medRxiv : the preprint server for health sciences最新文献

{"title":"Long-telomeropathy is associated with tumor predisposition syndrome.","authors":"Patrick Allaire, John Mayer, Luke Moat, Rachel Gabor, Jerry W Shay, Jing He, Chenjie Zeng, Lisa Bastarache, Scott Hebbring","doi":"10.1101/2024.11.26.24318007","DOIUrl":"https://doi.org/10.1101/2024.11.26.24318007","url":null,"abstract":"<p><p>Telomeres protect chromosomal integrity, and telomere length (TL) is influenced by environmental and genetic factors. While short-telomeres are linked to rare telomeropathies, this study explored the hypothesis that a \"long-telomeropathy\" is associated with a cancer-predisposing syndrome. Using genomic and health data from 113,861 individuals, a trans-ancestry polygenic risk score for TL (PRS _TL ) was developed. A phenome-wide association study (PheWAS) identified 65 tumor traits linked to elevated PRS _TL . Using this result, a trans-ancestry phenotype risk score for a long-TL (PheRS _LTL ) was develop and validated. Rare variant analyses revealed 13 genes associated with PheRS _LTL . Individuals who were carriers of these rare variants had a predisposition for long-TL validating original hypothesis. Most of these genes were new to both cancer and telomere biology. In conclusion, this study identified a novel tumor-predisposing syndrome shaped by both common and rare genetic variants, broadening the understanding of telomeropathies to those with a predisposition for long telomeres.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between weather and <i>Plasmodium vivax</i> malaria in an elimination setting in Peru: a distributed lag analysis.","authors":"Gabriella Barratt Heitmann, Xue Wu, Anna T Nguyen, Astrid Altamirano-Quiroz, Sydney Fine, Bryan Fernandez-Camacho, Antony Barja, Renato Cava, Verónica Soto-Calle, Hugo Rodriguez, Gabriel Carrasco-Escobar, Adam Bennett, Alejandro Llanos-Cuentas, Erin A Mordecai, Michelle S Hsiang, Jade Benjamin-Chung","doi":"10.1101/2024.11.26.24318000","DOIUrl":"10.1101/2024.11.26.24318000","url":null,"abstract":"<p><strong>Background: </strong><i>Plasmodium vivax</i> (<i>Pv</i>) is the predominant malaria species in countries approaching elimination. In the context of climate change, understanding environmental drivers of transmission can guide interventions, yet evidence is limited, particularly in Latin America.</p><p><strong>Objectives: </strong>We estimated the association between temperature and precipitation and <i>Pv</i> malaria incidence in a malaria elimination setting in Peru.</p><p><strong>Methods: </strong>We analyzed malaria incidence data from 2021-2023 from 30 communities in Loreto, Peru with hourly weather data from the ERA5 dataset and land cover data from MapBiomas. Predictors included average weekly minimum and maximum temperature, high heat (>90th percentile mean temperature), total weekly precipitation, and heavy rain (>90th percentile total precipitation). We fit non-linear distributed lag models for continuous weather predictors and generalized additive models for binary predictors and the lookback period was 2-16 weeks. Temperature models adjusted for total precipitation; precipitation models adjusted for maximum temperature. We performed subgroup analyses by season, community type, and distance to forest edge.</p><p><strong>Results: </strong>The median vs. lowest values of weekly average minimum temperature was associated with 2.16 to 3.93-fold higher incidence 3-16 weeks later (5-week lag incidence ratio (IR) =3.93 [95% CI 2.18, 7.09]); for maximum temperature, the association was hump-shaped across lags, with protective associations at 1-2 and 15-16 week lags and 1.07-1.66-fold higher incidence at 6-13 week lags. High heat (>27.5°C) was associated with 1.23 to 1.37-fold higher incidence at 5--9 week lags (9-week lag IR = 1.25 [1.02, 1.53]). Associations between total precipitation and malaria incidence were hump-shaped across lags, with the strongest positive association at 750 mm of precipitation at a 9-week lag (IR=1.56; [1.27, 1.65]). Heavy rain (>186mm) was associated with 1.22-1.60-fold higher incidence at 2-10 week lags (9-week lag IR=1.23 [1.02, 1.49]).</p><p><strong>Discussion: </strong>Higher temperatures and precipitation were generally associated with higher malaria incidence over 1-4 months.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obfuscation via pitch-shifting for balancing privacy and diagnostic utility in voice-based cognitive assessment.","authors":"Meysam Ahangaran, Nauman Dawalatabad, Cody Karjadi, James Glass, Rhoda Au, Vijaya B Kolachalama","doi":"10.1101/2024.11.25.24317900","DOIUrl":"10.1101/2024.11.25.24317900","url":null,"abstract":"<p><strong>Introduction: </strong>Digital voice analysis is gaining traction as a tool to differentiate cognitively normal from impaired individuals. However, voice data poses privacy risks due to the potential identification of speakers by automated systems.