Xin Zhang

Background: Cardio-renal-metabolic (CRM) diseases—including ischemic heart disease (IHD), stroke, type 2 diabetes (T2DM), and chronic kidney disease (CKD)—pose major threats to healthy aging. Yet the co-occurrence and evolution of these conditions across regions, and their modifiable risk factors, remain unclear. Methods: We analyzed CRM incidence among adults aged ≥55 years in 204 countries and territories from 1990 to 2021. Fifteen multimorbidity patterns were identified based on the population-level coexistence of high CRM incidence. Temporal dynamics were assessed using Bayesian age-period-cohort modeling, and interpretable machine learning was used to screen corresponding risk factors. Results: From 1990 to 2021, global incidence declined for IHD and stroke but rose for T2DM and CKD. High-income regions transitioned from IHD-dominated to T2DM- and CKD-predominant patterns, while North Africa and the Middle East became hotspots for the concurrence of high CRM incidence. Inequalities linked to sociodemographic development widened and are projected to persist through 2035. Declines in IHD and stroke were associated with improvements in blood pressure and lipid control, whereas rises in obesity and trans-fat intake were linked to increases in T2DM and CKD. Regional variation and clustering of these risk factors corresponded to global disparities in incidence trends. Addressing these risk factors was projected to improve healthy life expectancy at age 55, particularly in the Middle East and North Africa. Conclusions: Co-occurrence of CRM conditions is undergoing a transition, characterized by heterogeneous regional risk profiles and widening inequalities. Targeted prevention and policy strategies may be considered to promote healthy longevity worldwide.

Kaposi sarcoma, caused by the pathogen Kaposi sarcoma–associated herpesvirus (KSHV), is the most common neoplasm for patients with AIDS. Susceptibility to KSHV has been associated with several different genetic risk variants. The purpose of this study was to test whether variants of killer cell immunoglobulin-like receptors (KIRs) and their human leukocyte antigen (HLA-I) ligands influence the risk of KSHV infection. A case-control study was performed in Xinjiang, a KSHV-endemic region of China. We recruited 299 individuals with HIV, including 123 KSHV-seropositive persons and 176 KSHV-seronegative controls. We used logistic regression and the MiDAS package to evaluate the association between KIR/HLA-I polymorphisms and KSHV infection. HLA-A*31:01, HLA-C*03:04, and HLA-C*12:03 were found to be associated with KSHV infection, with A*31:01 showing a protective effect under 3 different models (dominant: 0.30 [95% confidence interval {CI}, .08–.82], P = .031; additive: 0.30 [95% CI, .09–.80], P = .030; overdominant: 0.31 [95% CI, .09–.88], P = .042). The effect of A*31:01 might cause the variants of amino acid at HLA-A position 56, with individuals carrying an arginine having a lower KSHV infection risk. The increased homozygous KIR2DL3 was associated with a relatively high KSHV viral load (16.30% vs 41.94%, P = .010). This study provides further insight into the link between HLA-I alleles and KIR genes and KSHV infection, highlighting KSHV-susceptible variants of HLA-I and KSHV replication caused by specific KIR genotype, and revealing a potential role of KIR-mediated natural killer cell activation in anti-KSHV infection.

INPLASY2022100123 Effects of natural products in Patients with Non-alcoholic Fatty Liver Disease—A Network Meta-Analysis of Randomized Controlled Trials Keywords: natural products ; Non-alcoholic F…

Objective To describe the prevalence and variations of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH) among children and adolescents (CADs) and young adults (YADs). Design A population-based observational study. Setting Annual cases and prevalence of NAFLD/NASH from 1990 to 2017, by sex, region and country were collected from the Global Burden of Disease database. Main outcome measures The estimated annual percentage change, which was calculated by a regression line, was used to quantify the temporal trends in NAFLD/NASH burden among young people at the global, regional and national levels. Results Globally, NAFLD/NASH incidence increased from 19.34 million in 1990 to 29.49 million in 2017 among CADs, with an annual increase of 1.35%. Additionally, in YADs, the number of cases and NAFLD/NASH prevalence significantly increased during this period, independent of sex and region. The greatest NAFLD/NASH increase was in North Africa and the Middle East. Almost all countries showed an increasing trend from 1990 to 2017, with the most pronounced increase observed in the developed regions. Conclusions The epidemiology of NAFLD/NASH in young people has changed considerably over the last three decades. Both the prevalence and number of cases have increased irrespective of sex, age and region. This phenomenon can result in a predictable increase in chronic liver disease burden in the near future. Understanding the prevalence of NAFLD/NASH and its variations is of paramount importance to develop strategies to implement public health policy.