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Background and Objectives: Hashimoto's thyroiditis (HT) is an autoimmune disease, characterized by abnormal elevation in thyroid peroxidase antibody and/or thyroglobulin antibody. In recent decades, HT disease has become more and more widespread. Patients always report multiple symptoms, even though their thyroid hormone levels are kept in normal ranges. However, no treatment exists to effectively reduce the levels of thyroid antibodies. Our study aims to determine whether calorie-restricted diet is helpful in improving health of HT patients. Methods and Study Design: This is a 3-month randomized controlled trial. HT patients will be randomized into a calorie-restricted (CR) group or a calorie-unrestricted control group. All the participants will be instructed to consume a diet that includes a combination of 45-55% calories from carbohydrates, 20-30% from fats, and 15-25% from proteins, according to current Chinese Dietary Guidelines. Participants in CR group need to limit their calories intake equal to their basal energy expenditure, which means that their daily caloric intake will be limited by about 20-30%. Results: The study population is planned to be 66 HT patients aged 18 to 65 years. The primary outcome is change of thyroid antibody levels from baseline. Secondary outcomes include the changes of non-hypothyroid symptoms scores, thyroid function indexes, morphology of thyroid, T lymphocyte subpopulations, inflammatory biomarkers and lipids from baseline to 12 weeks. Conclusions: This trial will have implications for nutrition treatment policy in regard to thyroid antibodies control, immune dysfunction and related non-hypothyroid symptoms improvement among HT patients.

Background and Objectives: Metabolically unhealthy obesity is characterized by the presence of cardiovascular metabolic risks such as hypertension, dyslipidemia, and hyperglycemia. Research has shown a correlation between remnant cholesterol (RC) concentrations and abdominal obesity in children. However, the effect of RC concentration on metabolically unhealthy obesity remains unclear. Methods and Study Design: This study included 3114 Chinese adolescents who received health check-ups. We used logistic regression models and receiver operating characteristic analysis to evaluate the correlation between RC concentration and metabolically unhealthy obesity in a cross-sectional design. Results: After controlling for possible confounding variables, we found that individuals in the top and fourth quintiles of RC concentrations had a significantly higher likelihood of developing metabolically unhealthy obesity compared to those in the bottom quintile (ORs, 4.810 and 1.836; 95% CIs, 3.209–7.212 and 1.167–2.890, respectively). The risk of metabolically unhealthy obesity tended to increase with RC concentration (p_trend<0.001). In addition, boys showed positive associations between RC concentration and both BMI (r = 0.305, p<0.001) and waist circumference (r = 0.306, p<0.001). According to the analysis, the predictive accuracy of metabolically unhealthy obesity was 0.736 (95% CI, 0.690–0.781) for boys and 0.630 (95% CI, 0.573–0.687) for girls. The ideal prediction threshold was 0.66 for boys and 0.59 for girls. Conclusions: Our findings indicate that elevated RC concentration is linked to a higher likelihood of developing metabolically unhealthy obesity in young individuals, regardless of other known risk factors.

Background and Objectives: Dyslipidemia has been reported to contribute to the psoriasis pathogenesis. Thus, evinacumab, a novel lipid-lowering drug targeting angiopoietin-like 3, may have therapeutic potential to treat and/or manage psoriasis. Methods and Study Design: Summary statistics were obtained from genome-wide association studies addressing psoriasis (FinnGen Consortium; n=216,752) and serum lipid concentrations (United Kingdom Biobank; n=403,943–440,546). Two-sample Mendelian randomization analyses were conducted to evaluate the associations of serum lipid concentrations and genetically mimicked effects of evinacumab, respectively, with the risks of psoriasis and its subtypes. Results: Genetically determined per standard deviation increase in triglyceride concentrations was associated with increased risk of psoriasis (OR: 1.17, 95% CI: 1.03–1.32, p=0.018), whereas that in low-density lipoprotein-cholesterol (LDL-C) was associated with both psoriasis (OR: 1.22, 95% CI: 1.05–1.43, p=0.011) and its subtypes, including arthropathic psoriasis (OR: 1.30, 95% CI: 1.02–1.65, p=0.032), psoriasis vulgaris (OR: 1.87, 95% CI: 1.16–2.99, p=0.0095), and guttate psoriasis (OR: 2.19, 95% CI: 1.17–4.07, p=0.014). Moreover, genetically mimicked effects of evinacumab, via angiopoietin-like 3 inhibition, significantly reduced the risk of psoriasis (OR: 0.752 per standard deviation reduction in triglycerides, 95% CI: 0.577–0.982, p=0.036) and arthropathic psoriasis (OR: 0.266 per standard deviation reduction in LDL-C, 95% CI: 0.0886–0.799, p=0.018). Conclusions: The genetically mimicked effect of evinacumab has the potential to reduce the risk of psoriasis and arthropathic psoriasis by lowering circulating triglyceride and LDL-C concentrations, respectively. These findings suggest that evinacumab may help prevent psoriasis and psoriatic arthritis progression in clinical practice.

