Weiyuan Yao

Background/Objectives: Early-life undernutrition may exert lifelong and intergenerational effects on height and weight, but its impact on body shape remains unclear. Using the Great Chinese Famine (1959–1961) as a natural experiment, this study explored the associations between early-life undernutrition and body shape indices across two generations. Methods: We analyzed nine waves of longitudinal data from the China Health and Nutrition Survey (1991–2015), including 5156 participants (F1) born in 1955–1966 and their 2383 biological offspring (F2). F1 famine exposure was classified by birth year; F2 exposure was defined by parental status. Anthropometric indices including body adiposity index (BAI), body roundness index (BRI), waist-to-height ratio (WHtR), conicity index (COI), and a body shape index (ABSI) were derived from repeated measurements. Age-specific fitted curves of these indices were compared across exposure groups using mixed-effects models with fractional polynomials of age. Results: Fetal famine exposure was modestly associated with lower COI and ABSI in adulthood, particularly among men. Childhood famine exposure was significantly linked to lower BAI (−0.40), BRI (−0.26), WHtR (−0.0140), COI (−0.0188), and ABSI (−0.0008), with stronger associations in men (all P for sex interaction <0.05). Intergenerationally, maternal childhood exposure was associated with higher offspring BAI, whereas paternal childhood exposure was associated with lower BAI, BRI, WHtR, COI, and ABSI. Conclusions: Famine exposure showed more pronounced associations with body shape in men, and maternal and paternal exposures displayed different intergenerational patterns. These exploratory findings suggest the possibility that early-life undernutrition may relate to long-term phenotypes in a sex-specific manner, though this requires independent replication.

Background and purpose: Atherosclerotic diseases are a leading cause of death worldwide, highlighting an urgent need for the early detection of pan-vascular atherosclerotic plaques in asymptomatic individuals. This study aimed to investigate the association between a novel biomarker, the pan-vascular atherosclerosis risk score (PARS, the ratio of spleen tyrosine kinase [SYK]-positive classical monocytes to total classical monocytes) and the presence of pan-vascular plaques. Methods: In this multicenter cross-sectional study, we enrolled 513 asymptomatic participants aged 40 to 65 years from three hospitals in China. PARS was measured using flow cytometry. All participants underwent coronary computed tomography angiography, carotid, and femoral artery ultrasound to assess atherosclerotic plaques systematically. The association between PARS and plaque prevalence was assessed using multivariable logistic regression, and its discriminatory ability was evaluated with receiver operating characteristic curve analysis. Results: Pan-vascular plaques were identified in 361 (70.37%) participants. After adjusting for confounders, each 1% increase in PARS was associated with 41% higher odds of having pan-vascular plaques (odds ratio: 1.41, 95% confidence interval: 1.31–1.51). The discriminatory ability of PARS was strong, with an area under the receiver operating characteristic curve of 0.84. The optimal PARS cutoff value was 9.91%, providing a sensitivity of 78.90% and specificity of 77.60%. The sensitivity of PARS increased significantly with the number of vessel types involved: 73.18% for one vessel, 80.20% for two vessels, and 90.12% for three vessels (P for trend < 0.01). Conclusion: PARS is independently associated with pan-vascular atherosclerotic plaques in asymptomatic middle-aged adults, demonstrating good discriminatory accuracy.

Objectives: This study aimed to examine the cross-sectional associations between serum folate concentrations and four lipid abnormality subtypes among community-dwelling adults in Zhejiang Province, China. Methods: This population-based cross-sectional study included 3254 adults from Zhejiang Province, China. Serum folate concentrations were analyzed both as quartiles and per 1-standard deviation (SD) increments. Multivariable logistic regression models were used to evaluate the associations of serum folate with hypercholesterolemia, hypertriglyceridemia, high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C). Restricted cubic spline (RCS) regression models were further applied to assess dose–response patterns. Additional RCS analyses using continuous lipid parameters were also performed. False discovery rate (FDR) correction, exploratory subgroup analyses, and sensitivity analyses were additionally conducted. Results: The prevalences of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C were 7.87%, 17.12%, 4.30%, and 4.46%, respectively. In the fully adjusted model, each 1-SD increment in serum folate was associated with lower odds of hypertriglyceridemia (OR = 0.82, 95% CI: 0.73–0.92) and low HDL-C (OR = 0.63, 95% CI: 0.49–0.81). Compared with the lowest quartile, participants in the highest serum folate quartile had lower odds of hypertriglyceridemia (OR = 0.62, 95% CI: 0.46–0.82) and low HDL-C (OR = 0.38, 95% CI: 0.22–0.64), with significant trends across quartiles (both p for trend < 0.001). No significant associations were observed for hypercholesterolemia or high LDL-C. These findings remained significant after FDR correction. RCS analyses suggested an overall inverse association between serum folate and hypertriglyceridemia, with no evidence of nonlinearity (p for overall = 0.001; p for nonlinearity = 0.212), whereas the association with low HDL-C showed evidence of nonlinearity (p for overall < 0.001; p for nonlinearity = 0.009). Additional RCS analyses using continuous lipid parameters showed broadly consistent findings for TG and HDL-C. Exploratory subgroup and sensitivity analyses showed generally similar results. Conclusions: Higher serum folate concentrations were cross-sectionally associated with lower odds of hypertriglyceridemia and low HDL-C among community-dwelling adults in Zhejiang Province, China, whereas no significant associations were observed for hypercholesterolemia or high LDL-C. Further prospective cohort studies are warranted to verify these cross-sectional findings and to explore underlying mechanisms.

