Objective: This study evaluates the relationship between the Life's Essential 8 (LE8) scoring system and all-cause and cause-specific mortality among obese individuals using National Health and Nutrition Examination Survey data. Methods: Data from 9143 obese participants (BMI >= 30 kg/m(2)) collected between 2005 and 2018 were analyzed. Participants were categorized based on their LE8 scores: low cardiovascular health (Low CVH, n = 2264), moderate cardiovascular health (Moderate CVH, n = 6541), and high cardiovascular health (High CVH, n = 338). Associations between LE8 scores and mortality were assessed using Kaplan-Meier survival analysis and Cox proportional hazards models. Results: Over a median follow-up of 7.3 years, there were 867 all-cause deaths (9.5%), including 246 cardiovascular disease (CVD) deaths (2.7%) and 621 non-CVD deaths (6.8%). In multivariable Cox regression analysis, compared to the Low CVH group, the Moderate CVH group had an adjusted hazard ratio (HR) for all-cause mortality of 0.63 (95% CI: 0.55-0.72), and the High CVH group had an HR of 0.25 (95% CI: 0.10-0.60). For CVD mortality, the HRs were 0.61 (95% CI: 0.47-0.78) for Moderate CVH and 0.19 (95% CI: 0.03-1.38) for High CVH. For non-CVD mortality, the HRs were 0.64 (95% CI: 0.54-0.75) for Moderate CVH and 0.27 (95% CI: 0.10-0.72) for High CVH. Each 10-point increase in LE8 score was associated with a 20% reduction in all-cause mortality (P < .001), 21% reduction in CVD mortality (P < .001), and 20% reduction in non-CVD mortality (P < .001). Conclusion: Higher LE8 scores are significantly associated with lower rates of all-cause, CVD, and non-CVD mortality among obese individuals. These findings support the LE8 scoring system as an effective predictor of health status and mortality risk. (c) 2024 AACE. Published by Elsevier Inc. This is an open access article under the CC BY license (http://

Objective: The study aims to explore the relationship between lipoprotein lipase (LPL) variants and hyperlipidemic acute pancreatitis (HLAP) in the southeastern Chinese population. Subjects and methods: In total, 80 participants were involved in this study (54 patients with HLAP and 26 controls). All coding regions and intron-exon boundaries of the LPL gene were sequenced. The correlations between variants and phenotypes were also analysed. Results: The rate of rare LPL variants in the HLAP group is 14.81% (8 of 54), [...] ABSTRACT Objective: The study aims to explore the relationship between lipoprotein lipase (LPL) variants and hyperlipidemic acute pancreatitis (HLAP) in the southeastern Chinese population. Subjects and methods: In total, 80 participants were involved in this study (54 patients with HLAP and 26 controls). All coding regions and intron-exon boundaries of the LPL gene were sequenced. The correlations between variants and phenotypes were also analysed. Results: The rate of rare LPL variants in the HLAP group is 14.81% (8 of 54),

The role of Klotho in metabolic processes and aging-related conditions is well-established. However, the link between Klotho and visceral adipose tissue (VAT) remains understudied. The aim of this study was to explore the relationship between Klotho levels and both VAT area and abdominal obesity. A cross-sectional analysis encompassing 3316 middle-aged individuals was conducted using data from the National Health and Nutrition Examination Survey (NHANES 2011 to 2016). Dual-energy X-ray absorptiometry (DXA) was utilized to assess the VAT region, while abdominal obesity was defined by a VAT area exceeding 100 cm². The relationship between Klotho and VAT area was evaluated using multiple linear regression, and the association between Klotho and abdominal obesity was assessed using multivariate logistic regression. To assess linearity and explore the dose-response curve, restricted cubic splines were applied. Higher Klotho levels were associated with a lower VAT area (β -5.57, 95% CI = -9.83 - -1.30; P = 0.011) and a reduced incidence of abdominal obesity (OR 0.57, 95% CI = 0.42-0.78; P < 0.001), after adjusting for all model variables. Furthermore, multivariate smooth splines analysis revealed a nonlinear, L-shaped relationship between Klotho and both VAT area and abdominal obesity. A significant negative association was observed, with the curves leveling off as Klotho levels increased beyond 1.155 ng/mL. An L-shaped nonlinear relationship between Klotho and the VAT area indicated a saturation effect. These findings warrant attention and suggest that further investigation into the association between serum Klotho and abdominal obesity is necessary.