Background and Objectives: Growing evidence has explored the effects of water-soluble vitamins supplementation on glycemic control and insulin resistance in diabetic patients; however, the results of previous meta-analyses are inconsistent. In this regard, we performed an umbrella review to synthesize evidence on the effects of water-soluble vitamin supplementation on glycemic control and insulin resistance. Methods and Study Design: A systematic literature search in Web of science, PubMed, and Cochrane Database of Systematic Reviews was performed from 2012 to November 2022. Quality assessment of the meta-analyses was performed using AMSTAR-2 and GRADE. Results: Fourteen systematic reviews and meta-analyses were eligible, which studied the effects of five water-soluble vitamins (vitamin B-1, vitamin B-3, biotin, vitamin B-9, and vitamin C supplementation) supplements on glycemic control and insulin resistance. Results of the review suggest that vitamin C supplementations can improve glycemic control in type 2 diabetes indicated by reduced FBG and HbA1c, and having more significant effects with durations >30days on FBG. Conclusions: Insulin resistance is improved by folic acid supplementations. More well-designed individual randomized controlled trials are needed in the future, as well as meta-analysis of higher quality.

Background and Objectives: Mechanism studies have indicated that magnesium (Mg) and calcium (Ca) had important biological functions in glucose regulation, but epidemiological data on their associations with glycosylated hemoglobin (HbA1c) are sparse. We aimed to explore the associations of Mg and Ca with abnormal HbA1c, and examined the mediating effects of inflammation in coronary artery disease (CAD) Chinese adults. Methods and Study Design: A hospital–based cross–sectional study of 11934 patients with CAD was conducted. Serum Mg and Ca concentrations were measured. Results: In multivariable analyses, Mg and Mg/Ca ratio were inversely associated with abnormal HbA1c (Q4 vs Q1: OR_Mg: 0.61, 95% CI_Mg: 0.53, 0.71; OR_{Mg/Ca ratio}: 0.67, 95% CI_{Mg/Ca ratio}: 0.54, 0.84). However, null association of Ca with abnormal HbA1c was shown (Q4 vs Q1: OR: 1.15, 95% CI: 0.92, 1.44). Serum Mg and Mg/Ca ratio were inversely associated with abnormal fasting blood glucose (FBG). In contrast, serum Ca was positively associated with abnormal FBG. Path analysis indicated that there were no mediating effects of hypersensitivity C reactive protein (hsCRP) on Mg and Mg/Ca-abnormal HbA1c associations. Conclusions: Our study suggested that serum Mg and Mg/Ca ratio were inversely associated with abnormal HbA1c in Chinese adults with CAD. The Mg-abnormal HbA1c relationship might not be mediated by hsCRP.

Background and Objectives: The role of serum copper in modulating body composition in patients with spinal muscular atrophy (SMA) remains uncertain. This study aimed to illustrate the correlation between serum copper concentrations and body composition in children with SMA. Methods and Study Design: This study was conducted at a pediatric medical center in China from July 2019 to August 2022. The study encompassed anthropometric measurements, serum analysis for copper, magnesium, zinc, and iron, as well as comprehensive body composition assessments. Multivariate analysis was utilized to assess the connection between serum copper concentrations and metrics of body composition. Results: This cross-sectional analysis encompassed 87 patients [median (IQR) age: 7 years (5–10), 58.0% female] diagnosed with SMA who were undergoing comprehensive multidisciplinary management. The results revealed a positive association between the serum copper concentration and both fat mass percentage (β = 0.50, 95% confidence interval (CI): 0.07 to 0.92, p = 0.025) and fat-muscle ratio (β = 0.02, 95% CI: 0.01 to 0.03, p = 0.009). Conversely, a negative correlation was detected between the concentrations of serum copper and muscle mass percentage (β = -0.70, 95% CI: -1.11 to -0.29, p = 0.001). Conclusions: These findings suggest a correlation between copper concentrations and body composition in SMA, which offers valuable insights for addressing metabolic dysregulation in patients with SMA.

