Background:Metallic biomaterials have transformed modern medicine,with copper(Cu),zinc(Zn),and selenium(Se)emerging as critical components in medical applications.The study of the single and synergistic effects of ser...Background:Metallic biomaterials have transformed modern medicine,with copper(Cu),zinc(Zn),and selenium(Se)emerging as critical components in medical applications.The study of the single and synergistic effects of serum metal concentrations on human health can provide valuable insights for future clinical transformation of biodegradable alloys.Methods:We evaluated 2381 NHANES 2011-2016 participants to study individual and combined effects of these metals on health outcomes.Multivariable logistic regression,restricted cubic splines,and piecewise linear regression were used to examine linear,nonlinear,and threshold relationships.Overall metal mixture effects were assessed using weighted quantile sum(WQS)and Bayesian kernel-machine regression(BKMR).Results:Elevated serum Cu levels were significantly associated with an increased risk of osteoarthritis.When Serum Cu≥99.48μg/dL,each 1-unit increase in Ln Cu raised diabetes risk 4.55-fold.For Se≥122.74μg/L,each 1-unit increase in Ln Se led to a 29.96-fold rise in diabetes prevalence,for Se<157.56μg/L it increased heart attack risk 165.19-fold.Furthermore,mixtures of Cu,Se,and Zn were positively associated with diabetes,hy-pertension,and heart attack risks;each unit increase in the mixture corresponded to a 23%rise in diabetes and a 15%rise in hypertension prevalence.Conclusions:Serum Cu levels≥99.48μg/dL are significantly linked to diabetes risk,while serum Se levels≥122.74μg/L are associated with diabetes risk and levels<157.56μg/L with elevated heart attack risk.Serum metal mixtures containing Cu,Se and Zn were significantly and positively associated with risk of diabetes,hy-pertension and heart attack.展开更多
Background:Zinc-based biomaterials,including biodegradable metal,nanoparticles,and coatings used in medical implants release zinc ions that may increase the whole-body and serum zinc concentrations.The impact of serum...Background:Zinc-based biomaterials,including biodegradable metal,nanoparticles,and coatings used in medical implants release zinc ions that may increase the whole-body and serum zinc concentrations.The impact of serum zinc concentrations on major health outcomes can provide insights for device design and clinical transformation of zinc-based biomaterials.Methods:This nationally representative cross-sectional study enrolled participants from the National Health and Nutrition Examination Survey(NHANES,2011-2014)including 3607 participants.Using unadjusted and multivariate-adjusted logistic regression analyses,two-piecewise linear regression model with a smoothing function and threshold level analysis,we evaluated the associations between elevated serum zinc levels and major health outcomes.Results:Elevated serum zinc levels were significantly associated with an increase in total spine and total femur bone mineral density(BMD).Every 10μg/dL increase was associated with a 1.12-fold increase in diabetes mellitus(DM)and 1.23-fold and 1.29-fold increase in cardiovascular diseases(CVD)and coronary heart disease(CHD),in participants with serum zinc levels≥100μg/dL.It had no significant linear or nonlinear associations with risk of fractures,congestive heart failure,heart attack,thyroid disease,arthritis,osteoarthritis,rheumatoid arthritis,dyslipidemia and cancer.Conclusion:Serum zinc levels are significantly associated with increased BMD in the total spine and total femur,and risk of DM,and CVD/CHD among participants with serum zinc levels≥100μg/dL.展开更多
In biomedical research,in order to evaluate the effect of a drug,investigators often need to compare the differences between one treatment group and another one by using multiple outcomes.The rank-sum tests can handle...In biomedical research,in order to evaluate the effect of a drug,investigators often need to compare the differences between one treatment group and another one by using multiple outcomes.The rank-sum tests can handle the case where the outcome differences between two groups are in the same direction.If they are not,MAX can handle it and is very useful when one/some of the differences is/are relatively larger than the others.When the individual outcome difference between two groups is moderate,a new method,summation of the absolute value of rank-based test for each outcome,is proposed in this work.Power comparison with the existing methods based on simulation studies and a real example show that the proposed test is a robust test,and works well when the difference for each outcome is moderate.The authors also derive some theoretical results for comparing the power between MAX and the the proposed method.展开更多
Motivated by a medical study that attempts to analyze the relationship between growth curves and other variables and to measure the association among multiple growth curves,the authors develop a functional multiple-ou...Motivated by a medical study that attempts to analyze the relationship between growth curves and other variables and to measure the association among multiple growth curves,the authors develop a functional multiple-outcome model to decompose the total variation of multiple functional outcomes into variation explained by independent variables with time-varying coefficient functions,by latent factors and by noise.The latent factors are the hidden common factors that influence the multiple outcomes and are found through the combined functional principal component analysis approach.Through the coefficients of the latent factors one may further explore the association of the multiple outcomes.This method is applied to the multivariate growth data of infants in a real medical study in Shanghai and produces interpretable results.Convergence rates for the proposed estimates of the varying coefficient and covariance functions of the model are derived under mild conditions.展开更多
基金the National Natural Science Foundation of China(grant nos.32222042,82225031,82172464,82172453,81972086)the National Key Research and Development Program of China(2023YFC2509600)+1 种基金the Program of Shanghai Excellent Aca-demic Leader(grant no.22XD1401900)the Shanghai Shuguang Plan Project,and the Shanghai“Rising Stars of Medical Talent”Youth Development Program:Outstanding Youth Medical Talents.