</p><p><strong>Methods: </strong>We developed a framework that uses weighted linear interpolation of privacy and utility metrics to balance speaker obfuscation and cognitive integrity in cognitive assessments. This framework applies pitch-shifting for speaker obfuscation while preserving cognitive speech features. We tested it on digital voice recordings from the Framingham Heart Study (N=128) and Dementia Bank Delaware corpus (N=85), both containing responses to neuropsychological tests.</p><p><strong>Results: </strong>The tool effectively obfuscated speaker identity while maintaining cognitive feature integrity, achieving an accuracy of 0.6465 in classifying individuals with normal cognition, mild cognitive impairment, and dementia in the FHS cohort.</p><p><strong>Discussion: </strong>Our approach enables the development of digital markers for dementia assessment while protecting sensitive personal information, offering a scalable solution for privacy-preserving voice-based diagnostics.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorespiratory Fitness in Adolescence and Risk of Type 2 Diabetes in Late Adulthood: A Nationwide Sibling-Controlled Cohort Study.","authors":"Marcel Ballin, Viktor H Ahlqvist, Daniel Berglind, Mattias Brunström, Herraiz-Adillo Angel, Pontus Henriksson, Martin Neovius, Francisco B Ortega, Anna Nordström, Peter Nordström","doi":"10.1101/2024.11.26.24318038","DOIUrl":"https://doi.org/10.1101/2024.11.26.24318038","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The importance of adolescent cardiorespiratory fitness for long-term risk of type 2 diabetes (T2D) remains poorly investigated, and whether the association is influenced by unobserved familial confounding is unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a sibling-controlled cohort study based on all Swedish men who participated in mandatory military conscription examinations from 1972 to 1995 around the age of 18, and who completed standardized cardiorespiratory fitness testing. The outcome was T2D, defined as a composite endpoint of diagnosis in inpatient or specialist outpatient care, or dispensation of antidiabetic medication, until 31 December 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;1 124 049 men, of which 477 453 were full siblings, with a mean age of 18.3 years at baseline were included. During follow-up, 115 958 men (48 089 full siblings) experienced a first T2D event at a median age of 53.4 years. Compared to the first decile of fitness, higher fitness levels were associated with a progressively lower risk of T2D. In cohort analysis, the hazard ratio (HR) in the second decile was 0.83 (95% CI, 0.81 to 0.85), with a difference in the standardized cumulative incidence at age 65 of 4.3 (3.8 to 4.8) percentage points, dropping to a HR of 0.38 (0.36 to 0.39; incidence difference 17.8 [17.3 to 18.3] percentage points) in the tenth decile. When comparing full siblings, and thus controlling for all unobserved behavioral, environmental, and genetic confounders that they share, the association replicated, although with attenuation in magnitude. The HR in the second decile was 0.89 (0.85 to 0.94; incidence difference 2.3 [1.3 to 3.3] percentage points), and in the tenth decile it was 0.53 (0.50 to 0.57; incidence difference 10.9 [9.7 to 12.1] percentage points). Hypothetically shifting everyone in the first decile of fitness to the second decile was estimated to prevent 7.2% (6.4 to 8.0) of cases at age 65 in cohort vs. 4.6% (2.6 to 6.5) in full-sibling analysis. The association was similar in those with overweight as in those without.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Higher levels of adolescent cardiorespiratory fitness are associated with lower risk of T2D in late adulthood, with clinically relevant associations starting already from very low levels of fitness, and similarly in those with overweight compared to those without. The association replicates, but becomes weaker, after adjusting for unobserved familial confounders shared between full siblings. This suggests that adolescent cardiorespiratory fitness is a robust marker of long-term T2D risk, but that conventional observational analysis may yield biased estimates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: &lt;/strong&gt;None.