scholarly journals Development and Validation of 2 Composite Aging Measures Using Routine Clinical Biomarkers in the Chinese Population: Analyses From 2 Prospective Cohort Studies

Author(s):  
Zuyun Liu

Abstract Background This study aimed to: (i) develop 2 composite aging measures in the Chinese population using 2 recent advanced algorithms (the Klemera and Doubal method and Mahalanobis distance); and (ii) validate the 2 measures by examining their associations with mortality and disease counts. Methods Based on data from the China Nutrition and Health Survey (CHNS) 2009 wave (N = 8119, aged 20–79 years, 53.5% women), a nationwide prospective cohort study of the Chinese population, we developed Klemera and Doubal method-biological age (KDM-BA) and physiological dysregulation (PD, derived from Mahalanobis distance) using 12 biomarkers. For the validation analysis, we used Cox proportional hazard regression models (for mortality) and linear, Poisson, and logistic regression models (for disease counts) to examine the associations. We replicated the validation analysis in the China Health and Retirement Longitudinal Study (CHARLS, N = 9304, aged 45–99 years, 53.4% women). Results Both aging measures were predictive of mortality after accounting for age and gender (KDM-BA, per 1-year, hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.08, 1.19; PD, per 1-SD, HR = 1.50, 95% CI = 1.33, 1.69). With few exceptions, these mortality predictions were robust across stratifications by age, gender, education, and health behaviors. The 2 aging measures were associated with disease counts both cross-sectionally and longitudinally. These results were generally replicable in CHARLS although 4 biomarkers were not available. Conclusions We successfully developed and validated 2 composite aging measures—KDM-BA and PD, which have great potentials for applications in early identifications and preventions of aging and aging-related diseases in China.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 887-887
Author(s):  
Zuyun Liu

Abstract Quantifying aging is crucial for addressing aging and related issues. This study aimed to: 1) develop two composite aging measures in the Chinese population using two recent advanced algorithms (the Klemera and Doubal method and Mahalanobis distance); and 2) validate the two measures by examining their associations with mortality and disease counts. Based on data from the China Nutrition and Health Survey 2009 wave (N=8,119, aged 20-79 years, 53.5% women), a nationwide prospective cohort study of the Chinese population, we developed Klemera and Doubal method-biological age (KDM-BA) and physiological dysregulation (PD, derived from Mahalanobis distance) using 12 routine clinical biomarkers. For the validation analysis, we used Cox proportional hazard regression models (for mortality) and linear, Poisson, and logistic regression models (for disease counts) to examine the associations. We replicated the validation analysis in the China Health and Retirement Longitudinal Study (CHARLS, N=9,304, aged 45-99 years, 53.4% women). We found that both aging measures were predictive of mortality after accounting for age and gender (KDM-BA, per one-year, HR=1.14, 95%CI=1.08, 1.19; PD, per one-SD, HR=1.50, 95%CI=1.33, 1.69). With few exceptions, these mortality predictions were robust across stratifications by age, gender, education, and health behaviors. The two aging measures were associated with disease counts both cross-sectionally and longitudinally. These results were generally replicable in CHARLS although four biomarkers were not available. In summary, we successfully developed and validated two composite aging measures‒‒KDM-BA and PD, which have great potentials for applications in early identifications and preventions of aging and aging related diseases in China.


2021 ◽  
pp. injuryprev-2020-044092
Author(s):  
Éric Tellier ◽  
Bruno Simonnet ◽  
Cédric Gil-Jardiné ◽  
Marion Lerouge-Bailhache ◽  
Bruno Castelle ◽  
...  

ObjectiveTo predict the coast-wide risk of drowning along the surf beaches of Gironde, southwestern France.MethodsData on rescues and drownings were collected from the Medical Emergency Center of Gironde (SAMU 33). Seasonality, holidays, weekends, weather and metocean conditions were considered potentially predictive. Logistic regression models were fitted with data from 2011 to 2013 and used to predict 2015–2017 events employing weather and ocean forecasts.ResultsAir temperature, wave parameters, seasonality and holidays were associated with drownings. Prospective validation was performed on 617 days, covering 232 events (rescues and drownings) reported on 104 different days. The area under the curve (AUC) of the daily risk prediction model (combined with 3-day forecasts) was 0.82 (95% CI 0.79 to 0.86). The AUC of the 3-hour step model was 0.85 (95% CI 0.81 to 0.88).ConclusionsDrowning events along the Gironde surf coast can be anticipated up to 3 days in advance. Preventative messages and rescue preparations could be increased as the forecast risk increased, especially during the off-peak season, when the number of available rescuers is low.


