BMC Public Health最新文献

{"title":"The association between visceral adiposity index and long-term all-cause mortality shows age-related disparities: a nationwide cohort study.","authors":"Qiushi Sun, Sibo Wang, Xudong Han, Lingfeng Gu, Hao Wang, Qin Yang, Liansheng Wang","doi":"10.1186/s12889-025-22428-6","DOIUrl":"10.1186/s12889-025-22428-6","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of obesity has increased rapidly worldwide over the past few decades and remains a recognized public health concern. However, studies exploring visceral adiposity index (VAI), a sex-specific indicator reflecting visceral fat distribution and function, and long-term mortality are limited. This study aimed to investigate the association of VAI with long-term all-cause mortality among general adults in the United States.</p><p><strong>Methods: </strong>This cohort study used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Participants were linked to National Death Index mortality data through December 31, 2019. Weighted Cox proportional hazards regression model was used to calculate hazard ratios (HRs) and 95% CIs, and restricted cubic spline (RCS) was also conducted.</p><p><strong>Results: </strong>A total of 21,943 US adults (weighted mean age, 46.9 years; 10,921 males [weighted, 49.1%]) were included. During 211,473 person-years of follow-up (median follow‑up: 9.3 years), 3326 total deaths occurred. After multivariable adjustments, compared with the 3rd quintile (Q3) of VAI, participants in the 2nd (Q2) and 5th (Q5) quintiles were at a significantly higher risk of all-cause mortality (HR 1.16 [95% CI, 1.00-1.34] and HR 1.15 [95% CI, 1.01-1.31], respectively). RCS revealed a U-shaped relationship of log₂-transformed VAI to all-cause mortality (P for nonlinearity < 0.001), with an inflection point of 0.824. Subgroup analysis indicated that there was a significant interaction of VAI with age on all-cause mortality (P for interaction = 0.005). Higher VAI levels were associated with higher all-cause mortality in younger adults (Q5 vs. Q3, HR 1.56 [95% CI, 1.12-2.18], P = 0.009) rather than older adults (Q5 vs. Q3, HR 1.05 [95% CI, 0.91-1.22], P = 0.497).</p><p><strong>Conclusions: </strong>In the nationally representative cohort of US adults, VAI was nonlinearly associated with long-term all-cause mortality and the association showed age-related disparities. A higher VAI was related to a higher mortality risk in younger adults. These findings underscore the importance of appropriate VAI for long-term health outcomes, especially for young adults.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1266"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of Alzheimer's disease and other dementias in adults aged 65 years and over, and health inequality related to SDI, 1990-2021: analysis of data from GBD 2021.","authors":"Wen Liu, Wei Deng, Xinhao Gong, Jinping Ou, Shuchun Yu, Shoulin Chen","doi":"10.1186/s12889-025-22378-z","DOIUrl":"10.1186/s12889-025-22378-z","url":null,"abstract":"<p><strong>Introduction: </strong>The disease burden of dementia in the elderly is predicted to rise, and dementia among older adults has become a crucial issue for public health. Quantifying the disease burden of dementia in the elderly can provide relevant areas and countries with scientific data to help them adjust their healthcare strategies.</p><p><strong>Methods: </strong>We analyzed the disease burden of Alzheimer's disease and other dementias among individuals aged 65 and older from 1990 to 2021; the relationship between mortality rates and disability-adjusted life years (DALYs) with socio-demographic index (SDI); conducted a frontier analysis of the disease burden across 204 countries; and quantified inequalities in age-standardized DALYs for Alzheimer's disease and other dementias using the slope inequality index and concentration index.</p><p><strong>Results: </strong>Globally, age-standardized DALYs and mortality rates for individuals aged 65 and older have declined over time. We find that the disease burden of dementia is significantly associated with SDI. High SDI countries have 169% higher baseline levels of dementia burden compared to low SDI countries, as estimated based on their current level of social development. Finally, our health inequality analyses reveal that while the overall trend of DALYs for dementia increases with SDI, the burden is primarily concentrated in populations with lower SDI, as non-developed countries account for the majority of the population.</p><p><strong>Conclusion: </strong>The global population aged 65 and older experiences a significant reduction in healthy life expectancy due to dementia. The burden of disease in most countries is higher than the minimum disease burden associated with SDI in those countries. The burden of disease in low and middle SDI countries has been showing an increasing trend. The gap in disease burden among regions with different SDI levels is also continuously narrowing.