Social determinants of health (SDOH) and metabolic syndrome (MetS) are related, but their combined effect on mortality risk remains unclear. We analyzed data from NHANES (National Health and Nutrition Examination Survey) cycles between 2005 and 2018. The composite SDOH score was calculated by summing the weighted scores for each SDOH, categorizing participants into four groups: Q1 (0–1), Q2 (2–3), Q3 (4) and Q4 (≥ 5). Kaplan-Meier survival curves and multivariate Cox proportional hazards models were used to examine the relationship between SDOH and mortality outcome. Restricted cubic spline (RCS) analyses were conducted to explore nonlinear relationships. Subgroup analyses assessed the consistency and robustness of the findings across various demographic and clinical factors. Of the 7,366 patients with MetS, 1,193 died, including 407 from cardiovascular and cerebrovascular diseases and 269 from cancer. Cox regression analyses, using fully adjusted Model 2, revealed that higher SDOH levels had increased hazards for all-cause mortality (HR = 2.41, 95% CI: 1.87,3.12), cancer-related death (HR = 2.45, 95% CI: 1.54,3.89), and Cardio − cerebrovascular disease (HR = 2.62, 95% CI: 1.79,3.84). Kaplan-Meier analyses further supported these findings, demonstrating that participants with higher SDOH scores had lower survival rates. Additionally, RCS modeling confirmed a linear relationship between SDOH and mortality, with no indication of a nonlinear relationship (P for nonlinear > 0.05). Our findings indicate that adverse social determinants of health are strongly linked to an increased risk of all-cause mortality in individuals with MetS. However, due to the observational and cross-sectional nature of this study, it is important to interpret these results as associations rather than implying any causal relationships.

Background: Pediatric stone disease, once considered rare, has gained significant attention over the past decade owing to its rapidly increasing incidence. Despite this surge, a comprehensive evaluation of this burden is lacking.Objectives: This study aimed to estimate the burden of pediatric stone disease, stratified by age and sex, at the global, regional, and national levels from 1990 to 2021.Methods: Data on the global incidence, deaths, and disability-adjusted life years (DALYs) related to pediatric stone disease from 1990 to 2021 were collected. The estimated annual percentage change (EAPC) quantified the disease trends over this period. Additionally, the relationship between disease burden and factors such as age and sociodemographic index (SDI) levels was analyzed. A Bayesian Age-Period-Cohort (BAPC) model was employed to project the future burden from 2022 to 2041.Results: In 2021, there were 3,289,663 cases of pediatric stone disease worldwide (95% UI: 1,724,296 to 5,384,797), resulting in 66 deaths (95% UI: 43 to 94) and 14,230 disabilities (95% UI: 9,264 to 21,569). Regionally, South Asia reported the highest incidence, mortality, and DALYs based on the Global Burden of Disease (GBD) classifications. Age-standardized morbidity (ASIR) and age-standardized mortality (ASDR) are highest in Eastern Europe, while age-standardized mortality (ASMR) is 0 in all regions of the world. At the country level, India recorded the highest incidence, mortality, and DALYs for pediatric stone disease in 2021. Armenia had the highest ASIR, while 28 countries, including Afghanistan, Armenia, and Brazil, reported the highest ASMR. Armenia and Kazakhstan recorded the highest ASDR. The disease burden was most pronounced among children aged 15–19 years, with boys being more affected than girls. These findings have significant global implications. Projections indicate that by 2041, the burden of pediatric stone disease will decline, although boys will continue to be more affected than girls.Conclusion: From 1990 to 2021, the global burden of pediatric stone disease, adjusted for age, has decreased. However, regional variations persist, with some areas experiencing an increase in burden. This underscores the importance of ongoing monitoring to effectively reduce the overall impact of pediatric stone diseases.

