Backgrounds: Excessive intake of sodium is a crucial risk factor of gastric cancer. However, it is still unclear whether the profile of gastric cancer burden is attributable to high sodium intake in China. This study aims to evaluate the levels and trends of gastric cancer burden attributable to high sodium intake across China from 1990 to 2019. Methods: We acquired data from the GBD (Global Burden of Disease Study) 2019 via the Global Health Data Exchange query tool. The details of regions from 1 January 1990 to 31 December 2019 from the China National Center for Food Safety Risk Assessment were also used. We conducted an integrated analysis on the gastric cancer burden attributable to high sodium intake among Chinese residents. The gastric cancer-related deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR), all being calculated to be attributable to sodium intake, were reckoned as separated by age, sex, SDI, and regions. Then, the estimated annual percentage change (EAPC) was regarded as the secular trends of gastric cancer’s ASMR and ASDR due to high sodium intake from 1990 to 2019. We further explored the associations between SDI (Socio-demographic index) and the ASMR and ASDR. The rates were calculated per 100,000 population as age-standardized rates. Results: Briefly, the number of gastric cancer-related deaths and DALYs being attributed to high sodium intake were 37,131.48 (95% UI: 833.14 to 138,478.72) and 873,813.19 (95% UI: 19,283.13 to 3,220,231.82) in 2019; both have increased by a third since 1990. However, the ASMR decreased with an EAPC of −1.72% (95% CI: −2.11% to −1.33%), while ASDR increased with an EAPC of 0.36% (95% CI: 0.08% to 0.68%), respectively. The age-specific numbers and rates of deaths, as well as DALYs of gastric cancer being attributed to high sodium intake, elevated gradually with age. And, they were higher in males than in females. The gastric cancer burden being attributed to high sodium intake in 2019 and its temporal trends from 1990 to 2019 varied greatly by SDI quintile and geographic locations. There was a strong negative association between the EAPC in ASMR and SDI in 2019 (ρ = −0.642, p < 0.001). The EAPC in ASDR and SDI also exhibited a negative connection in 2019 (ρ = −0.538, p = 0.0012). Conclusions: Overall, using a longitudinal sample from different regions, the study presented that gastric cancer burden attributed to high sodium intake still exists seriously and varies remarkably by regions, sex, and age across China. The disparity of socioeconomic status on disease burden also exists. Integrated and precise approaches for gastric cancer prevention are anticipated in the future.

Background: Overconsumption of sodium has been identified as a key driving factor for diet-related cardiovascular diseases (CVDs). China, being a country bearing a hefty burden of CVD, has a large population with diverse cultural traditions and ethnic beliefs, which complicates the patterns of dietary sodium intake, necessitating a systematic investigation into the profile of the high sodium intake (HSI)-related burden of CVD within its subregions. This study aims to estimate the evolving patterns of HSI-induced CVD burden across China from 1990 to 2019. Methods: The methodology used in the Global Burden of Disease Study was followed to assess deaths and disability-adjusted life years (DALYs) by age, sex, region, and socio-demographic index (SDI). The estimated annual percentage change (EAPC) was calculated to quantify the secular changes in the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR). Results: In 2019, 0.79 million deaths and 1.93 million DALYs of CVD were attributed to HSI, an increase of 53.91% and 39.39% since 1990, respectively. Nevertheless, a downward trend in ASMR (EAPC: −1.45, 95% CI: −1.55, −1.35) and ASDR (EAPC: −1.61, 95% CI: −1.68, −1.53) was detected over time. ASMR and ASDR were higher for males, individuals aged ≥60 years, and regions with low-middle SDI. A markedly negative association between the EAPC in both ASMR and ASDR and the SDI was found in 2019 (ρ = −0.659, p < 0.001 and ρ = −0.558, p < 0.001, respectively). Conclusions: The HSI-induced CVD burden is gender-, age-, and socioeconomic-dependent. Integrated and targeted strategies for CVD prevention are anticipated in the future throughout China.

Objective: Elevated sodium consumption is associated with increased risk for chronic kidney disease (CKD) and data for this disease burden attributable to high sodium intake in China from 1990 to 2019 are scarce in China. Our study aims to estimate and present the national burden of CKD attributable to high sodium intake, as well as its profile.Methods: The regional disease burden data from the China Center for Food Safety Risk Assessment (CFSA) from 1990 to 2019 were compiled based on the methodology of GBD 2019. CKD burden [deaths and disability-adjusted life years (DALYs)] was quantified according to population group (age, gender) and regions categories (province, SDI). The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were calculated to describe long-term trends.Results: Totally, the number of deaths of CKD attributable to high sodium intake reached 95,000, with DALYs amounting to 2.59 million person-years in 2019, while the trends of ASMR (EAPC: -0.31, 95%CI: −0.46, −0.17%) and ASDR (−0.33, 95%CI: −0.48, −0.18%) were down during the observation period. The age-specific numbers and rates of deaths, as well as DALYs increase with age are higher in males than in females. Significant disparities in CKD burden attributable to high sodium intake were observed across provinces and SDI regions. In both 1990 and 2019, the number of deaths and DALYs were higher in middle SDI regions, while low-middle SDI regions had highest ASMR and ASDR. The EAPC of ASDR was found to be significantly negatively correlated with the 1990 ASDR (ρ = −0.393, p = 0.024), and the EAPC of ASMR and ASDR were also significantly negatively correlated with the 2019 SDI (ASMR:ρ = −0.571, p < 0.001; ASDR:ρ = −0.368, p = 0.035).Conclusion: High sodium intake accounted for a sizeable burden of disease from 1990 to 2019 in China, also presents sexual and geographic variations. Despite a slight decreasing trend exists, the absolute number increased as much as twofold, particularly among males and seniors. Targeting to reduce sodium intake remains a priority, and progress requires systematic monitoring and evaluation, particularly in middle SDI regions that are experiencing rising trends and low-middle SDI regions being susceptible to approaches.