2021 ◽  
Vol 9 ◽  
Author(s):  
Benoit Bisson ◽  
Laurence Gottrand ◽  
Madeleine Aumar ◽  
Audrey Nicolas ◽  
Rony Sfeir ◽  
...  

Introduction: Scoliosis is a well-described complication of esophageal atresia (EA) caused by the associated spine malformations and/or thoracotomy. However, the sagittal posture abnormalities in patients with EA have not been described. The aim of this study was to evaluate the prevalence of and risk factors for sagittal posture abnormalities at the age of 6 years in patients operated on for EA.Methods: A prospective cohort of 123 patients with EA was examined by the same rehabilitation doctor at the time of a multidisciplinary visit scheduled at the age of 6 years. Children presenting with scoliosis (n = 4) or who missed the consultation (n = 33) were excluded. Univariate and multivariate logistic regression models with Firth's penalized-likelihood approach were used to identify risk factors associated with sagittal posture anomalies. Candidate risk factors included neonatal characteristics, associated malformations, atresia type, postoperative complications, psychomotor development retardation, orthopedic abnormalities, and neurological hypotonia.Results: The prevalence rates of sagittal posture abnormalities were 25.6% (n = 22; 95% CI, 16.7–36.1%). Multivariate analysis showed that minor orthopedic abnormalities (OR: 4.02, 95% CI: 1.29–13.43, P = 0.021), and VACTERL (OR: 3.35, 95% CI: 1.09–10.71, P = 0.042) were significant risk factors for sagittal posture abnormalities.Conclusion: This study shows that sagittal posture anomalies occur frequently in children operated on at birth for EA and are not directly linked to the surgical repair. These children should be screened and treated using postural physiotherapy, especially those with VACTERL and minor orthopedic abnormalities.


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3456
Author(s):  
Yuewen Sun ◽  
Puhong Zhang ◽  
Yuan Li ◽  
Feng J. He ◽  
Jing Wu ◽  
...  

Mixed evidence was published regarding the association of sodium, potassium and sodium-to-potassium ratio (Na/K ratio) with renal function impairment. This study was conducted to further explore the relationship between sodium, potassium, NA/K ratio and kidney function in the general adult Chinese population. We performed a cross-sectional analysis using the baseline data from the Action on Salt China (ASC) study. 5185 eligible general adult participants from the baseline investigation of the ASC study were included in this analysis. Sodium, potassium and albumin excretion were examined from 24-h urine collection. Albuminuria was defined as albumin excretion rate (AER) greater than or equal to 30 mg/24-h. Mixed linear regression models, adjusted for confounders, were fitted to analyze the association between sodium, potassium and Na/K ratio, and natural log transformed AER. Mixed effects logistic regression models were performed to analyze the odds ratio of albuminuria at each quintile of sodium, potassium and Na/K ratio. The mean age of the participants was 49.5 ± 12.8 years, and 48.2% were male. The proportion of albuminuria was 7.5%.The adjusted mixed linear models indicated that sodium and Na/K ratio was positively associated with natural log transformed AER (Sodium: β = 0.069, 95%CI [0.050, 0.087], p < 0.001; Na/K ratio: β = 0.026, 95%CI [0.012, 0.040], p < 0.001). Mixed effects logistic regression models showed that the odds of albuminuria significantly increased with the quintiles of sodium (p < 0.001) and Na/K ratio (p = 0.001). No significant association was found between potassium and the outcome indicators. Higher sodium intake and higher Na/K ratio are associated with early renal function impairment, while potassium intake was not associated with kidney function measured by albumin excretion.


Author(s):  
Oscar Mancera Páez ◽  
Kelly Estrada Orozco ◽  
Maria Fernanda Mahecha ◽  
Francy Cruz Sanabria ◽  
Kely Bonilla-Vargas ◽  
...  