Objectives: We aimed to examine the association between bubble tea consumption and anxiety symptoms among adolescents in Eastern China and to explore the potential role of sleep disturbance in the observed association between bubble tea consumption and anxiety symptoms. Methods: This study utilized cross-sectional baseline data from the Zhejiang Childhood Behavior and Health Cohort. Bubble tea consumption frequency was categorized as 0, 1–2, and ≥3 days per week. Anxiety symptoms were assessed using the Generalized Anxiety Disorder—7 (GAD-7) scale, while sleep disturbance was measured through self-reported items. Associations between bubble tea consumption and anxiety symptoms were examined using multivariable logistic regression models, and dose–response relationships were evaluated with restricted cubic spline (RCS) models. Subgroup analyses stratified by age, sex, school type, residence, and body mass index (BMI) were conducted to assess the consistency of the associations. An exploratory mediation analysis with bootstrap confidence intervals was performed to evaluate the indirect association through sleep disturbance. Sensitivity analyses using a stricter definition of anxiety symptoms (GAD-7 ≥ 10) were conducted to assess robustness. Results: A total of 11,847 adolescents aged 12–18 years were included, of whom 32.03% met the GAD-7 threshold for any anxiety symptoms (GAD-7 ≥ 5, including mild symptoms). Compared with non-consumers, adolescents consuming bubble tea 1–2 days per week had higher odds of anxiety (OR = 1.12, 95% CI: 1.02–1.22), while those consuming bubble tea ≥3 days per week had substantially higher odds (OR = 1.53, 95% CI: 1.30–1.80). Each additional day of bubble tea consumption per week was associated with 10% higher odds of anxiety (OR = 1.10, 95% CI: 1.06–1.14). RCS analysis demonstrated a significant positive linear association between bubble tea consumption and anxiety (p for non-linearity > 0.05). Associations were consistent across age, sex, school type, residence, and BMI categories (all p for interaction > 0.05). Sensitivity analyses yielded similar results. Exploratory mediation analysis suggested that sleep disturbance may be statistically related to a portion of the observed association between bubble tea consumption and anxiety symptoms. Conclusions: Higher frequency of bubble tea consumption was associated with greater odds of anxiety symptoms among adolescents in a dose–response pattern. Sleep disturbance may statistically explain part of the association. These findings should be considered hypothesis-generating and require confirmation in prospective longitudinal studies.

Background/Objectives: Several studies have suggested a positive association between salt intake and obesity, yet longitudinal evidence is limited. We aimed to investigate the longitudinal association between salt intake and multiple adiposity indicators. Methods: We used longitudinal data from a cluster-randomized controlled trial conducted in Zhejiang Province, China, including 7372 adults with 12,800 observations. Twenty-four-hour salt intake was estimated using spot urine samples. Adiposity was assessed using body mass index (BMI), body roundness index (BRI), body fat mass, overweight and central obesity. Associations between salt intake and adiposity were evaluated using generalized linear mixed-effects models. Mediation analyses were conducted to quantify the proportion of associations mediated by body fat mass. Results: Mean baseline 24 h salt intake was 9.88 g/d. Compared with participants in the lowest quartile of salt intake (1 g/d) were associated with decreases in BMI [−0.21 kg/m² (−0.33, −0.09)], BRI [−0.04 (−0.09, 0.00)], and body fat mass [−0.14 kg (−0.36, 0.07)]. Associations were stronger among women and adults aged < 40 years (p-values < 0.05). Body fat mass mediated 56.93%–84.73% of the associations. Conclusions: This study indicates a dose–response association between salt intake and obesity risk, partly mediated by increased body fat mass. The findings suggest that dietary salt may influence cardiovascular risk through adiposity-related pathways.