The persistence and biotoxicity of perfluoroalkyl and polyfluoroalkyl substances (PFASs) have raised concerns about cardiometabolic diseases (CMDs). Inflammation is thought to underlie the pathology of various CMDs. We aimed to comprehensively assess the risk of CMDs associated with PFASs and quantify the mediating effects of two kinds of inflammatory markers. Nine PFASs, a direct marker (high-sensitivity C-reactive protein [hs-CRP]), and an indirect marker (serum ferritin [SF]) were analyzed. A total of 12 CMDs of five types were defined based on 15 cardiometabolic biomarkers. The PFAS mixture had significant adverse effects on hypercholesterolemia (HC; OR = 1.20, 95% CI: 1.03–1.39), high low-density lipoprotein cholesterol (high LDL-C; OR = 1.13, 95% CI: 1.01–1.30), hypertension (OR = 1.10, 95% CI: 1.03–1.19), and hyperuricemia (OR = 1.31, 95% CI: 1.16–1.48) in the quantile-based g-computation (QGC) model, with PFNA and PFTrDA contributing the most. PFHxS was found to significantly impact all five types of CMDs simultaneously. The exposure-response analysis exhibited complex nonlinear patterns, with significant heterogeneity across diseases. Both inflammatory markers significantly mediated the effects of multiple PFASs on CMDs, with SF contributing a higher proportion of the mediating effects for obesity, dyslipidemia, and hyperuricemia. The highest mediation proportion reached 85.78% for abdominal obesity (FDR = 0.024). These results suggest that inflammation may serve as a key pathological mechanism linking PFAS exposure to CMDs, highlighting the potential value of SF as an iron status and indirect inflammatory marker in assessing PFAS-related cardiometabolic health risks.

The effects of perfluoroalkyl and polyfluoroalkyl substances (PFAS) on kidney function across physiological conditions remain inconclusive, and previous research has not assessed the potential mediating effect of iron status. We aimed to examine the relationships between PFAS exposure and kidney function in various demographic groups, as well as to evaluate the potential mediating role of iron status. This study included 7369 Chinese adults aged 18 years or older from the China Health and Nutrition Survey (CHNS). Estimated glomerular filtration rate (eGFR) levels were used to reflect the efficiency of kidney function. Generalized linear models and weighted quantile sum regression models indicated negative associations between PFAS and eGFR levels, with PFNA and PFHxS emerging as the dominant contributors. Subgroup analysis revealed that the adverse effects of PFAS on eGFR levels were more pronounced in the males, young and middle age, non-hypertension, and non-diabetes subgroups. Further mediation analyses demonstrated that iron status (ferritin, transferrin, and hemoglobin) partially mediated these associations, with mediation proportions ranging from 8.89 % to 60.84 %. Our study established PFNA and PFHxS as critical nephrotoxic PFAS in China while pioneering the identification of iron status as a novel mechanistic mediator between PFAS exposure and kidney dysfunction, advancing mechanistic understanding of environmental nephrotoxicity.

Background: This study aimed to explore the effect of household solid fuel usage on the multimorbidity trajectories among middle-aged and older adults.Methods: Based on the 2011–2018 China Health and Retirement Longitudinal Study, the group-based trajectory modeling and the multinomial logistic regression model were used to explore the relationship between multimorbidity trajectories of older adults with different fuel types, duration of solid fuel usage, and potential interaction with PM_2.5. Three multimorbidity trajectory patterns were identified by group-based trajectory modeling and labeled as “non-chronic morbidity” (no disease increase), “newly developing multimorbidity” (diseases grew from 0 to 2), and “multi-chronic multimorbidity” (diseases grew from 2 to 4).Results: Compared to “Non-chronic morbidity,” solid fuel was significantly associated with adverse multimorbidity trajectories, with an odds ratio (OR) and 95% confidence interval (CI) of 1.33 (1.11, 1.60) and 1.35 (1.18, 1.55) for newly developing and multi-chronic group, respectively. An adverse multimorbidity trajectory tended to be established with longer durations of solid fuel usage than “Non-chronic morbidity.” For “Newly-developing multimorbidity,” the ORs (95% CI) for 1–7 years and ≥ 8 years of solid fuel usage were 1.16 (0.94, 1.42) and 1.41 (1.12, 1.76), respectively, with P trend=0.001, while in “Multi-chronic multimorbidity,” those were 1.25 (1.07, 1.47) and 1.68 (1.41, 2.00), respectively, with P trend <0.001. In the interaction analysis, the association between solid fuel usage and trajectories was significant only in areas where PM_2.5 was lower than 50 μg/m³.Conclusion: For the middle-aged and older Chinese population, a higher risk of multimorbidity trajectory is associated with household solid fuel usage, especially in the areas with lower PM_2.5.