Ya Zheng

Purpose Prospective evidence on the association between type 2 diabetes mellitus (T2DM) and incident peptic ulcer disease (PUD) remains limited, particularly after accounting for comorbidities and medications related to ulcer risk. We examined this association in the UK Biobank. Methods We analysed 344,612 participants, including 13,193 with T2DM at baseline, during up to 17.7 years of follow-up. Multivariable Cox proportional hazards models estimated associations of T2DM with incident PUD, gastric ulcer (GU), and duodenal ulcer (DU). Results Participants with T2DM had a higher cumulative incidence of PUD (log-rank P < 0.001). In the fully adjusted model, T2DM was associated with higher risks of PUD (hazard ratio [HR] 1.40, 95% confidence interval [CI] 1.27–1.54), GU (HR 1.34, 95% CI 1.19–1.51), and DU (HR 1.56, 95% CI 1.34–1.82). There was no evidence of interaction by regular pain medication use (P for interaction = 0.473). The associations were similar in three sensitivity analyses. Conclusion Baseline T2DM was associated with a higher risk of incident PUD and its anatomical subtypes. Residual confounding, selection and detection biases, and the lack of systematic Helicobacter pylori data preclude causal interpretation.

Circadian Syndrome (CircS), a cluster encompassing metabolic dysregulation, short sleep duration, and depression, has been implicated in various chronic diseases. Gastroesophageal reflux disease (GERD) is a highly prevalent digestive disorder; however, its prospective association with CircS remains unclear. This prospective cohort study utilized data from the UK Biobank, including 330,925 participants free of GERD at baseline. CircS was defined as meeting at least four of seven components. The primary outcome was incident GERD, identified through the first recorded diagnosis code from linked hospital, primary care, death registry, and self-report data. Cox proportional hazards models were used to estimate hazard ratios with sequential adjustments for demographics, socioeconomic status, lifestyle factors, and medication use. Over a median follow-up of 13.05 years, 28,554 incident GERD cases were documented. In the fully adjusted model, CircS was associated with a significantly increased risk of GERD (HR = 1.20; 95% CI: 1.16-1.23). All seven individual components were each associated with GERD risk in separate fully adjusted models, with the strongest associations observed for depression (HR = 1.38) and short sleep (HR = 1.29). A significant dose-response relationship was evident as the number of components increased. Subgroup analyses revealed stronger associations among individuals aged under 65 years, women, non-White participants, and those not using proton pump inhibitors. Circadian Syndrome is independently associated with incident GERD, with depression and short sleep as core driving components. These findings support the integration of circadian, metabolic, and psychological health assessments into GERD risk stratification.

The associations between LDH and non-alcoholic fatty liver disease (NAFLD), as well as advanced hepatic fibrosis (AHF), have not been explored. This study aims to investigate the association between log-transformed LDH levels and the prevalence of NAFLD and AHF. In this cross-sectional study, after applying specific criteria for inclusion and exclusion, a total of 7,316 individuals were chosen from the 59,842 participants for the final analysis. LDH levels were measured using an enzymatic rate method. A fatty liver index (FLI) greater than or equal to 60 and an NAFLD fibrosis score (NFS) higher than 0.676 were found to be indicative of hepatic steatosis and advanced hepatic fibrosis. Both weighted multivariable linear and logistic regression analyses were used to finish the study. Moreover, additional analyses were performed utilizing weighted stratified analysis and weighted smoothed curve fitting using the generalized additive model (GAM). Following data analysis, the multivariable regression model 3 showed a significant association between the elevated log-transformed LDH levels and AHF (OR: 3.087, 95% CI: 1.378–6.915, P = 0.007). Furthermore, a modest association was observed between log-transformed LDH tertiles and FLI (βQ2 vs. Q1 = 0.965, 95% CI: 0.014–1.916, P = 0.047). However, there was no evidence to prove that there was an association between log-transformed LDH levels and NAFLD in model 3. The weighted smoothed curve fitting using the GAM suggested a linear dose–response effect between log-transformed LDH levels and an increased risk of NAFLD, as well as a non-linear relationship between log-transformed LDH levels with AHF risk. Moreover, the weighted stratified analysis further suggested that the associations of log-transformed LDH with NAFLD and AHF could differ in different population groups. This study indicates that elevated log-transformed LDH levels are associated with an increased prevalence of AHF in our study population. However, the cross-sectional study analysis cannot prove causality, which requires further cohort studies or mechanistic studies to elucidate the precise mechanisms and root causes.

