and serum uric acid levels and risk of hyperuricemia in different sex groups: A cross-sectional study.","authors":"Jingjing Huang, Chunrong Chen","doi":"10.1097/MD.0000000000041962","DOIUrl":"10.1097/MD.0000000000041962","url":null,"abstract":"<p><p>Dyslipidemia and hyperuricemia are recognized as significant risk factors for cardiovascular and metabolic diseases. However, the relationship between the novel lipid metabolism marker, non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR), and serum uric acid levels or hyperuricemia remains unclear. This study aimed to analyze these associations using data from a nationally representative population, with an emphasis on sex-specific differences and nonlinear relationships. Data from the National Health and Nutrition Examination Survey conducted from 2005 to 2018 were examined, involving 9439 adults, following the application of exclusion criteria. Weighted linear and logistic regression models categorized by sex were used to investigate the relationships between NHHR, uric acid concentrations, and hyperuricemia. Nonlinear relationships were assessed using restricted cubic splines, and threshold effects were explored using 2-part regression models. Subgroup analyses were conducted to evaluate potential modifiers of the relationship between NHHR and hyperuricemia. NHHR was significantly associated with serum uric acid levels and hyperuricemia in the general population with notable sex-specific differences. In females, NHHR was found to have a very significant positive correlation with hyperuricemia (OR 1.44, 95% confidence interval [CI]: 1.31-1.58, P < .001); however, this correlation was not as strong in males (OR = 1.07, 95% CI: 0.95-1.20, P = .20). Repeated analyses with nonlinear models showed that NHHR had a threshold relationship with hyperuricemia concentration which reached its highest level of 3.91 for the general population, with male and female inflection points at 4.637 and 4.452, respectively. Subgroup analyses demonstrated significant interactions with body mass index (BMI), smoking status, and stroke, further highlighting the heterogeneity of the NHHR-hyperuricemia relationship. NHHR is independently associated with serum uric acid levels and hyperuricemia, with significant sex-specific and nonlinear patterns. These findings suggest that the NHHR may serve as a valuable biomarker for assessing hyperuricemia risk, particularly in females. Further research is warranted to explore the underlying mechanisms and the clinical implications of these associations.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41962"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}