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research in context: &lt;/strong&gt;&lt;b&gt;Evidence before this study:&lt;/b&gt; Type 2 diabetes is a growing public health issue, affecting at least half a billion people globally. Modifiable factors such as physical activity and the closely related ","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convergent molecular signatures across eating disorders and obsessive-compulsive disorder in the human brain.","authors":"Michael S Breen, Ran Tao, Andy Yang, Xuran Wang, Pardis Amini, Miguel Rodriguez de Los Santos, Anna C Brandtjen, Amy Deep-Soboslay, Walter H Kaye, Thomas M Hyde, Joel E Kleinman, Joseph D Buxbaum, Dorothy E Grice","doi":"10.1101/2024.11.27.24318078","DOIUrl":"10.1101/2024.11.27.24318078","url":null,"abstract":"<p><p>Eating disorders (ED) and obsessive-compulsive disorder (OCD) exhibit significant clinical and genetic overlap, yet their shared molecular mechanisms remain unclear. We conducted a transcriptomic investigation of the dorsolateral prefrontal cortex (DLPFC) and caudate from 86 controls, 57 ED, and 27 OCD cases. ED was associated with robust differentially expressed genes (DEGs): 102 DEGs the DLPFC and 222 in the caudate (FDR < 1%) and replicated in an independent cohort. For OCD, no DEGs reached significance; however, meta-analysis with extant data identified 57 DEGs in the caudate. High concordance in transcriptomic changes was observed between ED and OCD in both regions (DLPFC <i>r</i>=0.67, caudate <i>r</i>=0.75). A combined ED+OCD analysis uncovered 233 DEGs in the DLPFC and 816 in the caudate, implicating disrupted GABAergic neuron function, neuroendocrine pathways, metabolism, and synaptic processes. Genetically regulated expression analysis identified nine genes with strong evidence for increasing ED risk, further validating these pathways. These findings reveal a shared molecular basis for ED and OCD, offering new insights into their pathobiology and potential therapeutic targets.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct medical and substance use histories associate with cognitive decline in Alzheimer's Disease.","authors":"Clayton Mansel, Diego R Mazzotti, Ryan Townley, Mihaela E Sardiu, Russell H Swerdlow, Robyn A Honea, Olivia J Veatch","doi":"10.1101/2024.11.26.24317918","DOIUrl":"10.1101/2024.11.26.24317918","url":null,"abstract":"<p><strong>Introduction: </strong>Phenotype clustering reduces patient heterogeneity and could be useful when designing precision clinical trials. We hypothesized that the onset of early cognitive decline in patients would exhibit variance predicated on the clinical history documented prior to an Alzheimer's Disease (AD) diagnosis.</p><p><strong>Methods: </strong>Self-reported medical and substance use history (i.e., problem history) was used to cluster participants from the National Alzheimer's Coordinating Centers (NACC) into distinct subtypes. Linear mixed effects modeling was used to determine the effect of problem history subtype on cognitive decline over two years.</p><p><strong>Results: </strong>2754 individuals were partitioned into three subtypes: minimal (n = 1380), substance use (n = 1038), and cardiovascular (n = 336) subtypes. The cardiovascular problem history subtype had significantly worse cognitive decline over a two-year follow-up period (p = 0.013).</p><p><strong>Discussion: </strong>Our study highlights the need to account for problem history to reduce heterogeneity of outcomes in AD clinical trials.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flooding and elevated prenatal depression in a climate-sensitive community in rural Bangladesh: a mixed methods study.","authors":"Suhi Hanif, Jannat-E-Tajreen Momo, Farjana Jahan, Liza Goldberg, Natalie Herbert, Afsana Yeamin, Abul Kasham Shoab, Reza Mostary Akhter, Sajal Kumar Roy, Gabriella Barratt Heitmann, Ayse Ercumen, Mahbub Rahman, Fahmida Tofail, Gabrielle Wong-Parodi, Jade Benjamin-Chung","doi":"10.1101/2024.11.25.24317922","DOIUrl":"10.1101/2024.11.25.24317922","url":null,"abstract":"<p><strong>Background: </strong>Prenatal depression can have lasting adverse impacts on child health. Little is known about the impact of floods on prenatal depression in low- and middle-income countries.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of 881 pregnant women from September 24, 2023 to July 19, 2024 in riverine communities in rural Bangladesh. We recorded participant-reported flooding in the past 6 months, administered the Edinburgh Postnatal Depression Scale (EPDS), and obtained water level data and remote sensing data on distance to surface water. We fit generalized linear and log-linear models adjusting for month, wealth, education, age, and gestational age. We conducted 2 focus group discussions with 20 adult women.