The consumption of sugar-sweetened beverages (SSBs) has increased substantially over recent decades, raising concerns about its various physiological effects on bodily function. However, the relationship between SSBs intake and constipation remains insufficiently understood. Data from 7,979 participants sourced from the National Health and Nutrition Examination Survey (NHANES) were analyzed in this study. Dietary intake of SSBs was assessed using two 24-hour dietary recall interviews, and constipation was defined according to the Bristol Stool Form Scale (BSFS) Cards. We employed weighted logistic regression analysis to examine the relationship between SSBs consumption (quantified in grams and kilocalories) and the risk of constipation, while stratified and restricted cubic spline (RCS) analyses explored population variability. After adjusting for all relevant variables, SSBs quantified in grams (SSBs-grams) (ORQ3 vs. Q1 = 1.419, 95% CI: 1.064–1.893, p = 0.019; p for trend = 0.02) and SSBs quantified in kilocalories (SSBs-kcal) (ORQ4 vs. Q1 = 1.567, 95% CI: 1.100-2.234, p = 0.015; p for trend = 0.016) showed a significant positive association with constipation. Furthermore, the weighted RCS and stratified analyses indicated that the association varied among subgroups, with a non-linear relationship between SSBs-kcal and constipation (SSBs-grams: p non-linear = 0.100, SSBs-kcal: p non-linear = 0.026). Our findings indicated that increased SSBs consumption is associated with a higher risk of constipation. The results underscore the need for public health interventions aimed at reducing the intake of SSBs and promoting healthier alternatives.

The circadian syndrome is linked with chronic diseases such as stroke, kidney stones, and overactive bladder. However, the relationship between circadian syndrome and gallstones is poorly understood. In this study, we aim to investigate whether circadian syndrome is associated with gallstones in a population-based study. Using data from the National Health and Nutrition Examination Survey (NHANES) database spanning from 2017 to 2020, a cross-sectional study with 2913 participants was performed to assess the relationship between circadian syndrome and gallstones. Univariate and two adjusted multivariate regression models were used to examine the connection between circadian syndrome and gallstones incidence. Smoothed curve fitting using the generalized additive model (GAM) was used to describe the nonlinear relationship. Subgroup analyses were also performed to investigate potential variations in the relationship between circadian syndrome and the risk of developing gallstones. The findings indicated a positive association of circadian syndrome with gallstones, with model 2 showing a 117% increase in risk (OR = 2.17, 95% CI 1.43, 3.29). In model 3, the incidence of gallstones increased by 76% (OR = 1.76, 95% CI 0.91, 3.43). However, there was no significant relationship between the number of circadian syndrome components and the risk of gallstones. Smooth curve fitting based on the GAM further demonstrated linear relationships between CircS and the risk of gallstones. Subgroup analyses further demonstrated statistically significant associations between circadian syndrome and the prevalence of gallstones among individuals who were non-smokers. Circadian syndrome was positively associated with the prevalence of gallstones, particularly among non-smoking participants.

The number of cancer survivors worldwide is increasing every year, making secondary primary cancers (SPC) is a growing health threat. Studies have been conducted to investigate the risk of occurrence between digestive system tumors (DST) and thyroid cancer (TC). However, existing studies have tended to focus more on the risk of developing SPC and less on the impact of SPC on the survival of cancer survivors. In this study, using the Surveillance, Epidemiology, and End Results database, we aimed to explore the impact of TC on the survival of patients with DST by data between 2000 and 2018. The study employed the standardized incidence ratio to assess the relative risk of SPC, propensity score matching was conducted to mitigate confounding effects, Kaplan-Meier, Cox proportional risk model and competitive risk model were used to analyze the factors affecting the overall survival and cancer-specific survival. We furthermore explored the influence of pathological types and radiotherapy of TC on the survival of DST patients. 518,901 patients with DST only, 801 patients with TC occurring earlier than DST (TC-1st), and 744 patients with DST occurring earlier than TC (DST-1st) were included. The total incidence rate of small intestine cancer after TC was higher than that of the general population, and the incidence of TC after DST was higher than in the general population. DST patients with a history of TC had better overall survival and lower cancer-specific mortality and this difference was particularly significant in patients with DST-1st. In addition, radiotherapy for TC had no effect on cancer-specific mortality in patients with DST.