Background and Objectives: On the basis of the previous population-based observations linking serum vitamin D to depression in non-alcoholic fatty liver disease (NAFLD) phenotype, the precise correlation between serum vitamin D and depression among NAFLD individuals remains controversial and in dispute. Thus, we conducted this study to evaluate the relationship between serum vitamin D and depression in NAFLD participants diagnosed via transient elastography. Methods and Study Design: This cross-sectional study was extracted from the latest NHANES 2017–2018 dataset. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) scores of ≥10. NAFLD phenotype was identified by vibration-controlled transient elastography (VCTE) examination based on diagnostic criteria. Binary logistic regression models were applied to estimate the impact of increased serum vitamin D on the decreased risk of depression based on sample weights. Results: A total of 1339 participants with NAFLD were included in this investigation, of which 127 (8.58%) were diagnosed with depression according to PHQ-9 scores. Binary logistic regression analysis presented that high serum vitamin D level was a protective factor for depression in NAFLD (OR=0.61, 95% CI: 0.37–0.99, p=0.048) after adjusting for all confounding factors. In subgroup analyses, these associations were more pronounced among men (OR=0.32, 95% CI: 0.13-0.81, p=0.024) and obesity population (OR=0.53, 95% CI: 0.33-0.86, p=0.019). Conclusions: Increased serum vitamin D was negatively related with the prevalence of depression in males and obese subjects with NAFLD diagnosed by VCTE.

Background and Objectives: This study investigated the influence of dietary intake on the relationship between serum uric acid (SUA) levels and the risk of hypertension. Methods and Study Design: Data from the 7th and 8th Korean National Health and Nutrition Examination Survey, a nationally representative survey, were analyzed. A total of 19,140 adults aged 19–64 years were included. Dietary intake was assessed using a 24–hour recall method. SUA levels were measured using a Hitachi Automatic Analyzer 7600–210. Hypertension was defined as a systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive medication. Statistical analyses included generalized linear regression, Cochran–Mantel–Haenszel analysis, and multivariate logistic regression. Results: The highest SUA quartile (Q4) had an odds ratio (OR) of 1.68 (95% CI: 1.41–1.99) for hypertension compared to the lowest quartile (Q1). Additionally, the association between elevated SUA levels and increased hypertension risk was stronger in participants who consumed fewer fruits (OR: 1.79, 95% CI: 1.44–2.21), vegetables (1.80, 1.43–2.25), nuts (1.87, 1.51–2.33), and milk (2.20, 1.73–2.79). The ORs (95 % CI) for the highest SUA quartile on hypertension were 1.68 (1.39–2.04), 1.35 (1.13–1.62), and 1.89 (1.57–2.27) in those consuming more seafood, meat, and alcohol, respectively. Conclusions: Reduced intake of fruits, vegetables, nuts, and milk, and increased consumption of seafood and alcohol, exacerbates the positive association between SUA levels and the risk of hypertension. These findings suggest dietary modifications as a potential strategy for hypertension prevention and management.

Background and Objectives: Prioritizing key preventive and therapeutic interventions are the one of the actions to accelerate the reduction of anemia. This study aimed to examine interventions intended for preventing anemia. Methods and Study Design: The systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Analysis of publication bias was done using The Joanna-Briggs Institute critical appraisal tool. Data collected from articles included author, year of publication, setting and location of the study, study type, participant of the study, intervention and control given, main outcome, main findings, and risk of bias. Results: Three nutrition-specific interventions aimed at preventing iron deficiency anemia in low- and middle-income countries utilized diverse types and dosages of iron. While most studies showed success, some indicated a worsening trend in anemia, even with standard dosages and the same form of iron. Determining effective interventions requires consideration of factors such as other micronutrient composition, compliance rate, availability of educational intervention, and dietary backgrounds in those countries. Conclusions: Supplementation, fortification, and food-based interventions generally result in higher hemoglobin levels and lower prevalence of anemia. It is important to consider several factors before deciding on an approach.