Background: Biomarkers are essential for identification of individuals at high risk of mild cognitive impairment (MCI) for potential prevention of dementia. We investigated DNA methylation in the ApoE gene and plasmatic apolipoprotein E (ApoE) levels as MCI biomarkers in Colombian subjects with MCI and controls. Methods: 100 participants were included (71% women, average age, 70 yrs., range 43-91). MCI was diagnosed by neuropsychological testing, medical and social history, activities of daily living, cognitive symptoms and neuroimaging. Multivariate logistic regression models adjusted by age and gender were performed to examine the risk association of MCI with plasma ApoE and APOE methylation Results: MCI was diagnosed in 41 subjects (average age, 66.5±9.6 yrs.) and compared with 59 controls. Elevated plasma ApoE and APOE methylation of CpGs 165, 190, and 198 were risk factors for MCI (P&lt;0.05). Higher CpG-227 methylation correlated with lower risk for MCI (P=0.002). Only CpG-227 was significantly correlated with plasmatic ApoE levels (correlation coefficient=-0.665; P=0.008). Conclusion: Differential APOE methylation and increased plasma ApoE levels were correlated with MCI. These epigenetic patterns can be used as potential biomarkers to identify early stages of MCI.


2020 ◽  
Author(s):  
Xiao-Ming Shen ◽  
Yi-Qian Huang ◽  
Xiao-Yan Zhang ◽  
Xiao-Qing Tong ◽  
Pei-Fen Zheng ◽  
...  

Abstract Background: Information regarding dietary patterns associated with prediabetes in the Chinese population is lacking. The objective of the present study was to explore the association between major dietary patterns and risk of prediabetes in a middle-aged Chinese population. Methods: A total of 1761 participants (aged 45 to 59 years) were recruited in Hangzhou city, the capital of Zhejiang Province, China from June 2015 to December 2016. Dietary information was obtained by interview using a 138-item, validated semi-quantitative food frequency questionnaire(SQFFQ). Multivariate logistic regression models were used to analyze the association between dietary patterns and the risk of prediabetes with adjustment of potential confounding variables. Results: Three dietary patterns were ascertained by factor analysis and labeled as traditional southern Chinese, Western, and grains-vegetables patterns. After controlling of the potential confounders, participants in the top quartile of the Western pattern scores had greater odds ratio(OR) for prediabetes (OR=1.54; 95% confidence interval(CI):1.068-2.059; P =0.025) than did those in the bottom quartile. Compared with those in the bottom quartile, participants in the top quartile of the grains-vegetables pattern scores had a lower OR for prediabetes(OR=0.83; 95% CI:0.747-0.965; P =0.03). Besides, no statistically significant association was observed in the association between the traditional southern Chinese pattern and prediabetes risk ( P >0.05). Conclusions: The findings of this study showed that the Western pattern was associated with a higher risk, and the grains-vegetables pattern was associated with a lower risk of prediabetes. Future prospective studies are required to validate our findings.


2020 ◽  
Vol 9 (6) ◽  
pp. 1693
Author(s):  
Zih-Jie Sun ◽  
Hsuan-Jung Hsiao ◽  
Hsiang-Ju Cheng ◽  
Chieh-Ying Chou ◽  
Feng-Hwa Lu ◽  
...  

Previous studies examining the association between kidney stone disease (KSD) and arterial stiffness have been limited. Both age and gender have been found to have an impact on KSD, but their influence on the relationship between KSD and increased arterial stiffness is unclear. This study included 6694 subjects from October 2006 to August 2009. The diagnosis of kidney stone was based on the results of ultrasonographic examination. Increased arterial stiffness was defined as right-sided brachial-ankle pulse wave velocity (baPWV) ≥ 14 m/s. Associations between KSD and increased arterial stiffness were analyzed using multiple logistic regression models. KSD was positively related to increased arterial stiffness in both male and female groups (males: odds ratio [OR], 1.306; 95% confidence interval [CI], 1.035–1.649; females: OR, 1.585; 95% CI, 1.038–2.419) after adjusting for confounding factors. Subgroup analysis by age group (<50 and ≥50 years) showed a significant positive relationship only in the groups ≥ 50 years for both genders (males: OR, 1.546; 95% CI, 1.111–2.151; females: OR, 1.783; 95% CI, 1.042–3.054), but not in the groups < 50 years. In conclusion, KSD is associated with a higher risk of increased arterial stiffness in individuals aged ≥ 50 years, but not in those aged < 50 years for both genders.


2014 ◽  
Vol 3 (2) ◽  
pp. 69
Author(s):  
Guangming Han

The main aim of this study is to explore the patterns, determinants and subsequent mortality prediction of change in self-rated health in the elderly American population. To achieve this purpose, we constructed logistic regression models and Cox proportional hazard regression models with the complex survey dataset from the National Second Longitudinal Study of Aging (LSOA II) to calculate the odds ratios (OR)/ hazard ratios (HR) and confidence intervals (CI) of risk factors. Our results show that chronic disease condition and difficulty in daily activities are the main reasons for change in self-rated health status. Furthermore, change in self-rated health has significant impact on survival function in the elderly populations. When change in self-rated health status was considered, self-rated health was a stronger and more flexible predictor of mortality for elderly populations. These findings will provide important information to establish effective strategies for prolonging lifespan by improving self-rated health status for elderly populations.


