Objectives: The global prevalence of diabetes is continuously rising, and the gut microbiota is closely associated with it. The Dietary Index for Gut Microbiota (DI-GM) assesses the impact of diet on the microbiota, but its association with diabetes risk remains unclear. This study aims to investigate the association between DI-GM and the risk of diabetes and analyze the mediating roles of phenotypic age and body mass index (BMI).Methods: Utilizing data from the National Health and nutrition examination survey (NHANES) 1999–2018, we included 17,444 adults aged 20 years and older. DI-GM (score range: 0–13) was calculated based on dietary recall. Diabetes was diagnosed based on laboratory results and self-reported information. Multivariable logistic regression was used to analyze the association between DI-GM and diabetes, adjusting for relevant covariates. Mediation analysis evaluated the roles of phenotypic age and BMI.Results: After adjusting for confounders, higher DI-GM scores were significantly associated with a lower risk of diabetes (OR = 0.93, 95% CI = 0.90–0.96, p < 0.001). Compared to the group with DI-GM scores of 0–3, those with scores of 5 (OR = 0.76, 95% CI = 0.67–0.86) and ≥ 6 (OR = 0.77, 95% CI = 0.68–0.88) had significantly reduced diabetes risk. Phenotypic age and BMI accounted for 41.02 and 25.57% of the association between DI-GM and diabetes, respectively.Conclusion: Higher DI-GM scores are associated with a lower risk of diabetes, partially mediated through reduced phenotypic age and BMI.

Rationale: We present a case of a 43-year-old female patient diagnosed with hyperthyroidism. This study aims to demonstrate the rare association between hyperthyroidism and severe cholestatic jaundice, and the effectiveness of methimazole treatment. Patient concerns: The patient developed severe jaundice, a typically mild symptom in most hyperthyroidism cases. Diagnosis: The severe jaundice was suspected to be a result of cholestasis induced by hyperthyroidism, with other potential causes such as drug-induced or autoimmune liver dysfunction being ruled out. Outcomes: The patient was effectively treated with methimazole. Outcomes: Treatment with methimazole alleviated the severe cholestatic jaundice and restored normal thyroid function. Lessons: The specific mechanism of cholestasis as a secondary complication of hyperthyroidism remains unclear, and there are no specific biochemical markers for cholestasis caused by this hormonal disease. This case underscores the possibility of severe jaundice as a clinical manifestation of hyperthyroidism, and highlights antithyroid drug treatment as an effective strategy for managing severe cholestatic jaundice.

Objectives: Growing attention has been paid to the relationship between the gut microbiota and diarrhea. A recently proposed Dietary Index for Gut Microbiota (DI-GM) reflects the overall dietary quality as it pertains to gut microbiota diversity. However, evidence regarding the association between DI-GM and diarrhea is still lacking. This study aims to investigate the association between DI-GM and the risk of diarrhea.Methods: A total of 15,590 adults (≥20 years old) from National Health and Nutrition Examination Survey (NHANES) 2005–2010 were included in this analysis. Diarrhea was defined by self-reported common Bristol Stool Form Scale (BSFS) type 6 or 7, or more than three bowel movements per day. DI-GM comprises 14 food/nutrient components known to be associated with gut microbiota. A higher score indicates a more favorable diet for the gut microbiota. Multivariable logistic regression was used to evaluate the association between DI-GM and diarrhea, with subgroup and sensitivity analyses performed to confirm robustness.Results: After adjusting for age, gender, race, physical activity, chronic diseases, and other confounders, each 1-point increase in DI-GM was associated with a 5% reduction in diarrhea risk (adjusted OR = 0.95, 95% CI: 0.91–0.98, p = 0.005). Compared with those who had a DI-GM score of 0–3, individuals with a DI-GM score ≥ 6 demonstrated a significantly lower risk of diarrhea (OR = 0.77, 95% CI: 0.65–0.91, p = 0.002). Subgroup and sensitivity analyses further supported this negative association. Notably, the “beneficial component” was found to have a more pronounced effect on reducing diarrhea risk.Conclusion: Based on a large representative population, our findings suggest that a higher DI-GM score is significantly associated with a lower risk of diarrhea, underscoring the importance of overall dietary patterns in maintaining gut function and homeostasis.

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://

Introduction: We describe a rare case of a 54-year-old male diagnosed with both ulcerative colitis (UC) and hepatitis C virus (HCV), posing clinical challenges. Patient Concerns: The patient showed worsened UC symptoms, leading to further evaluations. Diagnosis: Dual diagnosis of UC and HCV was confirmed through endoscopy and serological tests, ruling out other hepatic causes. Interventions: Treatment involved methylprednisolone for UC and sofosbuvir/velpatasvir for HCV, with attention to drug interactions. Outcomes: Significant improvement was observed in both UC symptoms and HCV viral load post-treatment. Conclusion: This case underscores the need for nuanced treatment in managing concurrent UC and HCV, considering potential drug interactions and disease impacts.

Obesity is linked to gut microbiota dysbiosis, and diet is a key determinant influencing the gut microbiome. This study examined the association between a newly proposed Dietary Index for Gut Microbiota (DI-GM) and obesity in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020. A total of 41,159 adults aged ≥ 20 years were included, with 15,327 individuals classified as obese (BMI ≥ 30 kg/m²) and 25,832 as living without obesity. DI-GM comprises 13 components deemed either beneficial or unfavorable to the gut microbiome, yielding a total score ranging from 0 to 13. Weighted logistic regression assessed the relationship between DI-GM (continuous and categorical) and obesity, adjusting for demographic and lifestyle factors plus comorbidities. Restricted cubic spline, stratified analyses, multiple imputation, and propensity score matching were also performed. Participants with obesity had a significantly lower mean DI-GM score than those without obesity (4.32 vs. 4.65, P < 0.001). Each 1-point increase in DI-GM was associated with 13% lower obesity odds (OR = 0.87, 95% CI: 0.85-0.88) in the crude model, remaining robust (OR = 0.88, 95% CI: 0.87-0.90, P < 0.001) after full adjustment. Higher DI-GM scores were linearly linked to lower odds of obesity, supported by multiple imputation and propensity score matching (P < 0.001). In this nationally representative U.S. population, a more microbiota-oriented diet, as proxied by higher DI-GM scores, was independently associated with lower odds of obesity. Prospective and randomized trials are warranted to verify causality and investigate underlying mechanisms.