Background and Objectives: Previous studies have reported there were associations with ovarian function for dietary factors, metabolic factors and gut microbiota. However, it is not clear whether causal associations exist. We aimed to explore the causal relationship of these factors with risk of primary ovarian failure (POF). Methods and Study Design: Two-sample Mendelian randomization (MR) analysis was performed to genetically predict the causal effects of dietary and metabolic factors and gut microbiota on POF. The inverse variance weighted (IVW) method was used as the primary statistical method. A series of sensitivity analyses, including weighted median, MR-Egger, simple mode, weighted mode methods, and leave-one-out analysis, were conducted to assess the robustness of the MR analysis results. Results: IVW analysis revealed that cigarettes smoked per day, coffee intake and cooked vegetable intake were not causally correlated with POF at the genetic level. However, there were associations with POF for fresh fruit intake, BMI, Eubacterium (hallii group), Eubacterium (ventriosum group), Adlercreutzia, Intestinibacter, Lachnospiraceae (UCG008), and Terrisporobacter. These findings were robust according to extensive sensitivity analyses. Conclusions: This study identified several dietary and metabolic factors and gut microbiota taxa that may be causally implicated in POF, which may provide potential therapeutic targets for POF.

Background and Objectives: This study aims to investigate the respiratory quotient (RQ) levels and its trend in the early postoperative period of patients with heart disease through prospective observation. Additionally, we explored factors influencing RQ and evaluated the predictive capabilities of RQ and lactic acid for various outcomes. Methods and Study Design: In this prospective observational study, participants included heart disease patients aged 18-80 years who underwent elective open-heart surgery and were subsequently admitted to the cardiothoracic surgery ICU post-operation. Indirect calorimetry (IC) measurements were conducted on patients during the first three days after surgery to assess their RQ levels. Clinical data, including personal information, postoperative characteristics, and duration of surgery, were documented based on the patient's medical history. Results: In the study, 135 patients, of whom 57.04% were male, underwent a total of 247 IC measurements following cardiac surgery. On the first, second, and third days of admission to the ICU, the RQ values were 0.77±0.09, 0.80±0.07, and 0.78±0.05, respectively. The ROC curve analysis shows that on the first day of admission to the ICU, RQ was a better predictor of prolonged mechanical ventilation, LOS in ICU, and LOS in hospital compared to lactate level. However, on the second day of ICU admission, neither RQ nor lactate level could predict longer durations of mechanical ventilation, LOS in ICU, and LOS in hospital. Conclusions: RQ may serve as a potential predictor for LOS in patients after cardiac surgery.

Background and Objectives: This study aimed to investigate readiness for hospital discharge of patients requiring home nutrition support and explore the factors that influence this readiness. Methods and Study Design: This cross-sectional survey included 220 patients discharged from the general surgery department of a tertiary-care teaching hospital in China with home nutrition support. Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale scores were calculated and general and disease- and therapy-related information were collected. Univariate, correlation, and multiple linear regression analyses were performed. Results: The mean standardized total Readiness for Hospital Discharge Scale score was 7.33±1.65, with the subscales expected support, personal status, perceived coping ability, and knowledge scoring 7.40±1.78, 7.35±1.66, 7.30±1.73, and 7.26±1.74, respectively. The mean standardized Quality of Discharge Teaching Scale score was 7.48±1.59. The Quality of Discharge Teaching Scale score, length of hospital stay, expected length of home nutrition support, first-time use of home nutrition support, Nutrition Risk Screening 2002 score, and diagnosis were all identified as influencing factors of readiness for discharge (adjusted R2=0.564, F=14.5, p<0.001). Conclusions: Patients requiring home nutrition support were only moderately ready for discharge. Enhancing the quality of discharge teaching could significantly improve readiness for discharge, with more attention needed for patients who have been in hospital longer, are expected to use home nutrition support long-term, are at risk of malnutrition, are using home nutrition support for the first time, or have a digestive system malignancy.