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1256"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between family function and depression among caregivers of patients with acute pesticide poisoning: a cross-sectional study.","authors":"Zixin Wen, Yanxia Zhang, Jie Shi, Yingying Zheng, Tianzi Jian, Xiangdong Jian, Baotian Kan","doi":"10.1186/s12889-025-22531-8","DOIUrl":"10.1186/s12889-025-22531-8","url":null,"abstract":"<p><strong>Background: </strong>Acute pesticide poisoning is a major public health concern. The relationship between family function and depression in caregivers of patients with acute pesticide poisoning is unclear. Therefore, this study aimed to explore the relationship between family function, coping style, and depression among caregivers of patients with acute pesticide poisoning and to provide a theoretical basis and intervention targets for future research.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among caregivers of patients with acute pesticide poisoning in the Department of Toxicology and Occupational Disease of a Grade A hospital in Jinan, Shandong Province, from November 2022 to June 2023. A general data questionnaire, family caring index scale, simple coping style questionnaire, and health questionnaire depression symptom group scale were used to collect the data. Pearson correlation and a structural equation model were used for data analysis.</p><p><strong>Results: </strong>The average depression score of the caregivers was 5.66 ± 4.291, and the incidence of depression was 54.7%. The family function may directly or indirectly affect depression in caregivers through coping styles.</p><p><strong>Conclusion: </strong>Future health education and interventions should focus on improving the family functioning of caregivers and encouraging positive coping mechanisms.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1252"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The structural and organizational aspects of human papillomavirus vaccine affecting immunization coverage in Europe: a systematic review.","authors":"Ronan Lemwel Valdecantos, Michele Sorrentino, Michelangelo Mercogliano, Vincenzo Giordano, Ugo Trama, Maria Triassi, Raffaele Palladino","doi":"10.1186/s12889-025-22343-w","DOIUrl":"10.1186/s12889-025-22343-w","url":null,"abstract":"<p><p>The introduction of HPV vaccinations, that can prevent most prevalent HPV-related cancers of various body districts, is a public health milestone. Despite broad immunization programs, European Health Systems face structural and organizational difficulties that hinder care. This study examined structural and organizational elements that may affect HPV vaccine coverage. We searched numerous databases from January 1, 1995 to May 15, 2023, for literature on HPV immunization research methodologies. Structural and Organizational aspects that cause HPV vaccine concerns in women and men were examined in the outcome evaluations and the research examined vaccination willingness factors. Ottawa, JBI's critical appraisal tool, and Amstar quality assessment assessed bias. A total of 10 articles from 312 studies met the inclusion criteria. Studies were undertaken in Italy, Belgium, England, Switzerland, France, the UK, and Spain. There were also combined-diverse studies in 15 and 27 European countries. Several primary healthcare strategies have increased HPV vaccination rates. These include vaccine procurement and cost-effectiveness, school-based immunization programs, electronic health databases, health professional training, health education and communication, and monitoring and surveillance.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1254"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global lung cancer burden attributable to air fine particulate matter and tobacco smoke exposure: spatiotemporal patterns, sociodemographic characteristics, and transnational inequalities from 1990 to 2021.","authors":"Yudong Zhang, Wenxi Wang, Keyao Dai, Ying Huang, Runchen Wang, Danjie He, Jianxing He, Hengrui Liang","doi":"10.1186/s12889-025-22450-8","DOIUrl":"10.1186/s12889-025-22450-8","url":null,"abstract":"<p><strong>Background: </strong>Air fine particulate matter and tobacco smoke exposure are primary risk factors for lung cancer. However, their recent global exposure levels, attributable burden, and patterns of inequalities remain insufficiently quantified.</p><p><strong>Methods: </strong>Utilizing the Global Burden of Disease 2021 study, we analyzed exposure levels of air fine particulate matter (ambient and household) and tobacco smoke (active and secondhand) by age-standardized summary exposure value (ASEV). Age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) were used to assess their attributable lung cancer burden globally. Temporal patterns were examined using weighted average annual percentage change (WAPC). Cross-national health inequalities were evaluated with the concentration index (CI) for ASMR and slope index of inequality (SII) for ASDR.