文摘Background:Metallic biomaterials have transformed modern medicine,with copper(Cu),zinc(Zn),and selenium(Se)emerging as critical components in medical applications.The study of the single and synergistic effects of serum metal concentrations on human health can provide valuable insights for future clinical transformation of biodegradable alloys.Methods:We evaluated 2381 NHANES 2011-2016 participants to study individual and combined effects of these metals on health outcomes.Multivariable logistic regression,restricted cubic splines,and piecewise linear regression were used to examine linear,nonlinear,and threshold relationships.Overall metal mixture effects were assessed using weighted quantile sum(WQS)and Bayesian kernel-machine regression(BKMR).Results:Elevated serum Cu levels were significantly associated with an increased risk of osteoarthritis.When Serum Cu≥99.48μg/dL,each 1-unit increase in Ln Cu raised diabetes risk 4.55-fold.For Se≥122.74μg/L,each 1-unit increase in Ln Se led to a 29.96-fold rise in diabetes prevalence,for Se<157.56μg/L it increased heart attack risk 165.19-fold.Furthermore,mixtures of Cu,Se,and Zn were positively associated with diabetes,hy-pertension,and heart attack risks;each unit increase in the mixture corresponded to a 23%rise in diabetes and a 15%rise in hypertension prevalence.Conclusions:Serum Cu levels≥99.48μg/dL are significantly linked to diabetes risk,while serum Se levels≥122.74μg/L are associated with diabetes risk and levels<157.56μg/L with elevated heart attack risk.Serum metal mixtures containing Cu,Se and Zn were significantly and positively associated with risk of diabetes,hy-pertension and heart attack.
基金supported by National Natural Science Foundation of China[grant numbers 51931001,51631009,51431002,51871004]NSFC/RGC Joint Research Scheme[grant number 51661165014]Shanghai"Rising Stars of Medical Talent"Youth Development Program(Youth Medical Talents-Specialist Program).
文摘Background:Zinc-based biomaterials,including biodegradable metal,nanoparticles,and coatings used in medical implants release zinc ions that may increase the whole-body and serum zinc concentrations.The impact of serum zinc concentrations on major health outcomes can provide insights for device design and clinical transformation of zinc-based biomaterials.Methods:This nationally representative cross-sectional study enrolled participants from the National Health and Nutrition Examination Survey(NHANES,2011-2014)including 3607 participants.Using unadjusted and multivariate-adjusted logistic regression analyses,two-piecewise linear regression model with a smoothing function and threshold level analysis,we evaluated the associations between elevated serum zinc levels and major health outcomes.Results:Elevated serum zinc levels were significantly associated with an increase in total spine and total femur bone mineral density(BMD).Every 10μg/dL increase was associated with a 1.12-fold increase in diabetes mellitus(DM)and 1.23-fold and 1.29-fold increase in cardiovascular diseases(CVD)and coronary heart disease(CHD),in participants with serum zinc levels≥100μg/dL.It had no significant linear or nonlinear associations with risk of fractures,congestive heart failure,heart attack,thyroid disease,arthritis,osteoarthritis,rheumatoid arthritis,dyslipidemia and cancer.Conclusion:Serum zinc levels are significantly associated with increased BMD in the total spine and total femur,and risk of DM,and CVD/CHD among participants with serum zinc levels≥100μg/dL.
基金partially supported by by the National Young Science Foundation of China under No.10901155the National Social Science Foundation of China under No.10CTJ004
文摘In biomedical research,in order to evaluate the effect of a drug,investigators often need to compare the differences between one treatment group and another one by using multiple outcomes.The rank-sum tests can handle the case where the outcome differences between two groups are in the same direction.If they are not,MAX can handle it and is very useful when one/some of the differences is/are relatively larger than the others.When the individual outcome difference between two groups is moderate,a new method,summation of the absolute value of rank-based test for each outcome,is proposed in this work.Power comparison with the existing methods based on simulation studies and a real example show that the proposed test is a robust test,and works well when the difference for each outcome is moderate.The authors also derive some theoretical results for comparing the power between MAX and the the proposed method.
基金supported by the National Natural Science Foundation of China under Grant Nos.11771146,11831008,81530086,11771145,11871252the 111 Project(B14019)Program of Shanghai Subject Chief Scientist under Grant No.14XD1401600。
文摘Motivated by a medical study that attempts to analyze the relationship between growth curves and other variables and to measure the association among multiple growth curves,the authors develop a functional multiple-outcome model to decompose the total variation of multiple functional outcomes into variation explained by independent variables with time-varying coefficient functions,by latent factors and by noise.The latent factors are the hidden common factors that influence the multiple outcomes and are found through the combined functional principal component analysis approach.Through the coefficients of the latent factors one may further explore the association of the multiple outcomes.This method is applied to the multivariate growth data of infants in a real medical study in Shanghai and produces interpretable results.Convergence rates for the proposed estimates of the varying coefficient and covariance functions of the model are derived under mild conditions.