Background: The association between coffee consumption and constipation remains unclear. This study aimed to examine the relationship of coffee consumption with the risk of constipation, while also investigating potential effect modifiers. Methods: This cross-sectional study included 7844 participants from the National Health and Nutrition Examination Survey (NHANES) 2007–2010. Coffee consumption was extracted from the 24-hour dietary recall. Constipation was assessed using the Bristol Stool Form Scale. The association between coffee consumption and constipation was assessed using multivariable restricted cubic spline and logistic regression with odds ratio (OR) and 95% confidence interval (CI). Results: There was a J-shaped relationship between total coffee consumption and the risk of constipation in the whole population (p for nonlinearity = 0.049), with 1–2 cups/day of total coffee potentially reducing the risk of constipation by 39% (OR 0.61, 95% CI 0.35–1.06, p = 0.07). As for caffeinated coffee, a J-shaped association between its consumption and the risk of constipation was also observed in the whole population (p for nonlinearity = 0.008), with 1–2 cups/day being significantly associated with a reduced risk (OR 0.57, 95% CI 0.35–0.95, p = 0.03). When restricting to never drinkers of alcohol, the associations between total and caffeinated coffee consumption and constipation shifted to inverse linear trends, where at least 3 cups/day was significantly associated with an 88% reduction in constipation risk (total coffee: OR 0.12, 95% CI 0.02–0.68, p = 0.02; caffeinated coffee: OR 0.12, 95% CI 0.02–0.70, p = 0.02). Decaffeinated coffee showed no association with constipation. Conclusions: Consuming 1–2 cups of caffeinated coffee daily was associated with a reduced risk of constipation in the general population. Among never drinkers of alcohol, a linear protective effect was observed, with a notable 88% reduction in constipation risk for those consuming at least 3 cups per day. Moderate caffeinated coffee intake may therefore be a viable dietary strategy for managing constipation in the general population.

Background: Observational studies have previously shown a possible link between fatty acids and aging-related diseases, raising questions about its health implications. However, the causal relationship between the two remains uncertain. Methods: Univariable and multivariable Mendelian randomization (MR) was used to analyze the relationship between five types of fatty acids—polyunsaturated fatty acid (PUFA), monounsaturated fatty acid (MUFA), saturated fatty acid (SFA), Omega-6 fatty acid (Omega-6 FA), and Omega-3 fatty acid (Omega-3 FA) and three markers of aging: telomere length (TL), frailty index (FI), and facial aging (FclAg). The primary approach for Mendelian randomization (MR) analysis involved utilizing the inverse variance weighted (IVW) method, with additional supplementary methods employed. Results: Univariate MR analysis revealed that MUFA, PUFA, SFA, and Omega-6 fatty acids were positively associated with TL (MUFA OR: 1.019, 95% CI: 1.006-1.033; PUFA OR: 1.014, 95% CI: 1.002-1.026; SFA OR: 1.016, 95% CI: 1.002-1.031; Omega-6 FAs OR=1.031, 95% CI: 1.006-1.058). PUFA was also associated with a higher FI (OR: 1.033, 95% CI: 1.009-1.057). In multivariate MR analysis, after adjusting for mutual influences among the five fatty acids, MUFA and PUFA were positively independently associated with TL (MUFA OR: 1.1508, 95% CI = 1.0724-1.2350; PUFA OR: 1.1670, 95% CI = 1.0497-1.2973, while SFA was negatively correlated (OR: 0.8005, 95% CI: 0.7045-0.9096). Conclusions: Our research presents compelling evidence of a causal association between certain fatty acids and indicators of the aging process. In particular, MUFA and PUFA may play a role in slowing down the aging process, while SFAs may contribute to accelerated aging. These findings could have significant implications for dietary recommendations aimed at promoting healthy aging.