</p><p><strong>Results: </strong>In 2021, air fine particulate (PM2.5) exposure peaked in low socio-demographic index (SDI) countries, while tobacco exposure was highest in high-middle SDI regions. Globally, air PM2.5 contributed to 374.21 thousand (95% uncertainty interval [UI]: 236.36, 520.26) lung cancer deaths [ambient: 297.60 thousand (95% UI: 183.71, 414.74); household: 76.48 thousand (95% UI: 28.6, 187.34)], whereas tobacco exposure caused 1,238.65 thousand (95% UI: 1,075.69, 1,423.12) deaths [active smoking: 1,195.80 thousand (95% UI: 1,054.67, 1,359.22); secondhand smoke: 97.91 thousand (95% UI: 11.96, 184.91)]. High-middle SDI countries and the Southeast Asia, East Asia, and Oceania regions bore the greatest burden. The attributable burden for males exceeded that for females by approximately twofold for air PM2.5 and fivefold for tobacco exposure. The 55 + age group showed disproportionately high impacts despite lower exposure. From 1990 to 2021, the ASMR attributable to air PM2.5 and tobacco exposure changed annually by -1.32% (95% confidence interval [CI]: -1.48, -1.16) and - 0.95% (95% CI: -1.03, -0.88), respectively. The attributable ASDR also showed declining trends. Regarding translational health inequality, the air PM2.5 attributable lung cancer burden shifted from high to low SDI countries (CI: 0.05 to -0.10, SII: 31.00 to -35.50), while the tobacco-attributable burden persisted in higher SDI countries, albeit with diminishing inequalities (CI: 0.34 to 0.25, SII: 572.20 to 304.60).</p><p><strong>Conclusions: </strong>This up-to-date study provides a comprehensive perspective on air fine particulate matter and tobacco smoke exposure's impact on lung cancer burden, highlighting its widespread nature, substantial impact, unequal distribution, and preventability. The findings call for targeted interventions and global cooperation across socioeconomic levels to reduce the overall lung cancer burden in the post-pandemic era.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1260"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A graded personalized exercise program's effect on muscle and body fat: randomized controlled trial.","authors":"Jung Yeon Son, Jiyun Jung, Jung Eun Son, Sang Gyu Park, Eo Jin Park, Junga Lee, Seung Don Yoo","doi":"10.1186/s12889-025-22453-5","DOIUrl":"10.1186/s12889-025-22453-5","url":null,"abstract":"<p><strong>Objectives: </strong>With population aging, personalized exercise programs considering clinical and demographic factors like sex, age, and physical activity level are essential; however, research on their effects remains limited. We aimed to evaluate the effectiveness of a Global Physical Activity Questionnaire-based graded personalized exercise program tailored for middle-aged adults aged 40-69 years.</p><p><strong>Participants: </strong>We enrolled 71 middle-aged adults in their 40s, 50s, and 60s (approximately 20 participants per age group) in a parallel-group randomized controlled trial.</p><p><strong>Intervention: </strong>Participants were assigned using age-stratified randomization to a treatment or control group. Participants were categorized into three levels according to weekly physical activity measured by the Global Physical Activity Questionnaire and physical activity guidelines for adults. Each participant's grade was determined by applying equal weight adjustments for sex, age, and physical activity level, and the participants were assigned an exercise program corresponding to their grade. The exercise intervention consisted of a circuit training program alternating between aerobic and anaerobic exercises. The control group was instructed to maintain their usual physical activity levels.</p><p><strong>Main outcome measures: </strong>Changes from before to after exercise in clinical results (body composition, physical fitness, ultrasound-measured muscle/fat thickness, and biochemical data) were recorded during the 8-week exercise program and differences between pre- and post-exercise values of the groups were analyzed using the t-test and Wilcoxon rank-sum test.</p><p><strong>Results: </strong>Among 64 participants who had completed the program, 33 (51.5%) participated in the exercise program. The exercise program significantly increased abdominal muscle thickness (p < 0.01), reduced body fat percentage (p = 0.02) and waist circumference (p = 0.01), and positively affected various physical fitness indicators.</p><p><strong>Conclusions: </strong>This study demonstrated the beneficial effects of a graded personalized exercise program on muscle thickness, body fat, and physical fitness and offers key data to support early preventive exercise programs in middle-aged adults to mitigate the risk of sarcopenia in later life.</p><p><strong>Trial registration: </strong>Registered on November, 29, 2024 at cris.nih.go.kr identifier KCT0009970.