</p><p><strong>Findings: </strong>3.6% of compounds were flooded in the past 6 months. Compound flooding was associated with elevated depression (adjusted prevalence ratio (aPR) = 2.08, 95% CI 1.14, 3.51) and thoughts of self-harm (aPR=8.40, 95% CI 4.19, 16.10). Latrine flooding was associated with higher depression (aPR=3.58, 95% CI 1.49, 7.29)). Higher water levels and shorter distance to permanent surface water were significantly associated with mean EPDS scores. Focus groups revealed that domestic violence, inadequate sanitation, gendered vulnerabilities in accessing latrines, childcare difficulties, and food insecurity were key drivers of depression due to floods. Flood preparedness strategies included relocation, storing food, and home modifications.</p><p><strong>Interpretation: </strong>Flooding, higher water levels, and proximity to water bodies were associated with prenatal depression in a rural, low-income setting. Inadequate sanitation and hygiene infrastructure were particularly strong drivers of depression.</p><p><strong>Funding: </strong>Eunice Kennedy Shriver National Institute of Child Health and Human Development.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Evaluation of Adiposity Indices as Predictors of Hypertension Risk in Children and Adolescents.","authors":"Bowen Zhu, Shumin Zhan, Hui Shi, Xingyun Wang, Jingwen Yue, Jianfang Gao, Tongshuai Wang, Rui Wang, Xirong Guo, Junfen Fu","doi":"10.1101/2024.11.26.24318031","DOIUrl":"10.1101/2024.11.26.24318031","url":null,"abstract":"<p><strong>Objective: </strong>To systemically examine the concomitant impact of adiposity indices on hypertension in children and adolescents.</p><p><strong>Methods: </strong>A community-based cohort study by China Health and Nutrition Survey (2009-2011) included 262 children and adolescents aged 7-17. Anthropometric and lipid profiles were analyzed for hypertension risk using logistic and cross-lagged models.</p><p><strong>Results: </strong>Of the 227 participants (mean age, 16.5 [2.3] years), 147 (53.9%) were boys. Over a two-year period, 26.4% developed hypertension, 5.3% had elevated systolic blood pressure (SBP), and 25.6% had elevated diastolic blood pressure (DBP). After adjusting for covariates, higher body mass index (BMI), waist circumference (WC), hip circumference (HC), triceps skinfold thickness (TST), and body roundness index (BRI) were associated with increased hypertension risk. Incorporating these measures into a BP-based model improved the AUC for hypertension prediction from 0.551 (95% CI: 0.463, 0.640) to 0.670 (95% CI: 0.592, 0.748). A longitudinal relationship were observed between these adiposity indices and hypertension symptoms.</p><p><strong>Conclusions: </strong>The study suggests anthropometry parameters are superior to blood lipid indicators in predicting the occurrence of hypertension in children. Abdominal obesity, as indicated by WC, HC, and BRI, accounts for a significant portion of the risk for hypertension, particularly in children aged 7 to 12 years.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary inflammatory index scores and cognitive aging: results from the Framingham heart Study offspring cohort.","authors":"Debora Melo van Lent, Paul F Jacques, Sokratis M Charisis, Hannah Gokingco Mesa, Claudia Satizabal, Changzheng Yuan, Ramachandran S Vasan, Sudha Seshadri, Alexa Beiser, Jayandra J Himali, Mini E Jacob","doi":"10.1101/2024.11.27.24318084","DOIUrl":"https://doi.org/10.1101/2024.11.27.24318084","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Nutritional factors can abet or protect against systemic chronic inflammation, which plays an important role in the development and progression of dementia. We evaluated whether higher (i.e. pro-inflammatory) Dietary Inflammatory Index (DII) scores were associated with cognitive decline in the community-based Offspring Framingham Heart Study (FHS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;1,614 older adults (mean age 61 years [standard deviation (SD)], 9;55% women]) completed validated 126-item Food Frequency Questionnaires (FFQ), administered at FHS examination cycle 7 (1998-2001) and examination cycle 5 (1991-1995) and/or 6 (1995-1998). We created a DII score (based on the published method by Shivappa et al. 2014) for each available exam; a cumulative DII score was calculated by averaging exam-specific scores across the two or three exams. Cognitive testing was completed at call back sessions following examination cycles 7 and 8 (2005-2008). Exam 7 was considered as study baseline and participants were followed over a mean time of seven years (SD 1). We excluded participants with prevalent dementia at baseline and those with no cognitive testing data at either/or exams 7 and 8. We examined associations between the cumulative DII score and cognitive test scores over time using annualized change adjusting for age, sex, education (model 1) and additionally for exam 7 measures of body mass index, total energy intake, total cholesterol: high-density lipoprotein ratio, smoking and anti-cholesterol medication (model 2).