2019 ◽  
Author(s):  
Bertolotti Antoine ◽  
Thioune Marême ◽  
Abel Sylvie ◽  
Belrose Gilda ◽  
Calmont Isabelle ◽  
...  

AbstractBackgroundThe chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic rheumatic musculoskeletal disorders, named chronic chikungunya (CHIKC+), which may be long-term incapacitating. A chikungunya outbreak occurred in 2013 in La Martinique. We constituted the first prospective cohort study of CHIKV-infected subjects in the Caribbean to assess the prevalence of CHIKC+ at 12 months and to search for factors present at the acute stage significantly associated with chronicity.Methodology/Principal findingsA total of 193 patients who tested positive for RT-PCR CHIKV, were submitted to clinical investigations in the acute phase (<21 days), and 3, 6, and 12 months after their inclusion. A total of 167 participants could be classified as either suffering or not from CHIKC+. They were analyzed using logistic regression models. At 12 months, the overall prevalence of CHIKC+ was 52.1% (95%CI: 44.5-59.7). In univariate analysis, age (OR: 1.04; 95% CI: 1.02-1.07; p=0.0003), being male (OR: 0.51; 95%CI: 0.27-0.98; p=0.04), headache (OR: 1.90; 95%CI: 1.02-3.56; p=0.04), vertigo (OR: 2.06; 95%CI: 1.05-4.03; p=0.04), vomiting (OR: 2.51; 95%CI: 1.07-5.87; p = 0.03), urea (OR: 1.33; 95%CI: 1.05-1.70; p=0.02) were associated with CHIKC+. In final multivariate logistic regression models for 167 participants, predictors of CHIKC+ were age (OR 1.06; 95%CI: 1.03-1.08; p<0.0001), male sex (OR: 0.40; 95%CI: 0.19-0.84; p=0.015), vertigo (OR: 2.46; 95%CI: 1.16-5.20; p=0.019), hypotension (OR 4.72; 95% -CI: 1.19-18.79; p=0.028), recoloration time >3 seconds (OR: 3.79; 95%-CI: 1.01-14.25).ConclusionsThis cohort study in La Martinique confirms that CHIKC+ is a frequent complication of acute chikungunya disease. Analysis emphasized the importance of age and female sex for CHIKC occurrence, and pointed out the potential aggravating role of dehydration at the acute phase. Early and adequate hydration could reduce the risk chronic chikungunya disorders.Author SummaryChikungunya is a mosquito-borne virus found in tropical countries that has been re-emerging in the last decade. It has caused major epidemics in recent years, such as in Reunion Island and in Southeast Asia. Nearly 2.5 billion people around the world are at risk of contracting the virus. During the acute phase of the illness, patients experience a flu-like syndrome with fever, headache, myalgia, rash, and severe arthralgia. These symptoms can persist for several months in some patients, and can lead to significant functional disability. During the 2013 epidemic in Martinique, we followed nearly 200 patients who had contracted chikungunya. More than half of the patients had a chronic form of the disease—mainly women over 50 years of age. Our statistical analyses indicate that poor hydration during the acute phase may be a risk factor for developing chronic rheumatism. Therefore, in the context of a chikungunya epidemic, it seems important to encourage patients to drink plenty of fluids as soon as the first symptoms appear.


2014 ◽  
Vol 3 (2) ◽  
pp. 69
Author(s):  
Guangming Han

The main aim of this study is to explore the patterns, determinants and subsequent mortality prediction of change in self-rated health in the elderly American population. To achieve this purpose, we constructed logistic regression models and Cox proportional hazard regression models with the complex survey dataset from the National Second Longitudinal Study of Aging (LSOA II) to calculate the odds ratios (OR)/ hazard ratios (HR) and confidence intervals (CI) of risk factors. Our results show that chronic disease condition and difficulty in daily activities are the main reasons for change in self-rated health status. Furthermore, change in self-rated health has significant impact on survival function in the elderly populations. When change in self-rated health status was considered, self-rated health was a stronger and more flexible predictor of mortality for elderly populations. These findings will provide important information to establish effective strategies for prolonging lifespan by improving self-rated health status for elderly populations.


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