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1258"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 reliability and validity test of the sleep health literacy scale for college students.","authors":"ZhengDa Long, LiPing Huang","doi":"10.1186/s12889-025-22455-3","DOIUrl":"10.1186/s12889-025-22455-3","url":null,"abstract":"<p><strong>Purpose: </strong>It is evident that there are some discrepancies in the connotations and substance of sleep health literacy and health literacy. The latter encompasses a broader construct, including health-related knowledge and the capacity for decision-making in domains such as diet, exercise, mental well-being and disease prevention. In contrast, sleep health literacy is a more specialised domain that aims to assist individuals in optimising their sleep quality and modifying their sleep behaviour.Sleep health literacy is defined as a specialized extension of general health literacy, with a specific focus on sleep-related knowledge and behaviors. Sleep health literacy is defined as the ability of an individual to obtain, understand, analyse and apply basic sleep health information or services and to make correct sleep health decisions.However, no formal assessment tool for sleep health literacy has been developed to date. Therefore, the Sleep Health Literacy Scale for College Students (SHLS-ST) was developed and its reliability was tested.</p><p><strong>Methods: </strong>The present study is founded upon extant theoretical frameworks and scales, in addition to comprehensive literary research, group interviews, and the Delphi expert consultation method. We administered questionnaires to on 300 college students, and the survey data were used for item analysis, exploratory factor analysis, confirmatory factor analysis, convergent validity, discriminant validity, and correlation analysis. These analyses were used to test the structural validity and reliability of the SHLS-ST.</p><p><strong>Results: </strong>The Sleep Health Literacy Scale for College Students was developed with 26 items. Exploratory factor analysis yielded five common factors, with a cumulative variance contribution of 72.05%, and Pearson's correlation coefficients between the five factor scores and the total scale score ranging from 0.568 to 0.947. The overall Cronbach's α coefficient of the scale was 0.960, the overall split-half reliability of the scale was 0.922, and the reliability coefficient of the test-retest reliability of 77 college students after an interval of half a month was 0.974.</p><p><strong>Conclusion: </strong>The Sleep Health Literacy Scale for College Students has a good reliability and validity, and is suitable for the assessment of college students' sleep health literacy. However, the length of the scale may affect its usability and participants' engagement in the assessment process.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1257"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural environmental factors at birth on risk for rheumatoid arthritis: the impact of season, temperature, latitude, and sunlight exposure.","authors":"Liang Luo, Jia Yi Hee, Sitian Zang, Zhike Liu, Kun Tang, Xuewu Zhang, Chun Li","doi":"10.1186/s12889-025-22448-2","DOIUrl":"10.1186/s12889-025-22448-2","url":null,"abstract":"<p><strong>Background: </strong>Environmental factors contribute to approximately 41% of the risk of rheumatoid arthritis (RA). Previous studies have focused on anthropogenic environmental factors, while much less attention has been given to natural environmental factors. Our study explored the potential influence of natural environmental factors at birth on the risk of RA.</p><p><strong>Methods: </strong>This large retrospective study utilized data from the China Kadoorie Biobank. A restricted cubic spline (RCS) model was employed to explore nonlinear relationships between natural environmental factors and the risk of RA. Additionally, a multivariable Cox regression model, adjusted for confounding factors, was used to examine correlations between season of birth, geographic, climate, and the risk of RA.</p><p><strong>Results: </strong>A total of 512,715 participants were included in this study, of which 2889 (0.56%) were diagnosed with RA. The RCS analysis revealed that the monthly average temperature at birth (p < 0.001), the latitude (p = 0.027) of the birthplace, and the sunshine rate (p < 0.001) exhibited a nonlinear relationship with the risk of RA. Multivariable Cox regression analysis revealed that participants born in Spring and Summer (HR 1.13, 95% CI 1.05-1.23) had an increased risk of RA compared to those born in Autumn and Winter. Additionally, participants born at latitudes ≤ 24°N (HR 1.49, 95% CI 1.32-1.68), with sunshine rate ≤ 28% (HR 2.00, 95% CI 1.75-2.29) or ≥ 60% (HR 1.22, 95% CI 1.08-1.38) had an increased risk of RA. Being born in regions with a monthly average temperature ≥ 27 °C (HR 0.82, 95% CI 0.72-0.95) was associated with a decreased risk of RA.</p><p><strong>Conclusion: </strong>Being born in Spring and Summer, as well as early-life exposure to low-latitude regions and extreme sunlight environments increases the risk of RA. Our study revealed significant associations between the risk of RA and natural environmental factors at birth, emphasizing the impact of the early-life environment on the onset of RA.