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Higher DII scores were significantly associated with (less) decline in performance on Similarities (verbal comprehension/reasoning) and Global cognition, following adjustments for model 1 covariates (Model 1:β and SE, 0.017, 0.008,p=0.03; 0.004,0.002,p=0.02, respectively). The effect sizes remained similar after additional adjustment for Model 2 covariates (0.018, 0.009,p=0.06; 0.004, 0.002,p=0.03, respectively). Additionally, we found that higher DII scores associated with accelerated decline in performance on Trail Making B-A (processing speed and executive function) (Model 2: -0.010, 0.004,p=0.03). We observed no relationships between higher DII scores and other neuropsychological tests. Further, stratified analyses revealed a linear relationship between higher DII scores and (less) decline in performance on Hooper visual organization among men, but not women (Model 2: 0.022, 0.010,p=0.02; -0.011, 0.009,p=0.23, respectively).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Higher DII scores were associated with (less) cognitive decline. We take our unexpected findings with caution as we previous have seen a relationship between higher DII scores and increased risk for dementia. To date, such studies have been very limited, most studies that found a relationship were cross-sectional and have used less sensitive testing. Future longitudinal studies with sensitive neuropsychological test measure","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Cardiovascular-Kidney-Metabolic Stages in US Adolescents and Relationship to Social Determinants of Health.","authors":"Carissa Baker-Smith, Abigail M Gauen, Lucia C Petito, Sadiya S Khan, Norrina Bai Allen","doi":"10.1101/2024.11.25.24317946","DOIUrl":"10.1101/2024.11.25.24317946","url":null,"abstract":"<p><strong>Importance: </strong>Given that many risk factors for atherosclerotic cardiovascular disease (ASCVD) begin in childhood, knowledge of the prevalence of cardio-kidney metabolic syndrome (CKM) in adolescents and its risk factors is critical to understanding the etiology of ASCVD risk burden.</p><p><strong>Objective: </strong>To calculate the proportion of US adolescents with CKM stages 0, 1, and 2 and to assess the social factors and behaviors most strongly associated with advanced CKM stage.</p><p><strong>Design: </strong>Cross-sectional analysis of 2017-2020 US National Health and Nutrition Examination Survey (NHANES) sample data.</p><p><strong>Setting: </strong>United States.</p><p><strong>Participants: </strong>Adolescents.</p><p><strong>Exposure: </strong>Social determinants of health, including family income to poverty ratio, health insurance, routine healthcare access, and food security, as well as behaviors including smoking, physical activity, and diet.</p><p><strong>Main outcomes and measures: </strong>The prevalence of CKM stages 0, 1, and 2 in adolescents was measured using survey-weighted data. Generalized linear models were used to quantify associations between social factors, behaviors, and CKM staging.</p><p><strong>Results: </strong>Of the 1,774 surveyed adolescents ages 12-18 years, representing 30,327,145 US adolescents, 56% (95% CI 52-60%) had CKM stage 0, 37% (33-40%) had CKM stage 1, and 7% (5-9%) had CKM stage 2. Physical activity score (1 to 100, 100=highest) was lowest among adolescents with CKM stage 2 (physical activity score for CKM 0: 60 (31), CKM 1: 60 (32), and CKM 2 49 (33); p=0.025). Other health behaviors, such as the DASH diet and nicotine scores, did not differ according to the CKM stage (p=0.477 and p=0.932, respectively). According to sex, race, ethnicity, and age-adjusted multivariate logistic regression analyses, a ratio of income to poverty level >1.85, having health insurance, and food security, were associated with a 32% (OR 0.68 [95% CI:0.52,0.89]), 40% (OR 0.60 [95% CI: 0.37, 0.99]), and 45% (OR 0.55 [95% CI: 0.41,0.73]) lower odds of CKM stage 1-2, respectively. After adjustment for all sociodemographic factors, only food security was associated with 41% lower odds of CKM stage 1-2 (OR 0.59 [0.43, 0.81]).</p><p><strong>Conclusions and relevance: </strong>CKM stage 1-2 in adolescents is most strongly associated with food insecurity. Improved access to healthy food and policies to address food security may help prevent higher CKM stage, beginning in adolescence.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}