Glycemic control plays a crucial role in the outcomes of acute pancreatitis (AP), yet traditional glucose metrics have shown limited prognostic value. This study investigates the association between mean glucose area under the curve (AUC) and mortality outcomes in AP patients. We conducted a retrospective cohort study of 1085 intensive care unit patients with AP using data from the Medical Information Mart for Intensive Care IV database. Patients were stratified into tertiles based on mean glucose AUC. Multivariable Cox regression and restricted cubic spline analyses were employed to assess the relationship between mean glucose AUC and mortality outcomes. Predictive performance was quantified using receiver operating characteristic curve analysis, and robustness was further tested through comprehensive subgroup and sensitivity analyses. A higher mean glucose AUC was significantly associated with increased mortality risk. In the fully adjusted model, the hazard ratio for in-hospital mortality was 1.10 (95% confidence interval: 1.08–1.12; P < .001). Compared with the lowest tertile, patients in the highest tertile demonstrated an 11.12-fold increased mortality risk (95% confidence interval: 5.78–21.41; P < .001). Mean glucose AUC showed superior discriminative capacity for predicting in-hospital mortality (AUC = 0.783) compared with other glucose metrics. The association remained robust across various subgroups and sensitivity analyses. Mean glucose AUC serves as a powerful, independent predictor of in-hospital mortality in AP patients. This novel metric outperforms conventional glucose parameters in prognostic accuracy, suggesting its potential utility in clinical risk stratification and treatment optimization.

Objectives: Cirrhosis signifies a critical phase in liver disease with high mortality, particularly in patients admitted to intensive care unit (ICU). Red cell distribution width (RDW) demonstrates prognostic value in various conditions, with evidence linking it to inflammation and adverse outcomes in liver disease. However, the predictive utility of RDW and its derived indices in patients with cirrhosis admitted to ICU remains undetermined. This study investigated the associations between RDW-related biomarkers and prognosis in critically ill cirrhosis patients. Methods: A retrospective analysis used data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, including 1,871 adults with cirrhosis at first ICU admission. The analyzed biomarkers were RDW, RDW-to-albumin ratio (RAR), RDW-to-platelet ratio (RPR), and hemoglobin-to-RDW ratio (HRR). The primary outcome was 30-day all-cause mortality; secondary outcomes were 90-day, and 365-day mortality. Adjusted multivariate Cox regression models determined biomarker-mortality associations. Receiver operating characteristic (ROC) curve analyses evaluated predictive performance of the biomarkers. Results: The cohort had a mean age of 58.8 ± 12.3 years and 64.8% of the patients were male. The mortality rates were 31.8% (30-day), 39.3% (90-day), and 48.0% (365-day). Mortality was consistently higher in high versus low RDW groups. After multivariable adjustment, all biomarkers were independently associated with 30-day, 90-day, and 365-day mortality, respectively. When expressed per SD, RDW (HR 1.41, 95% CI 1.30–1.52), RAR (HR 1.17, 95% CI 1.11–1.24), RPR (HR 1.19, 95% CI 1.11–1.28), and HRR (HR 0.52, 95% CI 0.44–0.61) were each significantly associated with 30-day mortality. ROC analysis revealed RDW had the highest predictive value (AUC 63.3%), followed by HRR (AUC 61.7%), RAR (AUC 59.6%), and RPR (AUC 55.6%). RDW demonstrated the highest discriminative ability for 30-day mortality, with incremental predictive value when combined with established scores (absolute AUC increase 0.68–1.58%). Conclusion: RDW-related biomarkers demonstrate statistically significant but modest associations with mortality in ICU cirrhosis patients. RDW and HRR showed the strongest predictive capabilities among the four indices, though standalone discrimination was limited. These accessible, cost-effective biomarkers may serve as adjunctive prognostic markers when combined with established scoring systems. However, further prospective validation is required before clinical implementation, and dynamic changes in these biomarkers warrant investigation in future studies.

Background: Portal vein diameter (PVD) is an important and objective marker of portal pressure and may be associated with the risk of recurrent esophagogastric variceal bleeding (EGVB) in patients with cirrhosis. However, the specific relationship between the two has not been clearly established. This study aims to investigate the association between PVD and the risk of recurrent EGVB in patients with cirrhosis. Methods: This study used a retrospective cohort design, including 1223 patients with cirrhosis discharged from Quanzhou First Hospital between January 2014 and December 2018. After applying inclusion and exclusion criteria, a total of 247 patients (179 males and 68 females) were included in the analysis. Portal vein diameter (PVD, in mm) was measured using standardized abdominal ultrasound or CT scans. EGVB events were confirmed by endoscopic diagnosis. The association between PVD and recurrent EGVB was assessed using a multivariate logistic regression model, adjusting for age, gender, etiology of cirrhosis, comorbidities, Child-Pugh classification, portal vein thrombosis (PVT), and laboratory indicators (such as platelet count, albumin, and coagulation function parameters). Stratified analyses and interaction tests were further conducted to verify the robustness of the results. Results: The incidence of recurrent EGVB increased significantly with an increase in PVD (trend test P =0.023). The multivariate-adjusted model showed that for every 1 mm increase in PVD, the risk of recurrent EGVB increased by 19% (HR=1.19, 95% CI: 1.01-1.40, P =0.039). Stratified analysis indicated that the risk was particularly significant when PVD>14 mm (adjusted HR=3.61, P =0.022). Subgroup analysis showed that, apart from an interaction between age and PVD (interaction P 0.05). Conclusions: An increased portal vein diameter is an independent risk factor for recurrent EGVB in patients with cirrhosis, with a particularly significant increase in risk when PVD>14 mm. Monitoring changes in PVD can provide an important basis for clinical identification of high-risk patients and optimization of portal hypertension management, thereby reducing the incidence of recurrent bleeding events.