Background and Objectives: This study aimed to examine whether eating alone, folate intake, and n-3 PUFA intake are independently associated with psychological distress in older adults. Methods and Study Design: We analyzed cross-sectional data from 1011 study participants aged ≥65 years in Japan. We assessed psychological distress using the Kessler 6 scale, whether the participants ate alone or with others, and folate and n-3 PUFA intake using a short food frequency questionnaire. Results: Of 1011 study participants, 465 (46.0%) were male and the mean (SD) age was 71.6 (4.8) years. In a multivariable logistic regression analysis, the odds ratio (OR) for psychological distress in participants eating alone compared to those eating with others was 1.32 (95% confidence interval [CI], 0.76–2.31). The ORs in the second and third tertiles compared to the first tertile, which had the lowest folate intake, were 0.92 (95% CI, 0.62–1.37) and 1.12 (95% CI, 0.73–1.73), respectively. The ORs in the second and third tertiles compared to the first tertile, which had the lowest n-3 PUFA intake, were 0.83 (95% CI, 0.56–1.24) and 0.95 (95% CI, 0.62–1.45), respectively. In an additional analysis, the OR in those eating alone combined with the first tertile of n-3 PUFA intake compared to those eating with others combined with the third tertile was 2.18 (95%CI, 1.05–4.55). Conclusions: Eating alone, folate intake, and n-3 PUFA intake were not independently associated with psychological distress in older adults, although eating alone combined with low n-3 PUFA intake was associated with psychological distress.

Background and Objectives: Evidence regarding the relationship between dietary and plasma lutein + zeaxanthin levels and the risk of depression is scarce. This study aimed to investigate the associations of dietary consumption of lutein + zeaxanthin and plasma lutein + zeaxanthin level with risk of depression in adult of United States by using data from National Health and Nutrition Examination Survey (NHANES). Methods and Study Design: A total of 7,829 and 7,324 individuals aged≥ 20 years were included from the NHANES to analyze separately the relation between dietary lutein + zeaxanthin and depression, as well as plasma lutein + zeaxanthin levels with the risk of depression, respectively. The multivariable logistic regression analyses were used. Subsequently, the dose-response relationships were conducted using restricted cubic splines. Results: In the multivariable model, the highest quartile of dietary lutein + zeaxanthin intake was associated with a significantly lower risk of depression compared to the lowest quartile (OR = 0.68, 95%CI: 0.52, 0.89, p ˂ 0.01). Similarly, the highest quartile of plasma lutein + zeaxanthin levels was linked to a reduced risk of depression compared to the lowest quartile (OR = 0.58, 95%CI: 0.44, 0.76, p < 0.001). Conclusions: This study suggests that appropriate increased dietary lutein + zeaxanthin intake and higher plasma lutein + zeaxanthin levels are associated with a lower risk of depression. These results should be confirmed by randomized controlled trial (RCTs) to explore the effects of supplementing lutein + zeaxanthin on depression.

Background and Objectives: Previous studies on the risk factors for prolonged pleural effusion (PPE)have primarily focused on surgical-related risk factors, with little research exploring the influence of postoperative nutritional factors on this delay. This study aimed to identify the nutritional risk factors for PPE in Chinese infants following congenital heart disease (CHD) surgery. Methods and Study Design: We retrospectively reviewed the medical records of patients under 3 years old with chylothorax following CHD surgery from 2016 to 2020. PPE was defined as pleural effusion lasting over 14 days. Logistical regression analysis was conducted to identify the risk factors. Results: : A total of 136 patients were included in this study, with 42 patients developing PPE (30.9%). The PPE group had significantly lower Height-for-Age Z-scores (HAZ) compared to the non-PPE group, while other demographic factors were not significantly different. Univariate analysis revealed that patients in PPE group exhibited delayed onset of chylothorax, prolonged duration of mechanical ventilation support, increased chest effusion volume on the first postoperative day, and a reduced proportion of energy intake from enteral nutrition (EN) during the stable phase. Variables with p-value of <0.1 in univariate logistic regression analysis were included in the multivariate logistic regression analysis. A delayed onset of chylothorax, extended periods of mechanical ventilation, and a lower HAZ were significantly correlated with the development of PPE. Conclusions: A delayed onset of chylothorax, extended periods of mechanical ventilation, a lower HAZ, and a reduced proportion of  energy intake from EN during the recovery phase predict a higher risk of PPE.