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus, often leading to poor outcomes in critically ill patients. Endothelial Activation and Stress Index (EASIX), a marker of endothelial dysfunction and systemic stress, has been associated with adverse outcomes in various diseases, but its role in predicting mortality in DN patients remains unclear. A retrospective cohort study was conducted using the MIMIC-IV database. A total of 1,260 critically ill DN patients were included and stratified into tertiles based on their EASIX scores. Kaplan-Meier survival analysis, Cox proportional hazard models, and restricted cubic spline regression were applied to evaluate the association between EASIX and 30- and 60-day all-cause mortality. Subgroup analyses were also performed to assess interactions with key patient characteristics. Patients with higher EASIX scores had significantly increased ICU and in-hospital mortality rates. Cox regression analyses revealed that EASIX was an independent predictor of mortality after adjusting for age, sex, and comorbidities (HR: 1.14; 95% CI: 1.03-1.26; p = 0.01). Kaplan-Meier analysis showed significantly worse survival rates in the highest EASIX tertile. Subgroup analysis showed that higher EASIX scores were still associated with short-term survival in patients with DN in the presence of older age, male gender, and severe complications. Higher EASIX scores are associated with increased short-term mortality in critically ill DN patients, highlighting its value as a prognostic biomarker for risk stratification and personalized management. Further studies are needed to validate these findings and explore therapeutic interventions targeting endothelial dysfunction.

Background: Congenital adrenal hyperplasia (CAH) is increasingly prevalent, leading to a surge in related research. To pinpoint emerging trends and recommend future directions, a bibliometric analysis of relevant CAH literature was performed. Methods: From January 1, 2000, to October 1, 2023, we searched the Web of Science Core Collection for CAH literature. For the bibliometric analysis, tools such as VOSviewer, CiteSpace, and the R package “bibliometrix” were employed. Results: The United States and England are at the forefront among 113 countries, contributing 5034 papers to CAH research. However, there is a need for more extensive global collaboration across institutions in this field. The number of publications on CAH is increasing annually. Leading research institutions include the University of Michigan, University of California, San Francisco, Karolinska Institutet, and Karolinska University Hospital. The Journal of Clinical Endocrinology & Metabolism is the most cited in this area. The most prolific author is Falhammar H, with 88 publications, 2568 co-citations, and a significant overall contribution. Key research areas include diagnostic methods and therapeutic strategies for CAH. Emerging research hotspots are identified by keywords such as “disorders of sex development,” “21-hydroxylase deficiency,” “ambiguous genitalia,” “testosterone” and “adrenal insufficiency.” Conclusions: Research on CAH is expected to expand globally. Future studies will primarily focus on exploring CAH’s diagnostic aspects and developing new therapies. This paper will help scholars better understand the dynamic evolution of the CAH and point out the direction for future research.

Sepsis-associated acute kidney injury (SA-AKI) is associated with adverse clinical outcomes. The De Ritis ratio (AST/ALT) has been studied as a biomarker f

Background: Chronic kidney disease (CKD) affects over 10% of the global population and is closely linked to increased cardiovascular morbidity and mortality. Mean corpuscular volume (MCV), a key hematological parameter, has been associated with various clinical outcomes. However, the relationship between MCV and mortality in CKD patients admitted to the intensive care unit (ICU) has not been thoroughly investigated, with previous studies primarily limited to single-center designs. Methods: This retrospective multicenter cohort study analyzed data from the eICU-CRD and MIMIC-IV databases. Statistical analyses involved Kaplan-Meier survival curves and multivariable Cox proportional hazards models. Restricted cubic splines (RCS) were employed to assess the potential nonlinear relationships between MCV and mortality. Results: A total of 23,724 patients were included in the analysis. Higher MCV levels were significantly associated with increased 30-day and 90-day in-hospital mortality. Kaplan-Meier analysis revealed a higher mortality risk in patients with the highest MCV levels. Cox models confirmed that MCV was a significant risk factor for mortality, with hazard ratios indicating an increased risk with each unit increase in MCV. Subgroup analyses consistently showed that elevated MCV levels were associated with a higher mortality risk across different patient groups. Conclusion: This first multicenter study demonstrated that elevated MCV levels are significantly associated with higher short-term mortality in CKD ICU patients, suggesting that MCV could serve as a potential biomarker for risk stratification. Future research should validate these findings and explore the underlying mechanisms.