ObjectiveTo examine the association of constipation with exercise, non-exercise physical activity, and sedentary behaviours in Hong Kong adolescents.MethodsIn 2006–2007, 42 secondary schools were randomly selected to participate in the Hong Kong Student Obesity Surveillance (HKSOS) project. A total of 33692 Form 1–7 students (44.9% boys; mean age 14.8, SD 1.9 years) completed an anonymous questionnaire on lifestyle behaviours. Constipation was defined as a frequency of evacuation of less than once every two days. Exercise (moderate-to-vigorous levels) and non-exercise physical activity (NEPA) were each considered insufficient when less than 1 hour per day, and sedentary behaviours were considered excessive when over 4 hours per day. Logistic regression was used to calculate adjusted odds ratio (AOR) for constipation in relation to exercise, NEPA, and sedentary behaviours, adjusting for potential confounders.ResultsConstipation was identified in 15.6% (95% CI 15.2% – 16.0%) of adolescents overall, 14.0% in those with sufficient exercise and 19.6% in those without. Constipation was associated with insufficient exercise (AOR 1.26, 95% CI 1.16 – 1.36), insufficient NEPA 1.21 (1.10 – 1.33) and excessive sedentary behaviours (1.25, 1.17 – 1.34). Compared with having none of the above 3 inactive behaviours, increasing AORs of constipation were observed for having 1 (AOR 1.23), 2 (AOR 1.57) and 3 (AOR 1.88) inactive behaviours (p for trend <0.001).ConclusionsConstipation was associated with insufficient physical activity and excessive sedentary behaviours among Chinese adolescents with a dose-response relation. If the association is causal, constipation could be prevented by promotion of physical activity.

Background The triglyceride glucose (TyG) index has been proposed as a reliable marker of insulin resistance (IR) and an independent predictor of cardiovascular disease risk. However, its prognostic value in patients with acute decompensated heart failure (ADHF) remains unclear. Methods A total of 932 hospitalized patients with ADHF from January 1st, 2018 to February 1st, 2021 were included in this retrospective study. The TyG index was calculated as ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. Patients were divided into tertiles according to TyG index values. The primary endpoints were all-cause death, cardiovascular (CV) death and major adverse cardiac and cerebral events (MACCEs) during follow-up. We used multivariate adjusted Cox proportional hazard models and restricted cubic spline analysis to investigate the associations of the TyG index with primary endpoints. Results During a median follow-up time of 478 days, all-cause death, CV death and MACCEs occurred in 140 (15.0%), 103 (11.1%) and 443 (47.9%) cases, respectively. In multivariate Cox proportional hazard models, the risk of incident primary endpoints was associated with the highest TyG tertile. After adjustment for confounding factors, hazard ratios (HRs) for the highest tertile (TyG index ≥ 9.32) versus the lowest tertile (TyG index < 8.83) were 2.09 (95% confidence interval [CI], 1.23–3.55; p = 0.006) for all-cause death, 2.31 (95% CI, 1.26–4.24; p = 0.007) for CV death and 1.83 (95% CI, 1.18–3.01; p = 0.006) for MACCEs. Restricted cubic spline analysis also showed that the cumulative risk of primary endpoints increased as TyG index increased. When the TyG index was used as a continuous variable, the hazard ratios of the three primary endpoints rapidly increased within the higher range of the TyG index (all cause death, TyG > 9.08; CV death, TyG > 9.46; MACCEs, TyG > 9.87). Conclusions The elevated TyG index was independently associated with poor prognosis, and thus would be useful in the risk stratification in patients with ADHF.

Background. Triglyceride-glucose (TyG) index is a convenient indicator of insulin resistance. It has been shown to be associated with macrovascular and microvascular complications in nonhospitalized diabetic patients. However, whether TyG index is a risk factor of diabetes vascular complications in hospitalized type 2 diabetic patients is unclear. We sought to explore the association between TyG index and the risk of macrovascular and microvascular complications in a large Chinese cohort of hospitalized patients. Method. A total of 4,721 patients with type 2 diabetes (T2D) who were hospitalized in the Department of Endocrinology, Kunshan Hospital Affiliated to Jiangsu University were enrolled between January 2015 and November 2020. TyG index was calculated as ln fasting   triglycerides   mg / dL × fasting   glucose   mg / dL / 2 . Measures of macrovascular complications included brachial-ankle pulse wave velocity (ba-PWV) and ankle-brachial index (ABI), whilst urine microalbumin (MAU), chronic kidney disease (CKD), and diabetic retinopathy (DR) were evaluated for microvascular complications. Logistic regressions were used to examine the association between TyG index and diabetes complications. Results. In univariate logistic regressions, higher TyG index was significantly ( p < 0.002 ) associated with increased odds of MAU ( OR = 1.39 , 95% CI: [1.22~1.59]) and ABI ( OR = 1.31 , 95% CI: [1.10-1.57]) but not CKD, DR, or ba-PWV. After controlling for confounders such as age, sex, and body mass index (BMI), TyG index remained strongly ( p < 0.002 ) associated with MAU and ABI. These associations were more pronounced ( p < 0.001 ) in patients with poor glycemic control or in the elderly. Conclusion. Hospitalized patients with an elevated TyG index were at a higher risk of lower limb vascular stenosis and nephric microvascular damage. Close monitoring of TyG index in patients with younger age or poor glycemic control could potentially reduce the burden of diabetes complications and prevent readmission.

Sepsis-induced AKI (acute kidney injury) is considered an inflammation-related disease with high mortality. LPS-induced (Lipopolysaccharide) TLR4-NFκB pathway activation plays an important role in sepsis-induced AKI. Pyroptosis closely associated with inflammation response includes inflammasome formation, caspase1 activation and GSDMD N-terminal fragment cleavage that leads to cell membrane rupture and cell death, which may be related to the pathogenesis of sepsis-induced AKI. MIF (Macrophage migration inhibitory factor), associated with inflammation response, has been proved as a biomarker of sepsis, and perhaps regulate pyroptosis in sepsis-induced AKI. In this study, we focus on investigating the mechanism of MIF promoting pyroptosis in sepsis-induced AKI. MIF and pyroptosis-related proteins were up-regulated in kidney tissue of mice with CLP (cecum ligation puncture) surgery and in LPS-injured human kidney-2 (HK-2) cells. NLRP3 was down-regulated following the suppression of MIF topoisomerase activity by ISO-1 in kidney tissue of CLP mice. Knockdown of MIF alleviated NLRP3 inflammasome mediated pyroptosis in LPS-injured HK-2 cells. Meanwhile, we noted that phosphorylation of p65 was down-regulated by knockdown of MIF. Up-regulation of NLRP3 in response to LPS stimulation could be reversed by JSH-23, an inhibitor of NFκB pathway, but MIF was not affected. In conclusion, up-regulation of MIF in sepsis-induced AKI shows a renal damaged effect that aggravates NLRP3 inflammasome mediated cell pyroptosis through promoting phosphorylation of p65. This study demonstrated a novel mechanism of MIF regulating NLRP3 inflammasome mediated pyroptosis in sepsis-induced AKI.

Generally, adolescents who were older and had higher socioeconomic status were more likely to drink. High family affluence was associated with wine and spirits drinking. Beer and spirits were preferred more by boys, and fruit wine by girls. These results indicated high-risk groups for adolescent alcohol interventions.