Purpose: To compare the efficacy, recurrence rate, adverse event rate and mortality of fidaxomicin compared with vancomycin in treating different types of Clostridium difficile infection (CDI). Methods: A systematic search was conducted on PubMed, Embase, Web of Science, Cochrane Library and clinical trial registration databases for research on fidaxomicin versus vancomycin in the treatment of CDI and the retrieval period extended from the establishment of the database to July 22, 2022. A total of 15 studies were included, including 8 RCTs and 7 retrospective cohort studies. Results: Results showed that there was no significant difference in the overall efficacy of the treatment between fidaxomicin and vancomycin, and results in the subgroups of CDI hypervirulent strains and recurrent CDI were obtained, but vancomycin was more effective than fidaxomicin in the treatment of severe CDI (RR = 0.94, 95% CI: 0.90–0.98, P < .01). Results showed that fidaxomicin is superior to vancomycin in terms of 40-day recurrence rate (RR = 0.52, 95% CI: 0.38–0.70, P < .01), 60-day recurrence rate (RR = 0.38, 95% CI: 0.21–0.69, P < .01) and 90-day recurrence rate (RR = 0.62, 95% CI: 0.50–0.77, P < .01). For the recurrence rate of the treatment in CDI hypervirulent strains, severe CDI and recurrent CDI, there was no significant difference between the 2 groups. In addition, there was no significant difference in the incidence of clinical adverse reactions, and same outcomes appeared in all-cause mortality at 40-day, severe CDI and recurrent CDI, but fidaxomicin was superior to vancomycin in all-cause mortality over 60-day (RR = 0.57, 95% CI: 0.34–0.96, P = .03). Conclusion: There were no significant differences between fidaxomicin and vancomycin in the treatment of CDI in therapeutic effectiveness and adverse reactions, while fidaxomicin was superior to vancomycin in terms of recurrence rate and long-term mortality, and vancomycin is more effective in treating severe CDI.

Sarcopenia, a multifaceted chronic condition, exhibits an ambiguous association with cardiovascular disease (CVD). This study aimed to elucidate the connection between sarcopenia and CVD, as well as its implications for cardiovascular prognosis, by analyzing globally representative data from the National Health and Nutrition Examination Survey (NHANES). The findings aim to provide valuable insights for clinical practice and future research endeavors. We used data from the NHANES database covering the period from 2011 to 2018. Sarcopenia was defined according to the Foundation for the National Institutes of Health criteria, while CVD was determined through self-reports. The association between sarcopenia and CVD was assessed via logistic regression analysis, with a nonlinear relationship explored using a restricted cubic spline curve. Cox proportional hazards regression was used to examine the associations between sarcopenia and both all-cause and cardiovascular mortality.Among the 7702 participants, the association between sarcopenia and CVD remained significant after adjusting for confounding factors such as age, sex, smoking status, alcohol consumption, and comorbidities (odds ratio, 1.89; 95 % confidence interval [CI], 1.04-3.43; P = 0.030). The hazard ratios for cardiovascular and all-cause mortality in this fully adjusted model were 1.95 (95 % CI, 0.62-6.12; P = 0.252) and 1.43 (95 % CI, 0.71-2.87; P = 0.319), respectively. Sarcopenia is significantly associated with CVD in the general population, even after adjusting for confounding factors but is not associated with cardiovascular or all-cause mortality.

Cardiovascular disease (CVD) remains a leading global cause of mortality, with metabolic and inflammatory dysregulation playing pivotal roles. The C-reactive protein-triglyceride glucose index (CTI), a novel biomarker integrating inflammation (CRP) and insulin resistance (triglyceride-glucose index), has shown promise in predicting adverse outcomes, but its associations with CVD and mortality in the general population remain unclear. The aim of this study is to explore the association of the C-reactive protein-triglyceride glucose index with cardiovascular disease and mortality. This study analyzed data from 8720 adults in the National Health and Nutrition Examination Survey (NHANES) 2001–2010. CTI was calculated as CTI 0.412 × ln(CRP [mg/L]) + [ln(TG [mg/dL] × FPG [mg/dL])]/2. Multivariable logistic regression examined the association between CTI tertiles (T1–T3) and CVD, and Cox regression assessed the relationship between CTI tertiles and cardiovascular and all-cause mortality, with adjustment for demographic, lifestyle, and clinical factors. Higher CTI tertiles were correlated with worse metabolic profiles and higher prevalence of hypertension and diabetes ( P < .001). After full adjustment, the highest CTI tertile (T3) was associated with increased CVD risk (odds ratio = 1.50, 95% confidence interval [CI]: 1.18–1.92, P = .004), cardiovascular mortality (hazard ratio = 1.54, 95% CI: 1.06–2.25, P = .024), and all-cause mortality (hazard ratio = 1.53, 95% CI: 1.29–1.89, P < .001). Restricted cubic spline analysis revealed a nonlinear relationship between CTI and cardiovascular mortality, as well as all-cause mortality . Higher CTI is associated with prevalent CVD and independently predicts increased cardiovascular and all-cause mortality.

Insulin resistance (IR) is a key factor in metabolic disorders. While lipid abnormalities often coexist with IR, their independent associations remain unclear. We analyzed 4698 adults from National Health and Nutrition Examination Survey (2013–2018). The Homeostasis Model Assessment (HOMA) of IR was calculated from fasting glucose and insulin. Lipid profiles (LDLC, HDLC, total cholesterol, triglycerides [TG]) were examined in relation to HOMA-IR using multivariable-adjusted regression models. HDLC showed a inverse association with HOMA-IR ( β = −0.877, P < .001), while TG had a correlation ( β = 0.679, P < .001). LDLC and total cholesterol exhibited weaker, nonlinear relationships. High TG (Q4 odds ratio = 5.53) and low HDLC (Q4 odds ratio = 0.15) were predictive of elevated HOMA-IR ( P < .001). TG and HDLC are associated with HOMA-IR, with distinct dose-response patterns. These findings emphasize the importance of lipid management in metabolic health.