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1267"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity patterns and premature mortality in a prospective cohort: effect modifications by socioeconomic status and healthy lifestyles.","authors":"Qingping Xue, Shanshan Zhang, Xue Yang, Yan-Bo Zhang, Yidan Dong, Fan Li, Shuo Li, Nianwei Wu, Tong Yan, Ying Wen, Chun-Xia Yang, Jason Hy Wu, An Pan, Yunhaonan Yang, Xiong-Fei Pan","doi":"10.1186/s12889-025-22216-2","DOIUrl":"10.1186/s12889-025-22216-2","url":null,"abstract":"<p><strong>Background: </strong>Few studies have explored the impact of multimorbidity patterns on premature mortality. This study aimed to assess the associations between multimorbidity patterns and long-term mortality and whether the associations were modified by socioeconomic status (SES) and healthy lifestyles.</p><p><strong>Methods: </strong>Data were from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 in the US. The latent class analysis was used to establish multimorbidity patterns based on 11 chronic conditions. Mortality outcomes were ascertained by linking with the public-use mortality data from the National Death Index through December 31, 2019. Accelerated failure time models were used to estimate time ratios (TRs) and corresponding 95% confidence intervals (CIs) for the associations between multimorbidity patterns and all-cause and CVD mortality and to exmine the extent to which SES and healthy lifestyles modified those associations.</p><p><strong>Results: </strong>In our study, six multimorbidity patterns were identified, including \"relatively healthy\", \"hypercholesterolemia\", \"metabolic\", \"arthritis-respiratory\", \"CKD-vascular-cancer\", and \"severely impaired\" classes. Compared with the \"relatively healthy\" class, TRs for all-cause and CVD mortality progressively decreased across the multimorbidity classes, with the \"severely impaired\" class showing the shortest survival time (TR, 0.53; 95% CI: 0.48, 0.58 for all-cause mortality; 0.42; 0.35, 0.50 for CVD mortality). A significant interaction was noted between SES and multimorbidity patterns for survival time, with a stronger positive association in individuals with low SES. Adherence to healthy lifestyles was related to longer survival time across all multimorbidity patterns, especially in those with relatively less severe multimorbidity.</p><p><strong>Conclusions: </strong>Multiple multimorbidity patterns were identified and associated with mortality. Lower SES was associated with higherexcess multimorbidity-associated mortality, while adopting healthy lifestyles contributed to longer survival regardless of multimorbidity patterns. Efforts should be mobilized to reduce SES gaps and promote healthy lifestyles to alleviate the health burden of multimorbidity.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1262"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing and validating a nomogram prediction model for osteoporosis risk in the UK biobank: a national prospective cohort.","authors":"Xinning Tong, Shuangnan Cui, Huiyong Shen, Xiaoxin Iris Yao","doi":"10.1186/s12889-025-22485-x","DOIUrl":"10.1186/s12889-025-22485-x","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a prevalent bone disease that increases frailty. Developing a nomogram prediction model to predict osteoporosis risk at multiple time points using bone mineral densities, behavioral habits, and clinical risk factors would be essential to identify individual risk and guide prevention.</p><p><strong>Methods: </strong>The study population from the UK Biobank was followed from 2014 to December 31st, 2022. The study outcome was identified as the first occurrence of osteoporosis in the UK Biobank during the follow-up period. After rebalancing with the synthetic minority over-sampling technique, a nomogram prediction model was developed using a LASSO Cox regression. Model discrimination between different risk levels was visualised with Kaplan-Meier curves, and model performance was evaluated with integrated c-index, time-dependent AUC, calibration curves and decision curve analysis (DCA).</p><p><strong>Results: </strong>The model identified several risk factors for osteoporosis, including higher age, underweight, and various clinical risk factors (such as menopause, lower hand grip strength, lower bone mineral density, fracture history within 5 years, and a history of chronic disease including hypercholesterolemia, cardiovascular disease, bone disease, arthritis, and cancer). Kaplan-Meier curves showed that risk levels predicted by the nomogram model were significantly distinct. The c-indexes were 0.844 and 0.823 for training and validation datasets, respectively. Time-dependent AUC, calibration curves and DCA indicated good discrimination, model fit and clinical utility, respectively.</p><p><strong>Conclusions: </strong>The nomogram model could properly quantify the five-year risk of osteoporosis and identify high-risk individuals. This might effectively reduce the burden of osteoporosis on the population.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1263"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}